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Don’t Poke The Tumor

(Oh my gosh! Two posts in one day!)

Stacey writes:

My husband took me to the emergency room two months ago today, at about 4:30 am. I was having nasty abdominal pain and couldn’t walk well on my own because of it. No nausea or fever, just pain, and lots of it.
The admissions nurse asked me on a scale of 1 to 10, how badly did it hurt? I remember giving her a funny look, because honestly I had no idea how to answer that. But I gave it a shot, and said maybe 6 or 7.

Fast-forward 14 hours later. [Ed: !!!!!]I’m still in ER, and my second doctor comes in. Neither I nor my husband have gotten any sleep in well over 24 hours now. The doctor sits down and introduces himself, says he and my first doctor have been looking over the CT and MRI scans for the last 20 minutes. So, I ask, what’s going on?

Well, I had a liver riddled with tumors. That’s what was going on.

I’m 25 years old. I just got married 8 months ago. All my brilliant mind could think to come up with was, “What?”
Immediately after this, I was admitted into the hospital proper and given my very own room and some much-needed food. My husband settled in the chair by the bed. I sent him home- he needed real sleep too, not a nap in an uncomfortable chair. Myself, I passed out after eating. Tumors be damned, I was tired.

I was awakened at 4:00 am with a request for blood. Ah, the hospital- the only place where they demand body fluids before God himself is awake…
Around 11:00 am we got the news- BENIGN!
I was transferred to a huge teaching hospital that afternoon. The largest tumor was located in a place the doctors here dared not go. I was sent to one of the United States’ leading liver transplant surgeons. If he couldn’t do it, no one could, it seemed.

They had to transfer me by ambulance, I guess it was hospital policy. The EMT’s showed up around 3:45, gurney and all. I told them I could walk. One said I’d be more comfortable on the gurney. Funny, he was right, hehe.
As they strapped me in, one asked why I was in the hospital. Hey, I’m young, in damned good shape, and I looked perfectly healthy aside from the hospital gown, so I didn’t mind his curiosity.

“Liver tumors.”

I didn’t mean to be blunt or anything, but the look on his face really was priceless. I immediately said hey, they’re benign, s’ok buddy, but the damage was done…
I should have read deeper into his expression, it would have told me what was coming.

I got to the big hospital 4 hours later, give or take. You know, when you’re in pain, the worst way to travel is ambulance, I swear. All that bouncing and jouncing did me no good. I really feel for people in those things more than ever after that ride.
So, we got there, I checked in, I got my room, and my first doctor came in. He wanted to poke at my belly. I wondered loudly if that was such a good idea, considering the TUMOR and all. He tried again, and I pushed his hands away. I said it wasn’t necessary to poke at the tumor. Thankfully, I think he saw my reasoning.

From that experience, my husband (who showed up shortly after I got there) and I created the Room Rules.

Rule 1: Don’t poke the tumor.
Rule 2: See Rule 1.
Rule 3: Donations gladly accepted.

I would have paid good money to see these printed on a vinyl banner hung from the ceiling. As it was, we made do writing them on a small dry-erase board on the wall.
Anyhow, by this point it was getting late, and my husband had to leave for the night. He headed to his hotel, and I laid down, turned on the TV, and cried. Yeah, I sound all brave in this story, but I would immediately revert to a bawling baby when I was all alone.
The next day was a bit of a blur. Tests, paperwork, family phone calls, visitors, tests, tests, tests. I was tired. I hadn’t had a good night’s sleep in a few days, and was living off hospital food. I was cranky and wished this all over with so I could go home.

I kind of wish I didn’t make that wish, but whatever. Too late now.
The day after was uneventful until 7 pm. That was when I was notified that my surgery was scheduled a scant 12 hours from then. More paperwork to sign, a living will to fill out, complications to learn about, and my first-ever experience with a panic attack. The lead surgeon asked me to quit smoking. I told him that after all he’s had to tell me, whoever takes my nicotine away is getting a boot in the jaw. I can quit when my life isn’t immediately threatened, thanks. (Yes, I know how bad smoking is for me- that’s not a newsflash. I am in the process of slowly quitting right now. I will be a non-smoker by September.)
After I had calmed down (and had a cigarette) it was nearly 11 pm. My husband, and my brother who had just made it there, went to their hotels. I flipped on the tube and cried again. I was exhausted and didn’t want to sleep. Sleep only makes the inevitable come faster. I would get plenty of sleep later anyway, I reckoned.

I called the hospital chaplain at about 2 am. I was lonely and very scared, and had no one to talk to or sit with me. Maybe it was a bad thing to do, but she didn’t seem to mind. I’m not religious at all actually, but she was fine with that too. She sat and chatted with me until I drifted off to sleep about an hour later.
At 6:30 am they came to get me. My brother made it there to see me off, and for that I am forever grateful. As we hugged I began to cry a little. Then I was whisked out into the cold hallway and down to the elevators, naked except for the thin hospital gown. I caught a glimpse of a beautiful sunrise through the windows in the hall, and I remember thinking to myself, what if this is the last one I see?

I’m assuming the room they took me to then was pre-op. This was the most terrifying 5 minutes of my life. Cold, nearly naked, and hungry, I listened as the anesthesiologist told me what he was doing. This is going to make you a little tired, this is your epidural here, now I’m going to have you roll over, good, good, now count to 5.

1… 2… …………………………..

I woke up in the ICU in such excruciating pain I couldn’t even think. I knew I was in the hospital for something. There was something in my mouth and throat and something making my neck itch like crazy. The room was very dark and long like a dim hallway. Someone was holding my hand, but I couldn’t see who it was. Someone else ran out of the room. I passed out.
I woke up again and stayed awake a little longer. I found a button and pushed it, I didn’t know what it was for but my hands were kind of going on autopilot. My legs were moving a lot and I couldn’t stop them. My neck itched. Someone came in and told me not to scratch my neck, I could really hurt myself. I tried to stop but it itched so badly. Everything hurt, everything from my neck to my knees was screaming, but I was obsessed with the itchiness. At some point I passed out again.

I remember being extubated, but I don’t know when that happened. I didn’t hurt like I thought it would, but then again, I was full of morphine. I remember when they pulled out the tube in my neck, and that hurt like hell. The rest of my memories of ICU are like little flashes of light through a thick fog- my husband leaning over me, my brother asking me how I’m feeling, groaning a lot, wanting to ask what’s going on but can’t because I can’t remember how to talk.
Not being able to talk was really hard. For about 24 hours I was in so much pain and so full of drugs, I couldn’t give my name or tell them where I was. I knew where I was, I knew my name, I just couldn’t say it. You know what it’s like to have something right on the tip of your tongue? It’s like that, only a hundred times more frustrating.

To me, it seems like I was in ICU for about a week. My husband insists it was only a day. Well, time flies when you’re having fun, and crawls when you’re not.
I can’t describe the pain correctly no matter how I try. I was like someone reached inside my belly with an egg-beater and just went nuts with it. Everything stung, throbbed, and burned, all at once. No amount of drugs made it better, nothing made it ease off in the least. Sedation was a blessing.
And that 1-10 pain scale? Nothing rates above a 5 compared to this pain. Natural childbirth might hit 6, maybe. That pain scale is worthless.
When I was moved to my own room, my mother had just arrived from New York. She brought me a little pink stuffed elephant, which has stayed with me to this day, two months later. I named him “Courage.”

Courage the Fluffy Pink Elephant held my PCA pump button for me. I was so out of it I would easily lose the button in the bedclothes or onto the floor, so my mom helped me clip it to the the elephant so I’d never lose it. Courage held my liquid courage supply, haha!
The rest of my hospital stay is very jumbled in my mind. Time doesn’t work like normal when you’re in a lot of pain and on a lot of narcotics. I remember hanging out outside the hospital’s front doors with other smokers, listening to surgery stories and our PCA pumps beeping. I remember fighting to stand up on my own the first time, so frustrated that my body was so weak. I remember one doctor telling me not to smoke, when he reeked of it himself. I had nightmares a lot.

There are two things I remember most though. One, is that no matter how badly off you are, there’s always someone worse. Being in a hospital reminds you constantly of that fact. I simply could not have self-pity after meeting some of the patients there.
The other is that nurses are goddesses. They come when you call them because they know you need them, and they explain what exactly all those pills are for. They listen when you need someone, and they comfort you when you cry. They scare big bugs out of the room so you can sleep. They do a million things you never see, but they still have time for you.
I was discharged 9 days after the operation, and I was so scared I wouldn’t be able to take care of myself. I had a fistful of scripts to take to the pharmacy, but I could barely walk.

The first few weeks at home were really hard. I couldn’t lay down flat, and didn’t own an adjustable bed or a recliner. I slept sitting up on the futon with a bunch of pillows around me to keep me from falling over. I had a pillow across my belly at all times, in case one of my cats jumped on me. I couldn’t eat more than a cup of food at a time, and couldn’t sleep more than 2 hours without having to take a pain pill. It was hell.
Now, it’s been 2 months. The staples are out, the scar is fading into the pink range, and I only hobble a bit now. I’m still pretty sore and stiff, but I can lay down an sleep on the bed. I can even roll over on my own.

I look forward to working again. I’m almost ready to get out on my own again, and I can’t wait! I’ve lost so much time… I want to catch up, you know?

Next year I start nursing school. Wish me luck, OK?

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Good luck! And I hope you continue to recover. Thanks for sharing your story. Hopefully, your experience will contribute to making you a wonderful nurse. You’ll have an appreciation both for what nurses are expected to do and how nurses can improve a patient’s experience.
(By the way, I hate the pain scale. I personally think it’s worthless. At my hospital, we are required to ask this question on arrival and every so often. I just love when patients who are smiling and cracking their gum look at me and tell me their pain is a 9 or 10. I am then obligated to record their answer, knowing full well they have no concept of how ridiculous it is for them to say that.)

what a tale! you will make one heck of a good nurse. compassion, yep.
I also hate that pain scale. JCAHCO imposed it on us. If someone walks into my office there is no way that I am going to believe that their pain is a 10.

Now wait just one second! I was always told that 1 is barely any pain at all, and 10 is the worst pain that YOU have ever felt in your life. That means that everyone has experienced one or more 10′s in his life, doesn’t it?

I mean, my 10 might be a new mother’s 3, but like, how am I gonna know that?

I think the pain scale is pretty much useless.. I had cancer in 95 went through 3 surgeries and the recovery from one of them was the worst pain I could ever have imagined. so, now when someone asks me what my pain is I can’t imagine it ever being a 10, so of course that is what I compare my pain to, and even though it may be very bad pain I will say something like a 3-4.

Thanks for your well-wishes! I am doing fine, started my prerequisite courses for the nursing program and am doing well.
I hope my story helped the nurses and medical pro’s who read this great blog to better understand what patients go through and feel. That was the point of sending it in. ;)

My best to you all, and to Geena, who needs to post more. *wink wink nudge nudge*

My round about way for assessing pain is to have them describe it, when they say achy and annoying I say, “so like a 2 or 3″ when it is “pretty bad, throbbing, makes it difficult to get out of bed” I will offer “so like a 5 or 6″ And when I had the girl who was screaming and crying the other night from killer afterpains (she had just had a baby and also had endometriosis) I didn’t even ask but charted it as 9/10. There is something cruel about asking a person in that much pain to try to rate it so I can fill in the appropriate box on my pain assessment charting. I might be a bad nurse for doing that, but I feel like a decent human so oh well!
PS I fixed the woman with the killer afterpains with two percocet and a warm pack to the abdomen.

Two percocet and a warm pack would fix a lot of people, I reckon. ;-)

What a great piece! I’m proud of you! I hope you are back on your feet again. You will make a terrific nurse! I’ve never been a patient (thank God) but I’ve been in the position of a newlywed where my spouse was ill. I think that experience in dealing with his cancer made me want to be nurse.

I totally understand the frustration with the pain scale and not wanting to be poked. I had my gallbladder out last March and would get extremely frustrated during my trips to the ER. Luckily I had a friend there to point out that I am extremely stoic so I was probably in more pain than I would admit. I think I was poked by 3-4 nurses and doctors one day and was ready to say yes, I hurt becuase you’ve been poking me all day.

As you become a nurse, it would be interesting if you could chart how you change as you become immersed in that culture. Nurses become people who do not report that which most needs to be reported. Loyalty to colleagues replaces loyalty to patients. But they rarely are aware of it. More about that is at http://www.patient-safety.com It would be interesting to see a nursing student keep notes on thoughts on certain issues in school and then on the job to chart the changes.

So, what brought you to the hospital today?

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  • profileI am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!

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