Category: The Initial Trauma

Today is a day of outings. Not the kind of outings splashed on tabloid headlines and secretly read by concerned conservatives. No, these outings are the kind that mark Aaron’s road toward independence, for us as significant as the national holiday coming next week.

The first outing comes with dawn: the gallbladder surgery drain tube. Drainage has slowed to a trickle, so Dr. Snickle says to Aaron “This may be a little uncomfortable” (which is another CODE, a special Doctor Code, for “You are going shriek in agony with excruciating pain”). A deft snip with the scissors, a quick tug by the doctor, and a sucking yelp from Aaron; the drain tube is out.

The TPN (food straight to the vein) having been discontinued, there is no further need for the PICC line (until the next round of poison). Dr. Lee repeats the special Doctor Code, works away at dissolving the adhesives around the line entry just above below the bicep on Aaron’s left arm, then pulls out the foot long line that penetrated all the way to the superior vena cava just about the heart. Aaron’s arm is pins and needles the whole way out. But the line is gone, and with it the last remnant of the tingling numbness. So Dr. Winston was right; it was the line after all. Nerves like the nourishment they get by staying close to blood vessels, so little unnatural goings-on inside vessels do not always escape notice by the masses of vigilant neurons.

The final outing of the day is the most momentous. One of the remarkable similarities between hotel rooms and hospital rooms is the location of the bathroom: it is almost always next to the room’s door to the outside world. This is not a conspiracy to confuse hospitals and hotels: hotels, no matter how exclusive, could never with a straight face charge $50.00 for disposable bedpans; for this reason alone (and there are many others) it is obvious that a conspiracy to confuse hotels with hospitals would never get far. The real reason is because hospital builders and hotel builders belong to the same union, and this union, unlike most unions, encourages humor. And like it or not, it must be admitted that just the thought of confused occupants stumbling into corridors at 3 a.m. looking for bathrooms is very funny.

Aaron’s hospital room layout conforms to the standard. It’s a good 12 steps from the bed to the bathroom. With dad pushing the IV stand behind, Aaron makes today’s final and best outing. He does not confuse the hall door with the bathroom door, he makes the proper left turn through the bathroom door.

Such a fuss over Aaron sitting on the toilet has not been made in 28 years.

There are yet more outings today.

The bag-o-urine, always hanging from some strut or another near the foot of the bed, meticulously measured, observed, emptied and tested for 6 weeks, is emptied one last time and the Foley catheter, the bag’s connection to the wellspring of Aaron’s bladder, is taken out. Over the last 6 weeks, when Aaron was in the twilight between awake and not, he was often concerned that his urge would make for an embarrassing situation. We had to remind him more than once that he did not need excuse himself, wait till we left, or get up to go. Hopefully those subliminal reminders will be quickly forgotten.

The trachea tube, having been replaced twice by successively smaller diameter tubes, is now completely taken out. The tracheostomy hole, created by a small vertical slit pried open and held open by the tube, begins to close by itself. It will slowly close over the next few days. Would that all plumbing were so conveniently self-repairable.

While the blood drive is underway in Ojai (our deepest thanks and gratitude to all), Aaron consumes (via the last remaining IV line) another couple units of packed red cells. His hemoglobin, always low, has been dropping steadily for the last few days so he needs a pick-me-up.

As the blood is finishing, Gabi arrives from Ojai with a stack of DVD’s and a marvelous Philips 7” DVD portable player from New Leads. Wow! Thanks! The player (which also receives and supplies composite video), together with a set of portable Logitech speakers, enables re-rigging the ancient hospital TV for better sound. (Another difference between hotels and hospitals is found in their respective TV’s. Hospital TV’s were excavated from the early Paleolithic, while hotel TV’s tend to be of more recent historical origin. It’s not enough that the hospital TV is ancient: it’s sound is further degraded by it having been hijacked from the TV’s bad speakers and re-routed to play though the nurse call button. When was the last time the sound quality of a nurse call button was reviewed by an audiophile magazine?)

We are grateful beyond measure that we are complaining of such things.

Sunday is a day of visitations: Aunts Janet & Gloria, Grandmas Boydston & Burke, Friends Dirk, Nathan, and Lisa. Together with the regular the regular crew, it’s quite a crowd even though not everyone comes simultaneously. Aaron’s room gets so crowded that Michelle (Aaron’s nurse who’s concerned reactions inspires us to tease her without mercy) feels compelled to scold us for being so many and thus possibly compromising Aaron’s path to recovery.

The visitations do not explicitly focus on Aaron: he is, of course, the reason everyone comes to room 1041, but after each visitor ogles at Aaron’s changes since last he was seen through the eyes of the visitor, the conversation becomes like that at any gathering of close family and friends where casual banter belies intertwining roots below the surface. Like the intertwining roots in a stand of old-growth redwoods, the roots of a community give its members identity and strength that a tree alone cannot attain. Like the trees in the stand, the growth of the individual is bound tightly to the growth of the community. The stand, its singular identity born of entwined plurality, reflects the Creator.

In spite of yesterday’s new stitches, the incision from surgery starts to ooze again as diluted blood soaks fresh dressings. White cells, whose responsibility it is to help heal wounds, grow and multiply fast; white cells usurped by the enemy even more so. Fast growth is the criteria used by the poison to select which cells it prefers to kill. White cells that are hijacked by the enemy do not attend to their responsibilities. Nor do white cells that are poisoned. So the white cells are compromised from both sides; by the enemy from within and by the poisons from without. Healing, then, is a slow process.

It was decided a couple days ago that, all things considered, a blood thinner to help dissolve and prevent clots would be beneficial. So Aaron pops pills of Coumadin (nice medical name for the common rat poison Warfarin. Take too much and you die.). As one might expect, rat-poison doesn’t help heal an oozing wound.

The doctors indicate that the next round of poisons against the enemy will begin within 2 weeks.

Independence Day comes a day early!

Aaron has progressed to the point where he does not need to occupy a hospital bed.

He is evicted from room 1041 to take up residence in room 214 of the Tiverton House across the street from the Medical Center. The Tiverton House is something of a hotel for patient families and a half-way house for a patients whose status is “out”, but who are not quite ready to travel to distant homes. Room 214 has been crash pad for Natalie, pit stop for visitors, and home-away-from-home to Michaela, Christopher, and Grandma Metz for a good bit of the last 7 weeks.

The oozing from the surgery incision has stopped. Aaron feels inexplicably cold, but seems otherwise fine. He is starting to find his way around a keyboard again (yesterday he transferred his contact list from his old Treo (whose keyboard ceased working for Natalie while Aaron was hallucinating along through his parallel universe in the ICU) to its new replacement.

For 7 weeks, dramatic and sometimes life threatening change has been a daily, and often hourly, hallmark. The pace of change for now is slowing. For the next couple weeks, as Aaron gains strength for the coming battle, we will attempt to catch up on some of the exigencies of life that have been left undone. For the next couple weeks, updates to this journal are likely be more weekly than daily.

since i showed aaron a photo of himself for the first time a week and half ago, i’ve been taking pictures every visit. i set up a section of my flickr account for him so you can visually see his progress. visit it by clicking here.

these are all taken from my phone, so i’ll have to start bringing my nicer camera when i visit. it’s still pretty interesting to see the differences between his photos taken 6/23, 6/29, and 7/2. his face is starting to thin out quite a bit, i assume because of bloating going down. anyways, enjoy!

– nathan stryker

Continue to Chapter 2: “Regular” Chemotherapy