Hospital Post 6

The fairly-invisible surgeon appeared a few minutes ago, tracked down Ed who was walking around the hallways, and had a discussion outside my observation post, so i'm not doing direct reporting here.  He thinks that discharge tomorrow is possible, presumably just depending upon whether Ed continues to do okay the rest of today.  The original estimate was 3-4 days; today would be Day 2, but Ed has the benefit of coming into this surgery in a very strong physical condition.  Reading some research papers on the web, I noticed one study in which they looked at people who were discharged within 72 hours of colectomy surgery, which included patients discharged on day 1, day 2, and day 3.  The earlier discharges were associated with fewer readmits.  Of course it makes sense, if discharges are based on rational decisions, that the better you are doing, the less likely you are going to do worse later, and the worse you are doing, the more likely you are going to be doing worse later.  But there was yet a 20% readmission for the early discharges (considerably higher for the later discharges).

Post-discharge, we are up in P.R. with no real medical access, so it would require a 911 call and helicopter medevac if something sudden/serious happened.

Biopsy report on the liver mets is not yet available, but it's not clear to us that if they told us those results we would at the moment anyway have no way of making any sense of it.  The oncologist conversation has not yet been scheduled.

A side note: The morning shift today for nursing included a male nurse and a male student nurse.  Compared to all the other nurses (all females), they seemed more like techinicals/clerks than caregivers.  Yesterday, Ed had a woman nursing student (in a LPN program) who followed him all through the pre-op, surgery, and post-op.  She came by this morning on her own time, just to see how he was doing and to talk to him a bit about how things would play out for discharge.  Just normal kinds of knowledge that she has and we don't.  (Like, 'ask your doctor when you'll be able to drive.)  We were asking her various questions of a simple nature like 'When's the next shift change?'  The male nurse came in while we were talking with her; she immediately reached out to introduce herself  to him and explained why she was there (just following on her own option from yesterday), and for the next ten minutes he visibly presented his irritation at her being there and his assertion of his authority: man, it was worthy of a videotape for a teaching session on how things go wrong in caregiver relationships.
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So, right now, the IV is being disconnected, leaving him pole-less and tubeless.

The difference between Day 1 and Day 2 that strikes me:  Yesterday there was a veritable circus of various kinds of nursing staff in and out of the room constantly (or just in the room for long periods of time). All very reassuring.  Today, they're hardly to be seen or heard.  I think that's a good sign; I perhaps even know that's a good sign.  But I also have a feeling of less concern.  Which would be an accurate judgment, I think, but there is some irrational feeling of, 'No, I want your level of concern to stay very high, even if the situation doesn't merit it.'  Today, I am less worried, but not less caring; I want them to keep on demonstrating their level of caring by continuing to be worried.  Well, that's not exactly what I mean, but close enough to convey the human dilemma on both ends of the family-patient-caregiver axis.