March 25, 2018. After last night’s disturbing phone call from Mom about Dad’s fall, I wanted to get an early start to Temple so that I could be there during Dad’s surgery. I was up by 5:30 A.M., called Mom 45 minutes later to let her know that I was coming, and left home at 7:40 A.M. Because of my early departure, and some good highway luck, I arrived at my parents’ home at 10:15 A.M. I quickly unpacked my car, drove to Scott & White Hospital, and made my way to room 566 in the south tower.
I had just missed the surgeon, who had stopped by to tell my parents that barring any emergency surgeries, Dad’s surgery was scheduled for that afternoon at 1:20 P.M. Shortly after I arrived, Dr. Karla Bolanos, Dad’s attending physician for the week, stopped by to visit with Dad. Dad was very charming and witty, giving her the impression that he was a cooperative patient. At this stage of the process, he actually was very cooperative because he had no idea what was in store for him.
The doctor said that Dad would have his first physical therapy session and evaluation the day after his surgery. Following the surgery, he would remain in the hospital for 2-3 days and then move to a rehab facility for two weeks of rehab. It was at this point in the conversation that Dad balked and said that this plan didn’t work for him. He had no intention of going to rehab; he was needed at home. Unfortunately, Mom seemed to agree with Dad. In an attempt to sell my parents on the notion of rehab, I related the story of their friend Sally and her experience with rehab after her hip-replacement surgery, but my parents were not swayed.
Shortly after Dr. Bolanos left us, I left the room to call Stan and my friend Rhoda, both of whom wanted an update on Dad’s condition. On the way to the lobby, I saw the doctor at the nurse’s station and spoke with her about Dad’s diuretics, his swollen legs, and I requested that she order an infectious diseases specialist to check Dad to see if he still needed the antibiotics to suppress infection in his lungs. She appreciated knowing about the diuretics but said that Dad would need to take suppression antibiotics for the rest of his life. Furthermore, she said that he needed the antibiotics because of his new heart valve. It seemed to me that he needed the antibiotics for a couple of good reasons. Because antibiotics can affect the kidneys, I had hoped that he could quit taking them, but the doctor dashed that hope.
When I finished making my phone calls, I returned to Dad’s room. Dr. Bolanos returned to the room a few minutes later and told us that they had noticed a spot on Dad’s heart that looked like a clot. Before they could operate on Dad’s hip, they would need to run some tests, which were scheduled for tomorrow. By now it was 12:30 P.M., and Mom and I were hungry and decided that we would leave Dad for an hour and go home for lunch. When we returned to Dad’s room, because his surgery was rescheduled for tomorrow, his NPO restriction had been lifted, and he was eating lunch and complaining about the food. Some things never changed.
At 3:30 P.M., an imaging tech arrived with an ultrasound machine to scan Dad’s legs for blood clots. She couldn’t tell us anything, and we assumed that we’d hear something soon from the doctor.
Shortly before 5:00 P.M., Mom and I left the hospital for home, having not seen any medical providers after the imaging tech left the room.
March 26. Mom and I arrived at Dad’s room shortly after 9:00 A.M. Dad said that he had been told that his surgery was scheduled for 1:20 P.M. Dr. Bolanos stopped by the room and told us that Dad was scheduled for a VQ scan at 10:30 A.M. I had never heard of a VQ scan, but I learned that it evaluates the circulation of air and blood within a patient’s lungs. The transportation tech arrived 10 minutes before the scheduled time and transported Dad to the procedure location. Not knowing how long he would be gone, Mom and I started getting antsy when he hadn’t returned by noon—especially because he was scheduled for surgery at 1:20 P.M. We didn’t want the surgery rescheduled for tomorrow. We also didn’t want to leave the room for lunch and risk missing the doctor.
Dad was returned to his room at 12:15 P.M., and a couple of minutes later, we were told that he was still scheduled for surgery today. Less than 30 minutes later, another transportation tech arrived to take Dad to the OR prep area. Mom and I were both allowed to accompany him. Dad wasn’t in favor of my coming, but I wanted to speak with the anesthesiologist. Dr. Daniel Stahl, the surgeon, stopped by to tell us about the surgery. He said that Dad would need three pins and that unless they found something different from what they had seen on the x-rays, the procedure should take less than two hours.
I told the anesthesiologist that following Dad’s previous two surgeries, he had had a heck of a time dealing with the anesthesia. For three to four days, he had been very confused and had had hallucinations of animals, insects, and water in the room. The anesthesiologist said that he had Dad for his second surgery in May 2015. He said that if this surgery lasted no more than 90 minutes, he could use a spinal tap. Dad would be aware of what was happening, but he wouldn’t have any pain, and he would not suffer the after-effects of the anesthesia. He said that he would confer with the surgeon and try using a spinal tap if we agreed that was the route that we wanted to take. He thanked me for the update on Dad’s history, and Mom and I hoped that we had found a solution to Dad’s post-op dramas. While we were speaking with the anesthesiologist, the nurses were having a heck of a time finding a vein so that they could type and screen Dad’s blood.
When the nurses had finished drawing Dad’s blood, Mom and I made our way to the OR waiting room. After waiting for about an hour in the freezing-cold room, we were pleasantly surprised to see Tom, my parents’ pastor. I don’t know how he found us, but pastors seem to know their way around hospitals. We had a nice visit with him, and during our discussion, I mentioned my concern about Dad’s reluctance to go to rehab. I hoped that Pastor Tom would be able to have a guy-to-guy talk with Dad sometime before he was discharged from the hospital. After talking with Mom, I learned that part of her reluctance to send Dad to rehab was because of the promise that my parents had made years ago to not put the other in a nursing home. I explained to her that he would be admitted to the temporary resident section of the skilled nursing facility, not the permanent resident section, commonly referred to as a nursing home. I think that she felt somewhat better about rehab after our discussion.
Just a few minutes after Pastor Tom left us, the surgeon arrived to tell us that the surgery had gone well. Unfortunately, because of Dad’s spinal compression, the anesthesiologist was not able to use a spinal tap and had to use a general anesthetic after all.