What hurts, what doesn't

I came home last night from the hospital. I survived the surgery. Flew through it, in fact.

They had me prepared for the worst. Two IVs: one 16 gauge, one 14 gauge fire hose. They were convinced I'd bleed out. I didn't. My total estimated blood loss was a completely unimpressive 5 mL. Although my gallbladder was swollen to three times the normal size thanks to portal hypertension, it came out easily, and when the collaterals were nicked, they clotted off appropriately.

The problems came afterward, when they took forever to start my heparin drip. They were supposed to get it going 8-12 hours post-op, but with poor communication and dilly-dallying and RNs expecting me to take a shit immediately post-op (no one does that, btw), I had to beg them. They finally got it going 12 hours after surgery, right at the cusp. I was about to call my hematologist and have him get serious. The Charge RN said she would do it "against protocol" since "it seemed so important to me." "Seemed so important"? Fuck yes. It was necessary. Read my chart, lady? How many clots do I have to throw before you think it's important?

Then to complicate things, they sent me to the floor with no orders for pain meds. WTF? Apparently my surgeon thought I was somewhat obtunded in the PACU on my 0.6mL of IV Dilaudid and told his resident to go easy on pain meds, but not to give me NOTHING. I went apeshit on them.

Six hours later, they gave me one Norco 5 PO, which with my history wasn't going to do much. Then 1mg PO Dilaudid, which helped some, and finally I got orders for IV pain meds. I was writing e-mail to my primary care MD and going crazy. It was a nightmare of sweaty writhing. I did have a great RN doing her best for me with a surgery service refusing to return pages.

At rounds the next morning, I let the residents have it. Of course, they wrote me off as crazy lady. They said that they had reasons not to give me pain meds (see above about the miscommunication). I said that if they'd decided to give a post-op patient no pain meds, the least they could do was come to bedside and explain why. They agreed. I was pissed off. I told them that there were other options, such as Toradol (which they may not have liked because of the GI bleeding) or IV acetaminophen (which they may not have liked because of it being processed through the liver) but that they had to discuss a PLAN with me.

I was a pain-in-the-ass patient. But you know, I was suffering. And I am tired of being treated like I don't know anything. I do. I felt so upset, so reminded of being patted on the head. My friend Katie  was with me and told them to give me Ativan, which was good and bad. Good in that it calmed me down, but bad in that it suggested that I didn't have a right to be upset, that my reaction was abnormal. Looking back, I was right, not hysterical. They did come up with a plan, but the plan kept changing without them telling me. It was horrible. Apparently transplant surgeons really hate giving out pain medications. Why could they not use critical thinking skills? I was on the transplant service because of my risks, but I am otherwise young and healthy. They saw that my liver was healthy. My enzymes were really pretty good (slightly elevated after surgery, but no big deal: they'd been moving it around!). The surgeon said my liver looked great; it's just the vasculature that's problematic.

Which then made me feel like I was fighting the same battle over again, with people who don't want to listen to me. CRITICAL THINKING. Where was it?

I am tired, so tired, of being around dysfunctional people who pretend that they're not dysfunctional, who blame me for their own bullshit. I have reached out and tried to have a relationship with people who are stunted. Tried and tried. Explained, apologized, admitted to being human, having made mistakes. I will meet them halfway, but if they want to be dysfunctional to such a degree, they are on their own. I refuse their labels and scapegoating. And now I refuse their silence. It's pathetic. Hiding in holes is pathetic. If you cannot communicate, you're not human. You're not dealing with anything. SAY it.

When you run out on me, when you tell me that my name is shit, when you dump me again and again and don't have the balls to admit you're wrong, or you've lied: you've lost all the high ground. And my respect. I can love you, but I sure don't like you.

You can be as important as you want in your own big picture. Have fun with it.

I am who I am, and fuck, I love myself. I'm a mess, I'm crazy, but I'm loyal and decent. I don't sell people down river, and I say what I mean. I am not lukewarm. I hate fake, lukewarm people: they're untrustworthy. Be in life to play and to love for real, or fuck off. If I scare you, then yeah, you'd better stay away. But that's on you, not me.

I have a great group of people around me who love me and accept me for who I am. My family is the family I've made. It's not the way I ever thought it would be; it may not be what I had dreamed or hoped for, but it's much more rewarding than chasing after unfriendly chimerae. The people who want to be with me are with me. My aunts told me that my father hated two kinds of people most of all: cheaters and liars. Go figure: like father, like daughter.

And for once, I am happy. Funny how when you find the right people, they don't tell you shitty things to make themselves feel better, or hide, or speak out of both sides of their mouth. They accept your difference, and love you.