Saturday, April 11, 2009

Post-Op Day 1 (P.O.D. 1) Ethan's AM Visit

I was on the train on my way in to see Chandler before heading to the office (need to catch up on work that piled up this week) when Michael called me to say that Dr. Kyles called to say Chandler was up, well and looked like he might even be able to go home tonight. Only thing, they're having trouble getting him to eat. So, on my way up 9th Avenue, I stopped off to get a Chicken-flavored baby food for Chandler, since he usually can't resist that stuff.

As they brought me downstairs to the inpatient unit (what an ENROMOUS HOSPITAL and unit, btw...) I heard this awful sound of crying. I thought it was Chandler and when I turned the corner and saw him, it was! He looked so horrible. Shaved for surgery, sutures everywhere, blood-tinged urine stains on the wee-wee pad... he looked as bad as I've ever seen a dog. He recognized me immediately and ran up to the front of the cage and the crying and the noises started to get louder and faster. This was very upsetting. After some attempts at licking me and such, he started to try and escape the cage. I decided that first I'd try to feed him. He was interested in the food as I was preparing it and taking it out of the jar but he wouldn't eat it. I put a little on my finger and he took the tiniest few licks but ran away and yelped each time. I assumed that meant that it hurt him to swallow it (there are incisions IN the mouth, too) so I abandoned that approach.

Next, I asked the handler if I could learn how to lift him and have him sit on my lap. This was not as easy as it should be for an 8 lb dog. Especially with him squirming and freaking out as he was. Eventually I got the hang of it and got him to lay on my lap, but it's hard for him to get comfy because his belly incision can't get on my lap and his neck incision shouldn't be on my arm. I digress...

The crying got worse and worse and I asked the handlers if this was going on all day/night? They said, "Yeah" as if it were normal. I said, "Well, I know him and this is PAIN!" They tried to talk me out of it, but I was having NONE OF IT! I said to her, "No offense to you, but please page Dr. Kyles and ask him to come in here RIGHT NOW!" So they did and Dr. Kyles arrived.

He was very matter-of-fact and said that he thought this was pretty reasonable for post-op day 1 and that Chandler could go home tonight if I wanted. I must have looked at him like he had three heads because he said, "What's wrong?" I politely voiced my concern that this is not normal for Chandler. Even when he gets whiny after sedation and such, it's NEVER like this. This is no anxiety or agitation... this is the sound of P A I N and we need to do something about this, NOW. He said that Chandler was getting 3 mg/kg of IV Fentanyl last night and this morning he looked good so, in anticipation of his discharge later today, they started to taper it down a few hours ago to 1.5 mg/kg. I said, "Maybe this is the issue? You've lowered his pain meds and now he's in pain again?" Dr. Kyles seemed skeptical at first but looked him over and then agreed and said he could definitely bring the Fentanyl back up but that would mean no coming home tonight.

I was torn and wanted to talk to Michael about this but there was no cellphone signal there and no landline in that room. I didn't want to leave Chandler after just getting there, but I wanted another opinion- MICHAEL'S. I asked Dr. Kyles, "If this were your dog, what would you do?" He said he couldn't answer that for me. Lovely. Okay, Dr. Ciment, you're on your own.

I thought it through and asked Dr. Kyles, "Okay, so let's say I bring him home and he has pain- what do I do? He won't let anything in his mouth, and I can't just shove a pain pill down his throat like you can with most dogs... will I be injecting him?" And, of course he said I wouldn't. "That's the challenge here" Dr. Kyles told me. The flip side of this is that, we KNOW he'd be more comfortable at home, resting in his own bed, in his own space, etc... so this was not a straight forward decision. In the end, we decided that we'd take the pain meds back up and let Chandler stay another day & night. Nothing will be comforting about home if he's in intractable pain.

I watched them up the meds on the IV infusion pump and Chandler slowly started to calm down. I gave him some Reiki. Then, I left him and now am back at the office, hoping that I, too, can calm down.

I'm planning to head back up at 1:30-2-ish and will visit again, this time with Michael. I'm hoping to see a very different little man-- one in less pain and more comfy.

Next update- mid afternoon.


  1. It's all about Chandler's comfort. PERIOD! How they could not see he was in pain is very upsetting.

  2. Every dog is different, hun. They probably expect an old, little Yorkie to be more vocal. They don't know him. They're strangers. That's why we're there for him... we speak Chandler and can interpret. That's why I raced to get there this morning.