Gosh’s side of the Tylenol story:
The first procedure scheduled was a subclavical catheter. This is where they stick a tube in my jugular vein and leave it there to do the hemodialysis through until I can get a shunt implanted in my arm and it has 6 weeks to heal.
While the idea of sticking a tube down my jugular was unnerving it wasn’t as bad as it could have been because I had just a similar procedure had done two weeks ago. As part of the screening to get on the kidney transplant list, I was found to be marginal by the first liver biopsy I had had done. A little too much fibrosis, scarring, was found so they ordered a second liver biopsy, this one of the trans jugular variety. In this kind they stick a probe through the jugular down into the liver, take a couple of samples, but also somehow check what the pressure is in there.
I guess this is some measure of how the liver is actually functioning, if there is too much back pressure or something.
I had had a lot of trepidation, not lessened by the fact they strapped me down completely and even taped my head to the table, but it had gone smoothly and only taken a few minutes so I hoped this time would be the same.
You have to hold your breath at certain times so they don’t knock you out plus any sedation always has a risk.
It was a fairly big production with about 5 people in the room. This time they didn’t tie me down or tape my head but I was cool. The most unpleasant part was the numbing with lidocaine which is a big needle they poke in several times but considering the alternative, glad to bear that.
They started working away, I sensed cutting and then a lot of pushing. Turns out they cut two holes, one to put the catheter into and the other to push a wire in and use the wire to push the catheter down. The whole thing was done under a CAT scan so they watch on the screen where it was going.
After what seemed like a sufficient period of time for them to have accomplished something, I asked what part of the process was done and was told about 50%. Good luck. That turned out to be about the 10% mark. There was more pushing and when he pushed it put pressure on the neck, like being half choked. He was giving instructions to a helper who also seemed to be physically involved (my head was covered with a cloth) but he spoke English as a second language and stuttered so I couldn’t really understand what he was saying.
I am sure it was less than 10 minutes, but when someone is poking around in your jugular vein, each moment can seem like 12 years or more. It was long enough that the lidocaine started to wear off and he administered a second round of it, thankfully without having to ask.
Finally he stopped and said to me, “The vein collapsed, we will have to go into the other side.”
Well, the first thing I did was a little math. I only have two jugular veins and if one is collapsed, that only leaves one. If you collapse that one, it may not be too good for the kid.
He assured me that the blood was still flowing, it just was too collapsed to push the catheter through. I found that only mildly reassuring.
So they swapped their operation around to the other side. They had to wait a bit until the glue they used to seal the initial two holes had dried, which did stick my skin together and when I had to turn my head the other way a little discomfort was added to the incision pain that gradually started to manifest as the lidocaine wore off.
The second side went routinely fortunately and while it did take some time , it was more reasonable. Both sides required some sutures in the vein in two places that were incised and some more sutures to hold the catheter in place so that added to the time and then taping up, but the insertion itself was relatively quick.
As the nurses were finishing up and the doctor was de-robbing, he asked me if I wanted any pain medication. As the lidocaine had worn off in the first set of incisions, I was able to evaluate what the pain was actually going to be.
I am an addict. I have been clean and sober for rolling up on 40 years but I am still an addict. I fear getting hooked on prescription pain pills so I avoid them as much as possible.
Being trained to endure some pain has advantages, say like in a soccer game when you take a hit, if you aren’t accustomed to enduring some pain it may make you lose your focus. Imagine if you are in a car accident and get hurt and you can’t handle even a little pain, it could lead to distracted and poor decision making in a time of crisis. So to consciously handle a little pain from time to time and learn how to block it using the power of your own mind has some advantages.
On the other hand I am not a masochist. Because I don’t grab pain pills at the first intimation of pain, I haven’t built up a tolerance to them, so I did a quick determination that Tylenol would be enough to take the edge off the pain I was going to have to experience.
So I declined his offer but said I wouldn’t mind a Tylenol. He repeated his question and asked was I sure I didn’t want some pain pills and I said again, no, but I would like to get a Tylenol. He walked out of the room.
The nurses were doing some cleanup and odds and ends so I waited a minute and then said, “Could I get that Tylenol?”
“No,” she replies, “I can’t give you one because he didn’t order it.”
“It’s an over the counter med, you don’t need a prescription.”
“Still, unless he orders it, I can’t give it to you. You can take one but I can’t give it.”
Well, how stupid is that I think. As I had had an encounter with this same hospital over medication on a previous visit that had ended in me being threatened with arrest, I was loathe to pursue what it might take to get a Tylenol from the staff. I asked one of the nurses who looked like she was getting ready to leave if there was someplace in the hospital that Tylenol could be purchased. She said yes, in the gift shop, so I asked her if she would go out into the waiting room and ask my wife to go get me some.
She walked out and never came back so in my mind a simple elegant solution to the problem had been found. My wife would go buy some Tylenol at the gift shop and return in a few minutes. I was pretty uncomfortable but that would only be for a short time.
They loaded me unto a gurney and transport whisked me away to the next procedure in another department that didn’t require a CAT scan for guidance. I was assured that this would be a quick procedure.
However, because we had gotten delayed in the first, by the time we got to radiology to do the second, the doctor had gotten off on another track. I was told he was just now coming but about 30 minutes elapsed before he did show up.
While waiting, the two nurses felt a little awkward and were chatting to pass the time. One of them asked where I was from and I said Limestone (the area where New Vrindaban is located). She asked, isn’t that where the Palace of Gold is and I said yes. She asked if I ever went out there and I told her that I had helped build it.
While the younger nurse was a tabla rasa, had never heard of the Palace or New Vrindaban and never been there, the older nurse started to reminisce. She had been at the Palace opening as a young girl in 1979. She remembered how wonderful it had all seemed to her and that she had driven by a field of sunflowers on the ridge.
This was a blast from the past for me. I used to be in charge of getting forage for New Vrindaban’s cows. While mostly we made hay and used corn silage, one year I had tried an experiment. While corn is king for the purposes of silage it does need a full season, so what if a field would come open in midsummer, what to plant, like if a crop of winter wheat had been harvested.
I tried a mixture of sunflowers and a sorgum/sudangrass hybrid. Both make tonnage quickly in the heat of summer and it was higher in protein than corn silage, something to feed directly to the cows in summer after the spring flush was gone from the pastures.
It was something I had only played with once and had forgotten completely that I had ever done it, but it was nice to think that a young girl had gotten a positive memory from it associated with Krishna.
As Iwas laying there waiting I was wondering what had happened to Vidya. That Tylenol was looking really appealing. About every 5 minutes I asked the nurse to go check the waiting room to see what happened to her and she would come back and say she wasn’t there. I surmised that somehow she got into the wrong waiting room, there being 4 of them in the hospital, and asked her to go check the others.
She came back after a while and said she wasn’t in the other waiting rooms either. Now this caused me some concern, as it would have been very uncharacteristic of Vidya to just wander away. Something must have happened. What could that have been?
All I could think of was that when the first nurse, who did not report back, told her to go buy some Tylenol she failed to communicate it could be purchased at the gift shop and she had left the hospital to go buy some at a grocery store, had an accident and wasn’t able to get back. What other possible explanation could there be? Naturally, this caused me some anxiety.
Eventually the doctor showed up, popped the needle into my gut and they hooked up vacuum containers that sucked out the ascites fluid, 4.5 liters worth to be exact. Which took a little time to drain.
That finished, they loaded me into a wheel chair and took me out to the waiting room. Again, no sign of Vidya and again I asked the nurse to go check the other waiting rooms and she again came back with a negative report.
This created a dilemma. If Vidya is unconscious in some Emergency Room, at what point do I start calling neighbors to come get me?
15 minutes go by and after checking again, the nurse suggested we try to page her. A sense of relief because surely if she is in the hospital she would hear the page and finally arrive with the now high desired Tylenol.
5 minutes went by and again nothing so she hadn’t heard the page. The nurse had been coming back to check on me from time to time so I turned to her and asked her if she would go buy me some Tylenol. She looked troubled but I assured her it it would be okay because she wouldn’t be giving it to me, she would only be buying it. She said she would have to ask if she could do that and she walked off, never to be seen again.
I had now been sitting in the waiting groom for 30 minutes. I reviewed my sitrep. A.) Vidya has vanished and I don’t have a ride home. That is a complex problem. B. ) I am in pain and need a Tylenol. That seems more solvable so I turned my mind to that.
I started talking to the man sitting next to me and explained the situation. He seemed open so I asked him if he would go buy me some Tylenol. He deferred , saying his wife was coming out momentarily.
I stood up and addressed the whole room. I asked if anyone was waiting for a patient and 3 or 4 raised their hands. I asked if one of them would go buy me a Tylenol and you have never seen gazes averted so quickly.
Bear in hand that prior to getting drained I had little breathing capacity and walking from the couch to the bathroom was enough to get me as winded as if I had just chased down an attacker on the soccer field for 30 meters. Plus I hadn’t been able to eat for 5 days and was recovering from pneumonia. So I felt righteously situated sitting in a wheelchair.
But I also didn’t like feeling powerless and at the whim of others, so I decided I would try to go buy the Tylenol myself. I got up and started walking, unsure of what I was capable of doing or if I could even avoid collapsing in the middle of some hallway. The first thing I noticed was I wasn’t immediately out of breath and that I could actually breath a bit.
I ended up taking a wrong turn but eventually made it to the gift shop, probably covering a couple of hundred meters in the process. Which, as a side note, was a little enlivening that I was able to do that. At that point, however, the whole adventure turned into one of those you can’t make this stuff up, nobody would believe it because it is too far fetched type deals.
The gift shop was closed for inventory.
All my tension dissipated and I had to laugh. I thought of the Krishna pastime where no matter how many ropes Mother Yasoda tied together to bind Krishna, it was always two inches too short.
I felt the hand of God, and He was amusing Himself at my expense and I felt blessed to sense Him. Which didn’t make the pain go away but I knew things were going to be okay.
I went to the volunteers at the information desk and plead my case, asking them to go knock on the gift shop door and beg them to sell me some Tylenol. One did go and after listening to whomever was in there she walked off down a corridor.
She came back and said we could go to the in hospital pharmacy. She led me there and they did intend sell me some Tylenol.
I was leaning over the water fountain taking some Tylenol when here comes Vidya walking down the hallway.
Vidya’s side of the Tylenol story:
After they took me to the subclavical catheter procedure, they directed her to the surgical waiting room which is in the main lobby of the hospital While she was expecting that was going to be a bit of wait, when it started going past the time the second procedure was scheduled to start she was wondering.
Eventually the surgeon came out and told her what had happened. She asked if she should go somewhere else but was told to stay where she was and assured that the next procedure wouldn’t take nearly as long. So she waited in what she was sure was the correct place.
Turned out the first nurse I had dispatched to tell her to buy the Tylenol had never found her but didn’t bother to come back and inform me she hadn’t.
So she waited. And waited. Time stretched out so every ten minutes she would go up to the desk and ask if there was any news. Nothing. Twice she went to the bathroom and once to the cafeteria but each time advised the volunteer at the desk she was leaving.
She could hear that the speaker system would say things from time to time but the sound quality was so poor she couldn’t make out what they were saying so she never heard the page.
Eventually she grew too frustrated to just sit and decided to go track down what was happening, and ran into me in the hallway. Who knows why the nurse never found her, maybe she never did go to the main waiting room, as normally the nurse would have expected her to be in the radiology department and maybe only checked the pre-op waiting room.
So that is the Tylenol Story.
Thursday had already been an adventure and it wasn’t over yet.