Hello Endone My Old Friend

So after never having had surgery in my 48 years I was heading in for my second session in three weeks.  This one was for the PEG insertion.  I still had the option to pull out of the procedure without copping WTF looks from the health professionals.  They'd squeezed me into a window that appeared and knew I (we) hadn't had long to weigh up our options. But as we sat in the right turning lane, the Darlington civil works going on - at a not too frantic pace - around us, I felt fully committed to our decision to go ahead.  Having the PEG in place felt like a secret weapon up our sleeve.  One of the main down sides was that patients with a PEG were more likely to suffer neck muscle and swallowing problems because they had not maintained their eating.  I am determined to push through the throat that has been blitzed and the nausea, to eat and drink through as much pain as I can.  The PEG is there for topping up hydration and nutrition, if I just can't keep on top of the weight loss.

No hotel-motel lobby for me this time, this one was being done publicly.  We made out way up to the Endoscopy ward and checked in - Name, Rank and Serial Number (NRSN) for the first time that day.  I got my dog tags (plastic wrist band) and sat back down amongst my unwell peers, trying to block out Kochie and the gang as they regurgitated their monotonous formula of east-coast, saccharine, multicolour marketing - way too much to take in the morning! Was only there for about an hour before I made it to the 'NEXT LEVEL'.

I was ushered into the green room.  NRSN requested by a really friendly and nerve-settling nurse, and I offered my arm, a finger and opened up an earhole ready for some obs.  Still 'young and fit'!  Turns out we had a mutual friend, typical Adelaide (Hi Julie W, if your watching, she used to nurse with you).

I got the curtain call. I was off, a cheery PSA dodging and weaving my barouche to theatre like a master.  I got to theatre and was wished well by PSA Schumacher.

Everyone in theatre was very friendly and engaging and reassured me what a simple procedure it was.  The surgeon did explain that I would not be under full sedation and mentioned that I might feel some pulling and pushing. Ummmm....no.  No. Not really part of the plan.  I tried my best to convince the anaesthetist to load me up just a bit more...she smiled at me annnnnnnddd I weeeennnn....

So I woke up in Recovery Ward 5D.  I had a room with a view.  I could seriously see the western horizon.  I was only sharing the 4 bed ward with one other guy - that would change.  My nurse seemed nice.  I could buzz for help without causing a CODE BLUE Resus Team to invade my room - unlike my FPH stay.  I wasn't too uncomfortable, 4's and 5's. But at one point it got a bit worse, and I was offered Endoooooonnnne!  'Hello Endone My Old Friend'.  I knew the digestive complications of long term use, but I could tell this was not going to be days of pain, so I enjoyed my single use pharmaceutical with no worries.

OK. That sentence is slightly concerning, as it makes me feel like I would be an Endone addict if I had the opportunity.  Well No.  I know I have more control than that.  When I realised, in 1994, that I was loosing the hours of 11pm to 4am to playing 'Age of Empires' on my new $2,400 desktop, which I had loaned the money from my Nana for, so I could pass my teaching degree.  I pretty quickly, like within a week, realised that I had a pre-disposition for gaming addiction.  So I took all games off my computer except, golf and pinball.  I could not play them for more than an hour.  Same with Endone.  If the idea of being addicted is not enough, thankfully the drug companies put the side effect of constipation in there, just to make sure.

Anyway I woke from my peaceful sleep, to a new room mate directly opposite me.  Poor bugger had some vital organs playing up.  I had judged him to be about 60ish from his voice and general nature, I hadn't really seen him as his privacy curtain was drawn - as it should always be unless requested otherwise, nurses of the world.  After a few NRSN calls from him I confirmed he was about 6 months older than me - whoah.

I'm calling him Bert, just to make him seem older.  Bert was set up with a PCA, I heard them say.  Hmmm...what was a PCA.  I was pretty happy, I got it - I googled it later.  I'll title the next blog with the answer - don't google it.  So they kept telling him to press the button, for more fentanyl.  They constantly asked him his pain score.

Pain Score.  I love the pain score.  What is your pain score between 0-10, if zero is no pain, and ten is the WORST PAIN IMAGINABLE.  I have had to say it many times, when I worked for SAAS, so I have maybe put more thought into it than non-Health folk.  But taken with actual signs and observations I think it can be really useful.  Not so for Bert.

Pain score requested "ummm.....orrr..I reckon 9 or 10".  NINE or TEN! WTF.  Ten is the worst pain imaginable.  I'm thinking bamboo shoots up toe nails, I'm thinking Daniel Craig  in Casino Royale and the chair with no seat (which I now see is called a 'Dutch Scratching').  So that's a TEN, let's work down from there.  Spending 6-7 seconds calmly considering your score with a few 'umms' and 'arrhhs' chucked in, rules out a nine or a ten I think.  The nurse pondered for about three seconds and said "OK, we'll get you some Panadol".

Bert may have been a private patient in a public hospital or he'd forked out for the TV access.  No worries, I suppose they come with headphones in case all four of us were watching.  Or the little speaker in you bed controller right next to your ear.  Nope.  I seriously spent fourteen hours listening to channel nine.  The magazine shows, the renovation shows, daytime, prime viewing, the ads.  Ahhh.  The curtain couldn't stop the compressions and rarefactions of this pollution reaching my ears.  I realised it was beyond my control and had the wisdom and mental power to let it wash over me.  Until about 2am.  I was woken by Berts snoring, blaring over the top of a home shopping informercial.    About twenty minutes later I had my obs done.  So I mentioned to the nurse that maybe it could be just snoring or just TV.  I asked if she could mute it while Bert was asleep.  She smiled sympathetically, possibly also going a bit mental at the constant rubbish coming out of that corner. Ahh..she get's it.  No she didn't.  Sticks her head into his area, loudly asks 'are you alright mate?' he waked up and reassures her he is, she gives me a look like 'hmm..he was obviously still watching it..can't touch it now'.  WTF.  What about a curfew at a certain point on the f'n RECOVERY ward!.

I drifted off to sleep, but was woken as the dawn was..actually still a fair way off, to a familiar sound.  The sound resonated inside me and instead of the nauseating feeling I had been getting, I had a sense of being at home as a nine year old.  I was comfy and maybe had a bowl of soup and some toast.  Ohhh, I was loving the TV now, what was it?  Ahhh...the 'Skippy' soundtrack. It was the beginning too.  I listened to the episode drifting in and out of sleep, seeing the sights and sounds of National Parks in the 70's - I guess a bit of a connection with my own grandfather, who was a Park Ranger at Belair for many years.  He didn't fly choppers, but they had their fair share of dramas and there were still the clean cut bitumen roads winding through raw scrub and sandstone walls defining the built up areas.  My dad had grown up in the Long Gully Kiosk, so I guess he'd had a something of a 'Sonny' upbringing. I didn't hear Clancy's voice in that episode, but it didn't matter, Bert was forgiven.  The hours of noise were forgotten in that 30 minute episode.
I guess the Endone hadn't worn off fully.

The morning came and the TV stayed on.  The morning obs and doctors rounds, and I was ready for home.  As packed up I noticed something missing? The noise.

I snuck a peek, and there was Bert.  Mid-morning he'd had enough of the television.  He'd turned it off and was fast asleep.
SSTM (Small Snigger To Myself).

Whoah! Some precarious jug placement.  I can see some 'Champagne Comedy' being set up here.