Chapter 12: Monday, August 26th. The Aftermath

Filed under: @ 1:20 pm

Laura and I met up in the surgery waiting area.

Having had experience with the surgical waiting areas of several different hospitals I can say with authority that the best one in the area is at Valley Medical’s main hospital in Kent. It’s a large, open area with relatively minimal back and forth traffic. Instead of having “artfully arranged” tables, chairs, and comfy spots to sit there are separate open… well basically they’re caves. Three walls and a ceiling separating you and your space from everyone else and their space along periphery of the room with tables, chairs, and comfy spots to sit. There are also less enclosed, more centralized tables and chairs, or comfy spots to sit. Basically if you want privacy you can cabbage on to one of the alcoves and have a table, chair, and someplace comfy to sit and it’s your territory for as long as you like. If you don’t mind being “in public” you can sit outside the alcoves. There is one, and ONLY one, TV although there are easy sight lines to it from many different spots throughout the area. The restrooms are close and boldly marked, there’s a coffee shop and a gift shop both within a few steps. The addition that makes me give the trophy to Valley, though, is the water feature. There’s a 10-15 foot textured glass wall with water running down both sides into a tiled pool with a raised edge where you can sit.
When you’re in a surgery waiting area you’re looking for close and easy distraction (gift shop, TV) for when your Big Bag Of Distraction isn’t enough. You’re looking for a comfortable area (options for alcoves or individual table/chairs or comfy spots) to set down the inevitable stuff you’ve brought with you. You absolutely Do. Not. want to be disturbed by half a dozen different televisions playing half a dozen different ideas of “ideal distraction material” because whatever it is it won’t be distracting to you and the antiphonal chaos created by the sound of six different TVs all at once is highly irritating. You’re looking for quick and easy access to food/drink and restrooms (both within sight so you don’t necessarily have to pack everything up and give up “your” spot when you have to go have a pee). And you’re looking for something to mask the terrifying idea that you’re in a hospital and someone you care about is potentially in danger. The water feature at Valley covers a lot of the hospital noise and although there’s a faint miasma of chlorine rather than a nice outdoor water smell, having something to splash and splish around is soothing.

Swedish First Hill isn’t bad, especially considering how old the building must be, but there are definitely some deficiencies.
There aren’t enough electrical outlets for one. And while someone obviously has made the attempt to create a “private alcove” like experience, the sofas are arranged in U shapes with a single coffee table and multiple end tables meaning that unless you’ve got a crowd waiting with you you either have to share your U shaped sofa arrangement with other families (ick) or you have to be a real butthead and spread out to cover all of the sofas in your U. The sofa clumps are backed up against each other with a small (roughly 12 inches) shelf for lamps, magazines, etc. in between which means that you’re sharing your personal space with someone in the next sofa clump (ICK). There aren’t enough tables to sit at, the restrooms aren’t within visual range so there’s a lot of shifting around, and while there isn’t a television, some halfwit put a children’s play area in one corner which means that people bring their kids to sit with them instead of doing something on the kids’ level to keep them occupied while they’re waiting for someone in surgery. By this I’m not saying that people with families shouldn’t have their kids waiting for them while they’re in surgery. I just mean that the adults who are in charge of the kids should seek out something on the kids’ level to keep them occupied while they’re waiting instead of expecting the kids to wait, and not disturb the other waiting adults, in a space that’s more designed for adults.

Where was I?

Oh, right. Laura and I waiting.

They’d taken Curt to surgery first, or so I deduced from the fact that when I got to the surgery waiting area Laura had already staked out a sofa and had even managed to lay claim to the coffee table. Laura has recently discovered knitting so she and I sat and knit at each other. Sometimes we talked, sometimes I listened to my audiobook, sometimes she read. I had my blueberry muffin cake, she had a Starbucks protein pack.
And we sat.
And we sat.
And we sat.
It was past noon when Curt’s surgeon came to talk to Laura. Laura was able to go directly to be with Curt, even though she kindly asked if I wanted her to stay until Andrew was done, so she left. Since the rest of our sofa clump had been occupied by a group of people with a pair of kids I packed up and went to go find a quieter stretch of ground, ideally with an electrical outlet since the charge on my tablet was getting a little feeble.
So I sat.
And I sat.
And I sat.
It wasn’t until almost 2 p.m. that Andrew’s surgeon came up to talk to me. I have no idea what he said and no idea what I replied. I was absolutely starved and had to give up my fairly prime spot (table, two chairs, and a convenient electrical outlet) to tell the surgical waiting coordinator (or whatever he’s called) that my patient was in recovery, if someone needed me they’d have to call my mobile, and where was the nearest food?
I got some lunch then came back upstairs to wait more. I snagged a sofa, at least, and was obsessively playing Candy Crush. Then I was obsessively playing Crunch Time. Then I was obsessively playing Words.
It’s all about distraction, but when you’re that wound up nothing distracts you for long. I went back to knitting and audiobooks for a while, then games, then my novel.
I got up. I asked the goon to call up to recovery. I sat down.
I played games, I knit.
I got up. I asked the goon to call up to recovery. I sat down.
It wasn’t until nearly 4:30 before I was told I could go back upstairs again.

They’d just gotten Andrew back into his room. I cut through the crowd of nurses, he turned his head towards me and I burst into tears.

I don’t remember much about the rest of the day. I know at one point after all the nurses and other to-do had gone that Andrew turned to me and told me that I didn’t have to stay and watch him sleep. A statement with which I firmly disagreed. I know Matt stopped by on his way to work and that the on-duty nurse who was fiddling with Andrew’s IV pumps was amused by his “Pro-Vax” button (Buy one. Profits go to an immunization information organization that helps promote the safety and efficacy of vaccines to various groups. https://store.dftba.com/collections/mcelroy/products/pro-vax-enamel-pin).

The next thing I remember is being at home eating dinner and watching The Grand Tour.
Pogo was on my lap, I’d finished my food and was about halfway through episode 1 of season 1.
I woke up two episodes later.


Chapter 11: Monday, August 26th. Happy Transplant Day

Filed under: @ 8:04 am

We normally retire relatively early. Even before Andrew’s need to hook himself up to an annoying laser printer for 8-10 hours every night, we’ve never been late night people
Probably in large part due to the fact that I am physically incapable of staying awake past about 10 p.m. unless I am forcibly prevented from assuming a sitting or lying position and closing my eyes.

The evening of the 25th of August, however, neither of us saw any use in going to bed at our regular time. We realized that neither of us was going to sleep well and since we had to be at the hospital at 5 a.m. we were planning an alarm time of 0300.
Why no, in fact, it doesn’t actually take an hour plus to get from our house to Swedish First Hill, especially not at 0400, and we were familiar with the route, but this was emphatically NOT a date that we wanted to be fashionably late for.

So that night Andrew took his prescribed full body shower with chlorhexidine body wash — and why does Hibiclens stink so badly anyway? I use multiple iterations of chlorhexidine disinfectants every day, including surgical scrub, and none of them have that artificially floral chemical smell that Hibiclens does.
Clean jammies, clean sheets.
We stayed up until a little after 11 when I, with half a Xanax on board, passed out entirely until the alarm kicked us out of bed at 3.

I fed the cat, dressed, and ate a piece of toast. Andrew took another Hibiclens shower.
Andrew collected his wheelie suitcase, I grabbed my purse and the Big Bag Of Distraction, containing two different knitting projects, my tablet, a paperback novel, coloring book and a collection of colored pencils, my iPod with multiple audiobooks, and a container full of blueberry muffin cake, and we were off.

In fact, at a little before 4 a.m. on a Monday it takes far less than an hour to get from our house to Swedish First Hill. It’s probably the one time of the day when that can honestly be said.

So at 4:17 we wandered into the lobby at Swedish, went to the registrar — what a miserable job that must be at that hour of the day — registered, and were told to report to the 11th floor.

I would like to say that they put either Andrew or Curt in room 1142, but they didn’t. Andrew was in 1145 and Curt in 1147 (although we didn’t know that at the time).
A flurry of activity including Andrew stripping, a full body chlorhexidine wipe down, IV catheters, and a number of various fluid samples.


I don’t resent the “hurry up and wait” part of that day. It was annoying, yes, to have to get up at well above the ass crack of dawn so that we could rush to the hospital only to have to sit and wait for multiple hours before they could start this whole circus. I know that behind the scenes things were happening at a remarkable, and probably quite frantic, pace.
I do resent the fact that there wasn’t any place for me to get even partially horizontal so that I could sleep some too.
Andrew nodded off for a while, easy when one is in a bed, and I napped periodically sitting in the chair.

It was probably about 7:30 before anesthesia came to get Andrew. We went downstairs in an entirely different elevator than the one we’d come upstairs in. Which, for the record, was an entirely different elevator from the one we’d come up from the parking garage in. I really wonder if there is one employee in that building who has seen every floor and can negotiate without having to stop and look at a map.

Once we were in the realm of the presurgical anesthetic suite…..we sat and waited.
Met the anesthesiologist, a dude with a most amazing mustache who was a little put off by my request to have the actual names of the drugs that he was going to be using.
Met with the surgeon.
People popping in and out of the cubicle like bloody hummingbirds then *poof* the driving team was there, they were moving Andrew along, and I found an elevator and went upstairs to wait.


Interlude: Hospital Starbucks

Filed under: @ 8:10 am

I got up close and personal with two separate Swedish hospitals over the period of a couple of months this summer.

I have to say that whoever came up with the idea of putting Starbucks coffee bars in the lobby of main hospitals is an absolute fucking genius for a number of reasons.

First, and most obviously, financial.
Any time, and I do mean ANY. TIME. I’ve been at either Swedish First Hill or Swedish Cherry Hill this year the Starbucks has had a line. My understanding is that the Cherry Hill Starbucks doesn’t operate 24 hours a day and I’m not *positive* that the First Hill Starbucks does (although they were open and hopping when we got there for surgery at too-damn-early A.M. on August 26th) but that’s beyond the point. Every time we were at a Swedish hospital with a Starbucks that Starbucks was SRO.
These branches aren’t making a major part of Starbucks’ profit over all, but I’m sure they are high performers in the “average daily take” sweepstakes.

Secondly from a psychosocial aspect.
No one except the employees that is in a hospital on any given day is there without stress, anxiety, fear, pain, grief, or angst. An easy, calm, every day experience -smell, interaction, taste- is a great appeal to the basic nature of such a discombobulated person. Hospital Starbucks don’t cure all ills, but having a slice of what to many people is every day life in an environment where pretty much nothing is an every day experience is, again, fucking genius.

And finally from a marketing standpoint.
Hospital food isn’t, popular myths aside, worse than any other institutional cafeteria food. It’s just really hard to make food that is produced to appeal to the palates of the largest number of people taste like anything other than mass produced food. Granted that Starbucks’ food (coffee, juices, etc. etc. etc.) aren’t much less mass produced than that which you would get at the hospital cafeteria, but the difference is that Starbucks is trying to make a profit off of their products. Not that the food conglomerates that manage hospital cafeterias aren’t interested in making profits, but they’re making profits off of a captive audience. Their mass produced food can be as run-of-the-mill as hell and they’ll still make a profit so long as they’re not actually poisoning people. Starbucks, regardless of where their outlets are placed, is trying to attract people who have an option of where to spend their, let’s call a spade a spade, fast food money. The bottom line being that if you have a captive population and that population has the option of choosing your packaged but familiar in taste and quality foods (even if they are only marginally better than the alternative) over taking a chance with cafeteria style “cooked right here!” (cough) food, a large portion of them are going to go with what’s familiar. And they’ll knock you down to get to it. The quality of the food has a certain amount to do with the financial success of these hospital based Starbucks outlets I’m sure. I am, however cynic enough to feel that many people would opt for Starbucks’ products even if they were dreck given the choice between a hospital’s cafeteria and a familiar “non-hospital experience” option. It’s all about the marketing.


Chapter 10: The Swedish Saving Throw

Filed under: @ 7:37 am

The administration at Swedish Medical Center may have its downfalls (what medical administrative authority does not?) but their medical and patient outreach people are absolutely top notch.

How else can one explain the fact that I left work at a little after 3 p.m. on Thursday afternoon and by the time I got home about 20 minutes later Andrew had spoken with the transplant coordinator of his team and she’d managed to shoehorn him into the schedule for the cardiac catheterization lab for the next day?

I submit that if we’d run across the same glitch -glitch, what a paltry little word for such a major upheaval- with the UW transplant service we’d have had to wait several weeks to a month before the test would have been scheduled.

As it was though…. 24 hours.
It was 24 hours of panic, a lot of frenzied e-mailing, apprehension, chaos and confusion, but 24 hours nonetheless.

We were at the Swedish Cherry Hill campus at 3p.m. the next day. Andrew was scheduled for angiography at 5. The regional head of cardiology, the specialist who’d just happened to be the one on call for that day, came to talk to us about the procedure at about 4. He explained that they were running a bit behind schedule, but they’d absolutely be able to get Andrew done that afternoon. We indicated that we really didn’t care what time the angiography was done so long as it got done that day and Dr. Cardiology assured us that it would be.

Then we heard him on the phone out in the hallway. Wheeling. And. Dealing.

The upshot being that Dr. Cardiology arranged with the scheduler for the cardiac catheterization lab and at least one other specialist that since Andrew wasn’t going to be hospitalized overnight and the *three* patients in front of him on the list for the catheterization lab that day were going to remain hospitalized overnight, Andrew would jump the line and go next.

*BING* And so it was.

I went down to the waiting area, conveniently close to the in-hospital Starbucks, plugged in my iPad and my headphones and spent 90 minutes or so frenziedly playing Candy Crush and sucking on an iced chai latte. In general I am a little jaded about Starbucks. I don’t really drink coffee, there are WAY too many Starbucks EVERYWHERE and my understanding is that their coffee, at least their “coffee bar” coffee, kind of caters to the tastes of the lowest common denominator, but I do love me an iced chai latte.
We all have our weaknesses.

Got a call, went upstairs (weirdly to the geriatric neuro ward) to the room where they’d stashed Andrew for post-anesthetic recovery and monitoring. And we proceeded to sit out the two hour post “you’ve just had a great enormous catheter shoved into your femoral artery and we want to be sure you’re not going to blow a gasket and blow up like the Sta Puft Marshmallow Man” waiting period.
Andrew, having heard my report of a Starbucks in the lobby, insisted on coffee. It was dinnertime anyway so I went downstairs, got a couple of sandwiches, the requested coffee (decaf) and came back in time to catch Dr. Cardiology coming by and telling us that the angiography looked good.

We’d known that Andrew had a blocked coronary artery. The angiography that had been done for the UW workup a year earlier had outlined that, but had also indicated that adequate collateral circulation had developed and that the cardiac muscle supplied by that artery was healthy.
This year? Another indication from the universe that the transplant was meant to be. Dr. Cardiology told us that the collateral circulation around the minorly blocked artery was improved over where it had been last year.
The upshot being that Dr. Cardiology personally was going to call the transplant surgeon with his recommendation that the transplant go forward. Dr. Cardiology noted that he’d also be talking to the transplant coordinator, but he wanted to tell us first so we wouldn’t have to wait to hear the final decision until the transplant coordinator called us. Normally we’d have to wait to hear the news until he’d made his official report and sent it to the transplant team, but he knew that time was running short and he didn’t want us to have to wait and worry any longer.

Seriously. Swedish medical personnel? Absolutely super people!

Things started moving rather quickly at that point.
Dr. Cardiology called and spoke with the transplant surgeon. Dr. Cardiology then called and spoke with the transplant coordinator who was waiting for the “go” sign from the transplant surgeon.
Transplant surgeon called transplant coordinator, transplant coordinator called Andrew.
During all of this we, in an absolute tidal wave of relief, were sending text messages and e-mails to everyone that we’d sent panicked “it’s off” messages in the previous 24 hours.
All with Andrew still lying flat on his back because he was still under orders to stay calm and flat so his femoral artery didn’t blow up.

And as soon as the transplant surgeon and transplant coordinator had the official “GO” from Dr. Cardiology (and as soon as the two hours “you haven’t blown up like the Sta Puft Marshmallow Man” waiting period had passed) Monday the 26th was back on.

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