Recurrence

^ No, I'm not referring to solving differential equations by using power series methods. Here, I will share some personal experiences from my recurring spontaneous pneumothorax, also known as a spontaneous collapsed lung. I will be covering approximately 11 days worth of hospital anecdotes in this post, so it probably won't be quite as detailed as those posts back in April 2008. In fact, I might actually skip some lackluster days and just divulge the highlights. Anyhoo, here goes...

-- DAY 1: Monday, June 9, 2008 --

It was Oxymoron Day (the great 6/9 of 2008) and I was at work as normal. Sometime in the afternoon, while I was trying to teach myself some Microsoft SQL Server stuff on the computer, I started to feel the same sqeezing feeling in my right chest area, much like the feeling I had at work at the Cornell Law School back in March when my lung started to collapse. Actually, the pain comes from blebs on the lung popping, which results in the lung collapsing if the bleb was large enough.

Weird, I thought. I had a pleurodesis on my right side 2 months ago when my right lung collapsed for the first time. A pleurodesis is where they go inside the chest wall and scrape it up, resulting in an inflammatory response which allows the lung to sort of stick to the chest wall upon full expansion. This will help prevent future pneumothoraces, because the lung shouldn't be able to collapse while stuck to the chest wall. I guess I'm one of the lucky few to have my lung recollapse post-surgery.

Later that evening (I refrained from telling my parents about my situation until they came home from my brother's PSEO orientation at the University of Minnesota), I went to the ER at Mercy Hospital of Coon Rapids, MN. After waiting around in the waiting room, being interrogated briefly, and a chest x-ray, I followed a d00d into the ER where I sat myself onto a bed and watched various ER nurses hook up a heart monitor, an oxygen supply, and an IV for me. Based on reactions from ER personnel during IV insertion for me, I guess my veins "roll around," the needle "goes through my veins," and my skin is "very tough," all not desirable qualities when inserting an IV into a patient.

Plan A for my hospitalization this time was to have me on constant oxygen supply until the next day (Tuesday), when the doctor will re-evaluate my lung collapse and go from there. If a chest x-ray shows things worsening, then surgery will ensue. The ER doctor told me that I had around 15-20% collapse after 7 hours or so, which is not quite as bad as 100% collapse after 2 days like last time.

After the plan was drawn out, it was another hour or so before they found a room for me to stay in. Room 361 was a single-occupancy room, and enough space for me I guess. I actually didn't see any double-occupancy rooms in the hospital this time.

-- DAY 2: Tuesday, June 10, 2008 --

Today I just sat around and watched CNN on TV (yes, I actually turned on the TV during this hospital stay). I ended up watching CNN for most of my waking hours in the hospital. After the chest x-ray today, the surgeon told me that they'll do another pleurodesis the next day (Wednesday) as an add-on patient, so at what time was unknown. Whatever, I thought. It's not like I have much to do in the hospital anyway.

It turned out that nutrition services canceled my dinner order this day as a mistake (in preparation for anesthesia for surgery). I ended up having a dinner of cold turkey sandwich, ice cream, and the such.

-- DAY 3: Wednesday, June 11, 2008 --

Today I ate my last solid food at 8:30 AM. Later, they let me take a shower (w00t), but had to cover my left arm in waterproofing plastic because of my IV. This would be the last shower that I have taken so far.

At 2:45 PM, they took me down to the surgery waiting room, and I guess at 3:30-ish the operation went under way. I remember the following: being told "this injection will make you feel relaxed," being wheeled down the hall from the waiting room to some operation-looking room, and waking up in the recovery room with a nurse sitting next to me, staring me in the eyes.

After this operation, there were a few differences. Most notably was the use of multiple chest tubes (by that I mean 2 chest tubes). It looked like as if both tubes were inserted through 1 incision, but it was actually 2 separate incisions placed closely together. Along with 2 chest tubes, other appendages I had attached to me included the continuous IV fluid into my left arm (probably to stave off hunger and keep me hydrated, as I was on the NPO diet immediately post-surgery), a heart monitor (probably why I ended up on floor 4-Heart), leggings that squeezed my legs periodically to keep the blood flowing there (since I couldn't stand up and walk quite yet), and worst of all...the Foley (urinary) catheter. Apparently I couldn't stand up and pee into the bottle, so they put the catheter up my dick so it can drain urine from my bladder. I guess having the catheter in wasn't quite as bad as putting it in nor taking it out while fully conscious, which I will elaborate on shortly. Oh yeah, and they brought me back not to Room 361 as I was in previously, but into a very spacious single-occupancy H4019, a room on the "heart floor," presumably for patients who have heart problems and need a heart monitor. I then joined my fellow senior citizens on the 4-Heart floor (I didn't see any patient who wasn't a senior citizen up there...)

The nurses came by every hour to inject a dose of morphine...I guess through experience they know pleurodesises hurt like hell, and morphine is fun. Also, I had to get a shot of heparin every 12 hours in my stomach while in the hospital to prevent blood clots in the chest tube. I never got used to that. In fact, I dreaded the heparin shot at 7:30 AM and 7:30 PM everyday. By the time I got out of the hospital, one can see numerous brown spots around my stomach, probably due to small amounts of bleeding from the heparin needles. I think at one point the nurse hit some organ in my left side with a heparin shot, and my left side was really sore ever since (now at home it's much better), preventing me from standing up straight.

The nurses also gave me a shot of ibuprofen-type drug (I forgot the name of it...began with a "T" I think) through my IV periodically to keep the inflammation down around the chest tube area. However, this was discontinued after a few hours as the doctor determined its effects would counter that of the pleurodesis. An inflammatory response was desired in the chest wall so the lung can stick to it post-surgery.

Sleeping at night with all the various appendages squeezing my legs and such and the "babbling brook" sound effect from the water seal vacuum on around me was rather difficult, but I managed I guess. Also, during the night there was an unexpected power outage (probably due to the storm that rolled by). Everything went dark for maybe 20 seconds, then generator power kicked in, and I continued in my attempt to sleep.

-- DAY 4: Thursday, June 12, 2008 --

This day was full of activity. Not the getting up and walking around activity (though I was able to get up now).

It started with getting the Foley catheter taken out sometime in the morning. Apparently the catheter holds itself in the bladder with a small air bubble. After letting the bubble pop, they told me to take a deep breath in. I've learned that when doctors/nurses tell you to "take a deep breath in..." usually something rather unpleasant is about to happen. Taking the catheter out through my dick was...kinda painful for about 4 seconds. After it was out, everything seemed fine.

Later in the day, the surgeon reviewed the chest x-ray from the morning and decided that one of my chest tubes needed to be pushed farther in by about 1 inch. So they came in, gave me some local anesthesia, and pushed the tube farther in. No biggie there I thought. The painful part was the needle of anesthesia going into my side.

It was this day that I learned I could have been getting regular doses of Dilaudid rather than morphine. Both are basically the same thing (IV pain medication), but different patients feel various levels of effects from the 2 drugs, and I happen to feel the Dilaudid much more than morphine. So they switched me off the morphine and onto Dilaudid, and I was happy.

Even later in the day, the shit hit the fan. I felt like I had to take a leak really bad every 15 minutes or so, and everytime I tried, I couldn't pee. Actually, I could, but it was only a few drops at a time (and it really burned at first - probably a side effect from the Foley catheter. I guess the painful urination was comparable to that of having gonorrhea, but I wouldn't really know due to lack of personal experience with STDs). The nurse came by with a bladder scanner, and found that I had 800 cc of urine stuck in my bladder (that's 80% of 1 liter). Having the Foley catheter in for over half a day probably messed up my bladder's valving system, rendering it unable to release urine. The cure was to insert another Foley catheter, have my bladder drained, then have the catheter taken out and hopefully I can then pee normally. I would say having the catheter stuck up my dick was more painful than having it taken out. Foley catheters suck royally, and here ends my rant about possibly my worst day in the hospital (the repeated Foley catheter tops the list of shit times).

-- DAY 6: Saturday, June 14, 2008 --

I guess the only thing I wanted to say about this day was that the nurse I had spoke very much like the band camp girl in the American Pie series (just the way she talked, not what she actually said). I was amused. She made me take a stroll through the floor, which I managed well I guess (didn't faint or anything upon standing up for extended periods of time).

-- DAY 7: Sunday, June 15, 2008 --

Well, as the days roll on, it's mostly just sit and wait, rinse and repeat. The interesting story I have for this day is that I asked the night nurse for dilaudid, and she shot it through my IV in one fell swoop instead of slowly injecting it in. I think my entire left arm went numb for about 3 seconds shortly thereafter. It was a fun experience in my opinion.

It was also sometime today that they moved me out of my room (H4019) and into a different room down the hall (H4002) because they needed my room for a new surgery patient. My new room wasn't quite as spacious as the old one, which is ok because then I don't need to walk as far to get to the bathroom. The thing I didn't like about my new room was the drastic temperature fluctuations throughout any given day. This was probably due to my massive window view of the hospital's parking lot and the trees surrounding it.

-- DAY 9: Tuesday, June 17, 2008 --

I learned that the hospital actually had a wireless network available, so my parents brought my computer. I read before that they didn't want wireless and cellular devices interfering with heart monitors, so I assumed I would have to live computer-free in the hospital. Guess not. Unfortunately, Mercy Hospital's firewall was much more aggresive than Cayuga Medical Center's, so I couldn't hop onto AIM or anything like that. I watched plenty of movie trailers on Apple.com.

-- DAY 10: Wednesday, June 18, 2008 --

Today they decided to take out chest tube 1 of 2. Once again I was told to take a deep breath in and hold it, but it wasn't too bad. I guess I can attribute this to a number of things such as a dose of dilaudid right before chest tube removal, or this chest tube not hitting as many ribs and/or nerves on its way out as the Ithaca one. Actually, the Ithaca chest tube removal wasn't too bad either, but what feels really uncomfortable is the pressure that the surgeon applies after taking the tube out (to stop the bleeding while preparing the dressing I guess).

-- DAY 11: Thursday, June 19, 2008 --

They let me go home with a Heimlich valve attached to my remaining chest tube instead of water seal. They also put a bag-like thing on the end to catch any drainage, which right now has a small amount of blood-like substance in it. Today I actually looked at the chest tube incision site while the nurse was doing the daily dressing change (previously I didn't want to look at what the chest tube site looked like). It actually didn't look too bad from my vantage point. The site where they took the tube out the previous day didn't seem to be spewing anything, and where the remaining chest tube went in has what looks like a pretty tight seal of skin around it, supported by some stitches around it. It wasn't quite what I had expected, but I still would rather not look at it if I don't have to. The most painful part of dressing changes is taking the foam tape off my skin. There are a few battle scars on my right side from where the tape tore off some skin. Sometimes it's because the nurse went a little too happy on applying ointment to the dressing gauze, resulting in foam tape + ointment that oozed out onto the skin, which makes the tape extra sticky and difficult to remove.

-- EPILOGUE --

Well, there's the lowdown on Round 2 of lung surgery for me. For now I'm just chilling at home with an awkward setup hanging out of my shirt draining blood and stuff. Hopefully when I go back for a follow-up on Monday, they can take this last tube out so I can shower again. I haven't showered in 9 days now.

I guess the surgery part of pleurodesises isn't too bad. It's just being chained to the wall in a hospital room for days and days that really sucks. Some of the doctors and nurses compare my situation in the hospital to being in a prison, but I'm sure the situation in a hospital is far more favorable than being in prison.

Thanks to all you loyal readers out there, and thanks for the support and concerns once again.