The Art of the Blade

There were two appointments today - one for each of us.  Mine was first, but I'll speak about that one later.  However, since mine was first we went downtown early and just sat in a coffee shop in-between while waiting to go to Deb's appointment.

I'd previously written that we hoped to be able to have Deb's last drain pulled on Monday if the drain cooperated.  It did not.  At least not right away.  It actually picked up in volume initially (taking over anything that the other abdominal drain had been dealing with) before finally starting to settle down on Monday and Tuesday.  It is now gone as of about 1115 this morning.  WooHoo!  Done with drains!

We hadn't expected to see Dr. Paige today, but he was the first one to walk in the door (followed by RN Susan, who actually pulled the drain).  He took a look at Deb's incisions, et al., and was very pleased with her progress.

Except maybe her navel.

We still can't really see it, but it's not healing as fast as he'd like.  He mentioned two different ways to deal with it surgically.  The first, and quickest, is to just seal it up and leave only a scar behind.  I like that one because I can play off on the whole Alien Abduction/Replacement scenario when we go to the beach.  Otherwise they can do a multistage process to try to work on it.  Meanwhile we are going to be using a new type of dressing made from algae and silver (algae to provide natural debridement and silver for it's anti-bacterial properties.  It may turn out that in two weeks the dressing will help reveal a healed navel without having to do anything more surgically.  That would be nice.

To recap: 1) No more drains. 2) Algae in the belly button.

My appointment was at the building right next door two hours before Deb's.  I'd been to my GP on Monday for general physical and had pointed out a bump on my arm that was annoying.  We couldn't tell if it was maybe an infected bug bite or possibly a squamous cell carcinoma.  I got referred to a dermatologist today.  She wasn't able to say exactly what it was, but just to be sure she cut it off (the bump, not my arm) and sent it to pathology.  Now I have a cauterized wound on my arm right where I was going to put the anchor tattoo.  No, I really wasn't.  As far as you know.  I should have the pathology results next week sometime.

After Deb's appointment we walked over to the Frye Museum for lunch, hoping to see the current exhibit first.  Except that there isn't a current exhibit.  There is a new exhibit being installed that will open on Friday evening, but only five visible works right now.  But we did enjoy lunch.

The trip home included a stop to pick up Deb's new contact lenses (now that she's cut back on the narcotics enough that she can focus again ... kidding ... maybe).  I also stopped in at a drug store for some vaseline for Deb's wound care.  But that was it.  We're home now, Deb is lightly snoozing in her recliner, and Betty the dog is heavily snoozing on her bed next to Deb.  Seems like a good plan for her afternoon.

Weekend Update (No Chevy Chase ... Sorry)

We went back to see the RN at Paige's office yesterday.  Her name is Louise, and I have to admit that I love listening to her talk (born and raised in Sydney, Australia, so she has that lovely Aussie thing going on).  She looked at the places where Deb's initial drains were pulled on Monday (healing nicely) and pulled one more of the two remaining.  So that means that drains A, B, and C are now gone and that drain D is the problem child that just hangs around and won't leave home, eating all of the groceries and playing Xbox into the wee hours every night.  However, we are hopeful that we can kick it out of the nest on Monday.  Maybe.  Possibly.  We have an appointment back with Louise, so D just needs to cooperate ... please.

Did I anthropomorphize the drain a little too much there?  Hmm...

In other news, I was able to make it out to Jerry Baker Memorial Velodrome one last time yesterday evening to see some people I won't get to see again for a long time, and some maybe not at all.  Why did I feel OK about leaving Deb at home while I was gone during the evening hours when I would normally be fixing dinner for her?  'Cause Emma is here.

Emma is one of Deb's much-younger half-sisters.  She lives in Portland, OR with her husband, but came up for the long weekend on Thursday evening so she can attend a conference/symposium/seminar/whatever it is over in Bellevue on the east side of Lake Washington.  She fixed dinner for herself and Deb last night, and I figured it was a good time for me to give them some sister-time.  Emma is back at the ... thing ... today (it runs Friday and Saturday), so we expect her back late this afternoon.  We don't know if she'll send another night here or if she'll drive on back to Portland tonight.  Depends on how she feels, I guess.

The run-down:

• Three drains gone, one remains.
• Deb has been feeling a bit more pain over the last few days, but then she has cut back to half-dosage on the OxyCodone.  She's also cut out the ibuprofen, so she's down to the half-dose and Tylenol for now.  She's still managing OK.
• She's been able to be a little bit more upright everyday.  Not that she looks like the Hunchback of Notre Dame, but maybe that disaffected-teenager slouch is a better comparison.  But it is improving!
• Deb looks forward to getting out of the house for short (at first) excursions as soon as the last drain is gone.

So that's all I have until at least Monday at this point.  Goodnight, and have a pleasant tomorrow.

Fables of the Reconstruction

Well, Deb had a bit of a down day yesterday.  She didn’t really feel very good all day.  Sometimes it was being unable to regulate her temperature (going from freezing to sweating at the drop of a hat).  Sometimes it was being unable to conjure up much of an appetite.  Sometimes it was feeling very run down (more than on previous days).  Mostly it was all three.  Underlying it all was a general malaise/ennui.  Yep.  I’ve been there before.  I call it ‘narcotic burn-in/burn-out’, but I’m sure there’s a medical term for it.  Deb did start the weaning-off process only recently (like, the evening before?), so I hope that this is something that improves … quickly.  She does feel better today and is in a lot better mood. 

She’s also upped the length of her walks around the house (at least time-wise, which should translate to distance-wise as well).  She’s also been staying awake more (she’s been binge-watching ‘Orange …’ on Netflix), though she still tends to nod off within 45-60 minutes of taking her OxyCodone (even at the reduced dosage).

I can tell she’s starting to get a little bit of cabin-fever.  She mentioned today how she looks forward to getting out to go for a walk at Richmond Beach Park soon.  Richmond Beach Park has an upper walking path that stays on top of the bluff (so not much, if any, elevation change) and has a great view of the Puget Sound and Kitsap Peninsula.  Not a long walk, but relatively easy to start off with.  Eventually we’ll try to get over to the Japanese Gardens at Washington Park Arboretum and work our way up to the Bloedel Preserve on Bainbridge Island.  No climbing Rainier, I’m afraid.

Deb’s update:

• -        Beginning to wean herself off of the OxyContin.
• -        Drain production still diminishing, but it looks like she may have to keep one around for awhile longer (I think that one will be removed at her appointment on Friday).
• -        There’s still some post-surgical bruising, but it is slowly beginning to improve.
• -        The navel is still … well, it’s still something.  I don’t know.  It’s scabbed over and until the scab comes away we really can’t tell how it looks.
• -        Energy is up today, alertness is up, but we’re to the point where some days are better than others.  Yesterday wasn’t a great day for Deb.

But I did buy her some Fran’s salted caramels at Central Market yesterday while grocery shopping.  Maybe that will help too.

Follow Up, Follow Through

Deb spent her second night upstairs in our bed versus downstairs on the sofa, so I think she's trying to get back into her routine as best she can.  That includes her morning shower before breakfast and wearing her own regular pants instead of my old hospital scrubs.  She is still wearing my button-front shirts, though, if only because they are plenty big and not restricting her at all.  That's fine.  I have plenty of those.

We went down to the Nordstrom Tower (northern end of the Swedish Hospital campus) today for Deb's recheck appointment with one of the surgeon's nurses (or is she a PA? To be honest, I never saw her name tag).  She took Deb's vitals first, of course, and then looked at the records I'd been keeping on Deb's drain production.  She agreed that the two upper drains were ready to are removed, but as we expected she wants to leave the two in Deb's abdomen (since they are still producing enough to keep them in - they have outlived their welcome, but sadly not their usefulness).  Deb has another appointment scheduled for Friday now, and we hope both drains will be gone after that.  It's possible that only one - or even neither - will be removed, but let's stick with hope, OK?

We are back home after stopping to pick up Five Guys (Deb has been having a burger craving) and Deb moved to her chair to watch Netflix on her iPad while I went out to continue painting the front porch and then finished off the laundry from yesterday.  She's dozing now, so I will wait until she's awake again before I go to the grocery store (she may have some specifics that she wants me to get).  But I'll have to go before I can make dinner.  I used the last of the fresh vegetables for dinner last night.  Except the beets.  But Deb doesn't really like beets unless I grill them using my 'ancient Scottish secret' method (no, I'm not Chinese - for those of you who get the reference).  Too bad I ran out of charcoal.

Deb's update:
- Two drains are now gone (Yay!) and two remain (Boo!). The two remaining are the ones that are located to create the most hassle, of course.
- Deb is starting to try to cut back on the OxyContin as of today.  It may not work out yet, but she's giving it a go (making up the reduced dose with some Tylenol).
- One week out from the initial surgery and she's starting to be able to stand a little straighter, but isn't yet fully upright.  That will continue to improve over the next week or two.
- Deb's healing is coming along well along all of her incision lines, though the navel area is still a bit angry.  That may take another week or two to resolve.

So, the plan is to just hold steady, keep to the plan, and allow healing to take it's own pace.

Easy Like Sunday Morning

Except that it's now Sunday afternoon. No matter. We are still taking it easy.

Deb decided that she's actually tired of sleeping downstairs, so she made two treks up the stairs yesterday (once for a shower, once for bed).  I think she had a better night of it.  I know that I was more comfortable.  But it's not about me. I'll be wherever she is for now. This morning we came down and sat in the two recliners we bought back in February before her last surgery, staying there most of the morning up until lunch.  We were even able to let Betty come in with us to that room as long as she learned that Deb is off-limits and that she needed to stay on her bed. She actually was better about that than I'd expected.

After lunch we decided to sit on the sofa until halftime of the Seahawks game, but Deb fell asleep on me with about a minute left. Seriously, she fell asleep on me, with her legs propped up across mine. So I'm stuck here for awhile, or at least until she wakes up and goes up for her shower.  But I could at least reach my iPad, so it seemed as good a time as any to write an update.

Deb's update:
- Her energy and stamina have been turned up to 11.  Sadly, that's only 11 out of 50 or so, but hey, baby steps.
- The production of her drains continues to decrease*, but I think that she'll only get to have two of the four removed tomorrow.
- She seems to having a brighter disposition as she continues to metabolize the anesthesia out of her system.  She's a lot more alert (except for starting about 30-45 minutes after her latest OxyContin, at which time she tends to slide/float into la-la land for a while.
- She's still dealing with pain, but she's dealing with it.

We have an appointment tomorrow for a recheck at her surgeons' office with one of the nurses.  As mentioned, we should say farewell to at least two drains, but it may be closer to the end of the week when the other two come out.  Nonetheless, I will post something about the appointment sometime tomorrow.

Until then, have a nice lazy Sunday if you can.

* Sorry if talk of surgical drains makes you squeamish, but that's just how it is here at Crawford House right now

There's No Place Like ...

Well, it's home for the next few months, anyway.  Moving still seems pretty distant with everything else going on right now though.

Deb got a lot of good rest yesterday afternoon and evening in between having to get up to go the the restroom, dealing with her surgical drains, and taking laps around the first floor to get some movement in.  She slept, as planned, on the sofa overnight taking up the longer arm of the sectional while I took the shorter half.  We were up at 0100 and 0530 to deal with the aforementioned items before waking up for the day at around 0830.

I ended up taking a mid-day trip out to run errands and grab lunch with my friend Tom, and Dane showed up a little late (of course).  But even with that and the grocery store and picking up other items in Fremont and Green Lake - oh, and the post office - I was still only gone for around three hours.  Deb slept for most of that time, though she did get up once (I had left things so she could easily reach what she needed to do that).

Deb took a shower this afternoon, and to my surprise decided that she wanted to go up the stairs to do it in our Master Bathroom shower.  I hovered appropriately while she navigated the stairs mostly on her own, but she dealt with the stairs like a champ.  Still, it was tiring, so she says she only wants to deal with the stairs once-a-day for now.

Her biggest complaint right now is that all of the sitting in one place is hurting her back.  For tonight she wants to swap out our sleeping arrangement, and I think she will try to spend more time in her recliner tomorrow just to get some different support.  She isn't complaining about the general pain she is in, but she is being honest when I ask her specifically about it.  The truth is, you can think that you've mentally prepared yourself for the pain in advance, but you find out that doesn't mean much until you are actually dealing with it.

Still, she's strong - a real trooper.  Stronger even than she'll admit to herself.  But trust me, I see it.

Parting Is Such Sweet … Ah, Forget It – Let’s Just Go Home

It is 1340 and I am just now getting a chance to write anything.  Busy morning.

That morning started early.  Deb was up at 0100 for a trip to the restroom and a lap around the ward.  Then we did it again at 0530.  She ordered breakfast for us both at 0630, but it took about 30-45 minutes (they say to allow them that long, so that wasn’t unexpected).  PA Jackie showed up at around 0700 and said she would put in the order to let Deb leave.  She also looked Deb over once again and was happy with the results of both surgeries.  We will go see one of the nurses in their office for a recheck on Monday and hopefully remove at least a couple of Deb’s drains. 

Nurse Chelsea then turned us over to Nurse Jan for the day shift.  She got started on the paperwork and we were hopeful to leave just after 1100 but before 1400.  Why that window?  Well, the I-5 express lanes switch from southbound to northbound at 1100 or a little after which would speed our exit from downtown a bit.  But if Deb had still been there at 1400 she would have gotten another Heparin injection, which she didn’t want.

Deb was allowed (and even encouraged) to shower this morning, so Jan and I assisted with that as much as we could.  I went ahead and helped Deb put on her ‘going home’ clothes (and old button up shirt and pair of scrub pants of mine) to help get her ready to leave as soon as notice of discharge and transport came through.

Not long after that was when Jackie P. arrived for a visit (the PA is Jackie L.).  Deb had taken a painkiller after the shower, but was able to be alert while Jackie was there.  Jackie left somewhere around 1100 when Jan showed up with the homecare instruction and said discharge was imminent.  I finished packing up our stuff and grabbed the prescription sheets while Jan left to call for Transport.  At that point I figured I had just enough time to stop at the hospital pharmacy (the prescriptions had actually been faxed the night before), get to the car in the sublevels of Dante’s Garage, and get up to the patient pick-up area.  I got there, but no Deb.  So I pulled aside and waited*.  And waited.  And waited.  And waited some more. I finally called the hospital switchboard, got connected to the 11SW nurses station, and asked Jan (who’d been the one to answer) if Deb was still up there waiting for something else or if she was somewhere on her way down.

Jan had gotten distracted by another patient and had forgotten to call for Transport.

Profuse apologies to me followed (and apparently where given personally to Deb as well), so at least there’s that.

We left the hospital around noon or so and made the trip home without too much discomfort for Deb.  I have since gotten her to the restroom, fed, and into the succubus-like embrace of the sofa where she is currently dozing.  And I’m doing this.  And now I’m going to stop doing this and take a nap.

Zzzzz

*Turns out I was parked in a spot that was posted "No Parking Or Waiting", but I didn't see the sign until the car parked in front of it moved.

Moonlight Over Seattle

I have performed my dog walking/feeding duties for the evening and got back to the hospital at around 2230 or so, only to find Deb – with the help of Chelsea, the night nurse – coming back out of the restroom and ready for another walk around the 11SW ward (which is where we are tonight, and there’s a really good view of the southwest end of downtown/SoDo from the room’s window).  Deb took her third lap around the longer course for the evening and plans to go for maybe one more sometime during the night.  The slippers I brought from home should be more comfortable than the textured socks that hospitals like to give out.

I left this evening for home at around 1920 since I wanted to wait until the handoff between the day nurse, Susan, and Chelsea.  That way Chelsea would at least recognize me when I got back and not wonder who that strange guy is walking into Deb’s room.  Deb had already had her dinner (which looked very good, by the way – some kind of cod preparation) and Jackie had been by one more time to try to work with that one problematic surgical drain (I think she got it this time).

Deb was just nodding off into la-la-land when I left, and reportedly had remained there almost up to the time I got back.  That’s a good thing, but she noted that she had stiffened up a good bit due to lack of movement during her last walk around the ward.

Here’s a current report on Deb’s condition overall:

-        - She’s off the IV and onto oral meds now except for the occasional shot of Heparin they put into her leg (which apparently stings a good bit).

-        - The recovery of the right side (the one they went back into yesterday) appears to by improving, though Jackie will evaluate it again in the morning.

-        - Her kidneys are working quite well, thank you, as evidenced by the regular trips to the restroom.

-        - Her navel area still looks like it is a bit angry, so Jackie will be looking at that again tomorrow morning as well.

-        - We expect to be sent home tomorrow morning, though the time it takes to be discharged can vary wildly.  I’m hopeful that we can leave soon after 1100 (since that will be one of the best times traffic-wise to head home with the least delays).

-        - Deb will likely spend most of the first week at home on the first floor of our house due to the challenges presented by stairs at this point.  I still haven’t quite figured out how to get her up the two stairs to our front porch without causing abdominal strain.  But I will … I will.  Nonetheless, the sofa and her reclining chair are ready for her.

Look for another update sometime tomorrow.  If I have time between the morning assessment and actual discharge I will post something then.  If not, I will do so sometime after we get home and get Deb settled in.

Progression

After spending some time at home with the dog and getting cleaned up and grabbing Deb’s slippers and buying a walker and getting lunch to go from Citizen, I finally made it back to the hospital slightly after 1300 (including another wonderful time spiraling s-l-o-w-l-y into Hell Dante’s Parking Garage – I wonder if that Lincoln in front of me will ever make it back out).  Deb has left ICU behind and placed in a nearly penthouse room on the 11^th floor.

Jackie was with Deb when I came in the room, trying to figure out if and where there was a leak in one of Deb’s surgical drains (near the bulb).  She was using bandage tape to try to cover where she thinks it is, but that’s not the best kind of tape for that.  I promised to grab some electrician’s tape when I go home again this evening (which is probably the right kind of tape).  Jackie is the best.  I mean that.  She has been around to see Deb often and even came in last night while I was gone when the night nurse in ICU had called her to ask a question.  Really, most people I know would have just tried to explain things over the phone, but Jackie came in from home just to make sure that everything was explained and understood.  I know she doesn’t live very far away, but that’s still outstanding dedication in my book.

Since I have been here I have met Deb’s day nurses on the floor and helped Deb get to the restroom and then take a much longer walk than any she has done yet.  I think it wore her out, though, so she’s lying back now and dozing lightly.  That’s likely for the best anyway.

Deb has now gotten to eat twice today.  I don’t think she enjoyed her breakfast all that much since it arrived while they were doing checks on her and by the time she actually got it everything was cold (which was fine for the yogurt but not for the eggs, et cetera).  She seems to have enjoyed the BLT she had for lunch, though.

Deb is also off of the IV fluids and painkillers now too.  She’s getting oral painkillers from now until maybe two or three weeks out (though the space between them will start to increase in a week or so).

And the spirometer has arrived today.  She really doesn’t like that thing (or that I nag her to use it).

--- UPDATE ---

Since I wrote the above Deb has gotten back up to go to the restroom again and has taken another walk out on the floor.  While I was proud of her progression on previous walks, this time she knocked my socks off by increasing her distance at least an order of magnitude (and increased her speed somewhat as well).  She plans to take two more walks of at least equal distance tonight.  Her only complaint is that she still can’t stand up very straight, but that is quite understandable given the nature of the abdominal disturbance she has undergone.