Wednesday, November 28, 2012

Praise where it is due


 

I just had a 6-day stay at Hollywood Memorial Regional Hospital in Hollywood Fl. I was in to fix a "Triple A", a/k/a "abdominal aortic aneurysm.

If you want to see what happened to me, go to (http://www.youtube.com/watch?v=ksjhfw_Pcx8&feature=player_detailpage) or, for the squeamish, (http://www.youtube.com/watch?feature=player_detailpage&v=KCzCeK1kbTE). Wonderful thing, the Internet.

Several weeks ago, during a routine visit with my Primary Care Physician (PCP) - he's an Internal Medicine specialist, but I'm old enough to still call him a "GP" (General Practitioner).


I told my PCP, Eduardo Perez-Stable, in casual conversation that I often had a strong pulse in my abdomen. He checked and con firmed and, leaving me on the examining table left to arrange an ultra-sound for the next morning.

These are the things that set Perez-Stable apart from far too many other doctors: he listens and he acts. Of course, like most physicians, he's always running behind schedule.

When my PCP got the ultra-sound results the next day he arranged an appointment with a cutter (surgeon) on my insurance company's list.


A few days later I met Jeffery Hertz . Hertz and his partner, Author Palamara specialize in vascular surgery. Hertz sent me off for a Computed Tomography (CAT) scan. The scan, which wasn't too bad even for this claustrapobe, turned up a 7.5 cm aneurysm - and a smaller one "off to the side."

I have a serious anxiety about intubation - sticking a tube down the patient's throat to both monitor heart and lung activity and to pass O2. I met with the resident anesthesiologist emeritus who after collecting answers to numerous questions told me to tilt my head back and open my mouth. His opinion: "You've got a big mouth, you'll be OK." I felt like Joe E. Brown. This gentlemen was not to be my gas passer (anesthesiologist).

The hospital activated a new computer system the day before I checked in and with it all the related confusion. Originally scheduled to report for pre-op at 7 a.m. for a 9 a.m. grand opening, I was told to show up at 5:30 a.m. By the time I got to the OR, it was nearly 10 a.m.


In the OR I met "my" gas passer,Lauren Kimmel, who also assured me that sticking tubes down my throat was not a problem. Nor was it a problem to stick catheters in my neck and hand, or even to install a nasal feeding tube (the latter after I was "napping").

At 10:15, Hertz said, essentially, "to hell with the computers, my patient comes first; we're going to start." About 90 minutes later I was in post-op, later transferred to a general surgery ICU. After 2 days in the ICU I was transferred, thanks to the cutters' "proteczia," to the cardiac wing.

Good, bad, and ugly

The nurses and assistants - no LPNs at Hollywood Memorial - were almost without exception Tony-the-Tiger great. There was one young woman ("young" being relative) who drew blood three nights in a row - if she didn't have to wake me to do the job I would have slept through the venipuncture, she was that good.

During my stay I had at least 3 AvMed contact internists visit, usually only for a minute or two. The cutter turned over most post-op medical concerns to them. What concerns? For one thing, a major operation drives the liver nuts and its insulin production goes up and down like a yo-yo. Add to my already "high" sugar levels and you can understand why my fingers looked like pin cushions at the end of my 6-day stay.

The only really nasty part of my stay at Hollywood Memorial was the food. But, to be fair, Memorial was only partially to blame.

One of the conditions for my release was to prove my digestive system was fully functional. (I'm being delicate here.) Keep in mind that I had only ice chips and water since Sunday prior to the operation - 4 plus days with an empty "system." So what was my first meal? Rice and a slice of salmon. Rice, alas, is contra-indicated for my condition. The remaining meals were tilapia under a sauce that tasted like kosher salt in tomato paste, absolutely disaster for my blood pressure which, like the sugar, went nuts from the surgery. Inedible. Fortunately, the hospital allows food to be brought in by relatives and friends, so between my wife and a couple of friends, I did manage to eat something. My capacity for food had, by this time, greatly diminished - as had my weight; from 182 to 171. (Having major surgery is NOT a recommended weight loss option.)

I'm told the hospitals regular food is no better than the imported-from-Miami kosher meals; small consolation. What I fail to understand is why the hospital's dieticians don't give directions to the caterer regarding what is suitable - and not - for specific patients.

Jump to November 28 - 13 "post-op" days - and I'm 90% back to (my) normal.

I now can make the 0.7 mile walk to Nahar Shalom which makes everyone happy - even the surgeon who insists that I do some form of exercise. The rabbi is happy since there's one more in the minyan-plus, and of course this scrivener is happy to be able to make the trek.

It took about three weeks before I had any real hunger pangs.

The interesting thing, and even the surgeon has a hard time believing it, is that I NEVER had any post-op pain; not in the hospital and not at home. Some discomfort as my shirt rubbed first against the 23 staples that held me together and later the skin shaved hairless with a dull razor before the surgery. But no pain.

Would I go the "open repair" again. G-d willing I won't have to, but given the size of the aneurysm, it is a definite "probably."

Between the surgical and medical staffs and all the prayers and תהלים said for me by friends and people I don't even know, I am - baruk haShem - in great shape for the shape I'm in.