Alien?

I want to mostly talk about the hernia that Tom has developed at the site of the main incision from His bariatric surgery, but before I get to that, I wanted to give you another look at how significant the physical changes that we are seeing really are. Three months ago, on Sunday, April 5, we took some pictures of the, then pretty new, belly wounds. Of course, you cannot take pictures of "belly wounds" without also taking a picture of the belly. Back in April, the belly was something to behold...

Today, the belly is much smaller. Take a look...

But, as slim as He is getting, there is this hernia that is beginning to look like something right out of a science fiction movie. Our primary care doctors do not seem to think that this "critter" is presenting any immediate medical problem, but it really does seem to be getting bigger day by day, and He is beginning to talk about consulting with the surgeon who did the stomach bypass about correcting this...

Home?

I am almost afraid to say this here, or anywhere -- afraid to jinx it.

So, whispering in a very tiny little voice --

They say that tomorrow, Master might get to go home!

There'll be four different antibiotics to be administered intravenously, and 3x a day dressing changes until the wounds in His belly heal -- perhaps a couple of months or more. That is all a little daunting, and logistically complicated, but we will manage.

T came down to visit this evening, and I packed up most of our accumulated "stuff" and sent it home in her car. Most of it will just sit there in the back of the car until I can get home with Himself tomorrow afternoon, but it is out of the room, and won't have to be dragged out when we finally get the discharge...

I am excited, but also subdued; realizing the size of the mountain we still have to climb to get Him well and strong again. Keep your fingers crossed, friends. Tomorrow we go home again.

swan

Infection

T is home and doing well on this 7th day after surgery. It worries me to death that she is there by herself, but I simply cannot figure out how to be two places at once.

Master is still hospitalized, and really struggling. The doctors have FINALLY decided that He has a major wound infection. They re-opened His incision this morning, and extracted a lot of clear, foul-smelling fluid. It is now packed and covered, and they are running two different IV antibiotics. It does appear (to my untrained but dedicated eyes) that the angry red is receding on His belly this afternoon.

We still have no verdict on what is causing His diarrhea, although it does seem to be slowing down. Perhaps it really is a normal post-surgical bowel pattern. I hope so.

We were visited just a few minutes ago by an infectious disease specialist who has indicated that they will be establishing a PICC line and starting a course of vancomycin in the next 24 hours. This will be some pretty intense treatment, but feels promising as an approach to fixing all of this. I hope!

This afternoon, I've gotten Him cleaned up and into a fresh gown. He is now tucked back in and sleeping fairly comfortably. I am almost daring to hope that maybe things are improving a bit.

swan

Now I am Angry

We had an absolutely awful night last night.

Master had a serious coughing fit that lasted well over an hour starting at about 1:15 AM, and in spite of our repeated requests for something to help manage the ferocity of the cough, or at the very least, some way to reduce the pain He experienced because of it, we were met with indifference, hostility, and a general attitude of condescension. When I finally got stomping angry over it all, the night nurse gave in and called the resident to come look at the situation. He insisted that they wanted Master to keep coughing; that coughing is an important part of getting well; and he was simply unwilling to give Him anything to quiet the spasms. When I got my back up and told the arrogant jerk that this was NOT simply coughing; it was violent and wrenching and was leaving Him gasping unable to catch His breath. The best that the "medical professional" could offer -- IV morphine for the pain. There was just one problem with that BRILLIANT idea... Master's IV port had stopped functioning at around midnight, and no one in this supposedly "excellent" hospital was able to get a new IV started, even though four so-called "experts" tried. Some of those efforts were just brutal. They finally gave up on the whole business, and the coughing calmed on its own. At about 3:30 this morning, He and I finally fell into an exhausted sleep. We were not awakened by the usual parade of residents until 6 AM.

They did finally find someone who could efficiently and effectively re-establish His IV port this morning, and so as of now, He is once again being given IV fluids and antibiotics. He's also been given the go-ahead to restart clear liquids, so He's been given some apple juice and some sugar-free jell-o and a little warm tea. He did regurgitate a bit of that, but so far most of it seems to be staying down.

This morning, He has experienced repeated bouts of diarrhea, and there is some thought that perhaps He has now a C-diff infection. We are waiting to be able to get a stool sample that can be cultured. T is at home, and doing well, but understandably worried and wanting to be able to see Him. I may go home and get her later in the day and bring her down for a visit, but I am reluctant to do that until we know what we have going on here. She is doing so well. We do not need to expose her to some nasty bug and send her into a tail spin.

Mostly I am angry -- beyond angry, I am furious. The very excellent care that both Master and T received in the days immediately following the surgery has devolved to a style of medical practice that is seeming resentful, parsimonious, and just at the verge of neglectful. I am very aware, this morning that, had I decided not to spend the night here last night, He'd have been all alone in the face of the coughing and the horrible IV debacle; and no one would have cared. I find that just outrageous.

I am exhausted, but I am more than determined than ever that, one way or another, we will get the care that is needed here, and He will get better, and I WILL take Him home.

swan

Friday Evening Update

It is Friday evening, and I have been here at the hospital with Master since about 12:30 this afternoon. When I arrived this afternoon, He was miserable. He complained of more or less continuous "regurgitation" of liquid into His throat in quantities that would certainly cause choking if He were not constantly swallowing and/or spitting it into a basin. The coughing and throat clearing and gagging attendant upon all of that was making His already tender belly very sore and achy. On top of that, He hadn't slept (except in brief snatches of a few minutes here and there) in well over 24 hours. Now, some 6 hours later, He is freshly showered and installed in bed, resting comfortably for the first time in about a day and a half.


The working diagnosis, at this point, is that Master has a post-operative ileus -- a temporary paralysis of a part of the intestine, causing food and liquids to back up rather than flowing through as they should. This is apparently a fairly common complication after abdominal surgery. The doctors do not seem to be terribly concerned, and are basically telling us that the treatment of choice is to "rest" the


I've been in regular contact with T, who remains at home, and she continues to do well and feel good. She has reduced her pain medication, and feels really well. We've discussed it, and as it stands right now, I'll likely spend the night here at the hospital with Master. If T needs me, a phone call can take me to her side in about 25 minutes.

One really good piece of news in all of this confusion and worry -- As of this morning, four days out from surgery, Teresa has lost a total of 21 pounds. How kewl is that?

swan

Here we go again

I'm home.
Master is not.
They've admitted Him to the hospital and will be administering IV fluids.
He was feeling some better when I left, but surely not as well as we'd hoped He would be by now.
I'm going to try and get a bit of a nap. I am simply fried from lack of sleep.
His clothes are in the washer, and when they are dried and ready to go, I'll gather up the things He will need and head back.
This was the thing I dreaded -- that Master and T might end up in two places, and I'd not be able to be around for them both. Fortunately, T's mom will be down this afternoon, and so perhaps there'll be a bit of coverage at that point.

Meanwhile, I am trying to stay calm. This is a bump. The doctor is taking a very serious, very conservative approach, but then that is likely why his mortality rates for this surgery are so much lower than most other surgeons. He'll treat whatever this is as aggressively as possible, and soon Master will be home and feeling better each day.

swan