Day 37 - Bad Days and Good Days at Work

          More pain. Yuck. I’m getting tired of this. I went back to the urologist today. He found some infection and prescribed Cipro. That’s the antibiotic that was all over the news during the anthrax scare several years ago—poor schmucks opening letters at their offices, and getting dusted with weaponized anthrax. Some people have worse days at work than others.

Other than the infection everything looked pretty good. The doctor was pretty proud of himself for getting rid of all my stones with lithotripsies. Apparently lithotripsy isn’t the generally accepted treatment regimen for 14 large kidney stones distributed throughout both kidneys. I don’t know at this point whether or not I wish I had known that before we started. Now I don’t know if the doctor is way smarter than your average urologist or just way luckier. Either way I guess it worked out okay for me—except for the pain and suffering of course. The pain and suffering is making me less of a fan of the doctor’s than I might otherwise be.

          Winding up our appointment with a big grin he said to me, “You know if they’d showed me a picture of your kidneys during my board exams and asked me what I thought should be done, and I’d said ‘lithotripsy’ they would have sent me home to study the text books some more. They would have told to come back and try again later.”

          Some people have better days at work than others.

Day 26 - The Long and Short of It

          I made it to work today even though I didn’t feel much better. I had an appointment with the urologist in the afternoon, so I was determined to put in an appearance to meet my replacement.

          The replacement’s name is Gary. The first thing I noticed was that he is younger and better looking than I. The women who used to work for me will, I’m sure, enjoy working for Gary more, at least provided he is not a jerk. He was quite personable and seemed genuinely concerned about the state of my health. Of course if I don’t get well in time for the closing, Wallace will have to come to help him. Gary will be screwed.

          We spent a couple of hours going over all my work files in the computer. I showed him where everything is, how it’s all organized, and what it’s all used for. He took copious notes. I showed him the previous month’s closing. While I was at the doctor’s office this afternoon, he was going to work his way through last month’s workpapers and compare them to the templates I left him. We will go over his questions tomorrow. It’s a good plan I think. It’s the way I would have gone about it if I were him. I decided that he’s a smart enough fellow.

          Two things about Gary were noteworthy to me—not because they mean anything necessarily, but I have seen them in the past and made note of them because of the individuals to which they attached. First, Gary rolls the sleeves of his shirt to the inside. That is rather than rolling up his sleeves by turning the cuffs outward, he turns the cuffs inward. This makes a neater presentation, but it also means that whatever ink stains, pencil dust, and other detritus of desk work one picks up on one's sleeves will be on the outside and therefore impossible to hide by merely rolling the sleeves back down. This practice is best left to the more fastidious among us, to those less likely to drag their sleeves through the residue of accounting toil. The second thing Gary does is wear a fat gold chain around his neck.

          I have to say before I go further that I used to do both these things. The first controller I ever met did both these things. He worked for a small hospital where I got my first accounting job fresh out of college. I didn’t work for him. I was attached to an independent treatment facility that leased space in the hospital. I was in my twenties. He was pushing fifty. He seemed to have everything going his way. He was a stylish gent—salt and pepper temples on immaculately sculpted hair, nicely coordinated clothes, a well appointed home in a fashionable neighborhood, a chocolate brown Jaguar sedan with a tan leather interior, all the trappings. I started trying to emulate him almost immediately, unfortunately without the same effect. After a while I gave it up, rolled my sleeves like a normal slob, took off the gold chains, and resigned myself to an innate lack of star quality.

          Some years later I ran into another controller who rolled his sleeves just so and wore a gold chain. He also was pushing fifty (so was I by this point) although he was not the same trim fashion plate that the first guy had been. This second fellow had developed an infatuation with a dancer at a local topless bar. He began squiring her around the area malls on week-end afternoons, buying her clothes and baubles and, eventually, a car. That he could not afford these inducements did not dissuade or even slow him down. What did slow him down was getting arrested for embezzling some sixty thousand dollars from his employer to pay for the inducements that presumably never actually induced the girl to give up any favors. Since then I have never trusted accountants who try to dress too cool or wear gold chains. Accountants ought to wear conservative suits in charcoal and navy with striped ties. If they have a taste for the fashionable that won’t be ignored, they can add cuff links and a pocket square. Anything else is just asking for trouble.

          The doctor got another x-ray and a urinalysis. He decided that the stint was causing all the pain. Not unusual, and nothing to be alarmed about. He decided that I had passed enough sand that he could take the stint out. I could do it with or without anesthesia. If I did it with, I’d have to come back tomorrow. The thought of doing it without gave me the heebie-jeebies. I shuddered just thinking about it. Unfortunately that was the only option that made any sense time-wise. I told him to take it out without anesthesia.

          I had to put the silly little hospital gown on again. Then they took me into a room I hadn’t seen before with a nurse I hadn’t met to get prepped. Prepping consisted of soaking my private parts with an antiseptic solution. This went on way longer than I would have imagined necessary, but the last time this was done I was asleep so I don’t really know.

The nurse was pleasant, plump Jamaican woman of a certain age. When she finished with the washing she covered me with a surgical drape that had a hole cut out in the center so that only my private parts are visible. She went to tell the doctor that I was ready. I was lying on a table covered up, except of course for the stuff that I would like most to be covered up, and wondering what there might be to prevent just anybody from walking in there and seeing me like that. I have to say it was very disconcerting.

The nurse came back a few minutes later to tell me that the doctor was in the middle of another procedure and that it would be a few minutes longer before he could attend to me. Through the walls I heard voices and the staccato clicking of the lithotripsy machine blasting someone else’s stones.

The nurse asked me if I was warm enough. In fact my private parts were freezing. I imagined that they had shrunk up deep into my abdominal cavity, seeking their own warmth, and that the doctor would probably have to waste 5 or 10 minutes just trying to find them before he could go in after the stint. I wasn’t sure of the best way to convey this information to the nurse. She had just had my junk in her hands, so it seemed important to me to seem calm, collected, informal and free of embarrassment without lapsing into the vulgar. I decided on a particular phraseology that I do not normally use.

“Everything except my willie,” I said. “My willie is freezing.”

The nurse chuckled at this. I thought that the term ‘willie’ must have made her think of Bill Clinton. I don’t know why I thought this, but there it was. Slick Willie—limp, cold, and slathered in Betadine solution. It was not a proud moment.  

“Unfortunately that’s the one thing I can’t do anything about,” she said.

          The doctor came in ready to go to work. He used a cystoscope to go in after the stint. I knew that I didn’t want to see it, but I looked anyway because...well how could I not? A situation such as I was in is like a plane crash or a train wreck unfolding in front of you. You can’t make yourself look away, no matter what. If the cold had not shrunk my thing beyond finding, sight of the cystoscope was sure to finish the job. It was huge. It looked lethal. It reminded me of some bio-mechanical horror from a science fiction movie, something like the monster's telescoping jaw in The Alien. I closed my eyes. They squirted some topical anesthetic and lubrication into me to ease the passage of the scope.
         “You’ll probably feel a little pulling sensation,” the doctor said.

This was exactly what I felt, provided that what he meant by ‘pulling sensation’ was that I would feel like he had run the cable from a tow truck up my poor penis, attached it to the first thing he found on the other side of my bladder, and proceeded to pull my insides out foot by foot. When I first saw the x-rays of myself with the stint in, it seemed maybe 8 inches long. It curled into a small loop in my bladder on one end, and poked down into my kidney on the other. When the doctor pulled it out however, it suddenly turned into a garden hose—one of those thick rubber hoses, a 50 footer, complete with brass fittings and a twisty nozzle. I thought the hose, the ordeal, the discomfort would never end.

“All done,” the doctor said at long last.

I thought that little phrase, ‘all done’, did a grave injustice to the singular most remarkable feat of physical prowess I have ever accomplished.

Day 16 - Breaking Rocks

          The lithotripsy frightened me not at all. In fact I was kind of looking forward to it. It’s an interesting thing, and the place where they do it, the Kidney Stone Center at Memorial Hospital, is a fun place to be. I know this because I’ve already been there twice for lab work and x-rays. Everyone is good-humored and upbeat. They go out of their way to make you feel good. In my experience this kind of thing usually starts with the doctors. If the doctors are good natured, then so is the staff, and by extension the facility.

I like my urologist. He is Indian, but he was born and raised in Texas so he does not have one of those sign-song accents that you think of if you’ve seen too many movies or met some Indian transplants. He is very smart, very young, and very personable. He is too young to be doing what he is doing, but he capitalizes on his youth by being irreverent and taking a conspiratorial tone with his patients. He does not take himself too seriously although he does frequently lecture board certified urologists all over the state and has written some well received papers. He must be serious somewhere, but he is not serious with me and I appreciate it.

The nurses and technicians started flirting with me before I had a chance to flirt with them. I don’t know what’s up with that. I feel like I have a certain responsibility to my nursing staff public in the recovery room, and if these women are going to jump start the process before I even get any drugs into me then I am really going to have to kick out the jambs later. I don’t know if I’m up to the pressure.

They put me in a little dressing room where I have to strip naked and put on one of those ridiculous hospital gowns that tie up the back. I don’t know how they expect you to get one of those things on properly, but somehow I do. The x-ray tech stuck her hand through the curtain to get my attention, and asked if I need any help getting the thing on. I told her thanks, but the deed was already done.

“Darn,” she said. “I was hoping to get a look at your butt.”

I could scarcely believe what I just heard. I couldn’t wait to tell my wife about this.

“Sorry to disappoint,” I said to the tech, “but you didn’t miss much.”

“I’ll be the judge of that,” she said.

Anyway she took some pictures so the doctor would know where the stones were before he started the procedure. Then she took me to a staging area. I climbed into a rolling bed. They covered me up with a blanket they just got out of a warmer. They started an IV. They took my vitals. They asked me what I wanted to watch on TV while I was waiting. They brought me my wife. We were having a high old time. The nurses were in a party frame of mind. People kept stopping by to visit and ask me questions. I got visits from the surgical nurse, the staging nurse, the recovery room nurse, the nurse anesthetist, the anesthetist, and my urologist.

They all wanted to know pretty much the same stuff: what was I there for, which side kidney were we doing (left or right), had I have anything to eat or drink since midnight, had I had a bowel movement, did I need to go to the bathroom, where do I see myself in 5 years, what are me three best and worst traits and why? I was better at answering some of these questions than others.

Eventually they gave me something in my IV to help me relax. Relax from what I don’t know. This was about the most laid back, non-threatening, friendliest setting I’d ever been in, and the notion that I might require some pharmaceuticals to help me relax is near nonsense. Of course I wasn’t about to protest. I mean really. What harm could it do? Besides I didn’t want to upset the delightful ambiance by protesting.

I woke up in the recovery room. This is the great thing about surgical procedures. You sleep through the traumatic parts and wake up stoned and surrounded by women. I was feeling pretty good. Since there’s no cutting with a lithotripsy there’s no residual pain. The meds are less intense, so you wake up faster.

The procedure had broken up about half the stones in my right kidney. The 14 original stones were evenly distributed throughout both kidneys. The stones at the top of my right kidney have been pulverized into sand, but that sand is still in there and I’m going to have to pass it. To ease this process the doctor has inserted a plastic stint in my ureter—the tube that runs from my kidney down to my bladder. The stint is supposed to keep the sand from getting trapped in the ureter, clogging the works, and causing damage. The stint will stay in for a couple of weeks depending on how fast the sand passes. It may cause some discomfort. I’m to let them know if I have any serious pain. Other than that the doctor was pleased with how many stones he got and my prospects for a quick recovery and transition into the next procedure.

My wife drove me home. We stopped for lunch at a high-priced flatbread pizza place with snooty waitresses and some truly oddball, California inspired, fusion cuisine. It was all health food inspired, heavy on the whole grains and sprouts and such. I guess the idea is that the society matrons and trophy wives who inhabit that particular area of town need food that will help maintain their stick figures to go along with their Botox immobilized faces. My wife hated her food. Mine tasted like cardboard, but I was still a little high and trying not to interject any negativity into the proceedings.