Tuesday, July 23, 2013

A holiday - or is it to be cancelled?

I had wondered about getting away to Geelong, subject to respite leave availability, to visit a couple of old Geelong Band mates Graeme Daly and Trevor Trigg whom I had just learned still get together as a trio with one member missing.  I reckoned I needed to temporarily fill in my missing place after 38+ years of not having done so.

As time went on, I reasoned that Pam could possibly use a getaway holiday too and that would also obviate the need for respite care for her - up here at Mildura at least.  I put the idea to Pam, and she showed considerable interest, particularly as her mother's 90th birthday was coming up.  Goody!  Checking the calendar the week from Monday the 5th of August to Monday the 12th seemed to be promising, so I set about finding out how it could be done...

Pam's Case Manager, Peta Weber, suggested that non-emergency air ambulance might be available for transport and that she'd help me find a nursing home with respite care included.  I would be taking the car loaded with Pam's goodies - her electric wheelchair, food pump and stand, Compat feed sets, food, meds, toiletries, clothes, etc., etc.

After a few disappointments, I found a place for Pam’s care at Benlynne Park Nursing Home, which was (thankfully) more than willing to cater for Pam’s respite care.  And so, in due course, a number of documents were sent to me from there, including a BIG ‘Respite Chart’ for my GP to fill in.  The size of this had me worried about the impost I might be giving to Dr Bob and so I typed up a detailed page, carefully worded, to explain to and help Dr Bob fill in the big form.  I then made an appointment to see him in this regard, which was to be yesterday at 10:45am.
But that date was then a week and a day away, nevertheless things were going along swimmingly, so what could possibly go wrong?

If you’ve read earlier posts of this blog, you’ll know that Pam has a colostomy; and has had so for many years.  The colostomy (in Pam’s case) was achieved by cutting the upper rectum and protruding the upstream end through the abdomen as a ‘stoma’, to which is daily attached to a colostomy bag – for faece collection.  The downstream portion, no longer connected to the digestive system, became Pam’s ‘redundant rectum’.

Now a redundant rectum might well be redundant, but it’s not dead – OK?  Indeed, it still exudes secretions and proceeds to digest them.  After a few months, this mass needs to be emptied using a thing called a ‘mini enema’ and what is delivered is virtually identical to faeces, but who cares?  However in 2009, the three monthly routine suddenly became a two weekly one and quickly happening at even a much more rapid rate.  I was alarmed and subsequently the medicos found an adenocarcinoma (cancer) causing the over-production.

This cancer was magnificently dealt with by Dr Kevin Chambers and totally removed – leaving a much shorter rectum; perhaps just 10 – 14cm long or even less.  Nevertheless, this shorter length quickly settled down to about the same rate of output production as did its original length, prior to the adenocarcinoma. 

Last Saturday week, Pam asked for a mini enema (as she could feel it becoming an issue) and I went ahead noting that the previous one was two months ago.  However, though the coming week, more output was dumped (into Pam’s panty-pad) and this happened twice.  Then, during Pam’s Saturday shower (Saturday just gone), she inadvertently dumped a fair volume onto the shower recess floor – no drama, just surprising.  How much had I not gotten rid of the previous Saturday, I wondered.  So I gave her a second mini enema – and the output was alarming.  It was about the same volume as that on the previous Saturday.

By Monday morning, I was curious and so gave Pammy a third mini enema – and got another similar result and so by that evening I was getting very worried.  I called the ambulance, hoping to have Pam examined for (and yet hopefully not) yet another adenocarcinoma.

The two ambulance staff were very empathetic and explained that if I could get Pam to our own GP, it would be far better than taking her to A & E, as that was currently ‘a madhouse tonight’.  When I told them that I already had an appointment in place re the medication document, they implored me to take Pam along too – and get Dr Bob’s point of view.

I eventually retired to bed that night (just two nights ago – I’m writing this bit on Wednesday) semi-convinced that our holiday was on the rocks and that my darling frail wifey would have to undergo yet another massive operation that could possibly kill her.

And so, yesterday came and along to Dr Bob’s we went.  Dr Bob looked up Pam’s history and found that just last year, she had been tested by Mr Chambers and while found to have an inflamed zone within her redundant rectum, there was NO cancer to be found.

(Apparently, that test and result had been totally forgotten by me – but in fairness to myself, I say the symptoms were way too familiar.)

Dr Bob concluded that the inflamed zone might be playing up, causing the problematic over-production and that a course of Predsol suppositories would probably ease the situation, but otherwise there was no need to cancel anything, holiday-wise.

Beauty, I thought – but strangely I remembered seeing some suppositories sitting in Pam’s bedside widget container.  I wondered if these were they.  Anyway, I picked the prescription and, sure enough, they were the same as previously.  The prescription contained 30 suppositories, but what remained with Pam’s bedside widgets were only 3 in number.  Neither Pam nor I can remember why she had previously been on a Predsol course, but we both vaguely remember a ‘suppository routine’, now long gone.

Last night, I looked at the form I'd given the good doctor and noticed a pocket therein to place a picture of Pam.  This is the one I picked...

...which is pretty recent, being taken on 13/02/2013.

Anyway, all’s well once again and so, come Monday week, we’ll be off! 
Pammy by plane, me by car.  Eee-har!

Ah, the delight!  Now it's Friday 26th July as I type this...  After a re-read of the above it occurred to me that I neglected to mention a surprisingly fortunate consequence of the arbitrarily chosen holiday dates.

Pam's loving mother, Mary Austin, turns 90 years of age on Wednesday, 7th August - right in the middle of the chosen week away.  We even have time (on the following Saturday) for a birthday party with about 95% of the family to be in attendance.  So that's a bit of a plus, don't you think?  I should point out that the venue for the party is still an open question - Pam's poor mum had a fall a week or two ago and broke her hip.  She is currently in a rehab facility.  Wherever she happens to be on the 10th is, no doubt, where the party will be!