Throw Open the SASH or The Kissing Station

18 Dec

When you’ve been a relationship for a very long time and your significant other becomes seriously ill, it can really throw you. A thousand questions spin through your head:

Will he be OK?

What if he doesn’t make it?

Am I too old to start dating again?

I suppose that last one sounded a bit harsh. I should tell you that in my house, when the going gets tough, we turn to gallows humor. Truly,I was just kidding!

I am totally not too old to start dating again.

Joseph was released from the hospital with a PICC line installed in his arm. The doctor ordered two weeks of IV therapy to treat the abscess. The insurance company would cover only 2 nursing visits. After that “someone else” would have to administer the IV to Joseph.

Everyone was pretty much looking at me.

For those first two treatments, Joseph and I went to a place that offered “Infusion Suites.”

This is not as swank as it sounds. There was no mini-bar, but they did have a little fridge with soda and water and you could help yourself. They had a comfy chair with an IV pole so the patient could relax while the IV dripped away. It was there that we met a wonderful nurse named Debbie.

Debbie gave Joseph his  first IV treatment while I watched. The next day, it was my turn to administer the IV treatment while Debbie supervised.

Thus, I learned the SASH Technique.

It has nothing to do with windows.

I don’t know about you, but I think The SASH Technique would be a great name for a techno band. But SASH really doesn’t have anything to do with music.

SASH is the acronym for giving any medication through an IV.
With a PICC line there is one line for putting medicine in and one line for drawing blood. When it was time to give Joseph his IV, I would shoot a syringe full of saline (give me an S!) to clear the line, then I’d attach the IV and administer (give me an A!) the anti-biotic. After the IV finished dripping, I would shoot another syringe full of saline (give me another S!) into the line. Finally, I would  seal the deal by shooting a syringe full of Heparin (give me an H!), an anti-coagulant, into the line. (SASH!)

It is all terribly scientific, but I hope I’ve been able to convey the flavor of it for you.

After the two weeks were up, it was time to find out if the abscess had been adequately zapped by all that SASHing.

When Joseph went to the ER and was then admitted, the hospital assigned a surgeon to him. When the surgeon determined he couldn’t take out the appendix until the abscess was healed, the hospital hooked Joseph up with an Infectious Disease doctor.

I gotta say, I never understood why he needed a specialist. I’m not saying it is a racket, but…

All this specialist did was order the IV therapy, and as I’ve demonstrated, I did all the heavy lifting for that. Joseph had a surgeon and a primary care  physician. Either of them could have ordered anti-biotics. But for whatever reason, Joseph had an Infectious Disease doctor and the next step was to go see this guy.

Once we were there, all this specialist did was read the results of a blood test. It looked good. To be certain, the doctor ordered an abdominal scan (which, either of the other two doctors could have done. Just sayin’…)

To Joseph’s horror, the doctor announced that it was time to remove the PICC line. Joseph didn’t want that thing in in the first place, but once it was there, he couldn’t bear the idea of them ripping it out of him.

“Don’t panic,” I said to him. “Of course they’re not going to “rip it” out of you! Don’t be ridiculous!”

Next thing we knew, 2 nurses came in. One of them snipped the stitches holding the PICC line in place and then the other grabbed the end of it and would you believe, yeah, she pretty much just ripped it right out of Joseph’s arm. Fortunately, he said it didn’t hurt. but you should have seen the blood fly!

For the next stop on our medical journey, Joseph and I paid a visit to the facility where the abdominal scan was to be done. Joseph was given bottles of barium which he needed to start drinking the day before the scan.

There was a whole schedule for the intake of the barium. He drank the last one the morning of the scan.

His innards appropriately coated with barium (apple flavored!), I drove Joseph to the hospital for his abdominal scan. Once there, he met with a nice lady whose job it was to determine how Joseph would be paying for the procedure. It was during this meeting that we learned the Infectious Disease doctor who had ordered this scan had failed to obtain a pre-authorization from the insurance company. Just hadn’t done it. As the nice lady explained to us, if they did the scan without a pre-authorization, Joseph would most likely be stuck with a $10,000 bill for the procedure.

See, I knew we didn’t need that damn specialist!

Of course, this transpired on a day when the Infectious Disease doctor’s office was closed. The nice lady recommended that we go home and come back another day, after the insurance company had authorized the scan.

I must say, in the parking lot, I pretty much lost it! I was now squandering a day off from work when I still didn’t know how much time I’d need to take off once Joseph had the surgery. Not to mention, Joseph had been drinking barium all night. I fussed, cussed and fumed. I was pissed!

This turned out to be one of those rare occasions when Joseph was the voice of reason. (That’s usually my job…) He asked me to take him to the office of his primary physician-who for blog-purposes we will call Dr. P.

We both love Dr. P. and after this day, we loved him even more. He sent Joseph and I back to the facility while a member of his staff worked the phones. We checked back in at the hospital and then waited for the word that the pre-authorization had been received. We waited for hours, but in the end, Dr. P came through. The insurance company faxed the pre-auth and Joseph got his scan. All that barium drinking was not in vein.

In the days and weeks that followed, we learned that the abscess was under control. Joseph was admitted to the hospital yet again, and at long last, his appendix was evicted from his body. After the operation, the surgeon found me in the waiting room and told me everything had gone well. Except…He couldn’t really explain it, but most of the appendix wasn’t there anymore. Apparently it burst and went wherever appendix bits go when they explode. Still, Joseph was fine and he recovered from it all rather quickly.

There are many stories from this medical drama, and I may tell some of them in the future. But it was important to me that I get this last chapter posted to my blog before the end of the year. A way of putting this whole ordeal behind us as we head into a new year.  (Plus, now I can blog about something else!)

Ordeal it was, but still, there was much to be thankful for. First of all, I am thankful that my employer offers domestic partner benefits. After Joseph’s first in-patient stay, we received a statement from the hospital. The total cost of the stay was $50,000. After the cost was adjusted per the PPO contract and the insurance company had paid their portion, we owed only $1200. I have never been so happy to see a bill for $1200 in my life.

Secondly, as daunting as this medical episode was for us, as with all things in life, it could have been worse. Joseph and I come from a generation of gay men who spent a significant portion of their lives being care-givers to sick friends and lovers, many of whom did not survive.

That really puts our little appendicitis adventure into perspective.

I also have to say I am grateful for the terrific medical professionals we encountered. Not only for the excellent care Joseph received, but also for the way they treated us as a couple.

There’s one moment that really epitomizes the manner in which all of the doctors and nurses acted towards us:

After the hospital folk prepped Joseph for surgery, a nurse retrieved me from the waiting room so I could walk with Joseph as she wheeled him to the operating room. As we advanced down the hall, she said to me, “up ahead is what we call “the kissing station.” It was a little alcove that was relatively private, where the nurse paused so Joseph and I could kiss before he was wheeled into surgery.

No “special rights”, she just treated us the same as she treats everyone else.

Even ordeals have their highlights.

3 Responses to “Throw Open the SASH or The Kissing Station”

  1. Fred Lehman December 18, 2011 at 3:57 pm #

    Well, I’m glad to hear you got through that alright. Interesting story, my stories with the Medic aren’t that interesting. BTW the Specialist is because of mal-practice suits and it’s also a way of getting more money out of the insurance companies. Sending warm thought and healing energy your way.

  2. enwayne December 18, 2011 at 3:58 pm #

    Medicine in this country is a veritable octopus, with each arm trying to out-wrestle the others. Joseph is fortunate that his PCP was so willing to work in his favor, and that the burst appendix did not result in what used to be a foregone conclusion.

    May all Your and his medical encounters have such positive outcomes! I think that qualifies as a real Christmas present!

  3. Pamela N Red December 18, 2011 at 9:41 pm #

    That’s so scary. I’m glad he’s doing well. I don’t think I could put medication in an IV, I’m such a weenie. It’s so wonderful to be treated with dignity as I am aware how awful some people can be in these situations.

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