I'm pretty sure it was Wednesday, six days after my surgery, that I was truly me again. It's like I'd been completely out then in some kind of limbo, or maybe dreaming, or maybe some alternate reality. But by Wednesday, after the excess fluid was all gone and my improved breathing had re-oxygenated me, I was clearly clearer.
I don't know how much I was up and moving before, but as of Wednesday, I was up walking and made several rounds on the whole 5th floor, two or three circuits at a time, two or three times a day. It was a dog and pony show since I was still wired up to the IV 'cart' which is really just one of those stands on wheels with a control box in the middle and a bunch of bags and tubing hanging off the top that were ultimately threaded to me.
I did the double gown thing for modesty. Had one on properly, which of course could flap open in the back, but then I put another on over it, backwards, to make a sort of jacket or housecoat. It was loverly, I assure you. The good part of my attire though were my slippers. My parents had brought me a pair of beautiful purple (my favorite color) slippers that looked much like ballet slippers but they had a good textured sole on them so they would defy their name and keep me from slipping.
I waved or tossed a greeting or even a joke as I passed the nurses' stations on my walking rounds. There were three stations. Though only the one near my room had charge of me, the staff moved around so I eventually became familiar with, and to, nearly all the staff. They were always friendly and encouraging, noting my improvement and cheering me on. Later, after I'd been discharged, I wrote a letter to the management of the hospital and praised their staff on the 5th floor. I hope the kudos got back to them.
Anyway, by Friday, I was getting antsy to get out of there. I felt great. My turn around seemed sudden but it was quite complete. Even my surgeon was tentatively ready to release me as early as Saturday, if not, then Sunday.
But then, the delay happened. Suddenly late Friday afternoon, I got a fever and chills. I don't mean a mild case of chills. I mean uncontrollable, body-wracking chills. I shivered all over, my teeth were chattering. I couldn't have felt colder if I was outside in Alaska naked. I had my folks help pile on the blankets and it didn't help. I was still freezing.
We called in a nurse and tried to figure out what was going on. My temperature had suddenly jumped from normal to about 104. The weird thing is, I was lucid and all. I mean I thought that if you had a temperature that high your brain would be sizzling or would shutdown.
Naturally I was given something or other to break the fever asap and it worked, so then I sweat buckets and threw off all the blankets.
Tests were ordered and processed. My surgeon and the nurses tried to find out just exactly what was happening. While that was going on, the whole fever/chill scenario repeated a few times. And somewhere in that, I developed sores in my mouth which hurt and made everything taste terrible. When children get it, I think they call it thrush. I didn't care what it was called, but it was a miserable condition.
Wednesday, December 13, 2006
Sunday, December 10, 2006
Post-Surgical Recovery - part 1
I was, as noted, in a regular hospital room and still on a lot of pain medication but I was coming around more often. I still had trouble breathing. I finally had the ability to inform the nurses and such that my breathing trouble was from feeling my lungs were crowded. At some point this was determined to be fluid built up, likely in my gastric system. I was perhaps not eliminating fluid fast enough despite the frequent emptying of my ostomy pouch which to me seemed perpetually full.
Late in the evening on the 4th day, I think, I began to heave and it was all fluid. I guess I had really backed up at that point. I wasn't taking in food, just drinking water, eating the occasional popsicle, and getting my nourishment from my IV. My vomiting got pretty fierce before everyone started postulating on what could be done. The solution was presented to me, an NG (nasogastric) tube. They'd run a tube into my nose and down through my esophagus into my stomach. The tube could then convey the fluid up and out into a container. I had heard of that before and at those times I thought what a horrid arrangement that seemed to be, terribly uncomfortable to install and 'wear'. However, at this time, as I could barely catch my breath and the contents of my digestive system were overflowing as vomit, I was game. I asked them to please proceed.
What a relief! Very soon I felt less and less like a water balloon. I could actually take deeper and deeper breaths. All of me was happier about more oxygen and less bloating. I was still eliminating a lot of fluid through my small intestine into the pouch too. So, draining in both directions created a remedy and more comfort very quickly. It made a huge difference in my alertness and in my entire sense of well-being.
I think maybe it was as soon as the next day, perhaps a full 24 hours, that the volume of fluid coming through the NG tube began to subside and it could be removed. That was quite a weird feeling and considerably uncomfortable but quick. I was certainly relieved to have the tube out of my nose; it had begun to irritate me. That was another sign of my recovery. I was regaining sensations, feeling more myself, although thankfully I was still receiving sufficient medications such that I was in no real pain. Any pains I had related more to maneuvering in the hospital bed or getting in and out of it as I started to empty my own pouch, having been instructed in the care and maintenance of it as soon as my thought processes were working again.
Time in the hospital was seriously warped. Although I had a great bank of windows and a nice view of the town from the 5th floor, the medications and a lot of napping made it hard for me to keep track of the days and even the hours. Everything seemed to be a schedule of techs taking vital stats and nurses appearing with regular medications. I had been off the morphine pump for a while and was now taking oral pain meds as well as a plethora of other pills based on the test results from regularly extracted samples of my blood.
Late in the evening on the 4th day, I think, I began to heave and it was all fluid. I guess I had really backed up at that point. I wasn't taking in food, just drinking water, eating the occasional popsicle, and getting my nourishment from my IV. My vomiting got pretty fierce before everyone started postulating on what could be done. The solution was presented to me, an NG (nasogastric) tube. They'd run a tube into my nose and down through my esophagus into my stomach. The tube could then convey the fluid up and out into a container. I had heard of that before and at those times I thought what a horrid arrangement that seemed to be, terribly uncomfortable to install and 'wear'. However, at this time, as I could barely catch my breath and the contents of my digestive system were overflowing as vomit, I was game. I asked them to please proceed.
What a relief! Very soon I felt less and less like a water balloon. I could actually take deeper and deeper breaths. All of me was happier about more oxygen and less bloating. I was still eliminating a lot of fluid through my small intestine into the pouch too. So, draining in both directions created a remedy and more comfort very quickly. It made a huge difference in my alertness and in my entire sense of well-being.
I think maybe it was as soon as the next day, perhaps a full 24 hours, that the volume of fluid coming through the NG tube began to subside and it could be removed. That was quite a weird feeling and considerably uncomfortable but quick. I was certainly relieved to have the tube out of my nose; it had begun to irritate me. That was another sign of my recovery. I was regaining sensations, feeling more myself, although thankfully I was still receiving sufficient medications such that I was in no real pain. Any pains I had related more to maneuvering in the hospital bed or getting in and out of it as I started to empty my own pouch, having been instructed in the care and maintenance of it as soon as my thought processes were working again.
Time in the hospital was seriously warped. Although I had a great bank of windows and a nice view of the town from the 5th floor, the medications and a lot of napping made it hard for me to keep track of the days and even the hours. Everything seemed to be a schedule of techs taking vital stats and nurses appearing with regular medications. I had been off the morphine pump for a while and was now taking oral pain meds as well as a plethora of other pills based on the test results from regularly extracted samples of my blood.
Thursday, December 7, 2006
The Big Surgery
My surgery was scheduled for December 7th. I checked into the hospital the day before for prep, labwork, etc. I eventually spent two weeks in the hospital even the though the estimate had been something like six to ten days.
Once I was sedated just prior to surgery, the next few days were a blur. I was in surgery nearly four hours, so I am told. After that, I was in ICU for a couple of days. While in there, I only recall waking up for seconds at a time and seeing people, like the staff or my family members, appearing and disappearing.
I don't recall any pain at all. I do recall having trouble breathing and hearing people trying to coax me to breathe. I found this coaxing annoying. In my mind I was yelling at them. I was trying to tell them I was trying to breathe but something was crowding my lungs. It's not that I wasn't making the effort, as they seemed to be suggesting, it was that all my effort was hindered.
I do not recall being moved, but on about the third day after surgery I found myself in a regular hospital room instead of ICU. My consciousness came and went which presumably was an effect of the glorious drugs which kept me oblivious to any pain (likely a lot of morphine). When I was conscious long enough to contemplate it, I looked for my stoma and ostomy pouch.
A stoma is when a loop of intestine (small or large) is brought to the surface of the abdomen through a hole and opened so that waste can pass from it into an ostomy pouch, thus bypassing the usual path. In the temporary post-surgical instance, this is to give the surgery time to heal, aka a temporary loop ileostomy. In the permanent instance, this is the method for passing waste outside the body when the usual path is no longer available, aka a permanent colostomy.
When I was shown a video on stomas, I nearly passed out. That bit of bright red internal material pushing through a whole in the outer flesh was just too much for me to take in. I could not fathom that something from inside my body would be sticking out of my body. Furthermore, I could not believe it wouldn't be painful, I didn't care how much they reassured me that it wouldn't. To me, looking at that strawberry thing sticking out of the flesh might as well have been the raw end of a bloody bone jutting out of someone's leg and I knew that would have to be excrutiating. I had to block all of that and trust that these people knew what they were doing and meant what they said. I would just have to wait and see how it really played out.
For more details than that on stomas and ostomy apparatus, please google it.
Now my surgeon, during his briefing about the surgery, had told me that I would have a stoma and an ostomy pouch regardless of what he had to do to remove the tumor and how he had to put me back together. There would at least be a temporary ileostomy so the surgery could heal. I have already stated that a permanent colostomy was something I felt I could never abide, so I just put that whole idea off on some back burner with only a marginal link to get back to it, in case it actually happened to me.
Anyway, my primary fully-conscious first thought was "temporary or permanent?" When I was able to ask, I was happily assured that what I had was temporary and of course I was ecstatic. One of the first post-surgery jokes I made was to a medical tech taking my vitals and I told him how excited I was to know I still had an asshole!! Strange perhaps, but true.
Some days later, during a checkup visit from my surgeon, is when I really found out how complicated my surgery had been. I had already heard I was on the table about an hour longer than expected. My surgeon said that on a scale of 1 to 10 --- 10 being something he explained but I didn't understand --- my surgery was about an 8 1/2 or 9. I had no idea and I got the impression that he hadn't expected it to be quite that complicated either.
Part of the complication was removing all of the sizeable tumor and the regional nodes and getting at least a little bit into the good tissue to make sure he had all the bad. The other complication was in the reconnection. He had to construct a j-pouch from the good end of my colon which was, in my case, a handy redundant sigmoid section. Then, he had to make an opening in the j-pouch and connect it to a very slim margin at the anal sphincter. The available connection at the anus was so short that only an experienced colorectal surgery specialist would have been able to do it. A general surgeon would never have attempted it, so I have been told.
In addition to all of that of course was making sure he did not damage any other organs or structures in the area, and he had to set up the stoma. Fortunately my surgeon had called his older and even more experienced partner to assist with the entire operation and the two of them managed to get me undone, redone and put back together so that I should eventually have a mostly functional large intestine and preserved anal sphincter.
For more information on all of that, google it. I will only add that I later read up on the j-pouch and it is a viable and helpful way to construct a sort of substitute rectum or neo-rectum, serving as a reservoir for fecal matter to be eliminated, rather than a straight-line connection of colon to anus which can be more difficult when it comes to bowel movement control.
Once I was sedated just prior to surgery, the next few days were a blur. I was in surgery nearly four hours, so I am told. After that, I was in ICU for a couple of days. While in there, I only recall waking up for seconds at a time and seeing people, like the staff or my family members, appearing and disappearing.
I don't recall any pain at all. I do recall having trouble breathing and hearing people trying to coax me to breathe. I found this coaxing annoying. In my mind I was yelling at them. I was trying to tell them I was trying to breathe but something was crowding my lungs. It's not that I wasn't making the effort, as they seemed to be suggesting, it was that all my effort was hindered.
I do not recall being moved, but on about the third day after surgery I found myself in a regular hospital room instead of ICU. My consciousness came and went which presumably was an effect of the glorious drugs which kept me oblivious to any pain (likely a lot of morphine). When I was conscious long enough to contemplate it, I looked for my stoma and ostomy pouch.
A stoma is when a loop of intestine (small or large) is brought to the surface of the abdomen through a hole and opened so that waste can pass from it into an ostomy pouch, thus bypassing the usual path. In the temporary post-surgical instance, this is to give the surgery time to heal, aka a temporary loop ileostomy. In the permanent instance, this is the method for passing waste outside the body when the usual path is no longer available, aka a permanent colostomy.
When I was shown a video on stomas, I nearly passed out. That bit of bright red internal material pushing through a whole in the outer flesh was just too much for me to take in. I could not fathom that something from inside my body would be sticking out of my body. Furthermore, I could not believe it wouldn't be painful, I didn't care how much they reassured me that it wouldn't. To me, looking at that strawberry thing sticking out of the flesh might as well have been the raw end of a bloody bone jutting out of someone's leg and I knew that would have to be excrutiating. I had to block all of that and trust that these people knew what they were doing and meant what they said. I would just have to wait and see how it really played out.
For more details than that on stomas and ostomy apparatus, please google it.
Now my surgeon, during his briefing about the surgery, had told me that I would have a stoma and an ostomy pouch regardless of what he had to do to remove the tumor and how he had to put me back together. There would at least be a temporary ileostomy so the surgery could heal. I have already stated that a permanent colostomy was something I felt I could never abide, so I just put that whole idea off on some back burner with only a marginal link to get back to it, in case it actually happened to me.
Anyway, my primary fully-conscious first thought was "temporary or permanent?" When I was able to ask, I was happily assured that what I had was temporary and of course I was ecstatic. One of the first post-surgery jokes I made was to a medical tech taking my vitals and I told him how excited I was to know I still had an asshole!! Strange perhaps, but true.
Some days later, during a checkup visit from my surgeon, is when I really found out how complicated my surgery had been. I had already heard I was on the table about an hour longer than expected. My surgeon said that on a scale of 1 to 10 --- 10 being something he explained but I didn't understand --- my surgery was about an 8 1/2 or 9. I had no idea and I got the impression that he hadn't expected it to be quite that complicated either.
Part of the complication was removing all of the sizeable tumor and the regional nodes and getting at least a little bit into the good tissue to make sure he had all the bad. The other complication was in the reconnection. He had to construct a j-pouch from the good end of my colon which was, in my case, a handy redundant sigmoid section. Then, he had to make an opening in the j-pouch and connect it to a very slim margin at the anal sphincter. The available connection at the anus was so short that only an experienced colorectal surgery specialist would have been able to do it. A general surgeon would never have attempted it, so I have been told.
In addition to all of that of course was making sure he did not damage any other organs or structures in the area, and he had to set up the stoma. Fortunately my surgeon had called his older and even more experienced partner to assist with the entire operation and the two of them managed to get me undone, redone and put back together so that I should eventually have a mostly functional large intestine and preserved anal sphincter.
For more information on all of that, google it. I will only add that I later read up on the j-pouch and it is a viable and helpful way to construct a sort of substitute rectum or neo-rectum, serving as a reservoir for fecal matter to be eliminated, rather than a straight-line connection of colon to anus which can be more difficult when it comes to bowel movement control.
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