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Prostate Chronicles - Chapter 4: Rate Your Pain

Tuesday, September 2, 2008 at 7:31 AM

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My eyes opened a couple hours ahead of schedule. As consciousness slowly leaked back into my brain, my friend Robin from Washington was with me in the recovery unit, saying something about how the two operations had gone really well without any apparent complications. The goal had been to remove cancerous or potentially cancerous pieces from my body. That mission had been accomplished more quickly than anticipated. Now, those pieces would be analyzed in the laboratory to determine whether the cancer had been contained. The "labs," as they are known, would be back in seven to ten days.

It is said I was trying to crack jokes as the fog of anesthesia dissipated, but I can’t vouch for the wit, or lack thereof.  I just have shards of memory from this post-surgical phase.  A nurse testing my feet for feeling.  Rolling back down the Ben Casey corridors.  Then, arriving at my room, catching an out-of-focus glimpse of my roommate in the dark, watching political coverage on CNN.

Then came a long night.  After what was probably several hours of sleep, a nurse touched my arm.  “Time to get your ‘vitals,’ Mr. Barnett,” she said, checking my wristband and strapping a blood pressure collar to my arm.  “On a scale of one-to-ten, how would you rate your pain?”

Pain?  I touched my stomach and felt the stapled incision, but my stomach didn’t feel my hand. There was just a vague tingling sensation.  I would later learn that was because my skin nerves were still in the process of reconnecting, after having been severed by a scalpel.  Still, I felt a sharp shot of pain in my abdomen, as I slowly repositioned myself in the bed.

“Uh, I’d give it a seven, I guess.”

She stuck a thermometer under my tongue and proceeded to explain the two streams of drugs attached to my arms via plastic intravenous tubing.  Although there was a continual background flow of medication giving me a baseline of pain relief, I could also “self-medicate.” Within reach of my hands there were two buttons that would allow me to give myself an extra shot, as needed.  These triggers were computerized and wouldn’t allow me to overdose myself. 

“So, don’t hesitate to use the PCAs if you need them,” she said.

“PCAs?”

“That’s what we call those medication buttons - ‘Patient Controlled Anesthesia.’”

It was one of a number of acronyms or jargon-y terms that I heard during the course of my hospital stay.  For instance, there were three small plastic containers with tubes coming out of my stomach and pubic areas.  Most of the medical staff referred to them as drains, but several people called them “J.P.s,” after the manufacturer, Jackson-Pratt.  Another person advised taking a certain medication, “Q-4,” the medical abbreviation for “once every four hours.”

This has long been a beef of mine when it comes to specialized groups that use a specialized language that can have the effect of confusing people outside of the organization.  Non-profit institutions, for instance, often use so-called “politically correct” language in putting out news releases and annual reports. The goal is to be sensitive and inclusive to a diversity of people, but sometimes the heart of a powerful idea can be loss in fuzzy, multi-syllabic words designed to offend no one.  Insider language is a convenience, a form of shorthand for those in the know.

I think some medical professionals lose track of a patient’s need to understand the alien world of a hospital.  They use words and abbreviations that often fly by an already groggy person who is trying to come to terms with the fact that there are little plastic drains hanging out of his or her stomach.

That being said, I was given a very informative guide to my hospital stay ahead of time.  It was a tabbed notebook, filled with all sorts of facts and terms.  But, there’s only so much you can take in when you are facing the fact that someone is about to cut you open, reach inside, and take a bad thing out.

Still, aside from some quibbles over clear language, my interactions with hospital staff were great.  As I gradually made the transition from bed… to chair… to walking the hallways for exercise, I was always accompanied by a nurses’ aide who inevitably conveyed her enthusiasm about establishing a career in health care - everything from treating infants to helping the elderly.  At other times, I could see the stress of a huge patient workload in the faces of my nurses, but that never stopped them from taking the time to give me their undivided attention. 

And it was occasionally disconcerting to open your eyes and see a doctor and a half-dozen of his residents and interns clustered around the bed.  But, their earnest faces would win me over as they asked questions about my birth date, my current level of pain, and how the JPs were doing.  Then came the day that a resident stopped by and said that my JPs were going to be removed… and that I would soon be going home.

Home. That had a nice finality to it.  But, it made me both happy and hesitant.  I would be back in my own bed, but I wouldn’t have the 24-hour care.  My walks around the hallway would have to graduate to walks around the block.  And I’d have to find a way to disguise that fact that there still was one tube coming out of me.  It was my friend “The Catheter.” My recovery had just begun.

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Health, Prostate Chronicles

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