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The Fine Line Part 9: Tap Lessons

The Fine Line is a series of stories from Rick. Check out parts1, 2, 3, 4, 5, 6, 7, 8!

The hospital room was busier and busier as my health improved, it seemed counter-intuitive until I was notified why. My MELD score was dangerously high, which meant that a transplant was in my imminent future. As they’d brought me down to one antibiotic, I was starting to stabilize and beginning to be rid of my sepsis. With sepsis, I’d rounded out every potential symptom of HCV. To be honest I was a little disappointed it’s not more like BINGO. Did I miss my chance, are we at blackout bingo now? I really hope not.

But back in the hospital room…

One of my docs was unusually confident and boorish to say the least. He seemed oblivious to the clear repulsion he inspired in others as they seemed to quell this natural response around him to keep an air of professionalism. He would make inappropriate comments about the quality of my nursing staff. I wish I could say we agreed on the definition of quality in this case, but he was cocky in all the worst ways. As time went on he was looking to perform a tap on me, with a few pounds of fluid still in me I was curious as to when he would.

A day before the bathroom broke; he brought up all the tools, we proceeded and he inserted a short near 4 inch 22 gauge needle into my abdomen. (For a diagnostic Tap, the near 4 inch needle is pretty standard, but the gauge was small. And this was to drain fluid, not just to diagnose so he should have used a larger needle. Technically He’s not wrong, he’s just not correct.) This felt odd, because when I’d had fluid drained before a 16 gauge was used and the needle was near 8 inches in length. Although it looked like it was like 10 inches, Ketamine’ll do that.

I can say with some assertion that I was far more confident in the abilities and the performance of the first surgeon. I guess what I’m saying here is, size matters.

Rick Nash during the tap procedure

He began to drain; finding it difficult he would adjust the needle, draining as much as he could. His inability to pull fluid began to frustrate him, he pulled out the needle blaming its size. He reinserted it and tried again from a different location trying desperately to “chase the pocket.”  He would do this four more times until he had blamed each and every tool at his disposal. He managed to remove enough fluid to test it and barely a few hundred mLs more. The site where he drew from would leak more than any other drain site I’ve had to this day.

I reminded him several times during the procedure that “It’s okay, we can stop if you need to get a larger needle.” His responses were driven by his ego, thankfully he clearly doesn’t do this very often and I found out from his superior that he’d only been here for three months. The nurses would clean it every so many hours, each using different methods. All of them recognized that the skin was emaciated and responded accordingly.

Some would package it with gauze and paper tape others insisted on tegaderm. Each method had its benefits and drawbacks. The tegaderm was a seal, it would keep consistent pressure and felt more like really comfortable tape. The gauze would soak up the drainage allowing the ascites fluid an alternate route while my diuretics helped pull it from my system. Both would leave fluid on the wound worsening the emaciation, however the tegaderm was still superior in this regard. The irritation and pain would be insistent on reminding me of their existence and I would find little avail in my growing need for more pain medication.

The monotony of the walls began to have a distressing effect. I found joy where I could. Because I’ve always found that if you search for joy honestly, you will find it. This was my second hospitalization in so many months and each time my visits grew longer and more grim.

The room was always more of a place of reflection for me, the idea of watching TV doesn’t appeal to me so mine was almost always off. I found myself spending most of my time thinking or browsing Instagram. There were lots of distractions, but I wasn’t interested in that. I wanted to focus on what was happening, how much control I had and how I felt in each moment. About everything really, all of the painkillers and stress made me more emotional. Why did a photograph of a friend bring tears to my eyes? Why was this inspirational quote so apropos at this moment? Why was Ross so obsessed with Rachel? Real hard hitting life questions.

Looking back

I didn’t look back at my life and wonder about things necessarily, I looked back with a sense of accomplishment. I hadn’t done anything grand, but I have done what I wanted. I’ve always sought to improve the lives around me. My notion was that if you know me, your live would’ve been better for it.

To me that is what has always mattered most.

So while I had a veil of uncertainty about me I was clear in purpose. I don’t worry about my numerous failures, they’re part of who I am and I am stronger than I might have been, having experienced less. Mindset is a powerful thing. While I speak of worry, it’s because I let myself be worried. I want to know that feeling. Because without it how could I understand the worries of another and help them.
There’s nothing altruistic about my behavior, I just believe in people and the power of perspective.

So in those rooms, these were my thoughts.

Check back for more from Rick’s series “The Fine Line”

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