Christmas Morning

This was becoming routine. Four a.m. blood work. But this morning ordinary quickly became unordinary. The tech entered and drew blood and he was followed by a new nurse. She introduced herself and said that she was the Charge Nurse and she was covering for Night Nurse who went to be with her grandkids for Christmas morning. We exchanged some “smack talk” about Night Nurse getting to go home early while Charge Nurse and I were forced to face my bladder this Christmas morning. Charge Nurse helped me out of bed, Husband was having a hard time “coming to” this morning. I padded into the bathroom and noticed the hat had been turned backwards in the toilet. I commented and the Nurse’s Aide told me that she turned it around to make sure they caught it all. Charge Nurse chuckled. “See, she’s pulling for you. You can do it.” I felt more encouraged than I had the day before. I sat down. I focused. I peed for minutes on end. I just knew I “put up big numbers”. Sadly 300 mL was probably not going to cut it after a night of IV fluid and only one other pee break. I was ushered back to bed. Husband was upright. The bladder scanner was wheeled over.

My gown was up, lubricating jelly was placed over my bladder and the machine groaned to life. Just as Nurse’s Aid put the wand on my bladder, Urologist #2 came in. He didn’t have much hair but the hair he did have was disheveled. I wondered if he had been up all night assembling toys for his kids or engaging in some other Santa-type activity. He frowned when Nurse’s Aide read the number. He looked at me and said, “I can’t let you go home if you can’t empty your bladder.” I asked why. “If you take in 500 mL and only empty out 200 mL you leave 300 mL of residual urine in your bladder. Bacteria loves urine. So, chances are, if I send you home without a Foley, you will be back in a few days with a urinary tract infection and neither of us want that to happen. So, you have two choices. You can stay until you can completely void (after surgery it can take up to a week). You just had surgery Monday, today is Wednesday. Or we can put the catheter in and you can go home now. Your paperwork is done and you can be home by breakfast.” He looked at me, waiting for an answer. I wanted a minute to think. I didn’t need to think. I wanted to go home. I didn’t want a Foley. I wanted my bladder to work. I looked at the faces around my bed for a clue: Night Nurse, Nurse’s Aide, Urologist #2, and husband. They all just looked right back at me.

I agreed. Reluctantly. Urologist #2 left and the tears fell. Night Nurse took my hand and said “Sweetie, don’t cry. This happens to a lot of people. You will be fine. You can wear this under your clothes and no one will know. Use the big one at night and we have some that will strap to the inside of your thigh that no one will see.” The nurse with the southern accent from the night before came into the room with a package. She talked to me about what she was going to do. Husband had disappeared and I was glad. It was just us girls in the room. Southern Nurse put the catheter in while Night Nurse distracted me with conversation. They were both so sweet and kind. Night Nurse said that I was free to go whenever I wanted. I could stay for breakfast or even lunch if I wanted to. I told her I was ready right then.

She brought in my discharge papers for me to sign, husband moved the car around, I put on my robe and Nurse’s Aide wheeled me out of the hospital. Before shift change, we were pulling out of the hospital driveway. I was going home. Not as good as new but I was going home.

This was no ordinary road trip.

Twas the Night Before Christmas

I told my mom and my kids that I was getting to go home today. I already had my stuff gathered and packed. My mom left with my kids before lunch. They were going to stop at a steakhouse on the way and then be home in time to attend Christmas Eve Services at her church. I figured I would be home later tonight. Three o’clock seemed to be the magic hour. I kept peeing. I was up to 200 mL from my 50 mL this morning that the nurse laughed at. I do not care for this day nurse. I called her in to show her my progress. She informed me that Dr. Urologist #2 said I had to have less than 200 mL left in my bladder before I could go home. Excuse me. Where was this information this morning when everyone was saying that I could go home when I peed on my own? No one qualified it with an amount. I have only had IV fluids, so they were able to track how much was going in. They were measuring what was coming out. So the difference in the two numbers was not less than 200 mL remaining. Day nurse said that Urologist #2 wanted to do a bladder scan after my next void. So I peed and she scanned. I voided 200 mL . This seemed to be my best score on this bladder void game. She scanned and over 500 mL remained. She ordered me to walk more. I scowled. I have been walking. I made laps in the hallway. I voided. She scanned. My scan didn’t dip below 300 mL. Three o’clock was getting close.

Day nurse came in my room again. She looked at me and said, “It’s Christmas Eve and at 3 o’clock they are shutting down this hallway and letting some of us go home early. They will move you next door if you do not pee more.” She certainly had never been a cheerleader. “All of your paperwork is done we are just waiting on you.” I made a face at her as she left my room. I made another lap. When I came out of my bathroom there were two nurses in the room and my things were gone. Day nurse turned and looked at me “You have been moved next door.” With a heavy heart I left an empty hat in the toilet and walked to my new room.

Now I have a new nurse. She is much nicer than the other one. I am glad the first one is gone. My new room looks just like my old room except there is a recliner for husband to sleep on if I have to stay the night. The blinds are open and there is a warm spot inside the window. I stand here for a few minutes with my eyes closed. The warmth feels good. I let it wrap around me. Tears begin to stream down my cheeks. Why can’t I do this? Husband takes my hand and asks me to join him on a walk. I agree wiping the tears off my cheeks.

We walk and walk. I talk to him about the book that I am reading and he talks about his. We walk and walk. We stop at the nurse’s station and make some small talk. A nurse with a really southern accent has heard about my dilemma. She suggests that I start and stop my stream frequently to work up the muscle. “You mean kegal exercises?” I ask with a grin. She giggles and blushes and nods her head yes. I set off down the hall with a new “cheat” for this game. I sit down after turning on the water in the sink, at this point I need all the encouragement I can get. I follow the nurse’s suggestion. Once again I void 200 mL. I call the nurse and she scans, I can’t even begin to guess the number at this point. My new nurse looks at me with soft eyes. She encourages me to relax. The sun is sinking behind the buildings outside my window. It is almost time for a new shift. Three o’clock has come and gone.

Husband orders my dinner and then goes to the cafeteria to get his dinner. I am alone. I try to relax. I read my book. I scroll through my Facebook feed. Not much is happening. I am discouraged. I pee again by myself and don’t tell anyone. 200 mL is obviously nothing to get excited about. Husband returns with his dinner in a Styrofoam box so we can eat together. I drink my vegetable broth and savor my jello. I was able to add some Diet Coke to my menu hoping that the diuretic effect would help. After dinner we took another trip around the ward. Three laps and 300 mL. Thank you, Diet Coke. Now, it was scan time. 500 or more mL remaining. The tears welled up again. The nurse expressed her frustration with Urologist #2. My bladder was working, not to its full potential but it was working, why was he so insistent on draining it completely. With every void and every scan, she texted Urologist #2 who was attending his own Christmas Eve Church Service. Finally, halfway through the first airing of A Christmas Story in the twenty four hour marathon, she returned with an offer from Urologist #2. “If she wants to go home for Christmas she can go with a Foley and come into the office on Friday to have it removed.” The nurse waited for my answer. My pride was the first to speak. “NO! I will go on my own. I am not going home with one of those bags.” The nurse lowered her eyes and said she understood. Before she left, I asked her “Why do I have to void all but 200 mL?” Why hadn’t I thought to ask this sooner? Why hadn’t anyone offered an explanation? She said “If your bladder gets too full it could pop your stitches.” That made sense. I didn’t think about my bladder having stitches. Ok, I murmur and let her leave the room. Of course, if I was still retaining approximately 500 mL then were my stitches really in danger? I didn’t want to think about it.

Night nurse came back about 10:30 p.m. and informed me that Urologist #2 had already ordered my labs for Christmas morning. I guess he wasn’t expecting me to go home any time soon anymore. He had given up hope. Then I realized that Night Nurse had, too. She told me to get some sleep and we would resume scanning in the morning. I eased into my new bed defeated. Why do doctors tell you that you can go home and only give some of the qualifications? Why do they make the whole surgery and recover seem like no big deal? Why do they let you get your hopes up?

This was no ordinary day.