If it seems that I'm chronicling my experience as it happened, I suppose I am. Writing this all out as it happened has been very therapeutic for me to exorcise some of my frustration, fear and anger. As you might have guessed by now, the "fun" isn't over for me.

It's late afternoon on March 8 and I've just left the urologist office feeling cautiously positive. He has given me a transdermal patch, Oxytrol, to help calm my bladder spasms in preparation for a cystogram on Monday, March 12. His continuing instructions are to take it easy, stay off my feet as much as possible. So, it's back home and back to bed. At this point, my major source of discomfort is from the incision to the labia where the tissue was taken to support the bladder and provide an extra layer to seal the fistula repair. Since I can't get comfortable, I take a pain pill and go to sleep.

Around 11:45 p.m., I wake up with a very full bladder feeling as I haven't urinated in hours. But that isn't right. I have a catheter. I head to the bathroom. As I pull down the Depend, my catheter drops to the floor. I'm sitting on the toilet looking at this thing and I notice that the bulb looks like a balloon that burst. Again, with a surreal calm, recall thinking, isn't that interesting, I wonder how that happened. I carefully detach the tube from the large drain bag and attach it to the smaller, empty leg bag and place it in a plastic bag. I change the Depend and the pad, get dressed and go to the basement door and yell down into the "cave" for hubby. After a brief explanation and trying to answer his 20 questions about what happened, we finally head to the ER.

You know the drill at the ER - registration, sit and wait, triage nurse, sit and wait. Finally they call you back. The male nurse, Jason, comes in, gets the scoop on what happened. The ER doc pops in, asks a few cursory questions, feels my abdomen and leaves me in the hands of Jason. Do I have a problem with him re-inserting the catheter? No, not really. I've had so many folks doing things to me down there, I'm beyond embarassment, but I am very sore and swollen due to the recent surgery. He takes a look at my catheter, gets the size and comes back with a regular foley. I hate to be a know-it-all patient, but I have to stop him. The urologist specifically wanted the Couday (I finally looked up how to spell that word - aren't you happy!) catheter. Of course they don't have those routinely in the ER, so I have to wait about 45 minutes for them to get one from central supply. Finally, Jason re-inserts the catheter (and was very gentle and efficient) and we leave the ER around 2 a.m.

If you're counting, that's the second catheter that has just simply dropped out. Remember one dropped out right before I left the hospital the previous Sunday. So, I'm back home and suddenly very queasy. At the ER there had been a really sick college student vomiting like crazy while we were waiting. But I didn't think I'd had time to pick up his germs. Now that I thought about it, I'd been feeling nauseated before the ER visit and hadn't eaten anything since before I went to the doctor earlier in the day. Within 30 minutes of returning home, I was in the bathroom, vomiting and having dry heaves since I hadn't eaten. I didn't get much rest through the night and I kept trying to figure out what I'd done differently and it hit me - the patch! I pulled out the patient info flyer and, of course, top of the adverse reaction list - nausea and vomiting. So I pulled it off around 8 a.m. and was queasy for a few more hours, but it finally seemed to pass and I got some sleep. I didn't call the doc about the catheter coming out and nothing out of the ordinary occurred on Saturday.

Then there was Sunday. I finally woke up feeling somewhat better and got up to sit for a bit. Zaine and I had a light lunch while watching college basketball. Just before half-time, I felt a popping sting (like a rubber band) and heard a loud "pop". He looked over at me and said, "What was that?" I told him I thought my catheter had just popped again. So, at a quarter of 2 p.m., we head to the ER again. It doesn't appear all that busy and they take me back right away, skipping triage and all that. The nurse comes in, does the triage vitals and such, gets the info about what happened and says someone will be right with me.
About an hour later, Jim, the ER Liaison, tells me that I've been bumped due to chest pains. Okay. For some reason, I had grabbed a book on the way out ofthe house and I was occupied. At about 4 p.m., it looked like the wait was going to be really long, so I told Zaine to go home. He had been in the middle of a project and it was silly for us both to be wasting time doing nothing. I told him I'd call him when I was ready. (We live about 2 minutes from the hospital!)

So I sit in a treatment room watching person after person who came in after me leave. Jim keeps me informed that there is a terrible stomach flu (I remember the college kid from Thursday night's visit) and that there are a lot of dehydration cases that require attention. He's sorry, but I'm behind chest pain times 2 or 3 people and several folks with vomiting and diarrhea. Around 5 p.m., my nurse, Karen, who has been in and out, leaves for her lunch hour. She is in shock when she returns at 6 p.m. and I'm still sitting there, unseen by a physician! Both she and Jim are embarassed that they keep having to make excuses as to why I'm waiting. Finally around 7 p.m. - yes, more than 5 hours later - the doc comes in. I have to spend 10 minutes giving her the history from the TAH on January 17 to the surgery on March 2 and the current issue with the catheter. Karen had already called up for the Couday since I'd explained the problem from the previous visit, so it was ready. Finally the doc re-inserts the catheter, only inflates the bulb with 7ccs instead of the usual 10ccs and at 7:30, I called hubby to retrieve me. Very tired, I went straight to bed, only to wake up about an hour or so later vomiting. No patch this time, just a good dose of all those stomach flu germs I breathed. So I'm up for most of the night throwing up 7-up and cranapple juice.

Now, has anyone recalled that I have a cystogram scheduled for Monday at 7:30? That's right, I drag myself to the shower and off we go to the hospital for the test. I'm still nauseous as heck, but not throwing up at the moment. The radiology girls have me change into the lovely hospital gown and are quite pleased to learn I already have a catheter. The cystogram consists of injecting about 750-1000 ml of contrast dye liquid into the bladder and taking a series of pictures to determine if there is leaking. In my case, we wanted to know if urine was leaking from the bladder into the vagina. I left radiology with a basin and wet washcloths having been really sick after the test was over.

On the way home, I called my urologist's office and asked if there was any way he could call in something for nausea and vomiting. I also explained that the catheter had come out the day before. We had just gotten home when his nurse called. Could I come in and let him take a look? Sure, I only live about 5 minutes from his office. The nurse called in something for the nausea and while I was being checked in, the uro called the radiologist. Did he have my test results? Some conversation between them. And I hear him say, "Are you sure? Can you send them over?"

My heart sank. He came in the room and he looked totally defeated. The plan had been to do the cystogram, if there were no leaks, remove the catheter the next day. He says that he doesn't want me to panic. The radiologist said he sees a leak, but he wants to look at them himself before he says for sure. We'll leave the catheter in for another week. He's going to the hospital in the afternoon and he will look at my results himself. He felt that the radiologist may have been somewhat confused about what he was seeing. Try not to panic, he says, "You will be dry again." So I make an appointment for next week. I make it to the car before I completely breakdown and burst into tears. Zaine is angry and frustrated - why can't this be fixed? Do we need to go to someone else? His anger just makes my own frustration worse. He drops me off at home so I can go to bed. By this time, I'm sure I've got the lovely stomach flu and I'm depressed and miserable and I just want to escape into sleep. He goes to the pharmacy to pick up the nausea script. when he returns, I take one of the pills which makes me sleep.

From a sound sleep, I feel a stinging pop in my abdomen and hear a "popping" sound. I am instantly awake. It's five minutes until 2 p.m. I have the uro office programmed into my cell phone, so I called them up. I spoke with one of the nurses and explained that my catheter had just popped again. In case you've lost count, that's 3 times since Thursday night - twice in 24-hours! She puts me on hold, comes back to say the doc is in the office and wants me to come in, can I do that? Sure, so off we go, with Zaine even angrier than he was earlier. He thinks this is my body rejecting the catheter because it doesn't need it anymore. And me, I'm just worried and scared that something else really bad is happening.

My doc has looked at the cystogram results while he was at the hospital. He has them on his computer. We go into his office - the doc, myself and his nurse practitioner - and he calls them up. Sitting in his chair, I look at the screen. He says he doesn't see a leak - do I see there is no dye showing up between the bladder and the vagina? Yes, I see that. There is a good separation between them and no contrast dye which means no leak from bladder to vagina. He decides not to re-insert the catheter. He tells me that it may take some time for my bladder to return to normal because it has had a lot of trauma and it has had a catheter now for 5 of the past 8 weeks! I can expect some incontinence, but this should be from the urethra and it is to be expected. He'll see me in 3 weeks and if I'm still leaking, we'll consider medication to help me regain control. I can help matters if I begin doing Kegel exercises and such to re-educate those pelvic muscles and help the urethra get back to normal.

I'm ready to kiss him. When can I return to work? He says if I didn't have the stomach flu, tomorrow! However, since he was sure I didn't want to give the bug to my NH residents, that I should wait until the following Monday. He says I should do part-time days for the first 2 weeks then I can resume full duty. I make the 3 week appointment for April 5. Other than feeling really lousy due to the stomach flu, I was thrilled. No more catheter. No more fistula leak. I'm on my way back to normal and back to dry. I'm feeling pretty positive about that the end of the ordeal is in sight.

Next up: Still leaking.