And Then...And Then...Along Came the Rest of the Story

Well hello there. Good to see you again. I'm back, and using the neatest technology for typing: talk-to-text. So why am I using talk-to-text, you ask? Ah well, that's part of the rest of the story. Let's get started…

When last I wrote, Mr. T was headed for a cardiac ablation to correct an arrhythmia. (Please see the previous two posts to catch up with this part of the story.) The short version is it all went extremely well. The longer version? Of course, that's where the rest of the story begins!

We got to Wake Forest Baptist Hospital in Winston-Salem on Monday (2/16) before the 7 o'clock scheduled appointment time and followed the (excellent) directions we had found on the website. Those directions got us to the correct parking deck that serviced the Electrophysiology Lab. Unfortunately, we actually needed to be in Admissions...several floors below and one building over. It's like we were trying to collect (or rather SPEND!) our $200 without passing "Go." STOP! Retrace steps. Start over. Dear Readers, if any of you have ever been to WFBH (or any large, metropolitan University teaching hospital), you will know that "retracing your steps" is much easier said than done. Sigh.

How did this happen? You may remember from my last post, that the cardiac ablation procedure was planned late Friday (2/13) afternoon over the phone, in consultation with the electrophysiologist after he had read Mr. T's ultrasound. As it turned out, Dr. W is the head of the EP department. In other words, he makes the decisions, and he can make a procedure happen in three days rather than in three weeks. What he does not do, is enter information into the WFBH admissions system. And, even if the top doc has decreed you will have a procedure ASAP, you do NOT do anything until the (electronic) paperwork is in order. And it was definitely NOT in order.

Still, I must say, everyone we met at WFBH...everyone...did everything to make Mr. T's stay there the best it could be. The Admissions rep pulled in just the right person to finagle the system into admitting him. And more than one person called the EP Suite to keep them apprised of his progress. He got the ticket for admittance when they strapped the bracelet on his wrist (note the QR codes...more about those in an upcoming post).

When we got back to the place we had started, they wasted no time in getting him prepped for the procedure...but neither did they try to save time by neglecting to tell BOTH of us what to expect when. Then, as they wheeled Mr. T away, one of the nurses said to me "do you know where the Adult Surgery Family Waiting Center is?" When I said I didn't, she smiled and said, "well, let me take you there!" And she did! Two floors down and one building over. [I soon learned that was a theme: if you even appeared to be lost, a hospital employee (doctor, nurse, tech...didn't matter) would come to your rescue, and typically ask if you wanted him or her to take you there.]

I settled in for my long winter's wait, since Dr. B (who was the EP in charge of the procedure) had said he would call me in about 2-3 hours to let me know how things were going. Missy M had agreed to stay behind at home and make sure the pups were fed (it's all about the dogz, right?); then she'd come along to wait with me. I had started a raglan sweater (knit, knit, knit...round and round on circular needles) that seemed perfect for passing the time in the waiting room. Only two problems:

1) We were in the direct path of a winter storm, supposed to dump snow and ice on us starting at 4:00...almost the exact time Mr. T was to be discharged (if all went well with the 4-hour enforced flat-on-his-back recovery spent in the day hospital room); and
2) My left wrist was hurting worse than ever. But, I had an appointment with a WFB orthopedic doc that very afternoon, and Mr. T's doc had encouraged me to keep the appointment. Plus, his nurse told me not to even think about driving across the campus...there was a shuttle bus that would deliver me door-to-door! Well, alrighty then...knit on!

Meanwhile....up in the EP Suite...

Mr. T said he remembers the first part of the morning, when they put at least 16 electrode patches to determine whether he was in flutter (he was) and to begin what they called a TEE. Here's a bit about that:
"In a small number of patients, an ultrasound of the heart is needed to make sure that there is no blood clot present. This is called a transesophageal echocardiogram (TEE)...and involves a probe that goes down your throat to look at your heart. You will be given sedation during this test..."

Well, sort of. He remembers the lidocaine that was used to numb his throat. Then the foul-tasting benzocaine. And he had the impression that he had pulled into pit row in a NASCAR race: there were people all around him, with each one doing some portion of the procedure...all working in harmony. He thought he might hear the whirring of the air-jack at any moment! And then...and then...well, lights out.

Meanwhile, back in the Surgery Waiting Center...

I knitted. And I texted. And I watched the constant weather updates. And I waited. And before I knew it, Dr. B called me to say the procedure was over, and Mr. T was doing well. Hooray and hallelujah! He said his nurse would call me soon and tell me the room number in the Day Hospital, which was where Mr. T had to go for 4-6 hours of observation "flat on his back, no movements." (Right. I was wondering what they were going to use to tie him down.) Within 15 minutes, Nurse Mary called with the number...and detailed directions...but when I asked an employee for confirmation of the correct bank of elevators (I had changed Towers, so I wasn't sure whether I could use the first ones I came upon), she said "let me take you there." Then when I got to the nurses' station on 11, I asked if Mr. T had arrived in his room. "No, but you are welcome to wait in there. Let me take you to it." (Can you tell I'm going to give them the highest score on their follow up survey?)

Missy M arrived to the room just after Mr. T did. And she stayed with him while I caught the shuttle to the orthopedic surgeon's office. I got there way too early, but they took me right away: the weather was changing, and they wanted to make sure everyone was seen before the snow arrived. The doc came in, asked me lots of questions, and examined my left hand/wrist/thumb. He was just like everyone else we have met in this system: open, kind, and easy to talk with. (Not at all like the orthopedic surgeon I had for my back in Florida...but don't get me started...:-)

Turns out I have a tendon-and-nerve combo problem called deQuervain's Tenosynovitis. Dr. W says it's fairly common, but I've never known anyone with it, have you? Here's some more info for you: 


By Mayo Clinic Staff

De Quervain's tenosynovitis (dih-kwer-VAINS ten-oh-sine-oh-VIE-tis) is a painful condition affecting the tendons on the thumb side of your wrist. If you have de Quervain's tenosynovitis, it will probably hurt every time you turn your wrist, grasp anything or make a fist. Chronic overuse of your wrist is commonly associated with de Quervain's tenosynovitis. 

When you grip, grasp, clench, pinch or wring anything in your hand, you use two major tendons in your wrist and lower thumb. These tendons normally glide unhampered through the small tunnel that connects them to the base of the thumb. If you repeat a particular motion day after day, it may irritate the sheath around the two tendons, causing thickening that restricts the movement of the tendons."<<<

What causes it? Repetitive motion, like with tennis or golf (don't play), lifting a baby (don't have one...anymore), gardening (uh oh), crocheting (double uh oh), and knitting (triple uh oh). What can you do about it? For starters, NSAIDS are prescribed...but I already take Celebrex for arthritis, so obviously I'm beyond Step 1. Next up, stop doing any/all of the above, which is accomplished by splinting 24/7...for 4-6 weeks (only removing the brace for showering and hand-washing) to limit use and to keep the wrist and thumb in proper alignment. In other words, NO KNITTING. Triple sigh. And lastly, a cortisone the wrist. If you know me at all, you KNOW how terrified of needles I am. So, when you hear I was practically begging him to give me that shot, you will KNOW where I was on the pain continuum that day. And if the above doesn't work? The last stop is surgery. And the website that Dr. W sent me to showed a video of that surgery, which is probably the best incentive I have at keeping the brace in place. Ahem.

So here's the fashion statement I'm making for the next few weeks. "Lovely" isn't the word...and in doesn't fit inside of a sweatshirt sleeve very well. Still...I want to do everything I can to avoid surgery. [Yes, I admit it. I am a big baby. And no, I wasn't knitting with that ball of yarn. I was wondering if it would make a good squeeze toy. I may have to keep my thumb still, but I need to provide some therapeutic movement for arthritic fingers...which were used to knitting.]

Meanwhile, back on the 11th floor...

Mr. T's observation period was ticking away, with just a small hitch. At the 4-hour mark, the nurse who changed the bandage decided he needed to stay a couple more hours. Of course, that timing coincided perfectly with the arrival of the winter storm we'd been hearing about all day. You knew that was coming didn't you?

No worries. We made it home just fine, following the salt trucks and snow ploughs all the way. Missy M took good care of us until she headed back down I-85. And Mr. T was a good patient, following his doctors' orders for a quiet recovery. 

So far, so good. His heart rate is consistently registering below 100, his blood pressure is staying in the normal limits, and there is no indication of the arrhythmia. I say again...hooray and hallelujah!

And me? Well, I may have to give up knitting for a few weeks; I may have to forego using a keyboard and stick to talk-to-text and single-digit typing on an iPad; and I may have to figure out how to make-do in the garden with just my right hand (using a hand trowel, yes; using a cultivator or hoe, no). But I can tell you I am doing better already.

And that promised...the rest of this story.


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