Wednesday, April 28, 2010

Wednesday Night, 4/28

To watch Elaine recover is to see what happens when everything - the deep knowledge and skills of excellent, humane physicians; a capable, caring clinical staff; wonderful new technologies; and a lifetime of eating right, being fit and tending to one's health - converges.

Consider this. Less than 48 hours ago, Elaine had massive surgery: a radical hysterectomy, removal of parts of the appendix, bladder, ureter. Then reattachment of the ureter to the bladder. And much more. In the process, she lost 2 units of blood. She has had an IV drip, but hasn't eaten since Sunday, and until noon today her only fluids since Sunday have come from sucking ice chips.

But yesterday, she moved from her bed to a chair and sat vertically for an hour! Twice! The first time she was dreadfully nauseous. The second time was better.

And today, she circumnavigated the rectangular halls of the floor - probably a quarter mile - twice!

Several things made all this possible. One was the good judgment of her physician team - Rick Glock, Doug Swartz and Steve Buckley - who did not assume that all was well, and methodically explored until they discovered the deeper problem. In this case, if they had waited, a kidney might have been lost, and the tumors would have been larger and less manageable.

Another was great technologies that those of us who are not clinicians do not see often and often aren't aware of. For example, just before surgery, Elaine's anesthesiologist explained that, in addition to the anesthesia during surgery, an epidural block could provide significantly better post-operative pain management than a general anesthetic, while allowing the brain to remain clear.

She agreed and the results have been astounding. Even after this traumatic procedure, with an 8 inch traditional incision that goes down the center of her belly, she told a nurse yesterday that her pain was "1" on a 10 point scale. And she proved it today in her ability to move around. The elimination of pain as a barrier to recovery is beyond value, and a miraculous advance in medicine.

And then there are simple advances that make care dramatically better. Elaine has been bedridden, so she was fitted with pneumatic leggings that go around the calves, and massage the muscles in different rhythmic patterns. This prevents clotting and helps preserve muscle tone, which speeds total recovery.

And finally there is Elaine as the patient who has eaten carefully, worked to be fit and nurtured her own health as a lifestyle for as long as I have known her. When confronted with a difficult situation, her body responded overwhelmingly in her favor. It was clearly payback time, with an incalculable reward.

It occurred to us today that, in a time that is so cynical, we should celebrate when things work so well. This is not to ignore flaws - as many of you know, I spend plenty of time focused on those - but none of this would have been possible without wonderful resources like Baptist Health System, with its great patient care, overseen by a truly top tier quality office, Keith Stein MD.

It's been a tough week so far, but its also worth remembering and being grateful for the fact that the seemingly toughest parts have been the solutions. And those solutions, in a single event of patient care, resulted from the cumulative contributions of many important but steadfast sources, and allowed a women ravaged by a condition to succeed beyond our wildest imaginings.

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