We woke up with the alarm really early on Monday morning, and left the house at twenty to eight. We'd allowed plenty of time for rush hour traffic, but there really wasn't any, so we got to the pain clinic at five after eight for an eight thirty appointment. Even though I hadn't been there for about a year and a half, the receptionist greeted me by name. One thing that has always impressed me about this clinic is that everyone who works there seems to be "on message"--it's very patient-centered and welcoming.
I arrived using the portable oxygen concentrator, knowing that they would hook me up to their oxygen. Leaving Marty in the waiting room, but bringing my bear, Pinkypine, with me, I was taken into a preparation area, and seated in a comfortable recliner, where a nurse set up the oxygen (I asked her to bring the concentrator out to Marty so he could recharge it if he thought it necessary--we had run it off the car power while driving) and took my vital signs. Having been through all this once before, I knew what to expect, which made it much easier than the first time I had the procedure (two years ago almost to the day).
I really didn't think I was nervous, but the night before I had been up nearly all night, unable to sleep, which I attributed to unrecognized anxiety. So, although I was feeling outwardly calm, I know there was a lot that I was worried about. I focused a lot of that on having the IV put in--I have lousy veins, and have often had IV technicians poking around painfully trying to find a good vein. One of the many ways that hospice has increased my quality of life is that I have not had a needle stuck in me since October (the last time I was in the hospital). The nurse put the tourniquet on my arm and began searching for a vein, being very careful and thoughtful. I was clutching Pinkypine (his "job" is to get a squeeze every time I get a needle), and I was deeply appreciative when she called over one of the doctors and explained that she was having trouble, and he not only got a vein on the first try, but was so skillful that I really didn't feel it.
After that the rest was easy. Two nurses walked with me into the procedure room and helped me up onto the table. I had to lie on my stomach, with a pillow under my stomach and another under my head, and there was some adjusting until I was comfortable. I got a softer pillow under my head and squished it until it supported my head just right, and with Pinkypine clutched firmly I felt about as good as I could feel under the circumstances. Then a drug was injected into the IV line and I waited to feel the same "off in La-La land" feeling I remember from last time. Either they used less of the drug or I just had a different reaction than previously, but I never got that totally spaced out feeling, although the drug certainly did its job and I don't remember much until being told it was finished, with no real sense of time passing. I was helped off the table and back to the recliner, where I was offered something to drink with a light snack (I had ginger ale and goldfish crackers), and rested for awhile, until a nurse came to take my vital signs, which were normal, so she removed the IV and walked me back to where Marty was waiting. The only outward signs of the procedure were a band-aid on my arm and a few more on my lower back. More important is the inward result, as I am once again, pain free (my knees were aching when we arrived).
I was prepared to spend the day as I had last time, when I basically slept straight through twenty-four hours, but although I spent the day in bed, or on my recliner chair, I never did sleep. I felt a little shaky on my feet, so I had Marty walk with me whenever I needed to go to the bathroom. I didn't sleep at all until eight, when I tried to watch "Antiques Roadshow" and just saw the beginning and the end, and then was up for awhile, falling asleep around eleven and sleeping till eight (late for me). I was surprised to see Marty's side of the bed empty and I found him in the dining room already hard at work on his computer. I asked him to get my breakfast rather quickly, because Lauren was coming at nine (since she had skipped her usual Monday visit).
This turned out to be an extended visit, since Lauren had to do the paperwork for my sixty-day recertification. A lot of people think that hospice is time-limited, but the fact is that as long as a person remains medically eligible (in a disease process predicted to lead to death in the reasonably foreseeable future, and not receiving any curative treatments), there are two ninety-day eligibility periods, followed by an unlimited number of sixty-day periods. So we went through a rather lengthy questionnaire covering my medical status, needs, ability to perform daily tasks, supports, and a number of other items. This might sound dry, but Lauren related everything to me in a very personal way and it actually turned out to be an interesting and useful discussion.
In the afternoon, Katrina came for another helpful talk. She arrived just when Marty did, and he joined into the conversation, which ranged widely across topics from American history to human nature to my condition and coping skills. I like Katrina a lot and enjoy her very low-key manner.
Marty was out twice today. In the morning he had a doctor's appointment, and Judy arrived shortly before he left. Although Marty had originally said he'd be back by noon, he called to say he was stopping for lunch, and then to go to the supermarket. I asked Judy if she was able to stay, and she said she was not a problem, so she made me some lunch and we chatted for awhile. I really like Judy, and have been feeling a little guilty because when she first came for an interview and I brought up payment, she waved me off, saying she felt she was doing a mitzvah. That was fine when she came just once or twice for a couple of hours, but recently she's been coming a lot more, so when she was getting ready to leave, I told her that I was somewhat uncomfortable with the situation. I also told her that I knew that, in the relatively near future, I would be needing more coverage, and knew that she needed paid work and didn't have anything in the pipeline, so we agreed that I would start paying her from now on, with the expectation that her hours would eventually increase.
Laurel was here in the evening--she is the other person that I expect to eventually be using for additional hours, although she's not available as much as Judy is (Laurel has four young children, whereas Judy has only one). Poor Laurel has had a real string of bad luck recently--I had an e-mail from her on Sunday saying she had just been in an auto accident and had a broken wrist. I immediately called her, and she reassured me that she was fine, and that she felt ready and able to work. I was glad to see her, although it was difficult to see her helping me when she so clearly should have been at home herself with someone waiting on her!
It's after nine now, Marty is out again (Laurel left around seven-thirty--I could see she was very tired), but I expect him home soon and I will probably go to sleep shortly after he gets home.