Sunday, June 28, 2015

WHERE'S MY FRIGGIN' MORPHINE DRIP??

Over the last two months I've spent 9 days in the hospital here in Italy...I had gall bladder surgery.  The experience was most impactful because I was experiencing a completely new "hospital culture"....some of it was nurturing and caring, some of it was traumatizing.   Snapshots below.

*  Saturday night, emergency room, severe abdominal pain--the local hospital has 50 beds, a small guy.  They wanted to admit me for observation, even though no tests would be done until Monday.  I suggested I come back on Monday, but nooooo, they needed to reserve my bed-- with me in it.  WHAAAAT???

OH YEAH...you are expected to bring your own plates, silverware, glass, cup, toilet paper, towel, soap, and WATER, honest, I'm not kidding, WATER.

Luckily, my doctor, Dr. Garafolo, speaks English--she studied in NY and was a godsend.

*  My nights with MacBeth's witches:  I was put into what I call "the death room"...3 other patients, all over 90.  Who didn't sleep.  Who croned incessantly.  These women are not witches, but their voices, in tandem,  were a querulous cacophony, a symphony of pain, unhappiness, loneliness and dementia.  After my second night I told my doc I was going out of my mind...she changed my room.  3 nights to go. 

*  Each room has 4 patients.  The beds have no privacy curtains.  The walls have peeling blue paint.  The doctors' rounds are a public affair, unless you are a family member, in which case you are sent out of the room.  At shift change, the nurses stick their heads in the door, ask anyone if they have a fever and go on to the next room.  No one took my blood pressure the 5 days I was there-aside from the ER.

*  I couldn't eat for 3 days--they were prepping me for a colonoscopy and a gastroscopy.  (remember, nothing would happen until Monday!)

*  There was great celebration when they discovered my gall stones...from the ultrasound that wasn't done until Tuesday--I did have 3 xrays, however. 

*  Fabulous view from the hospital....Le Marche is stunning.


*  SURGERY SCHEDULED in two weeks, then rescheduled for 3, then 4.  ARRRRGH.

*  New hospital.  One roommate.  Check in the day before, not doing anything but chillin' while waiting for the next morning.  No privacy curtains. 

*  They took my blood pressure and temperature at every shift change.  The BP cuff was frayed and worn.  Nurses overworked and underpaid--I know cuz I had that conversation with one of the nurses.

**  here's the big one...I was rolled into the surgical theatre fully friggin' conscious.  Not kidding here...the docs were talking about lunch and what they did last night and I'm staring at those surgical lights and I lost it...I was trying to be strong and brave and grown up, but I couldn't do it any more...sobs erupted out of me, nurses told me to think of something beautiful, and then I got the shot.  shit....a little late.

When I met the surgeon for the follow-up I mentioned my fear, discomfort, and huge vulnerability. (I also told him in America no one goes into surgery conscious.)  He pursed his lips, tisked, shook his head and said, "this is how we do it in Italy.  The only ones unconscious going into the surgery room are babies."  (Me, Me, Me--I'm a baby!!)  Curiously, my friend, Germana, who lives in Bologna, said she never heard of such a thing.  My relatives in Rome said, "next time, you come to Rome.  We've got better doctors here."  (Next time???)   Our friend, Craig, an American who has had 3 surgeries here, said he's always been conscious when rolled into the surgical theatre. 
TOTAL TRAUMA--I couldn't even think about that surgery room for weeks without havin' a melt down.

*  After surgery I kept asking for more pain meds and the nurses told me I didn't need it, that I didn't want to be dependent upon it. FUCK, WHAT??  Where's my friggin' morphine drip????

*  Upon leaving both hospitals I had a list of questions for the doctors--NO ONE ASKS DOCTORS QUESTIONS here.  They were surprised, stopped, refocused on me before going to the next bed, and answered.  It was reminiscent of how things were in the US 40-50 years ago.

Three weeks later:

Okay, the surgery was a success...no more gallstones.  I am slowly reintroducing heretofore disallowed foods into my diet and my body is digesting well.  The laparoscopic incisions have healed.  The incision at my belly button is taking longer to heal, it was more invasive.  And my belly button, well, my belly button is no longer mine.  It's a different shape.  That's gonna wreak havoc on my bikini modeling career.

I chose to have my surgery here...the biggest obstacle--which I should have anticipated, but did not--was learning an entirely new system.  Things are done differently here...it's not what I'm used to and I was pretty vocal--in Italian, thank you very much. 

I learned I can survive and communicate my needs just fine, yeah me!  In a foreign country.  In another language.  My confidence got a heavy dose of "'atta girl."

My care was more than adequate.  The nurses responded to my needs, requests, demands with sensitivity and compassion, the doctors performed their due diligence, the job got done.

The surgery took a lot out of me (as surgeries are wont to do); It aged me.  I wonder if we too blithely succumb to surgery.  Hospitals house pain and vulnerability and deep, visceral fear.  The people who care for us face emotionally-charged situations every minute of every day.  My kudos to you for protecting us and caring for us and curing us.

My Gary was the hero of the day...he was vigilant, confrontive, supportive, vocal (also in Italian, thank you!) and he was by my side, holding my hand the rest of the time.  I couldn't have done it alone, and luckily, I didn't have to.

Wednesday, April 29, 2015

FROZEN

I've gone into a freeze mode...I know the signs--sleep, sleep, sleep, do one thing and be done for the day, cuddle up on the couch with a blankey and stare at the tv, eat, not keep up with my communications, shut myself off from all but the necessary daily contacts, not do the things I love to do....

Easter Sunday, on the train to Amsterdam from Brussels, I was struck with intense intestinal cramps.  I assumed it was something I ate, and while seriously uncomfortable, it didn't seem serious-serious.  And it continued, all Sunday and Sunday night, Monday, Monday night, Tuesday, Tuesday night, and so on----You know the question:  What is your pain level on a scale of 1-10?  1 being low, 10 being high?  I was at a constant 5 with shooting intervals of 7-8.  Ugh...

3 AM Monday morning, I knew, with the unrelenting pain, SOMETHING HAD TO BE DONE---so I rolled over and poked Gary.  I'm a firm believer in sharing my pain; no need to suffer alone.  Within minutes he was online (thank God we had internet in our apartment) looking for a Dutch doctor--he found an ex-pat clinic around the corner, we sent an email, waited, and in the morning got an appointment....

***a TMI spoiler***I also began to have rectal bleeding and, of course, I was sure I had colon cancer.

Long and the short of it, both doctors (I also went to Urgent Care because I wasn't satisfied I had all the information I needed) said it probably was food poisoning or an intestinal virus that led to a tear in the colon which resulted in the bleeding....watch what I eat, if it continues for a week, see a specialist...Phew, great news, a lovely birthday present, although the celebratory dinner was cancelled.  Who could eat???

Throughout the rest of the week in Amsterdam I slowly rebuilt my strength and stamina and was able to see some of the sights and play with our friend, Kathy Brue.

I have never felt so relieved to be "home" as when we landed back in Italy; I breathed deeply and immediately felt better.  I know the system, the people, the language, where to go, who can help....The biggest lesson?  I feel at home here.  I have achieved a comfort level that allows me to face apparently insurmountable obstacles.  Whoa--a HUUUUGE positive lesson.

SOOOO, why the freeze mode?  We were in a strange country--not that The Netherlands is strange, it's just not home--we didn't know who to see, where to go; we didn't know how serious this was--hospitalization serious?  Go back to Italy serious?  Go back to California serious? It's serious now, but it'll pass serious?  I am now hyper-aware of any "movement," monitoring everything I eat, responsive to any tiny twinge of pain....it's an obsessive thing that's no fun.  It's getting in the way of living my life.  I don't like it.   So I freeze up.  I'm working on the defrost mode.

Some Fun Amsterdam Facts: 

**we paid out-of-pocket for all the medical bills---
*  90 euro to see the ex-pat Dr.-ON A HOLIDAY
*  26 euro for a blood test
*  200 euro for a lab test
*  100 euro for the Urgent Care visit (and only because we asked if we should pay as we left--we could have walked out and not paid a cent!)
*  0 euro for the phone consult
Total:  416 euro, 3 doctors, 2 tests, 2 clinics

**  We don't have private medical insurance while we're here; so far (knock wood), we've been able to pay out-of-pocket with little impact.

**  English is the national language of The Netherlands; all classes are taught in English and there are English signs for everything..  However, the Dutch like their language...lots of Dutch spoken on the streets.

**  The Dutch of Amsterdam are bike crazy---there are more bikes than people (people, 800,000, bikes, 1,000,000).  The taxi and Uber drivers all say the bicyclists are anarchic--they truly don't care if there's a car coming or a pedestrian in the way, THEY have the right-of-way(!).

**  Amsterdam is a very clean city...very little graffiti, no trash in the streets.  It's lovely.

**  The tulips are in bloom and absolutely mind-blowingly beautiful.  The Van Gogh Museum is stunning, the Rijks Museum had a beautiful Rembrandt exhibit, and the Anne Frank Museum is a moving testimony to the indestructability of the human spirit.

**  Spring has arrive in Le Marche and I have nature exploding all around me.




With all this bounty, beauty and creativity around me, why wouldn't I set the defrost button???