This is a very long blog, totally self-indulgent, but dedicated to the nursing staff of North Side Hospital Atlanta. It all began very happily. My son’s fiancée gave birth to a beautiful baby girl Alice Violet on 21 May. Four days later I was experiencing severe stomach pains which I related to an unfortunate confrontation with a Friday Subway special.
Twelve hours later my wife drove me in the wee small hours to the Emergency Room at Northside Hospital. Following several knee-jerking lunges with the physician’s assistant, X-rays, and finally a cat scan it was confirmed I had appendicitis and the infected organ would be whipped out later in the afternoon. “Routine procedure; nothing to worry about”, said the affable but rather coiffured surgeon.
I had never been in hospital save to visit people, so initially in a strange macabre way the whole hospital experience and the” journey on a gurney” to the operating theatre was a novelty which I may add quickly wore off.
The key-hole surgery went according to plan and there was a possibility I could be home in three days. Unfortunately my intestines reacted to the anesthesia and promptly shut down; initially unbeknown to doctors, nurses or technicians. A three day stay turned into a two week nightmare. My stomach became distended resembling an over inflated beach ball.
I was diagnosed with an ileus (1.) A Hispanic nurse told me that it was commonly referred to as “a lazy gut.” It would wake up in its own good time and eventually I would be as good as new. I was discharged the following Saturday, but two days later I was readmitted with terrific stomach pain and suffering from severe dehydration.
The ER doctor determined that four liters of gunge needed to be removed from my stomach which required installing a NG tube (2) up my nose and down into my stomach to suck the damn stuff out. The NG tube was taped to my face to minimize movement and I now resembled “The Elephant Man.” I can honestly attest that the discomfort caused by this apparatus was unimaginable.
I was wheeled back into a private room and later that afternoon I was introduced to the PICC line (3) which supplied me with nutrition intravenously. The PICC line was effectively my lifeline. The saline drip, antibiotics and nutrition were all fed through the mechanism. Blood samples were also drawn from it which thankfully meant I was no longer a pin cushion.
By the way you are not allowed to sleep in hospital. Your vitals are checked on a regular basis including visits by a nurse and technician in the early hours. Blood pressure, temperature, and oxygen levels are carefully monitored to the exclusion of a good night’s rest. To be honest it was difficult attempting to sleep with a plastic tube stuck up my nose.
I endured the NG tube for two days until Nurse Stephanie mercifully removed the contraption with minimum fuss and pain. I understand now why nurses are respectfully known as “Angels.” My wife also falls into the “Angel” category. She is not normally the nursing type but she stepped up to the plate for me and proved to be a rock star.
I was tentatively re-introduced to solid food for the next few days and my internal plumbing slowly began returning to normal. On Friday 7th June, my son-in-law phoned from England to inform me that my daughter had given birth to a baby boy, Alexander Charles, weighing in at an even 9lbs. Things were definitely looking up, and I was discharged the following day; hoping I would not be returning again in the immediate future.
I was home but weak as a kitten. I was looking forward to flying to California the following Friday (14th June) to celebrate our 20th Wedding Anniversary. The trip had been planned for months and the doctors had given me the green light to go. I had a few days to rest up before we boarded the plane, and despite feeling and looking like one of the “walking dead,” my rehabilitation was progressing in the right direction.
Unfortunately, the night before our departure (13th June,) Atlanta was subjected to a violent thunderstorm. In the early evening I heard the wind howling viciously around the house followed by tremendous thunder and lightning and heavy rain lashing at the roof and windows. I decided to take refuge in the basement and momentarily I heard the huge crash of trees somewhere on our property. Three “sixty foot” trees and one “eighty foot” poplar had been uprooted in the backyard; one narrowly missing the side of our house and another crashed onto the roof of our neighbor’s house. Our power lines had been pulled to the ground by the fallen trees, but remarkably we didn’t lose power. Nevertheless the backyard resembled a war zone.
My neighbor insisted that we continue with the trip on the basis that the insurance company would take care of the damage to his house. My friend also assured us that he would keep a watchful eye on the house while we were away. Nevertheless, I couldn’t speak for my wife but I was beginning to think we weren’t supposed to get on the plane to California.
Despite my trepidations our flight made it to San Francisco, and we made our way up the coast of Northern California to spend eight relaxing days in a beautiful house perched on a cliff enjoying panoramic views of the Pacific Ocean. Just what the doctor ordered.
(1) What is an ileus?
An ileus is a blockage of the intestines (also called the bowel). The ileus prevents the movement of food, fluid, and gas through the intestines. The blockage is due to the lack of movement of the intestinal muscles. The intestinal tract is made up of small bowel and large bowel. The small bowel has three parts: the duodenum, the jejunum, and the ileum. The large bowel has four parts: the ascending, transverse, descending, and sigmoid colon. An ileus can occur anywhere in the intestinal tract.
(2) What is a Nasogastric tube:
A tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach. Abbreviated NG tube. It is a flexible tube made of rubber or plastic, and it has bidirectional potential. It can be used to remove the contents of the stomach, including air, to decompress the stomach, or to remove small solid objects and fluid, such as poison, from the stomach. An NG tube can also be used to put substances into the stomach, and so it may be used to place nutrients directly into the stomach when a patient cannot take food or drink by mouth.
(3) What is a PICC Line and Why Do I Need It?
A PICC line is, by definition and per its acronym, a peripherally inserted central catheter. It is long, slender, small, flexible tube that is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. It is similar to other central lines as it terminates into a large vessel near the heart. However, unlike other central lines, its point of entry is from the periphery of the body ? the extremities. And typically the upper arm is the area of choice.
A PICC line provides the best of both worlds concerning venous access. Similar to a standard IV, it is inserted in the arm, and usually in the upper arm under the benefits of ultrasound visualization. Also, PICCs differ from peripheral IV access but similar to central lines in that a PICCs termination point is centrally located in the body allowing for treatment that could not be obtained from standard periphery IV access. In addition, PICC insertions are less invasive, have decreased complication risk associated with them, and remain for a much longer duration than other central or periphery access devices.
Using ultrasound technology to visualize a deep, large vessel in the upper arm, the PICC catheter is inserted by a specially trained and certified PICC nurse specialist. Post insertion at the bedside, a chest x-ray is obtained to confirm ideal placement. The entire procedure is done in the patient’s room decreasing discomfort, transportation, and loss of nursing care.
