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With Andrea, the Jamaican goddess, and your blogger in tow, Mick arrived home from Beth Israel at about 11:30 Saturday morning. There are still issues of pain and swelling, and fatigue. The road ahead is not short but if his progress the past week is any indicator it may not be as long as we expected. He's still not up for calls or visits, but ought to be before too terribly long. There's a pretty hilarious/outrageous story about something that happened last night, which I will post later.

Friday

Extended sleep eluded Mick Thursday night. But he was firing on all pistons, and by morning was divested of all IV connections, which put him in a very, very good mood—not to mention the fact that, on an early morning visit, the orthopedic surgeon said Mick was doing so well he could likely go home Saturday. For breakfast our boy endured a bowl of oatmeal , and had coffee for what felt like the first time in years. By noon he was bathed (by the indispensable Andrea), dressed in his own clothes, shaved (save for the moustache), and sitting down to a cup of vegetable soup and a turkey sandwich. His spirits were buoyant, and on a post-lunch walk, using the cane lightly, with no one supporting him, he said he felt as if he were seeing the whole place for the first time. The thrill of being unencumbered was offset by an emerging pattern of pain and spasm—natural consequences of the surgery—but Mick’s patience and forbearance are something to see. It’s as if having withstood worsening pain for so long, facing even greater pain, which he knows is temporary, is no big deal.

Mid-afternoon Erica showed up with Justin, her trainee (“preceptee” in their parlance, don’t ask, we don’t get it either), to take Mick for a final workout. This involved at trek beyond the Hyman Unit to the “rehab gym” a couple of interlocked pavilions away (like so many hospitals, Beth Israel is a winding Frankenstein-patchwork of buildings.) The gym was full, so Mick had his biggest occupational therapy challenge to date in a fire stairwell: after a second of hesitation, he walked up ten stairs, halfway to the floor above, and back down. I was in awe.

Back in his room, he was triumphant but tired, and the pain got fierce. After extensive consultation with Andrea and Elena, the Russian floor nurse, whose pronunciation of valium is a sensual delight, meds were adjusted, and Mick took a deep half-hour power nap. A couple of hospital flacks came to observe and inform him regarding post-hospital nurse visits. Both were nonplussed by his demeanor and progress. By 5:00 the parade of visitors was over and he was ready to settle in for his last night in the hospital.

The idea is that he will be released late morning Saturday (Andrea will be coming home with him for at least the first day), but of course he awaits the orthopedic surgeon’s final word.

This dude is inspiring.

Thursday

Mick took another stroll around the Hyman Patient Care Unit last night (perhaps more like 60 or 70 yards, rather than the previously estimated 100, but still—) and one more before your faithful blogger arrived this morning at 10:00. While he continues to be a model of progress, in terms of activity and mobility, today his more immediate concern was the lingering effect of nearly nine hours under anesthesia on the operating table. This, and the accumulated effect of his IV pain meds, made him pretty uncomfortable, and not very happy. A lot if not all of this will be remedied when they switch him to oral meds, but they can’t do that until everything’s working properly, which should be very soon. Around 4:00, he got into bed and had just gotten begun to doze when the Occupational Therapy crew showed up—not the beloved Kristin, but Erica, a gum-cracking sparkplug who could be in the chorus of Grease, along with an OT trainee and an RN trainee. They said it was time to get moving (he’d just been on yet another jaunt around the facility.) Knowing how he felt, I fully expected him to tell them to fuck off—but no, our Mick was not only game, he was charming. They challenged him to put the slipper-socks on himself. It was not easy, but he did it. They’d brought an adjustable cane for him to try out, and he took to it like a trouper. Then the whole crew of us—Mick, the three OT nerds, and me—went for a walk. I’ve known this man more than half my life, but he never fails to astound me. If you could substitute brocaded duds for the bathrobe and gown, and a scepter for the rolling IV stand, he would have looked like Louis XIV, with retinue, touring Versailles. Satisfied with his progress (but for the IV pole, they were ready to have him walk up stairs), the OT crew left. Minutes later a custom-length wood cane was delivered. Mick was by this time exhausted, got into bed, and was dozing peacefully by 5:00.

Perhaps most significantly, when the orthopedic surgeon came by early in the morning (a lifetime ago in terms of the progress I saw Mick make over the course of the day), he said Sunday might be going-home day. That’s something to look forward to.

Small Steps and Giant Leaps

It snowed overnight in Manhattan. In the wee hours it was picture-postcard lovely, but by the morning rush hour the snow turned to sleet and rendered midtown a slushy mess, every street corner a guessing game of which step will not leave you shin-deep. This, and some other crap, kept me from getting to Beth Israel as early as I had hoped. I mention this only because when I walked into room 3 Dazian 3 at quarter of eleven, I was greeted with a breathtaking sight: Mickey, sitting upright in the chair beside his bed, talking animatedly with Andrea, the daytime private-duty nurse; Gerry, a physician’s assistant so sharp I assumed she must be the head of something; and Kristin, the physical or occupational therapist (I heard her referred to as both). Our boy had managed to sleep for about four uninterrupted hours during the night—a very good thing, except that when he awoke he was acutely reminded that four hours had passed without his using the pain pump (if you have never seen one, they look exactly like what you hit your thumb with when you want to answer a question on Jeopardy.) Meds were adjusted, and a brief crisis averted. Minutes before I got there, Mick had, with these sterling ladies’ help, for the first time risen from his bed, walked to the door of his room (a distance of ten or twelve feet), and back to the chair. Based on his condition the day before, I would have been only marginally more surprised if they told me he had levitated.

Gerry changed the dressings on the incisions, a delicate maneuver that increased Mick’s comfort level considerably. Penny and Susan arrived just after I did. Mick was back in bed, tired from his excursion, but obviously happy and empowered by it. Andrea (a spirited woman with a melodic Caribbean brogue and a seemingly encyclopedic knowledge of how handle post-spinal surgery patients) is a cat owner and lover, and she and Susan and Penny and Mick traded animal stories.

Later, the bright-eyed Kristin (whom we’d met and liked on a pre-op visit to the hospital, and who has the charm of your second-grade teacher and the will of George S. Patton) returned and said it was time for another walk. She and Andrea got Mickey out of bed and across the room and took him for a walk out and around the immediate area and back, a total distance of what I would estimate to be close to a hundred yards. He said it was like learning to walk all over again, and I have no doubt that that is true; rising and sitting are the hardest parts now, but getting all those joints and muscles to perambulate in their new configuration is no picnic, either. It will come as no surprise to you that while none of this was anything close to easy, Mick approached it all with methodical calm, determination, and amazing good humor. When he returned to the room, he sat in the chair and had a great phone chat with his father, Tony. Soon after, he was understandably exhausted, and got back in bed. As Andrea and Mira, the staff nurse, did one of their periodic checks of his vitals, he talked about how good he felt about what was going on. Mira referred to him as a “one-of-a-kind patient”—attentive to and cooperative with his caregivers, and reaping the resulting rewards. I know that this, too, will come as no surprise.

At 4:00 Adele returned, and Andrea left, and so did I. Mickey had a very good day, and deserves a very good night.

PS

In that last post I forgot one of the most important things: When Mick was in recovery, long before we saw him, the young doctor standing over him trying to hoist him out of eight-and-a-half hours of anesthesia said “I’ve heard people say a lot of crazy shit when they’re coming to, but I’ve never heard anyone say what you said.” Bleary and brainless, Mick asked him what he'd said. The doctor said "You said Life is so beautiful."

Day Two

At 9:30 Monday evening Mickey was moved from recovery into what they call at Beth Israel step-down care—sort of like ICU, a place to keep watch over people who have had major surgery before they are dispatched to their regular rooms. He was in a room with three beds, and a nurses’ station that adjoined another room. The other two beds were unoccupied. His spirits were generally good, but he was in pain, and a little cranky. By the time his sister, Penny (who had arrived from Philadelphia), Susan, and I got there he had a full hate on for the young male nurse on duty, a strapping guy with a thick Korean accent everyone called Mr. Oh (or perhaps O, I don’t know if it was an initial or his name—sorry.) Mick had been visited by a physical therapist, and was already occasionally rolling from side to side, stretching ever so carefully, because it felt good. This astonished us. At one point while we three visitors chatted apart, Mr. Oh came in and checked all Mickey’s tubes and beepers and clamps and flashing screens, and adjusted his meds. They seemed to make their peace. I think Mr. Oh had simply become a focus for our boy’s discomfort and frustration. But who could blame him? The room was overheated and noisy and open to random intruders. (Mick to the cleaning lady: “Miss! Please stop mopping.”)

A little before 3:00 Mr. Oh disconnected Mick from almost everything but the self-administered pain pump and said he would shortly be moving to his actual room, which pleased everyone. (We’d been told it would happen around this time, but you never know.) By 4:00 Mickey was firmly ensconced in a private room. Adele, the first private-duty nurse, could not have been nicer or more attentive. Ditto staff nurse Natalya, a stout Borat’s-sister type, with matching accent.

A little later a young associate of the orthopedic surgeon came by. She allowed the head of the bed to be raised to a 35 or 40 degree angle (because the removal of the benign growth involved entering the spine and stitching it up, he’d had to remain flat on his back for 24 hours.) She also authorized him to drink water. Tomorrow he begins a clear fluid diet. (Heretofore his diet has been restricted to ice chips, and swabs from those heinous little sponge-on-a-lollipop-stick things.) By now he was beginning to doze for the first time, so I got the hell out of Dodge.

Mickey is doing very well. It will some time before he is ready for calls or visits, but he sends his love and thanks for everyone’s good wishes. As do we all.

A Successful Procedure

At 4:30 our pal the orthopedic surgeon showed up in the waiting room, still in his scrubs and shower cap, and told Mickey’s mom, Susan, and me that Mickey was fine and that the whole procedure had gone as well as it could have gone. In addition to fusing L5 to L4 and L4 to L3, he had also, after seeing everything live and in person, fused L3 to L2 (he’d told Mickey last week that this was a possibility.) The additional fusion would not, he told us, cause an appreciable reduction in Mickey’s mobility or flexibility. In fact, once he’s healed, his movement will be less restricted than it currently is by pain and muscle spasms. The only downside of this I see is that he may have to cross “joining Cirque du Soleil” off his to-do list.

Beth Israel’s post-op visiting policy is to allow two loved ones per patient to visit in recovery for about ten minutes, every two hours on the half-hour—12:30, 2:30, etc. We’d missed the 4:30 viewing (and anyway, as the orthopedic surgeon blithely mentioned when he first came down, “they’re still sewing up the skin,” which frankly kind of grossed me out), so after such a long day it was a very long two hours for Suze and me to wait until 6:25 when we could go upstairs. But go we did, and there our boy was, tubed and clamped about everywhere you could put a tube or a clamp, but happy to see us, and happy that the procedure was a success and, more importantly, over. He already had the self-administered, no-more-than-every-six-minutes pain pump, which he used with gusto. All things considered, he looked great. The wit was intact. When I told him they’d done the additional fusion, he asked “Is it included?” And as the older man in the next bed, only about three feet way but mercifully separated by a curtain, moaned loudly in a haunted-house kind of way, Mick muttered “Dude, if you can’t take the pain, don’t have the surgery.” This, of course, was followed by a few choice Ows! on Mick’s part, and a couple of pumps in vain of the pain button.

They’ll keep him in recovery for a while, possibly until tomorrow, and the next destination will likely be step-down care, before he lands in an actual room. I’m pretty sure he’s not going to feel as good tomorrow, or even the next day, as he felt this evening. But it is done, and it went well, and now he just has to work on resting and healing.

Monday mid-day

After a day marked by remarkable calm and strength, and an evening marked by a couple of bursts of quite understandable jitters, and thanks to the miracle of modern pharmaceuticals, everyone in apartment 10C managed to sleep last night. We were at Beth Israel Admitting (which is also the Surgical Waiting room--more about that in a later post, from home rather than a creepy 14th Street internet cafe) at 5:45. Mickey filled out several hundred pages of forms and at 7:00, when he was tagged and gowned, I bade him farewell. At 11:45 the orthopedic surgeon, who is the team leader and a great guy, called me on my cell from the OR to say that phase one had gone very well, and that they were about to start on phase two, from the back.

I figure phase two will take just as long, so he won't be in recovery until the cocktail hour (at least that's how Mickey would parse the day.) His Mom's coming down this afternoon and I imagine if we're able to see him at all, it will be briefly, and in the evening.

More soon.

Sunday

Early on the morning of Monday, January 26, our guy Mickey will enter Beth Israel Medical Center for spinal fusion surgery, to end pain that has worsened exponentially in recent months, and which he has borne all along with characteristic cheerfulness and grace. It’s no walk in the park—in a single procedure a team of three surgeons will open him from the front and insert the steel rods that will correct the spinal degeneration and allow the fusion to occur, then close him and reopen him from the back, where the neurosurgeon will remove a benign growth around his spinal nerves that is not causing a problem now, but which will be inaccessible once the fusion takes place. The orthopedic surgeon will remove some herniated and burst discs, remove some bone spurs, deconstruct and reconstruct three vertebrae, and then bone graft them all together (that’s the fusion part). Hours of fun!

Originally it was scheduled as two surgeries, separated by a three-day hospital rest. After conferring, the surgeons decided that, since Mickey is young and healthy, it would in fact be easier on him to do everything all at once. However it’s possible that once the surgery is underway, the doctors may decide to revert to the original two-surgery plan. (Cross your fingers they stay with the one-day option.) The procedure will take a long time, and we assume he won’t be in recovery until late in the day; after that he will be in step-down care, and we’re guessing perhaps not in his regular room until Wednesday.

Mickey has asked me to tell you he has bought lots of fashionable loungewear for his hospital stay. He has also announced plans to grow back his moustache.

I’ll try to post an update here at least once a day, probably in the evening.