Annie at the hospital, 8/06/07

Leroy and I arrived at Kaiser's San Francisco Hospital (on Geary) at about 1:30. I decided to bring along one of Annie's ukeleles, hoping she'd be up to playing.

The view from the hospital is pretty spectacular, when it isn't foggy or overcast, which isn't all that often.

Sure enough, her eyes lit up when she saw her ukelele. She grabbed it and commenced playing it. She was happy.

Somebody called with good wishes.



She was a regular Chatty Kathy today. It was amazing. It was a mighty wind.


I think she wanted you all to see her "booboos," but I can't show you the real ones, so I'm showin' her left arm, which looks like crap, owing to IVs and such. But her right arm looks pretty great. This stuff heals pretty quickly.

(I managed to see her incision when her surgeons visited, and it looks pretty good to me, but waddoo I know. They thought it looked great.)

This bit of tacit communication was entirely for my benefit. Annie went from being Ms. Grumpy to being Ms. Cheerful in the course of about a day (maybe a day and a half ago). She's been joking with the doctors and nurses. She's mighty cheerful.

Her room, 6321, is at the end of the hall, right up against the stairs. This was the view today just outside that window, at the end of the hallway.

The east end of the hospital, at about 6:00 p.m.

All is well!

UPDATERY: ANNIE IN THE HOSPITAL, 8/8/07

Leroy and I visited Annie today from about 2 until 6 p.m. It's a long haul, but somebody's gotta do it. This is how we found her:

She was all tuckered out from having showered earlier and from having some gizmos pulled from her body, a painful experience. If Annie has a painful experience, everybody hears about it, and they hear about it good.

But, in fact, she was in great spirits, and she seems to have made friends with all the hospital staff, from the Renal Twins (kidney doctors) all the way down to the candystripers--except for a couple of "hospitality workers" (i.e., janitors) that she squealed on for having spoken Vietnamese nastily and for having slopped water onto her from a mop.

I think she carped about that three or four times just when I was there. It turned into this big story with several chapters.

"I guarantee you," she pontificated, "you get one drop of water from one of those mops into your mouth, and you're dead!" she said. "I'm serious!" she shouted.

I smiled at her. I could see Leroy, in the background, smiling too.

She hates it when we do that. --Yes, yes, we mustn't be hard on the poor woman, she's been through a lot. But, my God, she's full of shit.

Above, you can see the view from her window. It's not too bad. The other shot is the view from the window at the end of the hall, just outside her door.

I often go there to get away from her incessant prattling.

I think she wanted you to appreciate her POV. So here are two shots from her bed. Note the cry for help on the whiteboard. (Click on the image to make it larger.)

The woman is obsessed with herself these days. She's quite insufferable.

I took a shot or two from above her. She seemed to like that. She smiled.

And that's when she got the idea of this next shot, which she insisted upon:

"That's inappropriate," we said. But it mattered not. She cackled hideously. Nurses came running.

She's got some blisters on her legs, about the size of a marble, a pretty small marble. Nothin' to sneeze at.

But when she's on the phone talkin' to one of her friends, that marble becomes an "egg."

The woman is shameless.

She kept telling everybody about her "kidney failure" and how she had a couple of dicey moments but came through, owing to her mindboggling bravery and resourcefulness.

That's our Annie.

Later, when we were about to leave, I nurse came in. I reminded Annie to remind the nurse to empty her pee bag, which was nearly full. "Wow, that's a lot," said the nice nurse.

"Yeah, she produces urine on one end, and Bullshit on the other," said I.

The nurse ignored my little joke.

We skulked outa there.

Once again, all is well, although I do believe that the woman would have us sit there like morons all day long, listening to her bullshit, auditing her phone conversations, watching her bowel movements.

But after four hours or so, I just say, "I go now" and leave. That seems to work OK.

P.S.:

Here's a shot I took of Annie on Tuesday--the day after her 8-hour surgery (yes, the doctor told me that it lasted that long). As I recall, she wasn't in the mood to smile, but she did manage one for the camera. I have no doubt that she was utterly miserable for a few days. She really did have to meet a challenge, and she met it very well. We should be proud of her. I didn't want to emphasize all the pain she was feeling, but I also knew that she was on top of it. She really was feeling terribly. I think we did a good job getting her focused on being patient for improvement, just around the corner. It took some doing.

I should explain, too, that Annie has been given loads of water (and blood), and that has bloated her like a watermellon.

She claims--and I believe her--that she's got many pounds of extra weight from all that water. (Naturally, it will all be eliminated in time.)

She says it's 60 pounds of extra weight. Could be, I guess. She had to do some figurin' to get that figure, so it's possibly, um, high. But she's definitely bloated from water. They gave it to her (via IV) to promote the creation of blood--part of the scramblage that occurred Monday night and Tuesday morning (last week) to raise her blood pressure when it tanked. (Blood loss during surgery caused that.)

Today, I saw that her BP was perfect. Better than mine. And she's in no significant pain. She's quite happy, and rightly proud of herself for getting through some very difficult days.

-R

From the window at the end of the hallway, 8/9/07

UPDATE: AUGUST 13


Leroy and I visited Annie today from about 2:00 until about 7:00.


She was in good spirits. The chief renal doctor was very positive about Annie's prospects, and that was good news.

We went for a walk (around the 6th floor), and that went well. I took a shot of Annie against the backdrop of the City (looking north). I said, "What don't you make yourself useful," and handed her my camera. So she took a couple of shots, too.


As per usual, we had fun.

We watched "The Closer" on TV, and then it was time for us to leave.


All is well. We hope that the kidney experts will allow Annie to go home soon.




UPDATE: August 15

Photos: following a Cadillac in the fog on Skyline late last night:


I spoke with Annie over the phone this morning, and so here's the latest:

* The holdup in releasing Annie isn't the cautiousness of her renal (kidney) team (as was supposed), but, apparently, the cautiousness of her surgical team (Littel/Savage).

* Annie's white blood cell count is "down," and that's very good. She's making good progress, kidneywise. So, according to the head kidney person (she's very good, it seems), as far as she's concerned, Annie can be sent home.

(Yesterday, I asked her exactly what the hold up is. We made clear to her that she needs to make sure that the surgical team isn't confused about her view re Annie's readiness for release.)

* Annie's incision has some minor problems (at one extreme of the incision), and that has the surgeons (primarily, Dr. Littel) concerned, but the problems are not serious, though they incline the surgeons to want to keep Annie around. We're hoping that Littel will judge that things are good enough today to send Annie home soon. One complication might be that she's being given a course of drugs, and it may be necessary for Annie to remain a few more days to complete that (unless there is an alternative to the IV).


In general, ANNIE is doing very well--she's been very brave, very patient--but I do believe that her emotional resources are nearly tapped out. The photos above may leave the impression that Annie's simply in great spirits, and, generally, she is, but they do not tell the full story. The first few days after the surgery were brutal, painwise, and various procedures along the way have been difficult for her to undergo.

Annie and I share a fair degree of claustrophobia, and Annie expects to be stuck in the MRI machine again today, which is nightmarish for a claustrophobic. (It takes all that I have to get through it. Large people have no room in there whatsoever.)

So, Annie is dealing with anxiety issues, and these are not insubstantial. They are very difficult to control. We stayed late yesterday just to get her through some tense moments brought on by more poking and prodding and the realization that she would have to enter the MRI again.

But BE NOT CONCERNED: we're on top of it. We'll be leaving for the hospital momentarily. Angela will be visiting today, too. Earlier, Kathie called Annie and was as chirpy as possible. All of that is helpful.

Later! --Roy

P.S.:

In case I have not already made this clear: Annie's radical hysterectomy has gone very nicely. No significant problems have emerged.

It now appears that she entered surgery with an unrecognized "minor chronic renal insufficiency." That is, her kidney had been slowly damaged (by something), reducing its effectiveness, but not to a serious degree.

That condition helped cause the "acute renal failure" that occurred during surgery or because of the surgery (specifically, the blood loss). "Renal failure" simply means that the kidney ceased to do its job. "Acute" cases are typically temporary--full function is often restored--though recovery of renal function can take weeks, even years. Annie's renal recovery has been stubbornly slow, though it now seems much better.

Two or three days ago, I asked the doctor (Littel) specifically what Annie's ailment is. He said that she experienced "acute renal failure" during, or owing to, the surgery. He did not use the word "chronic." I said, "not chronic, then?"

He said, no. But: because she had/has "chronic renal insufficiency," recovery from her kidney failure will not bring back complete kidney function. That's OK, for the amount she had prior to surgery is quite enough.

There are indications that Annie's doctor (who treated her until two months ago or so), failed to appreciate Annie's "renal insufficiency." There has been talk, too, of a failure to place the BP cuff properly on Annie during surgery (hence the failure to appreciate her low BP). But I can see no point in pursuing these matters right now (if ever).

In general, her treatment at the hospital has been outstanding. The nurses seem universally terrific, as do the doctors. Very impressive. -Roy

UPDATE, August 15:

Just got back from the hospital, and it's late.


Dr. Littel did come by, and I pressed him on releasing Annie. Sure enough, he was under the impression that the kidney specialist (the chief Renal Twin) had not yet given the go-ahead for release. He was waiting on her (the kidney specialist), he explained.

"No," I said, "she made herself very clear to us yesterday and the day before that, as far as she was concerned, Annie can go home now." I looked right at him.

Littel stared at me for a bit. Then he said: "That's not what she told us." I held my tongue. He's a nice guy and a good doctor, and I made my point. I also informed Littel that Annie is now experiencing severe anxiety--and that's serious--and it is liable to get worse for as long as she stays in the hospital. "Obviously," I said, "she should stay here as long as she needs to." But, I added, if she stays any longer, she'll have to be treated for her anxiety, which, I informed him, was pretty bad last night.

It was.

Again, Littel seemed a bit perplexed or surprised. After a while, he declared that Annie would be going home tomorrow, as long as the Renal Twin said it was OK. Well, we know she thinks it's OK, so there it is.


Not long after, Littel's junior partner, Dr. Savage, returned to remove all of Annie's stitches (plus two or three staples).

That was bad. Obviously, Annie was in lots of pain as some of the stitches were yanked on, then pulled out. She was in tears, holding her breath, bracing for each stitch, covering her face with a pillow. She didn't make a sound.

Maybe a fifth of the way into it, Savage stopped to give Annie morphine via IV. That took about twenty minutes. Then she continued. It was still pretty bad at times--it looked pretty bad too, watching especially the bigger stitches get pulled out. Some of 'em were about four inches long. You could follow them under her skin as they made their way out. It was odd.

Well, after about twenty minutes, the stitches were removed, and boy were we all relieved, Savage included. We quickly got Annie's mind on other things: her beloved Tiger-Ann, the crispy slice of pizza she will eat tomorrow night, the silliness of the Mythbusters episode that was on the TV.

Pretty soon, she was OK, and, when we left her, maybe two hours later, she was in good spirits. Sheesh.


Naturally, I got a good look at her incision (re the belly surgery). It is three feet long, circling three-fours of the way around her body. Some of the stitches were very large, but most involved thin nylon thread. There were staples, too. They looked like--staples. It was odd watching them removed. Each was bent into shape, then pulled out, as though Annie were a cardboard box.

The incision looks very good, except for a small zone in the middle, which reveals some drainage. There is a tube running into her belly (at about midpoint, maybe two inches below the incision) that continually drains "fluid" from the general incision area into a plastic container attached to her side. She'll be going home with that. No doubt it will be removed within a week or two. All of this is routine.

I've made no effort to inspect the "other" incision, of course. All indications are positive regarding the "radical hysterectomy." It's funny: the renal failure and its complications have utterly eclipsed the hysterectomy in the last two weeks, though the latter was the reason for the surgery.

They're still giving her drugs through the IV, but it looks like they'll be switching to oral drugs tomorrow. One hopes that they're done with the IV now, for the "entry" she has on her right wrist is barely working. I don't think Annie would be very happy getting another hole of that size poked into her.

Boy will it be great to get her back home. With any luck, that's just hours away! I'll be driving her in my big dumb American car. And loving it!

-R


UPDATE: August 16:

I got a call from Annie late in the morning. "They're letting me go home!" she said.


An hour later, we got there, and it was the usual "hurry up and wait" scenario. We waited for some mysterious paperwork to be completed. We knew that we had to visit the pharmacy down on the 1st floor before leaving too.


Annie spent some time with Pipa, a very nice head nurse, who explained to Annie what she must now do, I guess. I took a picture. I do believe that Annie and Pipa became pals. Pipa's name is pronounced, well, "pippa," but Annie has always referred to the woman as "peepa."


"I like dat," says Pipa.

There was some sort of SNAFU concerning the availability of the "renal shake" Annie is supposed to consume once a day. We waited around a bit for that to be sorted out. Eventually, Pipa got to the bottom of it. Finally, she said, "You should go to Walgreens, not here, to get dat," she said. "It's cheaper there."


OK. So we said our goodbyes and then headed down to the 1st floor. The pharmacy stop wasn't too bad.

Soon, we were outa there. The first stop: Tony's "Cable Car" Drive-in, across the street. We saw it during Annie's many "walks" on the 6th floor. "French fries," Annie would moan.


So we stopped to get an order, and we gobbled it up plenty quick. Annie was in heaven.

It's a beautiful day, and we drove along the coast. Took a few pics. Stopped at Ross for two King Size pillows. Then we headed home.



Tiger-Ann was weirded out, of course, by her mamma's arrival. But Annie was happy. She sat in the sun for a bit, then headed to bed.

She's back!