Finally Home from a colonoscopy

Decision to have colonoscopy

During my 6 month check up with my primary care physician we had a discussion about my last colonoscopy. I’ll admit I don’t fully remember my last one but believe it is close to 10 years. Following the standard advice my PCP recommended another colonoscopy.

Now being 70, I wasn’t certain the benefit warranted the risk. While I know the risk is low any anesthesia has risk. On top of that I wasn’t certain I wanted to deal with a positive diagnosis with an aggressive treatment. I’d rather spend my life enjoying travel, family and friends.

She promised that this would be the last time she would ask me to undergo this treatment. After a little thought I decided, early discover and treatment most likely would add more productive time. So I agreed and contacted the gastroenterologist she recommended to schedule an appointment.

Appointment with Gastroenterologist

Was basically uneventful.

The gastroenterologist performing the procedure was concerned that my short neck might cause an additional risk during the procedure. He arranged an appointment with the anesthetist prior to scheduling the procedure.

Pre-opt and prior day instructions were provided. An over the counter flush was recommended. I gathered the necessary materials over the next couple of weeks.

Pre-operative Questionnaire

Before meeting with the anesthetist I received and completed an online questionnaire. The questionnaire was the standard medical history. I wonder if there are answers which may have changed my outcome. In truth there are, this is me taking my share of the blame.

• Have I had heartburn?
• Have I had acid reflux?

I suspect the answer to both is true. I have never been treated by a physician for either condition so I answered no.

How could the question have been worded to change the result?

The questions could have been asked based on the symptoms. I would have answered both to either of these questions. Have you ever had a burning of your esophagus? Was this burning caused by a release of gas from your stomach?

I’m sure you can argue my splitting of hairs, but by asking the question differently and describing symptoms for conditions not often diagnosed there might have been a different outcome.

Appointment with the Anesthetist.

He repeated the questions from the questionnaire. I gave similar answers. He looked down my throat and determined the outpatient facility was ok. The appointment was schedule for the outpatient facility.

Final pre-opt instructions.

I was instructed to take my blood pressure and beta blocker for migraines prior to arriving at the facility, with a tiny sip of water. I remember pushing back and suggesting that I normally take these medicines later in the morning / early afternoon, but was told to take the medications because they would be late in the cycle.

That morning I did as instructed.

Last Wednesday.

I arrived at the surgery center at the appointed time, finished the daily paperwork and waited. The wait was not long and shortly after I was brought into the operation center asked to disrobe and put on a gown and yellow slipper socks. Shortly after a nurse anesthetist came over and announced she would be with me through out. At the time, I didn’t know my plans for the week were about to change.

My Next Recollections

I was aware that I was being moved, I was being loaded into an ambulance. The tone was a sense of urgency. The only statement I heard was that CPR had been administered. Paddles had not been used. We were off.

Once in the ER, they moved me to another room for an ultrasound. Again I was aware but not an active participant.

Throughout this time I did not knowingly have any visitors from the great beyond. I was either unconscious or in the ER.

I became aware of having a dry throat and being hungry and asked for food. This was denied because there was concern I might need another procedure. CPR and another procedure. I became convinced that I had a heart attack.

My phone was delivered and I called a couple of people. All later let me know I did not make sense. I must have scared them more than reassured them. Texting was worse. Without glasses, I couldn’t make out what I was typing.

I knew I was connected to a saline solution and remember thinking it would help with accessing my veins later. The care I was receiving was top notch.

A therapist came in and asked if I would like a gram cracker. Starved and parched, I couldn’t imagine having the energy and wetness needed to chew and swallow a gram cracker. I declined. How about with apple sauce? Not a favorite, I accepted only after being told it was needed to evaluate what my diet would be. I took and ate the gram cracker with applesauce and repeated the process a couple of times. My diet for most of my stay at the hospital was a chopped, pureed and thickened diet.

For the next couple of days it didn’t make any difference.

The only Doctor visit I recall while in the ER.

Was a visit from the gastroenterologist.

About 36 hours after arriving in the ER I was transferred to the ICU.

The first 2 days in the ICU

The procedures started in the ER continued. The nurse practitioner from the gastroenterologist visited. Still no visit from a pulmonary specialist. I was on oxygen and had difficulty breathing. It was hard to eat or drink because I couldn’t have the oxygen mask off for very long. I knew I was sick, very sick.

Bathroom.

Both in the ER and in the ICU, I refused to pee while lying down in bed. I insisted that they let me sit on the side of the bed and use the urinal provided. While it made more work for the nurses, it gave me hope that I was going to get better. We made an agreement that they would help with this process so long as I asked for their assistance. I kept my part of the bargain, they kept theirs.

On so life established a rhythm.

Most of the time I was semi-conscious. Phone calls to the outside world kept me attached. I think I scared more then alleviated my friends and families fears. At one point on a conference call someone suggested I text. I said with my oxygen mask, I couldn’t wear my glasses and make out the keys. Phone calls would have to be it for now.

Finally, on Saturday a break through.

I believe this was prompted by a visit from the gastroenterologist’s partner. He asked if I had seen a doctor and I said no. His next stop was the nurses station and there was some activity.

Later that day a pulmonary specialist came to visit. He listened to my lung and went away. Another specialist came by later and repeated the procedure.

Breathing Treatments

They started IPRATOPIUM/ALBUTEROL SULFATE treatments. They consist of 3-5 minutes of deep breathing a vapor connected to the oxygen supply. Wow. The breathing treatments continued every 6 hours. I asked the person who administered the treatments how long the treatments would continue? The only answer I ever got was every 6 hours.

That night I had a sweat and asked for my bedding and gown to be changed. While I never had a high fever, any fever I had broke.

Sunday Morning.

I woke up to a breathing treatment and breakfast arrived. This was a common occurrence. Up until this time eating was a struggle.

Process.

• A couple of deep breaths.
• Take the mask off.
• A bite of food.
• Put the mask on.
• Chew
• Sallow
• Repeat.

In short eating was a struggle. After several bites the food would be cold and even less appetizing.

That changed on Sunday morning. I was able to take several bites at a time and started eating more. By Monday, I finished my breakfast, lunch, and dinner joining my Aunt Florence’s clean plate club at each meal.

ICU to non-ICU Bed

By Sunday afternoon, it was clear that I no longer needed ICU type services. A non-ICU room was ordered. This would have given me a bathroom with a door and a sink to clean up. I was ready for the upgrade.

My TV.

My TV did not work properly. It only received about 1/3 of the channels. Most of the channels I received were not of interest. Until Sunday, I thought it was me, but on Sunday I decided it was time to bring it up. A technician came up Sunday night and confirmed I was right and supposedly put in a order to have the TV replaced. Expected ETA was Monday.

The TV remained unfixed when I was discharged on Thursday.

Therapy

More than anything I wanted to be able to go to the bathroom without assistance. I was sick and baby steps were necessary. I’m not certain whether I broke our agreement first. I suspect I did. The the issue was resolved by having a therapist access my stability. I was granted bathroom privileges.

Over the next couple of days this process was continued. It was not without incident, but I now had a some freedom not previously available.

At one point in a hurry, I got into bed head first. The result was an all 4’s position which I’m sure looked like a runners stance. I stopped when I noticed all the connections were not in the right position. It was at this time another therapist saw and got concerned. We had an exchange which quickly deescalated, when I indicated I was mobile and tested. I figured out how to move so I didn’t entangle my lines and wires and was able to safely lie down.

My new friend continued as my therapist as I progressed to less oxygen and more mobility.

Last Night in Hospital

The previous day had resulted in at least 3 new patients in the ward. One of them was in the room next to mine. I’m not certain why but early in the evening it was clear he was in pain. Pain medication was administered. For a short time he was quiet. He then became nauseated and spent several minutes vomiting. An nausea medicine medicine was added. Again he quieted down.

There is a rhythm to a hospital. Breathing treatments every 6 hours. Vitals every 4 hours. Blood work daily. Medications on schedule both day and night. Sleep is not part of the schedule.

Once the patient on one side had quieted down. The patient on the other side woke up. I called this a testosterone issue. The patient had needs that required an aide to sit with him 24 hours a day. Their were times when he would refuse care. It may be my imagination but when a male aide was present the testosterone would take over and f**you exchange would occur. This was the case on the last night.

As a patient I get this one-on-one. For the nurses this activity is one-on-five or more and continuous. Twelve hour shifts, as many as 6 shifts a week. The pressure of providing care is enormous.

Discharge Process

On Wednesday the discharge process started. I would still need oxygen at home, and the wait began. On Thursday morning the gastroenterologist visited and listened to my lungs. Each day apparently showed progress. After breakfast and a nap

By Thursday, the nurses took me for a walk and determined that oxygen was no longer needed. I was discharged shortly afternoon.

My Patient Credo

I was aware throughout my stay that the work conditions in Hospitals throughout the country including Palm Beach County Florida are hard on staff. All hospital staff is dedicated to helping patients get well. They are also extremely overworked. As a patient I did not want to increase their burden so I developed my patient credo.

• I would thank everyone who came to assist me. Every time without exception. The staff at the hospital is there to help and should be commended for the work they have done throughout this pandemic.
• When given the opportunity, I would acknowledge the great care they were providing me. While it might seem overdone, it was not false. My episode increased their workload, it was neither their fault nor mine, but it was true.
• There were several times that incidents occurred where the staff might have thought they annoyed me. I tried to immediately point out it was the situation and while an alternative choice might have been possible, there might be times the alternative was incorrect as well. I let them know that I knew their hearts were in the right place and we were okay.
• As I improved, I wanted to find ways to make their lives easier. I had no desire to increase my limits in ways which were unsafe, but I did want to get better. They wanted me to get better as well. An example of this is by Wednesday, still in the ICU and approved through therapy, I was free to move about to the limits of my tethers within in my room. I took most meals in a chair in my room. They were as happy with this arrangement as I was. Because of the work we had done earlier we had created the trust needed.

This is my true belief right down to my core. I was cared for throughout my stay at the hospital by angels (both women and men) of mercy. If there is anyway that I can reduce their burden I would do it gladly.

Thank you, each and everyone of you.