Second Star On the Right and Straight On 'Til Morning

It’s a little after 0700 here, and Dr. Paige (one of Deb’s surgeons) has just been in.  More on that in a moment.

Deb got some rest during the night, but not a lot of consistent rest.  That isn’t uncommon in ICU, since the nurses come through to check you so often.  In Deb’s case they have been in at least every 30 minutes to check on her.  Add to that Deb’s general level of discomfort and the tendency of something or other to alarm every once in a while (like the respiration sensor, which only senses Deb’s breathing when her mouth is closed and she sometimes opens it a little when she nods off) … Well, it doesn’t make for consistent rest.  I may have slept for one straight hour at one point, but Deb has only gotten to drift in and out mostly.

One of the surgical assistants came in at 0600 or so and looked at the surgery site, noting that everything looked pretty good except that one side is a little pinker than the other.  Then Dr. Paige came in and took a look closer to 0700.

While he thinks that there is good blood supply to both sides, there is a little concern that blood may not be draining as well from the right side - hence the little bit more pinkness.  It might be something that will resolve itself over the next several hours, but there is the possibility that they might need to go back in on that side to make sure everything is doing what it is supposed to do and work on a better vein connection if necessary.  He is going to consult with the other surgeon, Dr. Beshlian, before deciding whether to take that step or not.  I expect to see Dr. Beshlian here within the next 30 minutes or so (he’s currently with another patient prepping them for surgery today).

Okay, so he just walked in.  He has taken a look and listened to her blood flow with the ultrasound.  I can’t really read him very well, so I don’t know which way he is leaning.  He and Dr. Paige will go talk it over and come up with a plan for her immediate care.

So definitely a bump in the road, but it remains to be seen how large that bump might be.  Go back in?  Wait and watch?  Whatever the case, Deb will remain in ICU for now and isn’t allowed food and water yet (she really really really wants something to drink right now). 

Not the news I wanted, but not the worst news we could get.  Simply stated, if the work on the right side doesn’t ultimately hold up they will remove that part and go back in later with an implant on that side.  But I definitely have my fingers crossed that everything goes well and I’d prefer that it didn’t require any more surgery, but if it does, it does.

I See You (Or Something Like That)

It is now 2145 local time and Deb has been in ICU for about 30 or so minutes.  I got to walk up just as they were wheeling her into the room, so I got to hang out in the shadows while the ICU team did their initial assessment. Once they left the room I got to talk to Deb a bit (in her really groggy state) and let her know what all had gone on while she was under sedation. She's resting some now - drifting in and out, really - but she's in a bit of pain.  But she has her finger on the button of the painkiller pump, so she has at least some level of control there.  I think I get to stay tonight, so I'll be here to keep her company when she is in her lucid moments.  No, I don't plan on getting much sleep.  I'll likely take a nap when I go home to walk and feed the dog in the morning.

But before I go home, I will stick around at least long enough to see the surgeons and hear their assessment and any care instructions in the morning.

That's five posts today.  Wow.  That's a lot.  I won't likely do as many tomorrow, but I will try to post something after the surgeons have come by or at least as soon as I get home.

To recap the important stuff:
- Deb is out of surgery and her doctors seemed pleased
- Deb is in ICU tonight before heading to a regular room tomorrow
- Deb is in some pain, but it seems to be manageable
- The surgeons will be by tomorrow morning to check in and see how she's doing

Yep, that's about it. Thanks go out to all who commented, texted or FB'd, and special thanks to Greg and Michael who came by the hospital (especially Michael for sticking around while I ran home so he could update me on changing information on the boards).

Wow, That's DIEP ...

I've seen the surgeons, and they are done.  All that was left when they came out to talk to me was the final sutures and supergluing (yeah, really ... that's what they do).  I still won't get to see her for another three or four hours, though.  Long sedation equals long stint in Recovery 1.  Then they will move her to a room in the ICU wing, where I will be allowed to see her and possibly even spend the night.  I've never been allowed to do that before, so I'm keeping my fingers crossed on that one.

So Deb had what's known as the DIEP procedure, which stands for Deep Inferior Epigastric Perforators.  'Inferior' just means they are below the fat layer, not that they are underperformers somehow.  The surgeons say that they are pleased with the results and everything should be fine, though she will be closely monitored (hence ICU overnight) should any complications arise.

I just know I won't feel better until I actually get back to see her.  That may not be until 2100 or 2200, but I'll just have to wait.  They don't appreciate family members who try to push their way back into the recovery area before they are called.  Yes, I've seen someone try it once.  Security got involved with stunning quickness. 

I wonder if she'll still have on the warming robe?

No News is No News ... Updated During Production

Quick note: Other than a few quick "The surgery is going well and I'll call you back in two hours" calls from Rebecca (one of the surgical assistants), I don't have much more to ... Wait ... Hold on a moment ...

As luck would have it, while I was typing I got another call from Rebecca.  They have finished the main part of the reconstruction and are starting the long process of closing up.  I may hear from the surgeons by 1800 or a little after (remember, I report in 24 hour clock time here), but the most detailed part is over.

So maybe it's a little more than 'no news' after all.

Notes From All Over

I'm now resting comfortably at home, and ...

Well, I am at home, but I'm not exactly resting.  I had to come home anyway to walk and feed the dog, Betty, but I'm hardly at rest.

They actually didn't take Deb back until closer to 0750 this morning, but before they took her away from me we'd had a lot more visitors.  Two of the surgical assistants (PAs) from Dr. Paige's office came by (one of whom will be monitoring Deb's care throughout her stay at the hospital) to say 'Hi' and that they will be in the OR with Deb as well.  Dr. Paige also came by to talk over things and then draw on Deb with a marker (incision lines and what-not).  The recovery room nurse also stopped in a couple of times, as well as another nurse who will update me every two hours from the OR and finally the anesthesiologist.  She put in Deb's IV line after going over the plans and procedures once again and then was the one who actually wheeled Deb out of the room.  So that was - including the first admitting nurse - Amy, Jackie, Kathy, Keith, Vicki, Rebecca, and Deborah (not my Deborah).  I really am trying to be better about getting names when I talk to people, especially since they knew ours.

I've been asked to be sure I am back at the hospital by 1430, though I will likely be back there by noon or soon after.  I'm not likely to hear anything definitive until 1500 at the earliest, though possibly not until 1800.  So if you check back and I haven't posted yet, I don't know anything yet.

One more word about the Bair Paws system.  Another stated reason from 3M for the use of the system is that patients under anesthesia can't properly regulate body temperature.  Since Deb is scheduled for a really long surgery I'm happy for that precaution.  The system looks like this:

Of course, the comment Deb made when they were hooking it up was that it reminded her of this:

Let's see how many younger readers of this blog aren't familiar with this antiquated apparatus (Deb said "I'm really aging myself, aren't I?").

Another Day, Another Surgery

Good morning from the Pre-op suite at Swedish hospital in lovely Seattle, Washington.  It is now a little after 0600 Pacific Time (0900 for you readers on the East Coast, adjust accordingly for everywhere else) and Deborah has signed-in, been brought back, changed into the lovely surgery clothes and is sitting with her eyes closed waiting for the next person to come by and do something or ask her name and birthday or whatever.  Or she could be sleeping.  Well, she’ll certainly be sleeping for a good long while today.

Something new this time is a new type of gown that they had her put on under the outer gown.  It’s a warming gown complete with a port for a warm air pump to be attached.  Swedish has only been using them for about the last month (according to Deb’s nurse that I just asked about it), but there have been studies showing that warming before surgery can help with recovery and even reducing the possibility of infection, et cetera.  3M has apparently jumped into action with their product called Bair Paws (Paws standing for Patient Adjustable Warming System – Google it).  Deb looks comfy.

So I’ll stay here with her until they shoo me away and take her over to the OR.  I don’t know when that will be, but I may post a quick note then.  Probably before 0700 or 0730.  Maybe.

More info forthcoming when there is more info.

Catching Up (Round Two Imminent)

Long time, no blog.  I can’t remember the exact date of my last post – and I don’t feel like going back and looking it up – but I know it has been a while.  Things have been progressing along as we have expected for the last couple of months.  Deb has been getting an infusion of Herceptin every three weeks ever since the Taxol infusions ended.  The Herceptin infusions don’t take nearly as long without the Taxol addition.  Mainly just a quick check-in with the oncologist followed by about an hour sitting in her chair in the infusion room.  Pretty tame now that we’ve sent the freezy-caps back to New Jersey.

As a matter of fact, we are back at the oncologist’s/infusion center now (I started this post in the waiting room and finished it in the infusion room).  This will be the last infusion before Deb’s reconstruction surgery, which looms large on the horizon (like a dark and angry storm cloud … at least that’s my perception of it right now).

Two weeks ago we paid a visit to the surgeon who will be doing Deb’s reconstruction surgery – in part.  In part, you might ask?  Yeah, seems that this will be a 10±2 hour long surgery, so he and his office partner will be tagging in and out.  That’s a really long time for Deb to be under anesthesia.  I’m not thrilled about that part.  Anyway, he seems to be happy with the healing on Deb’s chest area and is confident of a positive outcome, so I’ll just roll with that.

So that starts on Monday morning.  I’ll take Deb to the hospital really early and I’ll stay with her until they take her back into the surgery suite.  At that point I will try to remember to post something.  Then I’ll go sit somewhere in the waiting area until I get hungry.  Then I’ll go eat, maybe run home and walk the dog, and go back to the waiting area and watch the status board like a hawk.  When I hear something about her being in recovery I will likely post again, and then probably again once I have seen her.

I don’t know if I will be able to spend the night at the hospital with her that first night.  Deb will be in ICU overnight and won’t go to a regular room until sometime on Tuesday.  If we can get her a private room I might be allowed to stay overnight that night.  I’ve been told to expect that she’ll be sent home on Wednesday at the earliest or possibly Thursday at the latest.

So that’s the plan.  I’ll be posting updates as any new information comes up (which is a lot easier on us than having the same phone conversation with 50 different people – that’s hyperbole, but only a little).

So Monday.  See you then.