Guy with a flap
Jan. 29th, 2021 10:17 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
whitewriter It's my last 12 hr day shift (E12) for the week so I'm not feeling guilty about sitting up late and reading fanfic/writing in here. Mostly I try to find time during my shift to get a post written because I find it hard otherwise in a 24 hour day, 12 dedicated to work, 1 hour to commute (20 mins door to door; 5 to get through covid screening; 5 to put things in my locker)-- time to shower and dress-- eat -- and then before you know it it's bedtime. 12+1+8= 3 hours a day to prepare for the next day/do anything else that isn't scheduled.
Writing is a guilty pleasure.
Day 4 post pelvic exenteration.
Whats a pelvic exenteration, I hear you say. It's a ridiculously aggressive surgery for metastatic cancer of the bowel/pelvic organs. They literally: open up the peritoneum, remove the bowel (small and large - the bladder - the rectum - and sometimes also the anus too - in women the uterus/cervix etc. and in the male the prostate - cut out any visible tumours: sometimes also washing the area with chemotherapy (not in this particular case) then put all the organs back - making a colostomy (hole in the abdomen for which the bowel pokes through and the person can poop through) and an ileostomy (using non cancerous bowel to create a new "pouch" to then allow urine to leak out through the abdomen into another bag) such that for the rest of this person's life they will have no anus (because its been sutured shut and covered with a flap patch made from their leg or abdomen) - and will forever urinate and defecate through their various stomas.
As a student i was fascinated with stomas. I still find them ridiculously cool. When my uncle had one for a short while (and I only found out because I was an assistant in nursing that day on the same floor and bumped into my aunt the day my uncle was getting discharged: they decided not to tell my mum because they didn't want to stress her out; so I didn't know either) I told him it was cool: but he didn't think so. His was reversed, luckily (especially since he didn't want one).
Anyhow. So this guy, had a flap from his abdomen patching his anus.
It looked like something out of 'Silence of the Lambs'. Due to the flap he was to be nursed side to side, for 3 weeks with 2 hourly turns. It was day 4 post op. We managed just fine in ICU; but I don't know how the ward would go. If he could roll himself- fine - but he was massively confused.
His wife visited and 2 hours later he asked me to call her because "she doesn't know where she is".
He thought he was in a car, and asked me "where are we going?".
I'd been there all day and introduced myself a few times: and in the afternoon he asked me who I was.
He knew he was in NSW. That he'd had surgery recently (and he had the date right) but he thought that it was "a long time ago" -- that his current stay in hospital didn't seem to him to be related; but couldn't voice an alternative reason for being there.
Perhaps it was the Ketamine he was on (8mg/hr) or the fentanyl (50mcg/hr)
+ boluses.
Lovely guy.
PS. median survival rate post pelvic exenteration? 50% survive 5 years post surgery.
The other 50% either live longer or shorter lives.
Is it worth it?
From my vantage point, I'm not certain.
He said that the new young RNs coming through aren't friendly towards old staff members. That he wants to say hello and talk to them but he gets the vibe from them that they're not interested in saying hello. Once he had to ask them if they had a "problem with saying hello" in order to initiate conversation.
I find that interesting. To a degree.
Perhaps I'm too nice.
I just introduce myself to anyone that I haven't seen before that's nursing staff (I've lost track of the doctors since I last left to be honest - and i find them less interesting). My goal is to find out where they came from, what rotation their on; and if they're liking it. I used to then transition this into selling them Dragon boat if I thought they'd suit the team - managed to recruit 2 quality paddlers this way. Old senior is in his 50's and the young guns coming in are all in the mid 20s. I did spy someone new who looked to be at least in their 40s (we get one every so often) but he was in a different unit today so I didn't have an opportunity to say hi without going too far out of my way.
I wonder if I'll be as friendly when I'm 40+ or if I'll just expect people to come to me at that age.
The oldest senior in the place today admitted that she's planning to retire this year. It was because when we were checking magnesium the expiry date was in 2025 and I commented "jeeze, what will we be doing in 2025 Jill? Do you think you'll still be working here?" and she said no - I don't plan to be - ask someone outright and they will give you an honest answer. and then we talked about how rarely anyone retires out of MICH ICU. People usually don't stick around long enough (unlike at MSH)
Writing is a guilty pleasure.
Day 4 post pelvic exenteration.
Whats a pelvic exenteration, I hear you say. It's a ridiculously aggressive surgery for metastatic cancer of the bowel/pelvic organs. They literally: open up the peritoneum, remove the bowel (small and large - the bladder - the rectum - and sometimes also the anus too - in women the uterus/cervix etc. and in the male the prostate - cut out any visible tumours: sometimes also washing the area with chemotherapy (not in this particular case) then put all the organs back - making a colostomy (hole in the abdomen for which the bowel pokes through and the person can poop through) and an ileostomy (using non cancerous bowel to create a new "pouch" to then allow urine to leak out through the abdomen into another bag) such that for the rest of this person's life they will have no anus (because its been sutured shut and covered with a flap patch made from their leg or abdomen) - and will forever urinate and defecate through their various stomas.
As a student i was fascinated with stomas. I still find them ridiculously cool. When my uncle had one for a short while (and I only found out because I was an assistant in nursing that day on the same floor and bumped into my aunt the day my uncle was getting discharged: they decided not to tell my mum because they didn't want to stress her out; so I didn't know either) I told him it was cool: but he didn't think so. His was reversed, luckily (especially since he didn't want one).
Anyhow. So this guy, had a flap from his abdomen patching his anus.
It looked like something out of 'Silence of the Lambs'. Due to the flap he was to be nursed side to side, for 3 weeks with 2 hourly turns. It was day 4 post op. We managed just fine in ICU; but I don't know how the ward would go. If he could roll himself- fine - but he was massively confused.
His wife visited and 2 hours later he asked me to call her because "she doesn't know where she is".
He thought he was in a car, and asked me "where are we going?".
I'd been there all day and introduced myself a few times: and in the afternoon he asked me who I was.
He knew he was in NSW. That he'd had surgery recently (and he had the date right) but he thought that it was "a long time ago" -- that his current stay in hospital didn't seem to him to be related; but couldn't voice an alternative reason for being there.
Perhaps it was the Ketamine he was on (8mg/hr) or the fentanyl (50mcg/hr)
+ boluses.
Lovely guy.
PS. median survival rate post pelvic exenteration? 50% survive 5 years post surgery.
The other 50% either live longer or shorter lives.
Is it worth it?
From my vantage point, I'm not certain.
He said that the new young RNs coming through aren't friendly towards old staff members. That he wants to say hello and talk to them but he gets the vibe from them that they're not interested in saying hello. Once he had to ask them if they had a "problem with saying hello" in order to initiate conversation.
I find that interesting. To a degree.
Perhaps I'm too nice.
I just introduce myself to anyone that I haven't seen before that's nursing staff (I've lost track of the doctors since I last left to be honest - and i find them less interesting). My goal is to find out where they came from, what rotation their on; and if they're liking it. I used to then transition this into selling them Dragon boat if I thought they'd suit the team - managed to recruit 2 quality paddlers this way. Old senior is in his 50's and the young guns coming in are all in the mid 20s. I did spy someone new who looked to be at least in their 40s (we get one every so often) but he was in a different unit today so I didn't have an opportunity to say hi without going too far out of my way.
I wonder if I'll be as friendly when I'm 40+ or if I'll just expect people to come to me at that age.
The oldest senior in the place today admitted that she's planning to retire this year. It was because when we were checking magnesium the expiry date was in 2025 and I commented "jeeze, what will we be doing in 2025 Jill? Do you think you'll still be working here?" and she said no - I don't plan to be - ask someone outright and they will give you an honest answer. and then we talked about how rarely anyone retires out of MICH ICU. People usually don't stick around long enough (unlike at MSH)
