Today I am exactly one-month post-op from a surgery that was estimated to take six to eight hours, and require a 2-night hospital stay.
The good news is that the surgery took “only” five hours.
The bad news is that I ran into complications, and ended up being in the hospital for 18 days, and was sent home with a midline IV, drainage tube, a feeding tube, and strict NPO orders except for liquid pain medication and very small amounts of water.
But let’s go back to the beginning – the morning of May 23rd, 2016. My arrival time was 5:30am, so Dan and I left the house at 4:45am. We got to Hershey Medical Center a few minutes past 5:30am, checked in, and then proceeded to wait over half an hour for a greeter/tour guide to take us to pre-op – which is kind of silly when you think about it, because with this being my 10th surgery (not to mention over a dozen endoscopies!), we knew exactly where to go. But, eh, procedures.
The pre-op process, which I now don’t remember the fine details of, went smoothly. I stripped, wiped down my body with these special cleansing/disinfecting wipes that leave your skin feeling sticky, put on a hospital gown and snazzy yellow hospital socks, patiently waited for an IV to be put in (just two tries, hooray), and signed the consent forms. I believe I was taken into the OR sometime between 7am and 8am (again, fine details have escaped me).
According to my surgeon, Dr. R, and Dan, the surgery itself went well. She had to deal with a decent amount of scar tissue and some adhesions, but given my surgical history (10 abdominal surgeries in six years, with the last four being in just the last year), she wasn’t surprised. But that aside, the revision from a gastric bypass with a lot of scar tissue and a nearly decimated stomach pouch (due to the three ulcer perforations – oh and the fourth that was beginning to occur the weekend prior to the surgery – Dr. R said that the perforation evident and the only thing that saved me from having to be rushed into surgery sooner was the extra layers of fat and muscle she wrapped around the ulcer during the April 2016 ulcer perforation repair surgery) to a gastric sleeve went well.
I woke up from surgery sometime later Monday afternoon, and thanks to a PCA pump (hello, Dilaudid!) my pain was manageable. I had a catheter, which was unpleasant, but at least it bought me a night in bed before I had to begin doing laps around the hallway to decrease the risk of blood clots, regain strength, and get rid of excess air.
But by Tuesday afternoon, my pain hadn’t lessened any. It was significant enough that I refused to allow the nurses to remove the catheter.
By Wednesday, I was begging for more pain medication. At this point Dan was overwhelmed and didn’t know what to do, so he and my mom switched – my mom came to the hospital with the kids so they could see me, she stayed with me, and Dan took the kids home. Dan has a lot of amazing qualities, but truthfully his anxiety gets in the way of him being able to question and speak with doctors and nurses. My mom, on the other hand, has brass balls (where do you think I got mine from?), and is an excellent patient advocate.
By the weekend (Memorial Day weekend), the low-grade fever I had been battling all week began to climb. It had been hovering in the 99.2 – 99.8 range since surgery, but was now creeping over 100 degrees. At this point the catheter was out, and despite the relentless abdominal and left shoulder pain I was continuing to walk as much as I could. I was also allowed water, chicken broth, beef broth, vegetable broth, and jello. I drank plenty of water, but didn’t have much in the way of broth because I just felt so awful.
On Monday, May 30th, I was finally taken for a CT scan, which revealed pockets of air and liquid in my abdominal cavity. It should be clear to anyone at this point that I had a leak (leaks after a vertical sleeve gastrectomy are not all that uncommon, and the risk for complicated revision patients such as myself is as much as 12 percent), yet the idiot residents dealing with me obviously didn’t report their findings and the severity of my symptoms to my surgeon, because instead of being taken back to the OR I was given a TRU-CLOSE Accordion Drain in an effort to remove the excess air and fluid in my abdomen. This was done with me awake, using Lidocaine injections for numbing. The pressure was unpleasant, but other than that it wasn’t too bad – many thanks to the nurse who used one hand to put Fentanyl and Valium in my IV and the other to hold my hand.
But while the accordion drain did help, putting a drain in a post-op patient with a gastric leak is a lot like adding more water to a bucket with a hole in it – without repairing the hole.
By Thursday, June 2nd, the pain was unbearable, my steadily-climbing fever now held steady above 103, and both my mother and Dan said I was somewhat delirious and incoherent. I don’t remember much from this week, other than pain, begging residents to do something, taking my temperature frequently, trying to walk, and asking my mom if Ryan had gone to bed yet because he had to get up for school in the morning (meanwhile, my mom was with me in the hospital – 50 miles away from Ryan!).
On Friday, June 3rd, my surgeon was finally clued in as to how bad things were, and at 4:00pm, shortly after having a midline IV placed because all of the veins in my hands and arms were completely shot from so many sticks, I was rushed to the OR for endoscopic repair. It was kind of funny, actually: one moment I’m lying in my hospital bed, miserable. The next, two old lady nurses are tearing me and the room apart in an effort to get me ready for transport and surgery as quickly as possible. They were like a geriatric tornado – but they were terrific, and they were most definitely efficient!
Here’s how bad things must have been: as soon as I got into the OR I started crying, which isn’t exactly unusual for me, a serial bawler. But my surgeon, Dr. R, came over to me and hugged me, smoothed my hair back from my face and promised she’d fix everything, and she stayed by my side and held my hand until the anesthesia was administered. My last memory is of her holding my right hand tightly, while I felt the burn of the anesthesia in my left hand.
* * * * *
When I woke up in recovery, my first realization was that the majority of the awful pain and pressure in my chest and abdomen was gone. After getting back to my hospital room (and my mom, who was worried sick at that point about me dying – and to be honest, as sick as I was, I was running out of time so I can’t blame her for being so worried, because in between my sleeping and my fever-and-sepsis-induced delirium I was worried too), Dr. R came in to let us know her findings: a significant leak in the connection in my gastric sleeve, which she and another surgeon were able to fix via the endoscopy (no lap or open surgery required). They put in sutures and clips, and sucked out more fluid and air.
I was NPO for the weekend, which sucked, but I did sneak a few ice chips here and there just to wet my mouth and throat. But I was ecstatic over the lack of severe pain, the lack of left shoulder pain, and more importantly, the lack of a fever. My blood draws were being done every 12 hours, and each one since the Friday surgery showed improvement with everything – whereas previously, everything from white blood cells to red blood cells to potassium to lactic acid were all severely out of whack.
But I was so tired and weak by this point. I still had the PCA for pain, and here’s an indicator of how weak I was: sitting in a chair for about half an hour while my mom washed my body from head to toe exhausted me so much that I told her to skip washing my hair, and I then napped for several hours.
* * * * *
On Tuesday, June 7th, 2016, Dr. R asked me how I felt about discharge. I was excited and very much on board – at this point I was feeling better, lab work showed continual improvement, and I was doing fine with water and tiny bits of chicken broth. So discharge paperwork was drawn up, prescriptions were filled at the hospital pharmacy, and… and then one of Dr. R’s residents came in with a cup of blue dye. “She just wants to make absolutely certain you’re okay”, he said. So I began taking tiny sips.
For about two minutes, all was well – all three of us (myself, my mother, and the resident) watched my drain anxiously as I took sips. Nothing. Then all of a sudden… blue dye. I should tell you at this point I lost my fucking mind and had a total breakdown – gasping sobs, inability to breathe, hysterics, the works. Blue dye in the drain meant there was still a leak, which meant no discharge, more time in the hospital, and more procedures to find and fix the leak. It was at this point that 2mg of Ativan every 8 hours was added to my chart.
The next day I was taken back to the OR for another endoscopic procedure: this time, not just an EGD to find and suture and clip the leak, but the placement of a nasojejunal feeding tube (NJ tube). I had been warned about the possibility of an NJ feeding tube the previous Friday, and was told the day before it would be necessary so my new stomach could rest for “several weeks”. I was frustrated, disgusted, and terrified. But I said yes, because what other option is there? Supplemental nutritional feedings via IV can be done, but as it was explained to me, leaving the digestive tract “dormant” is a very BAD idea because that can cause further issues down the line, even if it’s just for a short amount of time such as a few months or even a few weeks.
* * * * *
On Friday, June 10th, 18 days after my initial surgery/admission, and after one laparoscopic abdominal surgery and two endoscopic surgeries as well as a separate procedure to place the accordion drain, I was finally discharged. If memory serves me correctly I had a contrast swallow test either that morning or the day before to confirm I was leak-free. I also had nearly 48 hours worth of NJ tube feeds with no adverse effects – no nausea or vomiting or any other negative reactions that would indicate sensitivity or intolerance. And I was still fever-free, and my lab work was yet even more improved. As Dr. R put it, I was medically stable, so send me home and have home nurses come out to see me.
My mom — yes, she spent 16 days in the hospital with me, with no complaint; she literally dropped everything to come stay with me, advocate for me, and take care of me as much as she was able to (including running out to Panera Bread to get me a cheese danish because she was so desperate to see me eat something, only to get back in time for the confirmation of a leak in my stomach) — and I decided not to tell Dan I was coming home – we thought it would be a nice surprise.
And it was – overwhelming, because the house was a bit of a mess and here we come loaded down with bags and medical supplies. But it was nice. But I was exhausted. My first week home was a blur of a midline IV, NJ tube feedings, drain checking and emptying, crying, and sleeping – lots of crying and sleeping. My mom actually stayed with us for the first week because I didn’t want her to leave my side. I was terrified of being without her after having her with me for so many weeks. She was wonderful – she didn’t even balk at helping with tube feed setup/adjustments in the middle of the night, or sleeping in bed with me (and Dan didn’t balk at giving up his side of the bed so my mom could sleep with me).
* * * * *
My second week home was a little better – we even got into a better routine with the NJ tube feeds, which kept me bed-bound for 12 hours a day due to needing to stay with the IV pole (which was in the bedroom next to my side of the bed) and upright and semi-still. Needless to say, with so much literal downtime with being in bed so much I’ve been watching a lot of TV – when my mom was here, we split our TV watching between Catfish, Forensic Files, and Grey’s Anatomy (aside: Ryan is now hooked on Forensic Files, and both my mom and Dan are into Grey’s Anatomy).
But with more of a routine and feeling a bit better I was sleeping less – which gave me plenty of time to google VSG complications and VSG leaks, as well as information and statistics and horror stories about leaks, NJ tubes, and accordion drains. After I ran out of Ativan I was a hot mess, because it’s a lot harder to talk yourself down from a panic attack without any tools to help other than your own mind – the same mind that is running wild with negativity and fear.
* * * * *
Today, June 23rd, 2016, exactly one month after surgery, I had two very important appointments: a liquid contrast swallow test to check for leaks, and then a post-op appointment with Dr. R. I bugged and bugged and bugged the doctor and nurses who administered the swallow test for answers, and not surprisingly I cried a lot; but at the end of the test I was crying tears of relief and joy because the doctor assured me repeatedly that I had no leaks – he did the test twice as long with twice as much fluid as usual, and had me lying and standing in all sorts of positions so he could check for leaks from any possible angle. Nothing. And like he pointed out, the drainage tube in my abdomen remained clear – a sign that a leak simply couldn’t be happening, because if it was, there’d be glowing liquid in the tube – and there wasn’t.
Then I saw Dr. R. She came into the room beaming, and after hugging me she asked me which tube I wanted removed first. We went with the NJ tube, though like I told her, I was equal parts excited and anxious about having both removed, so it didn’t really matter. I’ve refrained from googling “NJ tube removal”, and was somewhat pleasantly surprised to find that sensation-wise, there was no coughing or retching like I expected (wouldn’t you? I mean, if there’s a tube shoved down your throat all the way to your small intestine wouldn’t you expect throat and stomach irritation when it is being removed?). Instead, there was just a lot of burning and pressure in my sinuses. Then it was out, and I was laughing in relief.
Finally, the drainage tube. Since I’ve had both a gastric feeding tube and a JP drain removed previously, I expected a tugging and burning sensation. Instead, most of the pain came from the large Tegaderm patch that my mom put on top of the drainage tube at the insertion site. But again: wrong! As soon as Dr. R cut the two sutures keeping the tube in, it began to fall out of my stomach on its own! The only discomfort came when Dr. R pulled out the last inch or so – this was from a slight “bulb” on the end to help keep the tubing in.
* * * * *
So now I’m home, healing, free of uncomfortable and gross tubes, and I’m cleared for liquids, protein shakes, and soups free of chunks (basically, broths and creams). Next week I can add chunkier soups and yogurts. The following week, mashed potatoes, hot cereals. And after that, I can very slowly work on introducing soft meats and other items – but nothing tough, and no fruits or raw vegetables for eight weeks.
This whole situation has been physically painful and exhausting, but also emotionally exhausting, frustrating, terrifying, and draining. I finally feel like I can really begin to heal myself not just physically but mentally – and I won’t lie, scheduling an appointment with a psychologist to help me cope and work through the probable PTSD caused by all of these medical crises but especially this last one is on my to-do list for tomorrow.
* * * * *
So many of you have reached out to me on social media, via email, and via PayPal and mail with financial help – I can’t thank you enough. Your words of support and love and gestures of kindness have meant so much to me, and to my family. Thank you. I will never be able to thank you enough, but I hope this will suffice. ♥
An earnest plea: my family is sinking with my 2-day hospital stay turning into a 2-week+ hospital stay. Any donations will be used for food, gas, and utilities. Receipts will be provided to show use of funds.
Please help: my PayPal address is email@example.com
And now our internet bill is off, and I rely on our internet to work.. I’m being discharged tomorrow and am now frantic about being able to get back to working to support our family. Please help. Please – I can repay some donations on July 1, and if you request, I will with yours.
Please help…any amount would mean a difference.
After a horrible weekend due to the very sudden and very unexpected death of Simba, and a migraine that lasted 16 hours, I’m finally at Hershey Medical Center. I’ll be headed to pre-op any minute now, and will hopefully be wheeled into an OR within the next hour or two.
I’m so glad my surgeon was able to move my surgery date up by 8 days. I’ve been having non-stop heartburn for nearly a week, and there were bits of dark blood (like the cliche “coffee grounds”) in the migraine-induced vomit I dealt with yesterday.
This surgery is slated to last 6 to 8 hours, and will be rather extensive due to dealing with so much scar tissue and removing the stitched-up ulcer before getting to the revisioning part, but it will be worth it.
See you on the other side!
Current status: FREAKING THE FUCK OUT BECAUSE MY SURGERY IS MONDAY, NOT TUESDAY. Ahhh!!!
photo credit: Julia Caesar
Our friends mean a lot to us. They are often a sympathetic ear, a confidant, and even the voice of reason. It is likely that they have seen us through some of the highs and lows of our lives. Even if our friendship with someone is still in fairly early days, we probably came together for a reason. There is something about them that we like or feel connected to. Perhaps their outlook on life refreshes us or puts a smile on our face. Whatever the reason, friends help us make the best of life. It is now even supported by research that friendship and interaction has a profound impact on our overall wellbeing. If we have good friends in our lives, it follows that we want to be a good friend ourselves. There are many times that a friend of ours might not be feeling their best. Perhaps they’ve undergone something stressful at work. They might be dealing with a difficult family situation. They may even be recovering from illness, or just feeling generally down. If you want to pamper a friend in a thoughtful and creative way, browse the ideas below for inspiration.
photo credit: Pexels
A Pamper Evening
In our busy modern lives, it can be difficult to find any time for ourselves. If we add a family into the mix, things can become even more complicated! A pamper evening can be a great way to help a friend to unwind. With affordable face masks and hand cream, we can instantly start to feel fresher. Prepare the bathroom ahead of schedule by adding some fresh towels and bathroom accessories. After you’re clean and relaxed, it can be nice to sit in a warm room with scented candles. You can then catch up over herbal tea or a glass of wine, or simply watch a movie together. Whatever you choose to do, the emphasis should be on feeling tranquil and carefree.
photo credit: Pexels
The tradition of “afternoon tea” is especially popular in Britain and Europe, and it’s easy to see why. Participants settle down with friends or family to enjoy a selection of fresh sandwiches, cake, and warm drinks. It is easier to recreate at home than you might think. With a few plates, containers, or cake stands, you can arrange things beautifully. You may choose to make a few small sandwiches from scratch. Or you can buy them and arrange them later. The same goes for slices of cake, biscuits or muffins. Lemonade, cordial, or sparkling water can be offered on the side. But a sip of freshly made English Breakfast Tea or Earl Grey can be especially refreshing. This is an opportunity to make your friend feel special and to enjoy something novel. You can have afternoon tea in your own kitchen or lounge. On a nice day, it is particularly pleasant to enjoy it in the garden.
Pampering a friend in any way and on any budget shows them how much they mean to you. Everyone deserves a treat and to feel appreciated every once in awhile.