For my regular visitors, if you find that this blog hasn't been updating much lately, chances are pretty good I've been spending my writing energy on my companion blog. Feel free to pop over to Moving On, and see what else has been going on.

Wednesday, March 09, 2011

"Hullo, George."

Continuing my tale...

I was now into the wee hours of the morning.  My pain was under control.  Dh had gone home to the girls, and I was more than ready to try and get some sleep.

Of course, there were a number of interruptions.  Necessary ones, though, so I didn't really mind.

Having been turned over to the emergency gyno team, one of the team members came by to talk to me.  He was actually an intern, working with the doctor heading the team that night.  A very young, very soft spoken man with a gentle voice and mannerism.  He had a whole lot of questions to ask me, and apologized ahead of time for some that would be of a rather intimate nature.  There were the usual questions about my health history; was there any cancer in my family?  Diabetes?  Heart disease?  Did I have any health problems?  Past surgeries? (While it seemed odd to have to tell him about an appendectomy that I had 30 years ago, I did make a point of telling him that the dr had removed a cyst off my right ovary at the same time, just because he happened to be in there to see it, and it was unusually large.)  Had anything like this ever happened to me before?

Then he had to ask the more personal question.  Was there any chance of STDs?  Had I ever been tested?  How often did I have sex, and did I ever feel discomfort/pain/etc. during intercourse?  When was my last menstrual cycle?  Was there any possibility of being pregnant?  He spent a good, long while with me, talking to me as much as asking the questions.  Then he explained that the dr would be coming by later to talk to me and to do a pelvic exam; did I have a problem with that?  Or with both of them having to do an exam?  Blech.  I hate pelvic exams.  Not for any reasons of modesty - I assured him I'd lost those sorts of hang-ups long ago!  They're just really unpleasant.  Under the circumstances, it was rather necessary.  He was quite thorough in explaining everything to me.

I had a chance to doze a bit before I was awakened by an apologetic trio who were loath to interrupt my sleep.  The intern was back with the doctor and a female nurse to be my chaperon.  The doctor was another young guy with a gentle speaking mannerism, though not quite as soft spoken as the intern.  There were more questions and clarifications from the doctor, though it was more a matter of me assuring him I understood what was going on so far, and the possible repercussions.

Then it was exam time.  Blech.

I made sure to go to the bathroom first.

The purpose of the exam was to find the mass and get a handle on where it was, what it felt like and how big it was.  This first involved palpating my abdomen, then fingers reefed around internally while being pressed against from the outside in different areas and asking me if I felt any pain. Aside from being stabbed by fingers, that is.  The intern went first, and he was pretty gentle about it.  Then the dr had his turn.  He was a lot more... thorough.  By the time he was done, I was feeling almost bruised, inside and out!  Going to the bathroom before the exam had been a very good idea. *L*

With all that, neither one of them could feel the mass, though I could pin point to them exactly where I was feeling the pain, even dulled as it was by the drugs.  They talked with me a bit more about the upcoming ultrasound, then they shut off my lights so I could go back to sleep.

Sleep was not yet to come.  Between the walk to the bathroom and the pelvic exam, things started acting up again.  At first, I just ignored it.  It was obviously triggered by walking to the bathroom and the pelvic exam, and I thought it would settle itself outsoon.  Instead, it got worse.   Quickly.

Which left me back to my earlier dilemma.  Do I nip it in the bud before things get too uncomfortable and ask for painkillers, even though it was still quite bearable?  Or do I give it more time and see if it went away on its own?  There had already been a couple of times when it felt like the pain was returning, only to fade away again, but this time was already well past previous levels of discomfort.

In the end, it was the speed at which the pain was increasing that decided it for me.  Within less than 2 minutes after they left, I was calling the nurse back.   On telling her the pain was coming back, she asked me how, on a scale of 1 - 10, would I rate the pain?

I'd been asked that question several times through all this, and I find it one of the most annoying things to answer.  Just how does one determine that?  Pain is such an individual thing.  I've always had an unusually high pain tolerance - one of the side effects of standard pain killers not working well on me.  It makes getting dental work a rather unfortunate experience, among other things.  Pharmaceuticals in general just tended to not work properly with me, though that seems to have improved as I've gotten older.  Then there's my tendency to avoid using painkillers in general, so I've learned to put up with quite a bit of pain.  So my idea of the pain scale was going to be a bit off.  As the pain was increasing so quickly, however, I rated it higher than I normally would have.  As this nurse hadn't treated me yet, I told her what I'd already had over the evening.  At her questioning, I told her that I preferred to stick to the Toradol rather than go back to the morphine, explaining that while I could still feel things going on with the Toradol, I preferred it to feeling nothing at all with the morphine, and fighting the urge to go home.  So off she went to check my chart to and get some Toradol.

She came back empty handed.  It turned out that I was no longer written up for Toradol.  Instead, I was written up for Voltaren.  She explained to me the difference between it and the other meds, and why it was considered preferable.  That it lasted for a full 8 hours being one of them.  Less likely to cause nausea or stomach damage was another.  The problem?

It was a suppository.

Eww.

I was told that I could administer it myself, if I preferred.  No thanks! *L*

Thankfully, it worked rather quickly, and I was soon happily drifting off.

Then my neighbour, B, started up again.

Most of the time, it was the usual stuff, like body noises.  At one point, I could hear someone wheeling around a cart in between sweeping, changing garbage bags, and restocking the rack of things like towels and facecloths, among other things.  That rack happened to be located right next to B's room.  I guess he had his curtain open or something.  He started telling the woman doing her work to go away, come back after he was gone, stop what she was doing.  A nurse came by because of the commotion and tried to tell him the woman was just doing what she was supposed to, and that she couldn't stop doing it just because of him.

Other times, he seemed to be giving his neighbour, the guy with 3-4 broken ribs, a hard time.  There were a few times I heard him pipe up for B to just be quiet!  B didn't appreciate that and would have a little snit.

Still, it wasn't too bad.  I actually did fall asleep for a while.  It wasn't very long, unfortunately, before I started hearing, "Oh!  Oh... yuck!  That's disgusting!"

Instantly, I knew exactly what happened.  The thought just popped right into my head, without any doubt at all.

Sure enough, I soon heard exactly what happened, as did everyone else in the ward.

B had just shit his pants.

I heard him getting out of his bed, making disgusted noises the whole time, and could see his sneakered feet under my curtain as he shuffled across the ward towards the nurses' station.  He then loudly began telling whichever nurse got to him first that he had thought he just needed to fart, but instead he had a squirt.

After a while, the nurse had to tell him he didn't need to be so loud, and remind him that other patients were trying to sleep.

He didn't appreciate that.

He shuffled around, calling out to the nurses, asking if they had any hospital pants he could have.  I could hear someone come back and start changing his bedding, and he somehow thought it necessary to explain to this person what needed to be done.  He shuffled off to the bathroom, then I could see him shuffling back - this time it was bare feet and bare legs I could see under my curtain - still loudly asking for a pair of pants.  They didn't have any, but someone did bring him a pair of disposable underwear.  Then I heard someone saying they'd go to the Social Services desk to find him a pair of pants.

He responded by telling her he needed a 32 inch waist and 32 inch leg.  No thanks of any kind.  Actually, he showed no gratitude at all the entire night, but somehow, the lack of it stood out a lot more this time.

After a while, someone came back with a pair of pants for him in the size he's specified.  He was pretty talkative while trying them on, so it wasn't long before we all knew that they didn't fit and could she get him another pair?

Eventually, he was back in his stretcher, and I dared hope to finally get back to sleep. 

Yeah, I should have known better.  Soon, he started loudly moaning and groaning and calling for the nurse, with everyone being treated to the knowledge that he needed to go to the bathroom and he was afraid he'd shit himself again.  The head nurse finally had had enough.  When she went to help him, she admonished him for being so loud and keeping everybody up.  I must say, she displayed remarkable patience and respect in her tone.  I was impressed by it.  Before we knew it, he was yelling at her and repeatedly called her a bitch.  She promptly went to get security.  He managed to get out of bed and shuffle off to the bathroom again. Security was waiting for him by the time he got back.  The guard tried to talk to him, but B started yelling at the security guard and claiming that the one particular nurse was treating him so badly, and that she'd refused to put down his safety rail, and that she was trying to kick him out of the hospital (what she'd really said was that he was free to go if he didn't want to be there - it seems he didn't actually need to be there, but they were letting him stay to sleep off his high blood alcohol level that he denied having) then he was crying about how awful everything was, and on and on.  Eventually, the guard got him calmed down, but by that point, I was wide awake again. 

With all the stuff I'd been hearing from this guy all night, B was clearly someone who could turn it on and off at will.  A total manipulator, trying to play different staff members off the other.  His lack of success didn't stop him from keeping it up.  Things did quiet down again briefly, but this guy just couldn't go for long without finding something else to whine about.  This time, it was the lights.  He wanted them off.  Not his lights.  The main lights for the ward.  He couldn't sleep with them on - but he didn't want the curtain pulled, either.   After asking several people to turn off the lights and being refused, he tried a different tactic.  While talking to one nurse, he started going on about how the hospital depended on staff like her, that she should be able to do whatever she felt was comfortable, that if she was comfortable working with the main lights off, she should be able to do that, and the hospital wouldn't be able to stop her.  She emphatically told him she wouldn't be comfortable with the lights off, and neither would the 20 other people working in the ward.  That finally got him to shut up about it.  Finally... peace and quiet! Finally, a bit of sleep!

Can you guess what happened next?

Yup.  It was time for my ultrasound.  Someone came to get me just before 7:30 am.  B had managed to keep us all up almost the entire night with his antics.  I got maybe an hour of sleep after he finally quieted down.  Either that or I was so exhausted, I simply slept through anything else.

The timing was perfect, though.  I was just being wheeled away when Dh walked in.  He stayed in my room and got my phone hooked up to charge for me - I had finally turned it off, as it was almost completely drained.  I found out afterwards that he was entertained by B while I was gone.  He was sitting and waiting for me when he could see B going by in a wheelchair, dragging against our curtain in the process again.  He'd started calling out to the nurses for a sandwich.  Most of the daytime shift change had happened, though, so what he got was a bunch of people asking who he was, and why was he there?  A nurse that was still there from the night shift came by asking B why he was still there, as he had been released.  And why was he in a wheelchair instead of walking?  He started claiming that he couldn't walk, and that they couldn't kick him out, and he was taking that wheelchair until his dad came to pick him up (I was surprised by that detail, considering this guy's age) and generally being abusive to the staff.

Emergency room staff deserve medals!

I, however, had other things on my mind.

As I was being wheeled away, I couldn't help but laugh.  Chatting with the nurse pushing me, I pointed out the Xray ("been there already") and the CT scan ("been there, too!").  I was getting to know the bowels of that hospital rather well!  I was left to wait in a stretcher waiting room for a couple of minutes with one other patient.  (After the ultrasound was done, I was left to wait in a different area for a minute or so before being taken by to my room.  There I found my neighbour in the emergency ward; the one with th 5mm kidney stone.  The poor guy looked so worried and scared!  I hope things went well for him.)

The ultrasound tech got me into the room and started the explanation of what was going to be done.  It turned out I was getting two different types of ultrasounds.  There was the type I was already used to, having had a couple of babies.  The other was going to be internal, which was a procedure I hadn't known about.  As she started explaining to me how it worked, she told me, "don't worry about the size when you see it.  Most of that is handle."

Uh huh.  That didn't make me feel any better!  The darn thing looked like a futuristic dildo.  I was getting more action in one night than I've seen in a long time!  Too bad none of it was any fun. :-P

She started me on the jelly belly ultrasound first.  Unfortunately, the screen was angled in such a way that I couldn't see it.  She did her thing around the area in question, but didn't seem too happy with the images she was getting.  She got quite a series of images, though, taking plenty of extras.  She could quite clearly see the dark mass in question.  I asked her some questions and, while making sure I knew this was her unqualified observation, as it would be up to the specialists to interpret what was there, she said she thought it looked like it was full of liquid.  Which was about what I expected, since I felt it was most likely to be a cyst.

Then it was time to do the internal.

After my experience with the pelvic exam, I asked to go to the bathroom first.  I didn't need to, but I figured better safe than sorry!

While I was away, she set up the stretcher for me. This involved a triangle shaped pillow with a section removed at the top.  I was to lie with my hips at the top, so that my butt was at the cut out section.  This was to prevent the bed from being in the way of the ultrasound wand. 

Not the most comfortable of positions.

After a bit of privacy to strip down even more than I already was, get on the triangle pillow and cover up with a paper blanket, the tech got me to reach around and insert the idiot thing myself.  It made things easier for the patients that way, apparently.  I'll take her word for it, since reaching around with my hips up in the air like that wasn't the easiest thing.  It did allow her to do what she needed to do without ever having to look under the paper blanket, and I guess that's something a lot of patients would be more comfortable with.

Then she started reefing it.

To think I thought the dr's very thorough pelvic exam on me had been a bit much!  She was yanking that thing in directions I didn't realize I could bend in down there!  She wasn't just trying to get the affected area.  She was trying to get a series of images of the entire area from right to left. 

She had troubles finding my right ovary.  I'm not entirely sure she ever did.

And yeah, I was very glad to have gone to the bathroom first!  She was pressing that thing against some very sensitive areas.  It brought back memories of having a baby stomping on my bladder while pregnant.

She was not happy with the images, though, so she left to get someone with more experience than herself - leaving the wand dangling out of me.  Ew.  The specialist came in and tried to get the images, but wasn't satisfied with what she was seeing, either.  They did take images, but she decided to try again with the jelly belly method.  Ah, well.  So much for my getting all cleaned up from that the first time.  It meant they had to get the triangle pillow out from under me, though, and that got a touch awkward.  There's just not a lot of maneuvering room on a stretcher.  It was worth it, though, as the specialist got a series of images that they were much happier with.  Then after she left, the tech took a few more, just to make sure they had a lot of decent quality shots. With the shifting around, I could just sort of see the screen at an angle, but not well enough to make anything out, though I could see the dark mass they were talking about.  I think.

After giving me some privacy to clean up and get semi-dressed again, it was back to my room in emergency to wait for the results.  Dh was waiting for me and we filled each other in with news. I regaled him with what a lovely night we all had thanks to B, and how glad I was to see that bed empty as I was being wheeled back, he told me about B's attempt to not leave, after all. 

I still hadn't eaten anything since late in the previous afternoon, and hadn't had anything to drink since before the CT scan, so I was absolutely famished and thirsty.  Dh went to ask if I could finally eat something, but once again I was told no.  The reason this time was the possibility of going into surgery after they got a look at the ultrasounds. 

Once again, we waited.

It was a surprisingly short wait, all things considered.  The doctor came by to explain what they could see - which still wasn't much.  They could now say it was attached to my left ovary.  They could also tell me that it measured 13 x 11 cm.  That's about 5 1/2 x 4 1/2 inches.  Definitely something with some heft to it!

They still couldn't determine if it was cancer or not from just the ultrasound.  For that, they would need to take more blood and test for specific markers.

So much for the 7 vials I had taken when I first arrived having "extras" they could use!

He asked if we had any questions, but we didn't have many.  There's only so many things it could be, and we were aware of what sort of treatment might be likely.  I did have one main question, though.

Would I finally be able to eat and drink?

Nope.  There was still a possibility I'd be going into surgery.  They needed to spend more time going over my details to decide.

*sigh*

A few minutes after the doctor left, a nurse came by and took another 4 vials of blood from my other elbow for the tests.  After she was gone, we had nothing to do but wait.

And wait.

With time on our hands, we discussed the thing that was found.  Not knowing if it was a cyst or a tumour, we didn't know what to call it.

I decided to call it George

Dh thinks I'm silly. ;-)

With the possibility of surgery now in the air, we talked about one problem I was having that I was now seriously considering getting fixed.  The IV in my right elbow was an issue.  Though I had some movement in my arm, it was severely limited.  I couldn't put my glasses on properly, for example, leaving me with one handle resting crooked on my head, making it not only uncomfortable, but affecting my vision.  (For the folks who don't wear glasses: If the lenses are not positioned properly on your face, it distorts the vision.  Depending on one's prescription, this can lead to headaches, dizziness and nausea.  It also can affect depth perception.  Not pleasant.)  I also couldn't put my hair back up into its clip, so it was constantly getting in my way.  Dh had brought my project bag so I could crochet while I waited, but there was no way I could manipulate a hook.  Even holding the book he also brought me was more difficult than it needed to me.

Dh went to ask a nurse to come by about the possibility of moving the IV.  When a nurse came by shortly after, I explained what I wanted done and why as he looked at the veins in my arm.  He suggested that I would still have the same problem if it was in my hand, as my ability to bend my wrist would be affected by the needle.  He thought it might be worth moving the IV to the underside of my arm, instead.  This area has almost no movement to affect the IV, and it could be taped down quite securely.  He offered to give it a try and, if it didn't work, he could still move it to my hand.

I decided to give it a try.

It didn't work.

After inserting the IV needle, he injected a bit of saline solution, as is usually done, but instead of going into the vein, he could see it was going into the arm. He took it back out and bandaged the area for me while we discussed trying on the hand.  In the end, I decided against it.  Getting yet another poke (I was up to three) and still not being able to use that hand didn't make much sense, so he left it at that.

Shortly after, a different nurse came by saying, "so, someone wants their IV moved?"  She didn't know someone had already been to see me about it.  We told her what was done and why I'd changed my mind.  She took a look at the back of my hand, declared I had excellent veins, and assured us that she could place the IV so that I would have full use of my wrist.  With that, I told her to go ahead and do it.  It worked just fine, and she was able to tape the tubing down out of the way, too.  What a relief!  As soon as she was done (and the bleeding was stopped in both the old IV location and the attempt made just before she came in), I immediately put on my glasses properly and put up my hair.

What a relief!! 

It's the little things that make me happy. :-D

We were left to our own devices again for a while, passing on information to various family members and letting them know about the possible surgery.  After a while, a new doctor came in.  She was the day shift doctor for the gynecological team and had just finished going over my file.  As she started talking about the object, we told her we named it George.  She got a good laugh out of it and referred to it as George from then on.  She then told me that some of the new blood tests ordered could take a few days, and that she was recommending I not go for surgery until we got the results back.  She asked how I was feeling, and I told her I was feeling great, but I wasn't quite sure if it was because I was actually feeling normal again, or if the drug hadn't worn off yet.  She told me that if I did end up going home, they'd make sure I had more of the Voltaren prescribed to me to use as I saw fit - I no longer had any restrictions on the type of painkillers I could use to treat my pain, now that we had a better idea as to the cause.

Which lead me to ask - at 13x11cm, clearly George has been with me for a while.  Why would it start causing me problems all of a sudden like that?  She wasn't able to give me the exact reason, of course, but the most likely reason was that George got twisted around while I was walking Youngest to her guitar lesson.  In doing so, it would have wrenched my ovary and cut off blood supply, which would be extremely painful.

Uhm.  Yeah. It was!

As soon as she told me that, though, I suddenly started remembering things.  When Eldest and I started going for our mall walks last winter, there would be the odd time when I would feel what I thought was a muscle being pulled in my abdomen.  The location of that pain, minor as it was, was exactly where George was found.  Then I began remembering other times when I'd been walking, whether it was to the library, while running errands, or just for an outing, I would feel discomfort in the area.  It had never been of much concern to me, as the pain was brief, relatively mild, and didn't happen all that often.  Except that in the last while, it was happening a bit more often - and sometimes even when I hadn't been doing any walking at all, but just being actively moving around.

Now that George was getting bigger, he was taking my ovary out dancing.

In mentioning that I might not be going for surgery that day after all, I was quick to ask her if it meant I could finally eat!  Yeah, I had food on the mind a lot by that point, I was so hungry.  After explaining how long it had been since I'd had anything to eat or drink, she left to talk to the rest of the team and get a decision for me.  It was only a few minutes before she was back to verify that I would be going home!  I only had to wait for the nurses to come and remove the IV (the one I had just had moved to my hand! *L*) and take care of a few other little details, and I was free to go.

Yes!!

Dh immediately went to the nurses station to ask if I could get something to eat.  At first he was told no because of the possibility of surgery, as they hadn't been updated yet, so he told her I was now slated to go home.  With that being the case, she said, I could indeed eat again! 

Not at the hospital, though.  Within minutes, I had a nurse back with me, removing my IV and giving me a prescription for the Voltaren.  In no time at all, I was getting changed and packing up.

It was time to introduce George to the girls.  *L*



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