So, this second time through for abdominal surgery is proving to be no more fun than the first time in 2007. Between the physical recovery aches and pains (I have no idea how many stitches are holding my liver, abdominal muscles, and skin together, but the process of knitting organ membranes, muscular tissue, nerves and skin together is not pain-free), and the recovery from the drug effects (including the anesthesia and the side effects of the pain meds - mainly stomach upset and constipation), I am never really sure what signal is trying to get through. And I have not gotten back to a regular sleep pattern yet.
So I am constantly guessing about hunger, pain (to be tolerated), pain (to be alleviated with oxycodone), urges to use the bathroom, and just tiredness. I spend a lot of time either in the recliner or in my bed, propped up with pillows and drifting from awakeness to dozing. The cats have been generally fun to watch, as they tumble and scamper throughout the house.
I felt like an update was needed, though I have little to say today. Should know a bit more tomorrow, after our consultation with the OHSU surgical team.
Namaste.
Sunday, June 12, 2011
Tuesday, June 7, 2011
Little update
Life and recovery are proceeding apace. I have my little pill matrix (what I take when), and have settled into the recliner space at the corner of the living room. We are tracking at least two medical situations still - MRSA associated with my ingrown toenails, and the surgery itself. Bactrim is controlling any infection that might come form the MRSA, and oycodone / ibuprofen are tackling the pain bits. Then there are the drugs that counter the constipatory effect of the oxycodone (senna, miralax, and milk of magnesia, in that order). So far we have only had to escalate to miralax.
My sleep at night is not good. Our beds assume that lying flat (on one's back or side) is an option, but those positions put weird stress in my incision. I am also having nasty dreams from the oxycodone (??), and that makes the nights seem to last forever. I am trying to be a good patient, but the sleep deprivation is hard. My next meeting with my surgeon is on Monday, June 13. And I have a meeting with my oncologist on June 20. I hope to have clarity of mind and spirit by then, but am not sure how that comes to anyone, much less a cancer patient.
In short, all is well enough. Will be "back-to-normal" before we know it. Amen.
My sleep at night is not good. Our beds assume that lying flat (on one's back or side) is an option, but those positions put weird stress in my incision. I am also having nasty dreams from the oxycodone (??), and that makes the nights seem to last forever. I am trying to be a good patient, but the sleep deprivation is hard. My next meeting with my surgeon is on Monday, June 13. And I have a meeting with my oncologist on June 20. I hope to have clarity of mind and spirit by then, but am not sure how that comes to anyone, much less a cancer patient.
In short, all is well enough. Will be "back-to-normal" before we know it. Amen.
Sunday, June 5, 2011
Where to start?
Let's not begin at the beginning this time. The tale is long, and the storyteller has to concentrate too hard on typing. I will start by saying that my dexterity and depth perception are definitely affected by oxycodone (or bactrim, or polyethylene glycol). So I sometimes find that I am correcting one word ten or more times! It is frustratingly clear that while I am recovering I will be car-free (too tippy to trust my driving skills) and typing-restricted (my depth perception is whacked). I get tired easily, so reading is a challenge as well. Total bummer. Guess that means mindless TV and movies (DVD and Netflix)! (Luckily for me, I have been offered the use of several DVD libraries by friends.)
Quick run-down on drugs in use today: Bactrim (trimethoprim sulfamethoxazole) - 160mg-800mg oral tablet, 1 tablet twice daily, antibiotic regimen to control MRSA (methicillin-resistant stapylococcus aureus) bacterial infection. Will be on this drug for seven days at home; OxyCodone immediate release 5mg oral tablet, 1-3 tablets every six hours as needed for pain relief; Senna-ducosate 8.6-50mg oral tablet, 1 tablet twice daily, to relieve constipation (hold for loose stools); Polyethylene Glycol (MiraLAX) 17gm/dose oral powder, once daily as needed (hold for loose stools); and, Ibuprofen - 200mg tablets, 2 tablets every six hours for pain relief, (can increase ibuprofen dose to maximum allowable 2400 mg per day as decrease dosage of oxycodone). Also still applying clindamycin 1% topical gel for acneform rash (chest, back, and thighs).
Incision is LONG, beginning at approximately middle of right waist, travelling across my abdomen (and slightly up) to just above my belly button, then straight up to end just below my sternum. It is sealed internally with soluable stitches (too many to see and count through the steri-strips) and the externally with seventeen steri-strips. Total length is about 10 inches.
More incisive dialogue to follow...
Quick run-down on drugs in use today: Bactrim (trimethoprim sulfamethoxazole) - 160mg-800mg oral tablet, 1 tablet twice daily, antibiotic regimen to control MRSA (methicillin-resistant stapylococcus aureus) bacterial infection. Will be on this drug for seven days at home; OxyCodone immediate release 5mg oral tablet, 1-3 tablets every six hours as needed for pain relief; Senna-ducosate 8.6-50mg oral tablet, 1 tablet twice daily, to relieve constipation (hold for loose stools); Polyethylene Glycol (MiraLAX) 17gm/dose oral powder, once daily as needed (hold for loose stools); and, Ibuprofen - 200mg tablets, 2 tablets every six hours for pain relief, (can increase ibuprofen dose to maximum allowable 2400 mg per day as decrease dosage of oxycodone). Also still applying clindamycin 1% topical gel for acneform rash (chest, back, and thighs).
Incision is LONG, beginning at approximately middle of right waist, travelling across my abdomen (and slightly up) to just above my belly button, then straight up to end just below my sternum. It is sealed internally with soluable stitches (too many to see and count through the steri-strips) and the externally with seventeen steri-strips. Total length is about 10 inches.
More incisive dialogue to follow...
Saturday, June 4, 2011
100th post is a record for brevity...
I am discharged as of about 5:30pm today - June 4th, 2011. Relief is spreading across North America and Europe.
Longer posts will ensue, but probably not before tomorrow. And another nurse is added to the shout-out list... Carrie!
Longer posts will ensue, but probably not before tomorrow. And another nurse is added to the shout-out list... Carrie!
Friday, June 3, 2011
Naming names
So, how many of you got a little nervous when you read that blog title? Hmmmm.... I am sure there is another blog post or two on that topic, but we ain't goin' there today.
Nope, I mean the support staff that have been so wonderful during my visit to OHSU. Many of these people will remain unnamed (because I do not KNOW their names), but they include the custodial folks, the dining support staff, and just everyone I talked to. There is an unnamable pathologist (we do not yet have a copy of the report yet, but know the finding (as expected, metastatic adenocarcinoma) and the fact that there is a clean margin surrounding each tumor).
But I digress. The names I want to share and memorialize forever in the Web are the RNs that were so helpful, professional, and wonderful to me and my analytical habits. Can we have a "way to go" for Christy in the ICU and for Rachel, Sharka, and Stefanie in Unit 13K of the Kohler Pavilion? I was very worried about many things (pain, peeing, and passing gas to name a few - but you already knew that if you have been folowing this blog over the past couple days). They handled everything with empathy and confidence. Over the past two days at 13K, I especially felt like Rachel, Sharka, and I were a team working to clear the pain med delivery and peeing hurdles.
[More details necessary, I know. In the operating room, pain suppression and anesthesia drugs were delivered via an IV placed in my right carotid vein. This vein is used because it is big enough to handle any drug they need to use, especially those that might burn the inside of a smaller vein, and in case I needed a blood transfusion (not all that unusual for liver surgery, but I did not need one). On my right forearm, I had two additional IVs - one in an artery and one in a vein. The arterial IV was used for lab draws, and the venous IV was for pain suppression. We were removing the arterial IV in my forearm, but ran into some tape issues and had to also remove the venous IV. This was OK because I still had the one in my carotid vein. I then had another IV placed in my left arm, and we removed the carotid vein IV. Then, that one started to have issues, aand we accessed my PowerPort. Things are pretty good now, except that we seem to need to flush that line every few hours (blood draws, mainly, but also for a magnesium drip later this aftenoon. Whew!]
That's enough. Big shout-out to nurses and their assistants. Amen.
Nope, I mean the support staff that have been so wonderful during my visit to OHSU. Many of these people will remain unnamed (because I do not KNOW their names), but they include the custodial folks, the dining support staff, and just everyone I talked to. There is an unnamable pathologist (we do not yet have a copy of the report yet, but know the finding (as expected, metastatic adenocarcinoma) and the fact that there is a clean margin surrounding each tumor).
But I digress. The names I want to share and memorialize forever in the Web are the RNs that were so helpful, professional, and wonderful to me and my analytical habits. Can we have a "way to go" for Christy in the ICU and for Rachel, Sharka, and Stefanie in Unit 13K of the Kohler Pavilion? I was very worried about many things (pain, peeing, and passing gas to name a few - but you already knew that if you have been folowing this blog over the past couple days). They handled everything with empathy and confidence. Over the past two days at 13K, I especially felt like Rachel, Sharka, and I were a team working to clear the pain med delivery and peeing hurdles.
[More details necessary, I know. In the operating room, pain suppression and anesthesia drugs were delivered via an IV placed in my right carotid vein. This vein is used because it is big enough to handle any drug they need to use, especially those that might burn the inside of a smaller vein, and in case I needed a blood transfusion (not all that unusual for liver surgery, but I did not need one). On my right forearm, I had two additional IVs - one in an artery and one in a vein. The arterial IV was used for lab draws, and the venous IV was for pain suppression. We were removing the arterial IV in my forearm, but ran into some tape issues and had to also remove the venous IV. This was OK because I still had the one in my carotid vein. I then had another IV placed in my left arm, and we removed the carotid vein IV. Then, that one started to have issues, aand we accessed my PowerPort. Things are pretty good now, except that we seem to need to flush that line every few hours (blood draws, mainly, but also for a magnesium drip later this aftenoon. Whew!]
That's enough. Big shout-out to nurses and their assistants. Amen.
Thursday, June 2, 2011
In the category "granted, taking things for..."
I am back in the blogging saddle, as they say, and am ready to profess some profundity. Really, I'm ready. Ummmm... So where is the creative promise - that "I'm the driver here" feeling? I guess that should not be taken for granted. OK then, Ed, enough with the cutesy. Let's go.
I have been told that there are two things (at minimum) that I must be able to do before they will consider releasing me back into our urban wilderness: pass gas, and pee. These are straightforward and automatic processes, and I take them for granted. Somewhat unbelievably, I am struggling with these simple bodily functions! And, just to complicate things a little more, I am told that I must work to remain hydrated (water and Gatorade). Input is not equalling output and that creates a problem. The solution so far has been to insert a temporary catheter every six hours. The passage of gas - which many of you can attest has not been a problem in the past - is not even on the radar screen... Once we nail the bladder issue, it's on to flatulence. :-)
My strength is good, probably in no small way due to the Salem Hospital RISE fitness exercise classes with Dave and Nancy. But the hydromorphone pain killer that I can self-administer may be masking things... (Has anyone noticed that I use ellipses a lot?)
OK - I need ro make this a short posting, since I have dozed off five times already while typing with two fingers. (But not before having three vials of blood drawn for three lab tests.. Geez..)
I have been told that there are two things (at minimum) that I must be able to do before they will consider releasing me back into our urban wilderness: pass gas, and pee. These are straightforward and automatic processes, and I take them for granted. Somewhat unbelievably, I am struggling with these simple bodily functions! And, just to complicate things a little more, I am told that I must work to remain hydrated (water and Gatorade). Input is not equalling output and that creates a problem. The solution so far has been to insert a temporary catheter every six hours. The passage of gas - which many of you can attest has not been a problem in the past - is not even on the radar screen... Once we nail the bladder issue, it's on to flatulence. :-)
My strength is good, probably in no small way due to the Salem Hospital RISE fitness exercise classes with Dave and Nancy. But the hydromorphone pain killer that I can self-administer may be masking things... (Has anyone noticed that I use ellipses a lot?)
OK - I need ro make this a short posting, since I have dozed off five times already while typing with two fingers. (But not before having three vials of blood drawn for three lab tests.. Geez..)
Wednesday, June 1, 2011
Update 2
(Karen posting again)
Today Ed moved from the ICU to the surgical oncology floor where he has a very nice private room at the end of a long quiet hallway. This is a huge improvement over the ICU which was subterranean and under construction. He is still pretty doped up on dilaudid for pain and not able to chat for long or really even focus on email or facebook. I am reading your replies to him in between his catnaps. He would prefer not to receive phone calls so that he can sleep.
One unexpected development came last night when I picked up a voicemail from Ed's doctor in Salem, telling him that the cultures from his ingrown toenails (please see his May 22 entry if you missed that little distraction) tested positive for MRSA which is a pretty nasty bacterium. The short story is that they put him on antibiotics and he is in isolation until they decide he is not infectious. That sounds horrendous, but it basically means that everyone in contact with him has to wear a gown and gloves. Luckily the touch pads on the iPhone and iPad work while wearing lovely purple nitrile gloves!
We expect him to be at OHSU through the week end. He thinks he can handle a few visitors starting tomorrow for very short (15 minute) visits, but you might want to check with me first to see for sure. And he promises to be more social once he gets home. He will be very tired for a while, even once he is over the immediate post surgery issues, because his body is working really hard to regrow his liver.
Thanks again for all the love. It means so much to us and is most definitely a critical part of the healing process.
Today Ed moved from the ICU to the surgical oncology floor where he has a very nice private room at the end of a long quiet hallway. This is a huge improvement over the ICU which was subterranean and under construction. He is still pretty doped up on dilaudid for pain and not able to chat for long or really even focus on email or facebook. I am reading your replies to him in between his catnaps. He would prefer not to receive phone calls so that he can sleep.
One unexpected development came last night when I picked up a voicemail from Ed's doctor in Salem, telling him that the cultures from his ingrown toenails (please see his May 22 entry if you missed that little distraction) tested positive for MRSA which is a pretty nasty bacterium. The short story is that they put him on antibiotics and he is in isolation until they decide he is not infectious. That sounds horrendous, but it basically means that everyone in contact with him has to wear a gown and gloves. Luckily the touch pads on the iPhone and iPad work while wearing lovely purple nitrile gloves!
We expect him to be at OHSU through the week end. He thinks he can handle a few visitors starting tomorrow for very short (15 minute) visits, but you might want to check with me first to see for sure. And he promises to be more social once he gets home. He will be very tired for a while, even once he is over the immediate post surgery issues, because his body is working really hard to regrow his liver.
Thanks again for all the love. It means so much to us and is most definitely a critical part of the healing process.
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