Mets Day 25 - Monday morning rounds

Chelsea and Jennifer came over at about 6 am to meet with the doctors doing their morning rounds.  We did not know when they would make their appearance - last Thursday at Friday it was around 6 am, but on the weekends it slipped to 7:30 or 8 am.  I warned Chelsea in advance that the rounds were not about the patient, but about the doctors.  They rarely would ask the patient questions, but would instead review the charts, speak among themselves in the hallway, then enter the room, announce the day's orders, and leave.  Questions were barely tolerated by one doctor standing in the doorway, his colleagues having moved on to the next patent's room. 

Fortunately, today's rounds were a little better.  They were led by a 6th year resident who also participated in the surgery.  With him was the only female resident that I've seen on the urology on the staff, who efficiently flushed the neobladder and foley and freed up a blockage in the foley that had been there for at least a day.  They were more responsive to  questions, but proceeded as was usual - announcing the treatment plan, and answering limited questions.  They said that they had to keep on schedule, and one would return later to answer additional questions. 

As for the substance:

1. I am now on an unrestricted diet.  They encouraged me to go gently at first, and let my GI system get back up to speed.  The neobladder handout that the hospital provides is rather funny - it recommends that patients avoid high-fiber foods and whole grains, and instead have easy to digest food like pies and cookies.  I can do this, I thought.  I've been practicing for years.

2.  Assuming that I continue to make good progress, tomorrow the doctors will remove the two stents into my ureters, as well as the JP abdominal drain.  I likely will be discharged tomorrow afternoon, with the SPT and foley still in place.  I'll receive in-hotel health care, and likely would be scheduled for a clinic appointment on Tuesday, May 15.  If everything looks good, I could be cleared to return home to DC on Wednesday May 16, where I would continue my recovery and physical therapy. 

3.  I finally have been unhooked from the IV pump.  Happy day.  They used my port for most of the infusions, but did blood draws the old-fashioned way, and my arms look like a heroin addict at death's door. 

4.  We spoke at length about managing the balance between diarrhea and constipation.  This morning at around 5:30 am, I was sitting on the toilet, full of gas, but afraid to bear down and push. I had been warned not to do so, because bearing down on a still-healing neobladder could cause some damage.  It took about 20 painful minutes for the intense gas pressures to dissipate without pushing, accompanied by rocking, sweating and trembling.  I didn't want to go through that on a regular basis.  The doctors generally were pleased to hear that the GI tract was producing gas, and approved my using MiraLax to stay regular, and see how it goes. 

5.  I can expect to have additional leakage from the SPT tube as long as it is in place.  It can be packed with dressings to catch the leaking urine, but nothing will be 100%.  Jennifer will be trained on changing the dressings, and I will be modeling the latest versions of Depends.  I was also warned that, after all the tubes are removed, I'll still need De[ends as I learn how to pee again.  I'll have Jennifer talk to my mom to find out what incentives worked for me the last time I was potty trained. 

Chelsea had a lot of questions, and helped focus the treatment and plan.  She is flying back to DC this afternoon.  We've been grateful for her assistance and knowledge.  Jennifer will stay out here for the duration.  We probably won't have Spencer come out because everything is going faster than anticipated.

As for the cancer that caused this stay in the Windy City?  We have not yet received the pathology report, but hope to see it today or tomorrow.  Fingers and toes still crossed for a favorable report.