Hospital Musings and Ramblings

When I went down to the ER at St. Mary's Hospital on Tuesday, October 23, I knew I had cellulitis. It had been a year since I'd had it but I had had it before. Although cellulitis can occur from many things (a student nurse I had assigned to me had gotten it from a bee sting and one of the workers at the hospital said her husband had with a fracture), the lymphedema puts me more at risk because the swollen areas are rich in protiens and provide an ideal background for bacteria to grow if they get in through any opening; even a tiny scratch or a crack from dry skin. The past infections had been handled with pills and the last bout had produced a reaction to penicillin so that I could no longer use it. I had awakened at 6 am knowing something was wrong but Heinz was getting ready to leave for a 7 am to 7 pm shift. As the day went on, I made the decision to go to the ER that evening. After Heinz got home, I showered and got ready to go. St. Mary's Hospital is on a large island in the center of Queen's Boulevard (I'll explain further later) and so is one way traffic all around. When Heinz missed the ER entrance and had to circle around again, I nearly said to go back home. I was feeling better than I had all day. I always seem to feel better if I'm going to the hospital or doctor's. But I didn't chicken out. After all I expected to just get a prescription for antibiotics and go home. It was about 9 pm and a very busy night there. I'm not sure how long we sat in the waiting room after seeing the triage nurse before going to a treatment room, but it was just after midnight before I actually saw a doctor. He looked at my leg and asked a couple of questions and then said, "I gotta keep you. I can't let you go home." When I said that I'd just had pills before, he said pills wouldn't do it this time but that I would need IV antibiotics. He said he would give me something for pain by IV too. I hadn't taken anything for pain all day because my stomach was upset and I was afraid of worsening that. A nurse came in with the IV stuff and I asked to go to the washroom first. She said to go out in the hall; first door to the left. Of course I've one of those neato open-down-the-back gowns on. I was asking Heinz to try holding the sheet up behind me but the nurse offered a second gown to wear backwards. She told me to take 3 tylenol she had for me first. Now that confused me since the doctor had said something by IV for pain. As it turned out, I was given demerol once the IV was in place. Sometime later (I was just a tad slow on this) I realized that the tylenol had been for fever. Heinz finally went home as we didn't know whether I was going to go to a regular room or not. Things must have slowed down as I was the only one in the room (which had 4 or 5 beds) by this point. I tried to go to sleep on that skinny, hard, high bed but wasn't very successful. At one point a porter (some hospitals use the term orderly but this one uses the term porter) [Lottie: Cute Alert! very cute but also seemed so young but maybe because I'm getting old.] came in, asked how I was doing and offered to turn down the lights. He returned a bit later with another porter to take me upstairs to "third floor overflow".

Many times I heard what a small room this room on third was. Usually they didn't put a bed where mine was although it did have all the "stuff" (light, buzzer, oxygen, etc) for a bed, because it was too crowded on that side of the room. But, the space is used when needed. It was an older wing and out the window was a view of ...... a brick wall! Third floor was a surgical floor. I was asked about my 'surgery' several times and would explain I didn't have any but just got put there.

Wednesday morning about 7 am there was a person asking me about food preferences. When I'd been in hospital before (over 20 years ago when Megan was born) they gave menus for 2 days later and you picked what you wanted. Well, St Mary's now had everything sent in from an outside service and there was just a listing of things you like and don't like that they used. I also got asked about regular or small portions. Remembering the servings of the past, I said small. When my breakfast came, and it was a full breakfast, I realized I probably had goofed on that. Breakfast was a small bit of oatmeal, a hard boiled egg, one piece of toast, coffee, milk, and juice. When the small portions kicked in, I got half a slice of toast at breakfast and half a sandwich at lunch. Someone must have realized the goof because the last couple of days I was in, I got full portions again. The food was pretty awful anyways with a lot being pre-packaged items.

That room on the third floor was a very busy place. The physiotherapist, Bruce, and his assistant came through early telling each patient what they'd be doing that day (my roommates had a broken hip, hip replacement, and knee surgeries). They would be in and out of the room many times during the day. The second day I was there, Bruce noticed I was reading Harry Potter. He said he'd read them all and read them all to his 6 year old son. As he was leaving the room, he passed my bed (which was partially behind the open door) and stopped to ask where I was at. He was closest to the door and his assistant (he had different ones each day so I didn't learn their names) next to him. She said to him, "Don't tell her how it ends". Bruce waited about a minute and then goes, "By the way .... the ending" and she shoved him out the door! Later that day, Bruce was working with a patient in the room while his assistant was elsewhere when he got to a point of needing assistance. Behind the curtains of the next bed, the nurse was asking Bruce to help her with getting a patient back into bed from a chair. Bruce stood at the corner opening, looking in. "If I help you, will you help me? ..... I don't hear you! ..... Ok." Turning to look at me and the person in the bed next to me, he says, "I've got witnesses!" before he went to help.

Nights were rather noisy in that room as one roommate snored and another talked non-stop in her sleep in another language mainly. And then there was Harry. Harry was in the room across the hall and mustn't have ever slept as I heard the poor nurses night and day. "Harry, what are you doing out of bed?" "Harry, how'd you get your bed up high? That's dangerous!" "Harry, you're not supposed to sit in that chair." Harry had a broken hip but he sure was busy. One time during the day, the head nurse came to tell the nurse who was in our room and who also had Harry that day, that the nurse's station in another wing had called. Harry was in their lounge watching TV.

I had been told early on that second day that I was being moved to the fifth floor that morning but it turned out to be after lunch. Before I leave the third floor, I must mention my roommate Katryn. She was such a sweet person and really very beautiful. She was 82 years old. Her husband of 62 years, who was quite handsome, came to visit her three times a day. She told him he didn't need to do that but he'd say he wanted to. If she was sleeping when he arrived, he'd sit there watching her and the caring was so obvious. He always kissed her before he left. I still smile when I think of them.

On the fifth floor, I was in a newer wing and a semi-private room. My bed was next to a large picture window. Queen Street becomes Queen's Boulevard a few blocks before the hospital if you are coming from downtown Kitchener. There are islands dividing the road that have very old lamp posts and flower beds. There's tulips in spring and annuals later on. As the road gets closer to the hospital, there's a triangle island as the space in the road increases. Then the big island that is St Mary's Hospital. Beyond the hospital, the road goes back to a regular road. My room was at the very front of the hospital and looked over Queen's Boulevard where the beds are all empty looking as they'd be planted with the spring bulbs. I could see a great deal of Kitchener. At night, it was especially interesting. Sitting in bed, I could see the sunrise each morning off to the right (foot of the bed). I kept meaning to be out of bed, looking the other direction at sunset but always forgot till it was dark. The one day was so windy that leaves were flying past the window even though it was the fifth floor. Other times I watched the clouds ... or saw a distant plane ... or a formation of ducks or geese.

On the fifth floor, directly across the hall from my room, was the Servery. It's sort of like a small kitchen. It had the ice machine; a fridge, toaster and kettle for patients to use; and a dumb waiter that I guess was for sending things to or from the food service area. Since the washroom was next to the door, I often took my mug and a teabag with me when I went to the washroom and then just went across the hall before heading back to bed. Heinz had brought me up a few of my favorite herbal teas. Patients could put things in the fridge with their name on them. The staff also saved all the untouched items (yogurts, milks, juices, crackers) on trays for anyone to have other times. Down the hall a bit and to the other side of the nurses station was a beautiful lounge. First there was a small room with a kitchenette ( bar fridge, microwave, cupboards) and table and chairs on one side; a couple of wing chairs, phone, stereo on the other. Then it opened into a much bigger room. There was a TV and VCR in an armoire with a couple of couches and some chairs grouped by it; several other groupings of chairs; and a musical keyboard. Fifth floor was general medicine but also palliative care.

I was allowed to get out of bed as I liked but did have to take my IV pole wherever I went. On third floor I had just a plain pole on wheels. On the fifth floor, I got one with a pump on it. It had to be plugged in at times but ran on the charged battery for periods of time. It was bigger and a bit harder to 'drive' but I managed. My regular IV was set at 125 ml per hour. The antibiotic was joined up from it's own little pump three times a day. Anbody offended by potty talk can skip to the next part. It's impossible to talk of a hospital experience without potty talk. Having given that warning, I shall continue. When I went to the washroom, and in each room I was in, I was the only one using the washroom, I noticed a white plastic thing placed on the toilet to catch the ... um ... pee. The first time was okay but the second time I was so shocked. I nearly overflowed the thing! I could not believe my bladder could even hold that much. One nurse pointed out to me though that, besides what I drank in a day, that, at 125 ml per hour, I was getting 3 liters of fluid per day from the IV. No wonder I only lasted two hours. Now, I was still getting demerol by IV for pain which would make me groggy, especially if they gave me gravol with it (I never did figure out why I got gravol with it sometimes but that combo had me out in seconds). I timed things so that I'd ask for pain meds just after going to the washroom. That way the worst of the grogginess would be past by the time I next had to go. When I explained that to one nurse she offered to bring the commode chair but I really preferred my way. One of the things I really wasn't going to miss after leaving the hospital was being asked if I had a bowel movement all the time. And some would want descriptions! Sheesh! One time I was just heading back to my room from the Servery, when my nurse of the day called from the nurses' station just that question. There was a staff room between my room and the nurses' station so it was fairly close. I had to answer in the hallway and she was one that wanted a description! Okay that ends the potty talk.

Here's a sort of odd little story. Part of the cellulitis is that it feels hot to the touch. In bed, my leg was turned so that the affected part was toward the center of the bed. On day a nurse was standing at the side of my bed, I think giving me demerol, and commented that she could feel the heat from my leg. That surprised me because she wasn't right next to it and there was a sheet and blanket over the leg as well.

One day I had to go down to Xray for an ultra sound to see if there was a blood clot. A porter arrived with a wheelchair to take me there. I knew I'd not be comfortable in the wheelchair so asked to walk. She really didn't want to let me but asked the nurses and they said okay. I was IV-less at the time as my IV had become painful and been taken out but another had not yet been put in. Now the really funny part of this story is that after I was done at Xray I was just given my chart to take with me; shown to the elevators; and sent back by myself! After getting back to my room, it was awhile before an IV nurse came back. After an hour and four misses (I really have lousey veins), she went to answer some other calls. When she came back, she found a vein that must have been hiding before so the break had been a good idea.

A couple of times, my friend Sue Ann, came to visit. Her visits were always memorable. The first time, she handed me a PharmaPlus (drugstore chain) bag and joked about the wrapping. I took out a crossword puzzle magazine; a pack of pens; a couple other magazines; some peach body lotion; and ..... deodorant. When I took out the deodorant, she grabbed it saying, "Oh that's for me! They had it on special. I forgot it was in there." Then as she was putting it in her purse, she says, "Unless you want it." Even my roommate, who was very quiet and slept most of the time, was just about laughing at this. Sue Ann kept asking what I needed so before she came the next time I said I could use some fresh fruit. She brought this huge gift pack that had a good sized plastic container in it and then all done up in cellophane. There was even a whole pineapple in it. She said that in the elevator on the way up people kept asking her to trade for their flowers. There were green grapes and black grapes and oranges and apples and pears and peanut butter cups. The pineapple and some of the other fruit went home with Heinz and Megan.

I probably should have mentioned this before but oh well, better late than never. There's been a recent trend, locally, for family doctors who feel that they aren't paid enough for hospital visits, to give up their hospital privileges. The hospitals have hired doctors knowns as Hospitalists to care for the patients of those doctors. I was in that situation. The doctor I got was very personable and I rather liked him. Now the ER doctor had said that if I responded well to the IV I might be able to go home in two days on pills. That would have been the first Friday I was there. But when the hospitalist visited that day, he said another doctor would see me on the weekend and he'd see me on Monday. I said, "Does that mean I'm staying here till Monday?" and as he went out the door, he said, "You got that right." A different doctor did see me on Saturday. [Lottie: Cute Alert! for the weekend doctor] A specialist in Infectious Diseases also got involved in my care. [Lottie: Cute Alert! and a sort of charming shy manner] They started doing blood cultures. Now the first time that they came for blood for a culture I nearly freaked when the lab person took these little bottles from her tray. As it turned out, they had stuff in them and only some blood was going into each ... they weren't being filled with blood. For that they use a strange sort of needle with tubing connected to put blood from me into the bottles. A few days later they were doing four more. My veins aren't very good and after getting some blood for one culture it kinda quit. So that technician, just took blood the regular way from another vein and I guess transferred it in the lab. The doctor decided to take a couple of tissue samples, too, one day to "see what bugs are in there". He did freeze the area before taking his samples and stitching the two spots. It was kinda strange to watch. One itty bit was for a biopsy and the other one a culture. He used a needle to freeze the area but when the IV nurses put in a midline for me to go home they put a freezing patch on my arm for an hour first. A midline was more comfortable than a regular IV as it was just tubing that was in my arm; no needle. But the fine blue tubing went in for 20 centimeters (about 8 inches). It was rather freaky watching it get pulled out!

As much as I disliked the food at the hospital, I have to say the staff were great. One memorable nurse was Bob. He worked 3 pm to 11 pm my first day on fifth floor. When he was doing all the different readings in late evening he had left for a minute while I had the thermometer in my mouth. When he came back he said, "Did I cook you?" Then looking at the device, he goes, "Nope, still going up." Then, "Still rising. You're hot stuff." One thing he and one other nurse on that floor did that I liked, was to actually say what every reading was. It's nice to know how you are doing but most don't say a thing and I never felt like I could ask.

That pretty much is my hospital experience. Of course it doesn't include having to go back to the ER to get meds ordered because my family doctor only wanted me to see a specialist and there was a gap between my meds ordered when I left the hospital running out and the appointment for me to see this specialist. I had seen that specialist before and didn't really wish to see him again but the appointment was made. It was at K-W Hospital as he has many stairs to his office. I was told to go to Outpatient at K-W. I did and they had no record of an appointment for me but that doctor was there doing some surgery. He said that he knew I was coming there - just hadn't told the hospital. Argh! I was glad they decided to work me in. There was another trip to St Mary's ER (St Mary's Hospital is closer to where we live, so we tend to go there) because I was itching so badly I was only getting a few hours sleep per day but there was nothing to see and I was just told to use antihistamines. A few days later, back to St Mary's ER because I had hives by then and the area around my eyes was affected. It was decided that I was reacting to the antibiotic so I was given prednisone and a new antibiotic to start.

Heinz really prefers that, if we are going to the hospital, that we get there while Tim Horton's is open. For those that may not know, Tim Horton was a Toronto Maple Leafs hockey player about 30 years ago who decided to start a chain of coffee/donut shops. They've done incredibly well and now, on any main road in Canada, large city or small town, you'll see one every few blocks and they will all be busy! Over the years the menu has been expanded to include muffins, bagels, sandwiches and soups. K-W Hospital is a larger hospital and has a full Tim Horton's. St Mary's, being smaller, has only a small outlet with coffee, tea and a selection of donuts, muffins, etc. When I'd go to the ER, Heinz would drop me off, go park, drop by the Tim Horton's, then join me. Every time Heinz visited me when I was in the hospital, he had a coffee from Tim Horton's. I think a large percentage of Canadian adults are addicted to Tim Horton coffee! And I'm sure every Canadian child knows what a timbit is (small sized donuts). I once read that Canada has the greatest number of donut shops per capita in the world and I believe it. There are other chains but nobody does as good as Tim Horton's. My personal favorites are the bran muffin with blueberries and cranberries or a toasted blueberry muffin with strawberry cream cheese.

I guess the home care nurses should get mentioned too. They were really good. There was a team of 4 with different ones coming on different days. They were especially good at getting things done. They'd make phone calls and write notes to doctors. When I could get no information from my family doctor about the gap in the meds, the nurse called and got results even if it was for me to head back to the ER. I had to call them once in the middle of the night as the alarm on the pump was going off and I couldn't figure out what to do. The batteries had only been in about 36 hours as they changed them regularly on a 3 day basis but changing them did work. There was one other time that I had to call about the pump. That time it turned out that the tubing of the midline had somehow become twisted and so wouldn't let the fluid through. Once the IV was out, I was "discharged" by them. And the pump was promptly returned as Heinz had signed for it acknowledging it's value of $4500. It was good to get it safely back where it belonged.

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