Interventions and devices

Yesterday Wendy had the preoperative assessment to determine her fitness to undergo the minor surgical procedure involved in installing a PEG tube. It's a simple little operation done under local anesthetic with a small dose of intravenous tranqulizer to ensure that she stays calm and relaxed. It usually takes about 15-20 minutes. The assessment was carried out by Dennis Reid, a Scot from Aberdeen, a 1967 graduate, so he was a student there while I was at the University of Edinburgh. He is one of the senior, most experienced men on staff. He pronounced her fit, with the proviso that to be on the safe side she should have it done in the main operating suite rather than in the outpatient endoscopy unit -- hedging his bets a little bit. Meantime she continues on course. We have a fairly smooth routine now: I give her a small dose of the same tranquilizer she will have before the operation on August 3, except that I inject it subcutaneously rather than intravenously. We've figured out between us a quick and easy way to fit her face-mask, then we tuen on the bilevel ventilator, she drifts off to sleep and the ventilator helps her respiratory muscles do their work. In the same way, the PEG tube will help her by eliminating the uncertainty and occasional distress of swallowing 'the wrong way' and choking. I'm getting expert at doing Heimlich manouvres to help flush stuff out of her airway. She spends a good deal of her day sitting quietly, reading, and I got a neat little tilting table that is light enough for her to move easily into position to support the book or magazine she is reading. And so we go on day by day, small victories, minor setbacks, but much more often we are cheerful than misrerable.