Nurse David

by Dennis Green

A very tall man, rangy features, broad-shouldered, tapering down to pencil thin legs. Outspoken.

“I’ll give you some swabs for those bed sores!” he exclaims. “You swab the sore, wait a few minutes and let it dry, then swab it again. Might take 15-20 minutes total. You’ll wind up with a shiny coating on the sore, and it will soon dry up. Poof! Gone!” Nurse David is brusque, and efficient, but when he warms up to you, he’ll shake your hand warmly, firmly, and even, after awhile, touch you affectionately on the shoulder.

On our fifth visit to Urology, I say to Nurse David, “So what’s the plan? When can I get rid of this Foley? I’ve had the damned thing now for more than a month!” The Foley is a “permanent” catheter that stays in my penis and drains the bladder into a small plastic bag strapped to my leg. A miserable situation.

“Well,” he looks pleased that I have finally asked. “There are several alternatives. One is ‘intermittent catheterization.’ That’s where you insert a catheter at home, on your own, four times a day, drain the bladder and take it back out. No permanent catheter, no bag strapped to your leg. And some folks on I.C. begin to urinate on their own again.”

“That sounds like a big improvement!” I enthuse.

“Another alternative is minor surgery on your prostate, shave it down just a bit so it doesn’t block your urination…” he explains.

“Is that what’s blocking mine?” I ask.

“Probably so. Not for certain, but a likely cause,” he says.

“I’d rather avoid any more surgery just now,” I say, “after all the catheters…”

“Well, Nurse David explains, “I’m just telling you some of the things you might be aware of when you meet with Dr. Cheng, your Urologist. The more information you have, the better prepared you will be when he talks to you.”

I know medical protocol well enough that Nurse David’s words make perfect sense to me. He’s not supposed to prime me for my clinical interview with Dr. Cheng, but he’s certainly free to answer my questions. Now that I’m thinking more clearly, the hemodialysis relieved by a day of peritoneal dialysis, and asking those questions, Nurse David is a wonderful source of information.

Kaiser Oakland Urology Department. One of many I have known. Not Nephrology, which deals with the kidneys, dialysis and so forth. Dr. Cheng, my Urologist, fires up the computer screen. “These are the worst kidneys I have ever seen,” he remarks. “They’re nothing but stone!” I can tell how relieved he is that the kidneys are not his turf.

And then I ask the leading questions that prompt him to order “intermittent catheterization” for me rather than the surgery. Nurse David returns, and, after removing the Foley, shows me how to do the I.C., using a thin catheter with a blue line up one side of it, how far to insert it to reach the bladder, 18 inches, 20 inches, 22 inches…when about 10cc of urine pours out. “Do that four times a day,” he tells me, and we huddle over a daytime scheduler to decide the times.

Nurse David then loads me up with enough catheters for a month, two tubes of lubricant, swabs for the bed sores and gives me the firm handshake, then walks me out to the front desk to schedule my next appointment. He puts his hand on my shoulder affectionately, and I know I’ve made the cut.

©2010 Dennis Green