Master Evaluation (Cleveland 2b)

At 9:30, our party of 4 takes the shuttle to the main campus. There are 37 buildings on the 140-acre campus. I wait for a landmark to identify our stop. I describe the entry of the building we're looking for. Here it is, KK. Verify with the driver. And we're in.

The International Center is as polished as ever. I draw the same consultant as before and she remembers the little mix-up from before. Information verified, we wait for the financial consultant.

In the Finance Coordinator's office, I introduce my Financial Advisor:Medical to Lucy. And it's like I'm 14 all over again. Lucy turns all her focus to Dad. They exchange cards and arrange their direct communication lines. "I'll just send it all to you, Joe, no need to bring Chris into it."

Hello? I'm in it. Here's the thing: I'm 40 years old. In September, my son will be a high school senior; my daughter, a junior. When will I be considered an adult?

John accepts the map from Bernice, our concièrge. My method of getting around is a little too dicey. He's concerned that I won't be with them to "recognize a piece of concrete and know to go left." Bernice escorts us to our first stop in the pre-op process.

Welcome to the paperless hospital. I complete the medical questionnaire online. We go to the next stage. Julie begins the online admission. The Resident does a physical and enters the data. My newest itinerary shows a psychological assessment...we all think this could be trouble!

Each member of the surgical team tries to cut and paste the info from one tab to the next. It's a lot of repetition. The team members are helpful and informed. Each patiently answers questions from all of us. Sydney, Teaching Team Leader, reviews the mechanics and engineering of the device.

Ace surgeon, Dr. Bipan Chand, describes the procedure in great detail. He is prepared to spend as much time with us as we need. We discuss protocols and follow up. He quickly dictates a letter to my specialists at home.

For a paperless health care site, I've collected several copies of my itinerary for the day, a binder of instructions, some promo material, papers of I-don't-know-what...and I still have a couple stops to make.

It's a lo-o-o-ong walk from M-building to A, the final destination. We review it all again with the anaesthetic consultant - meds, allergies, history. She understands the cross-contamination/airborne allergy concerns. We reach the fitness part of the questionnaire. I've been indoors too long, so when she asks "Can you walk 6 blocks easily?", I respond, "Is that uphill?".

She leaves the office with my paper chart to discuss whether I'm cleared for surgery. The image of a person, sitting in a darkened office with walls of dark-tint glass makes me laugh. I ask Jennie to sell my case well, and suggest that if this person could only meet me, he'd clear me in a jiffy!

In a short while, she comes back and pronounces me Cleared for Surgery. It's 2:45 p.m.

Cleveland 2a
Cleveland 2c
Cleveland 2d
Cleveland 2e

Operation Order (Cleveland 2c)

At 6:00 a.m., we walk across the street to the Surgical Center. At the check-in, we verify patient information again. John is given a pager. As information about my case is available, he will be paged by the clerk. My code-name is jotted on a piece of paper and slipped across the desk.


The Cleveland Clinic performs an average of 250 surgeries each day. In order to keep families updated on the status of their loved ones, a large video display terminal hangs in the lounge.

For privacy, each patient is listed by code. My progress will be updated throughout the morning on the board. Jokes about Delayed, Cancelled, etc. appearing beside my code ensue.

The rest of the day's recap, courtesy of John's emails from that day:
8:06 a.m. - Chris is in surgery. It will take about 3 hours and then another 2 hrs. in PACU. We'll be able to see her for 10 mins. in the recovery room after that.

11:19 a.m. - Picture the arrival/departure board at the airport. The board now shows she has entered PACU though we haven't heard anything yet.

11:58 a.m. - Spoke to the doctor. Surgery went fine...The pacemaker is on and seems to be working fine. Probably another hour before we can see Chris.
Keeper, The Caring Canine, stopped to visit us. The hospital has a Chocolate Labrador Retriever that is walked through the waiting area, offering comfort to family members.

1:00 p.m. - We had our first 10 minute visit with Chris...She looks better than expected and is feeling pretty good overall. Once she's in her room, we will be able to stay with her longer. Looks like we can finally celebrate. Time to go have a beer!

At some point, we'd been told that 2 visitors would be allowed to see the patient in the Recovery Room. I pictured John, Mom and Dad playing Rock-Paper-Scissors in the waiting room. Luckily, they find Lloyd is willing to bend the rules a little. At the 9-minute mark, he shows up to escort them out.

I am moved into a room in M-building. At some point, the Nursing Aide comes in to present me with some swag. Cruel to receive a water pitcher and not be able to use it, don't-ch-ya' think?

Cleveland 2a
Cleveland 2b
Cleveland 2d
Cleveland 2e

Positive Wave? (Cleveland 2d)

It is a terrible night. I do not have good symptom control. I'm miserable.

Knowing that I'm being discharged, I'm convinced that if I could just get out of the bed, clean up and dress in real-people clothes, I will feel better.


I jimmy the side-rails down, gather the various equipment on one side and devise a system for getting up. After a few modifications, I am up and moving. It takes a couple trips to drag stuff around to where I can access it. Ready to become human again, I realize that until I'm disconnected from some of the paraphernalia, there's really not much I can do. I put on some brand new sister socks...and nearly wipe out on the slick floor. The bag of swag included some slipper-socks, so I don those instead.

When the nurse comes with the meds, we discuss the discharge and she disconnects me from everything so I can get dressed.

John, Mom and Dad arrive. I'm really bad company. I haven't slept and I've done a lot since 6 a.m. Let me now apologize to Gladys and Ethel, the nice ladies from the church who stopped by to see me. "This is not a good time," I snapped at them. Ladies, I'm sorry for treating you so poorly. If they ever go online and Google their names, maybe they'll see it.

After some confusion, shortly past 1:00, I'm cleared to go. John works with Bernice to arrange transport back to the hotel. He's prepped the meds.

Back at the hotel, I return to my regular routine of med delivery and at 5:00, I call my parents to play some cards. They are surprised by the difference. I feel well enough to count trump. And my partner and I win at Pinochle. At least, that's my version.

Meds, TPN and a good night's sleep. That's what I need.


[Gladys]
[Ethel]

Cleveland 2a
Cleveland 2b
Cleveland 2c
Cleveland 2e

Return to Base (Cleveland 2e)

I'm grateful that my husband and my parents still love me after I was so miserable most of yesterday.

At 6:00 a. m., I take an inventory and determine I feel pretty good. I work the numbers: if I take one med now, prep the other then infuse it an hour from now, I can supplement the first one at 9:30 and we can be on the road for 10:00 a.m.

John works with the gracious staff to clear the room and load the car. Dad befriends the police officers directing traffic on West 89th. Mom chats up the family waiting by the door. I'm tempted to ask the producer what he and his crew are doing, but decline, only because it's pretty tough to get up from the chair.

Smooth sailing all the way. John wins the first car game. We still need the Commissioner to rule on a play in the second game. I'm pleased that the $12.60 we've paid in Interstate tolls this year is working: parts of I-90 have been recently resurfaced. It is a comfortable drive.

Nothing unusual at the border. No funny stories from the Duty Free Store. It's good to be home.

Michelle has stepped in and handled the household like a superhero. She has directed the day's power-work but her staff have to leave early- one to a football game and the other to work. John tries to take the dog for a walk, but Buddy refuses to go unless I go too. His feelings are still hurt because his Auntie can't walk him either. Eventually, we trick him into going.

Michelle cuts off the 4 allergy hospital i.d. bracelets. Other hospitals in which I've been a patient just use one bracelet and write on it 'Multiple - see chart'. The Cleveland Clinic staff wrote each allergy individually: one bracelet for drug allergies, one for latex, and 2 for food.

When Andrew gets home, he greets me by a warm and loving, "What are you doing home?" At least he let me kiss him in front of Calvin, his teammate who drove him home from the game. I could tell Jess missed me, "Hey! Hi!" she said when she got home from work.

We sit down to the meal that Michelle has slaved to prepare. Michelle decided to have Andrew and Jess select dinner each night by its picture. I don't think she'd ever do meal-planning that way again.

It's hard to choose a movie to watch that evening. We want something funny, but not too funny because it hurts to laugh. We're not up to a thoughtful documentary; our brains are too tired to try a mock-umentary; not looking for a whack-'em-sock-'em-blow 'em upper either. Jessica feeds us Fever Pitch. I see a movie critic promises this movie is "A Grand Slam Comedy", but I know it's tame enough for us tonight.

I can't measure if I feel better or different at all. We're all hopeful because I responded so well with this treatment before, but I have to heal from the surgery first. I'll take it all one day at a time.

Back toThe Beginning of this trip

Destination: Cleveland

This is less a road trip, more a mission. It has been several years since Roni and I embarked upon a Road Trip together. We used to travel lightly - a case of water, a case of ginger ale, a toothbrush and some pyjamas each. The last time Roni and I took a true road trip, we threw all that, plus some juice boxes, water and pop into a cooler, some sleeping bags into the back and all the Tootsie Rolls 6 kids could want. Now we've added a box of sterile medical supplies, and a cooler of medication. A Flometric pump. A telescopic pole on a 30" base. Roni's laptop so she can work and 14 bottles of pills between us. Times sure have changed.

We picked 'the best' line at Customs, crossing from Canada into the U.S. Well, it seemed like a good choice. Neither Roni, nor I believe in regret. My philosophy is that one must consider all the information that's available at the time and make the best decision he can. That said, I regret that I chose this lane.

First, I had to explain the pole. Then the pump. And the cooler of medications (all in original packaging with original labels from the pharmacy). "I guess you got all those needles and stuff, too, then?" he drawled, rummaging through the box of tubing and syringes. "I use a needle-less system," I explained, flashing the intravenous port embedded below my clavicle. The packages in the boxes look like "needles and stuff", but technically, they're not. He didn't seem to care about the distinction.

Since beginning a regimen of TPN nutrition and IV medication I have travelled between Canada and the U.S. on many occasions. Why, just last month, Michelle, our two brothers and I entered the U.S. at a different border crossing, with all my usual paraphernalia, without any difficulty at all...well, except having to explain different citizenship and last names even though we are siblings.

Finally, we were allowed to enter. It's a road trip. Let the games begin! A sign in western New York state proved we were in The Zone after we both interpreted it the same way and made the same joke about it. Soon after that, at the same time, we made the same jokes at the end of a story. We kill each other, we're so funny!

Roni related a story about an online chat she was participating in recently. As she told me what she 'said' she moved her fingers in the air above the dashboard, imitating typing. I asked her to stop since it was evoking a memory from high school typing class. We had the same teacher. Her name was Ms....Ms...Ms...B.....also taught phys. ed....Ms. B. Curses! How do I inevitably get sucked into the remember the name of the person who....on these trips?

Soon, we found ourselves crossing into Pennsylvania. Roni has history with Pennsylvania. She loves the state so much that she has difficulty leaving it. She gets lost in Pennsylvania...every time. On that last road trip we took; again last year, in Philadelphia; the year before that, with Lori.

She wanted to drive, but I told her I was fine. I wasn't going to take any chances. I had to get to Ohio. Eventually, we stopped for dinner. We ordered and went to get our drinks at the soda fountain. I filled my cup 2/3- full with Dr. Pepper then added a little 7-Up, then topped it off with some more Dr. Pepper. I can't remember the last time I did that.

"What's that called?" Roni asked. "Mud-something. Muddy-something. Dirty..." Curses, it's that damn game again. We walked to a table in the nearly-empty restaurant. Just as I turned toward our table, I spotted a boy of about 10-years old at another table. I was thinking of approaching him to ask what it's called when you mix a bunch of different soft drinks together and then, I had it. I opened my mouth, but I'd lost the word. Roni encouraged me to retrace my steps to try to remember.

"That never works," I told her. But I did it anyway. I made the turn, looked at the boy and blurted out,"Swamp-water."

In Cleveland, we arrived at the hotel and Lori was waiting for us. After we got the rooms set up, I looked at Roni and said "Burnham."
"That's it," she agreed. "Ms. Burnham." (I also pulled out Ron Griffin's name, previously only identified as the guy who drove the brown Chevette). Turned out that Lori wasn't getting our Smokey and the Bandit bit, which confirmed it was a full-out 'You-had-to-be-there'.

[Cleveland Clinic]   [Smokey and the Bandit]

Mahogany and Mirrors

The Cleveland Clinic is like a city inside Cleveland. The Cleveland Clinic Police headquarters are located across from our hotel. The hospital spans an area of 6 city blocks by 3 blocks. There are several sites under construction as the facility expands. To say the organization is impressive is an understatement.

A shuttle bus took us to the International Patient Center to check in and receive my itinerary. The lobby of the International Patient Access Center immediately bestows a feeling of trust and confidence upon the patient. The polished marble floor reflected our images. Mahogany-clad walls with mantles, mirrors and showcases interspersed, displayed various gifts from patients: Ming Vases, Fabergé eggs and the like. It was a little intimidating.

My Registration Agent started the process inside her spacious office. I was asked to verify the info: My name: check. Address: oops, that wasn't me. Birthdate: oops, again. Email address: mine. The Agent made the corrections to the info then introduced me to my Financial Agent. They had all the correct info on me in this office. Next, I met Marina, my Concièrge. She escorted us to the first appointment and arranged a driver for the following day.

The day before, Roni presented me with a gift of Kick-it-up-a-Notch socks. Regular readers know well the Summers' obsession with Kick-Ass footwear and accessories. Refer also to:Kicking II . I had chosen a kind of Pippi Longstocking look for the day.

Back in the hotel, after the set of investigations, I contacted my Patient Coordinator to clarify my schedule for the next day. I also had to return calls to some of the staff who'd been trying to reach me in Ontario over the past 4 hours.

The Cleveland Clinic: It's technologically advanced. It's a world leader. The Ambassadors in the hallways greet each passerby with a cheerful "Good morning" reminiscent of the Monty Python bit. The atmosphere exudes Excellence, with capital E. Behind the mahogany, under the Ming vases, after the Diplomat patient-base has gone home, it's just like other outfits: misplaced data and records, communication barriers and conflict from the blends of formal and informal groups. It's not smoke and mirrors, it's mahogany and mirrors. It's actually kind of comforting, you know?

Having our own driver is a nice touch,too.

[Cleveland Clinic]   [Good Morning]

Mission: Reconn - Accomplished

We loaded up the car before our driver arrived. After 36 hours, the remaining Swampwater got tossed out, along with the usual collection of half-finished drinks I always leave in my wake.

I passed Roni in the lobby again without recognizing her. Her hair is growing back. I was so used to seeing her with no hair, or wearing a toque or scarf, it's strange to see her sporting a crew cut.

We arrived at the M-entrance. Roni had apparently done some exploring while I was out of commission yesterday. She led the way to the Metabolic Institute.

After another diagnostic investigation, the surgeon declared me a suitable candidate to have a gastric pacemaker re-inserted. We left with a commitment to receive the treatment and care that I need.

I handed the keys to Roni for the drive home. I was in no shape to drive. The relief in the car was palpable. Here's some of my thoughts on that drive:

It was good that I had done so poorly on the clinical tests to qualify for the treatment;
I told you so, Ontario's Ministry of Health;
Must be the lime-green socks!

We called John to tell him the good news...and left a message. We called Michelle...and left a message. We called Mom and Dad, and Dad was home. Through Pennsylvania, I didn't dare fall asleep with Roni at the wheel. I didn't want to wake up in Altoona!

Roni trusted me to drive from the restaurant to the gas station. "I know you," she warned. "You won't get out of the car when you come back."
"I promise, promise, pinky-swear that I will let you drive after I gas up," I promised. The pinky-swear locked it, I think.

We talked with Lori, and Joe, who said at first that he was OK to talk, but during the call, admitted he was up in the air, and it would be better to talk later. Then Jay.

Across the border without incident and home. We were tired.
Now we wait while the surgeon writes up the treatment plan, the finance department costs it out then sends it to me.

There's light at the end of the tunnel...and it's not a train.