On July 8th I have an open parastomal hernia repair, and colostomy revision. I had two surgeons doing the surgery, my colorectal surgeon, whom is amazing. I also had the hernia repair specialist. We went over everything. The plan, options, and knew it wouldn’t be an easy surgery, or recovery. We even met with the pain/anesthesia team to manage my post op pain with a povicaine pump.
We were told the surgery would be 2 hours. That the incision would be on my right side, maybe 3-4″. No big deal. I remember waking up in recovery screaming from the pain. Just screaming. The pain was absolutely horrendous. The pain team (APS) came in to reprogram and fix the pain pumps. We decided pre-op to use povicaine pumps to manage the pain, as I refused the epidural. When I was finally awake enough, I learned my surgery was over 4 hours long. That hardly anything went to plan.
My colorectal surgeon told my mom there were so many adhesions, so much scar tissue. That at one point they had moved my entire abdominal cavity and organs. No wonder the pain was so horrendous. We prepared for a 2 hours surgery. We got a 4 hour surgery, with a 7″ incision down the middle of my abdomen, with a 6″ piece of mesh repairing the hernia. I was not prepared for that. It was so overwhelming when I saw it. I cried. I could fell myself spiraling. Another scar, another story, another victory. Is that what we call this surgery though? Yes, I will call this surgery a victory. Each surgery is a victory a small win.
So I was admitted, and would be in patient for a few days. It was honestly a horrible experience. I’m on TPN, and a high dose of antihistamines to manage my chronic hives. I also have a form of CKD. So fluids are important. To make matters more complicated, I went into surgery with low hemoglobin and hematocrit.. I was anemic. Definitely not the best way to head into a major surgery. We managed though. What WASN’T managed was my TPN. The hospital pharmacist absolutely refused to do my TPN. My surgical team fought and fought, but he adamantly refused to make it for me.
How was this even acceptable? What’s even worse is the hospital dietician knows the pharmacist is like that. The nurses new, hell even my TPN infusion pharmacy warned me he’s difficult. What blows my mind is how he thinks he has the authority, and final say to fill TPN orders. Does he do this to every TPN patient? Who gave him this power? And why does NO ONE stand up to him or hold him accountable?? The dietician tried to put me on J-tube feeds…..That I don’t even have a tube for.
I was in the hospital for barely 48 hours before I wanted to come home. My antihistamines weren’t given to me correctly, the incorrect dressing was used. This resulted in blisters all over my abdomen where the dressings were holding there pain catheters in. The incorrect antihistamine dose resulted in my being unable to be accessed for my port in order to run my TPN, for 2 weeks. This should not have happened? I shouldn’t have been without my meds, I shouldn’t have had to suffer because instructions and orders weren’t followed.
My surgery was Friday, July 8th. By Sunday I was done, and wanted to come home. I didn’t feel safe. I wasn’t given the correct dose of my meds, not even my gabapentin. I wasn’t even given fluids the entire time I was in the hospital. The surgical team, after extensive discussion, decided it was best, and safest for me to come home Sunday, July 10th. Barely 48 hours after a major surgery.
How did we get to a point where coming home is safer than the hospital? What happened to patient care? What happened to following physician orders? Why does a pharmacists get to refuse TPN orders? Why weren’t the orders followed on the floor regarding iv fluids?
This surgery, and hospital stay has lingered on my mind. I’m upset at how so many things were ignored or just dismissed. What if I were a true TPN dependent patient? This has all left me questioning if patient safety and care are still a priority, because lately it doesn’t feel like that. We need better, not just us patients, but providers, especially nurses. None of this should have been ignored. No pharmacist should have that kind of power to refuse orders.
What I do know, is I won’t let this slide. Conversations need to be had. He needs to be held accountable for this behavior. It’s harmful. It’s dangerous.
I’m slowly recovering. It’s been a very difficult recovery. Very slow. I’m doing my best to heal, and ensure the repair holds. In time, I’ll feel better. For now though, the pain hits randomly. For now, I let go of the anger at how bad my in patient was stay. For now, I’m focusing on healing.