Hospital Journal

Wednesday, June 12th 2002

We arrived at the Hospital around 8:30a.m. Shortly after signing in, J's name was called and the entire family was directed over to pre surgery. In the following couple of hours J got checked over, changed into hospital attire and given a dose of valium to help him relax.

At 10:30 J was rolled into the pre surgery holding area. We were permitted to accompany him right up until the start of the surgery. While waiting for the operating room to be prepared we met with his surgeon, the anesthesiologist and the ICU nurse. Our family was reassured and J was encouraged to remain calm, which he found difficult.

Finally the moment came to send him off and it was a bit emotional. The doctor said they would call during the surgery and give us an update on J's progress. About half way through the surgery, we got a call from the ICU nurse. She said everything was just fine. I heard the surgeon in the back repeat the same reassuring remarks.

By around 3:30p.m. we were beginning to get restless. One of the recovery nurses informed us that they were closing up and we would be able to see J shortly. Just before 4:00p.m. we were escorted back to the holding area. At first J was very nauseous from the anesthetic but after a while we were allowed into the post surgery recovery unit.

J was still out of it, but starting to come around. Our first look at his chest brought tears to our eyes. It looked awesome. Later he could respond with a yes and no nod to our questions, but he was a bit uncomfortable with pain. He was given pain medication which allowed him to sleep some more. The surgeon discussed the surgery with us and even showed us the Lorenz kit, containing a collection of tools, bars and stabilizers used in the Nuss procedure. We had our first look at the bar inside Jason's chest, with an ex-ray taken on the spot.

After a while J got transferred to ICU. We were fortunate to have a private room. There J spent the next 17 hours, cared for by the very competent staff. The night was a bit restless but his pain was well controlled with the epidural anesthetic and some boosters for minor discomfort. He was also given antibiotics.

Later in the evening he was helped into a chair to sit for a while. He found this very exhausting and once again a feeling of nausea came over him. But he managed to hang in there. A couple of times he was asked to exercise his lungs, by using a breathing device with a tube, to suck air through . He managed to raise the progress monitor to a satisfactory level. No problems with the urinal catheter. He was well hydrated and asked for drinks often.

Thursday, June 13th, 2002

Following the night we were confident that the worst was over. Unfortunately this was not the case at all. The morning started out with a nursing shift change with the unfortunate disadvantage of having an ICU nurse assigned who was not experienced in dealing with J's age group. She made several remarks about having only dealt with babies.

When J's surgeon arrived he took Jason for a bit of a walk to test his strength. After a bit of breakfast and sitting up in the chair, J received the approval to transfer to our HMO's own hospital. We anticipated the transfer around 11:00. This is where things started to go wrong. The nurse was becoming increasingly inattentive and asked a couple of other nurses to perform the preparation for the transfer. Since they were busy with their own patients, they disconnected the medications and pain management devices ½ hour prior to the 11:00 a.m. transfer. There was no backup medication given.

The ambulance arrived about ½ hour late so by the time we reached the other hospital, J had been without pain medication for 1 and ½ hours. He was beginning to feel some serious discomfort. The nurse in the new location tried her best to speed things, but the epidural required approval from the surgeon. She gave J some morphine but for some reason this did not control his pain at all, it was getting progressively worse. Panic set in and he could no longer cope. I requested extra assistance and a number of nurses tried various things to comfort him. Nothing seemed to work, we were both in tears, J from his pain and I from my frustration, in not being able to do anything about it. He had been without the epidural for 2 and ½ hours by the time they got it going again. It seemed like forever to take hold, but it finally did. By this time J was exhausted. He slept for several hours.

Friday June 14th, 2002

The night was good. Just a minor problem with the urinal catheter that got resolved with the nurses' efforts. In the morning J was quite irritable and complaining about pain. They took the edge off with some morphine. The unfortunate thing about morphine was that it made him very sleepy and lethargic. Mid morning we managed to catch some pain free time and J walked around the ward. Then he sat up in the chair for about 45 minutes. I washed him with hospital cloths and changed his gown. The nurses changed his bedding and he was ready for more pain medication and a long nap. He still had no appetite and a bit of a fever.

In the afternoon the doctor ordered to have the epidural level increased so that he would not have to be given morphine. He needed to get up and walk around and eat. It took a while for the increase to take affect so he was given one last dose of morphine. He slept all afternoon but once the morphine wore off and the epidural kicked in, he was a lot more energetic. He walked and was able to eat.

After all the walking and coughing, Jason was sore and tired. He thought he may need a boost of morphine for the night but by the time the nurse came he was asleep. It was a good night with no interruptions.

Saturday, June 15th, 2002

We were both very tired in the morning despite the good night sleep. J was not motivated to walk but he pushed himself anyway. He did not have much of an appetite either. At 9:00a.m. they gave him his first dose of Toradal with plans to discontinue the epidural. The nurse said they would use Tylenol with Codine for the break through pain. The transition was a bit frightening after the experience from Tuesday when Jason was off the epidural for a couple of hours.

It turned out to be another rough day with the transition from the epidural to the other pain medications. They ended up doubling the dose on the Tylenol. J was beginning to experience sharp, stabbing pains on his left side that got progressively worse. He was not coping well. He no longer wanted to walk or practice his breathing exercises because it was too painful.

On the positive side, he got the urinal line removed and was able to go the bathroom on his own. But getting in and out of bed became a challenge. We managed to figure out a system of pulling him up by his neck. Later the pain settled and he was able to cope as long as he did not move around much.

The night was quiet except that the nurse did not give the pain medication on time and J had some discomfort while catching up again.

Sunday, June 16th, 2002

The mornings seem rough. J was beginning to feel significant nausea from the medications. He could barely keep his breakfast down. He ate so little and it was such an effort, it would have been a shame to bring it up. The doctor called and suggested a change for the breakthrough medication, to something without Codeine. He also prescribed an anti nausea medicine and soon after taking it, J fell asleep. The nurse made plans to have the epidural catheter removed.

Things turned around by the afternoon. J began to feel better except for the nausea. The surgeon dropped in to discuss J's progress and it was decided that he could leave the hospital and continue his recovery at home. His dressings were removed and the stitches examined. Everything was in order.

The surgeon gave specific instructions for recovery care and medication for at home. The nurse prepared J for the drive home by giving some extra anti-nausea medication. J was wheeled down to the patient pickup area and loaded into the 'family bus'.