I don't know how, but I think Deb and I actually got little more sleep last night. We still had the every-30-minute intrusion for monitoring by the night nurse, but I think Deb was able to remain semi-asleep/semi-awake for most of those. I know I didn't wake up for all of them.
Jackie (surgeon's PA) showed up early at around 0630 and looked Deb over. While Deb's Doppler sounds and capillary refill are good, there is a little concern that the color is still a little pinker than the other side. She left to file her report notes to Dr. Paige.
Dr. Paige showed up at about 0715 to have a look. He noted the same things, but didn't think it warrants another surgery. This time it's going to be a 'wait-and-watch' approach. I think he feels that this will work itself out across the day (and I think he also feels that going back in again now might cause potential issues for no gain). Still, he felt encouraged enough that Deb's dietary restriction is over. She gets to eat! Seeing as how she hasn't eaten since Sunday evening at 2130, she's ravenous (I've been careful not to mention food around her before now). I think his larger concern right now is around her navel which is right in line with the abdominal incision, but that's just something else to watch for now. Dr. Beshlian came by a few minutes later and also thought things looked promising (he seemed more willing to show outward confidence today).
Deb will also begin the process of transitioning from ICU into a regular room. Sometimes that happens quickly, sometimes it happens slowly, so I don't know exactly when we get to wave 'bye-bye' to ICU. Maybe by the time I go back.
I've come back to the house this morning to take care of the dog and to get a shower and wash dishes and set up the sofa for Deb's homecoming and find a place to buy a walker and ... but enough about me. Let's talk about Deb.
Deb has now made three excursions from the bed. Twice she's been out into the hall (further the second time) and once to the bathroom. She feels a bit weak right now, but thinks that is in large part due to lack of food (she was calling in her order to Food Services when I left, so that should get better). It's painful - to no surprise - to get up and move around, but she's doing it and showing improvements.
Annnnnd I just got a call from Teri (one of the ICU day nurses) to let me know that they have a room assignment for Deb and that she'll likely be moved there before I get back. I will go back in a few more hours once I complete everything else and I will try to provide another update this afternoon.
So maybe not completely out of the woods yet, but I think I can at least see the edges of suburbia now.
Wednesday, September 14, 2016
Tuesday, September 13, 2016
Putting Her Foot Down
A lot has happened today. It's been hard to keep up at times. I rewrote one post this morning four times because the information I was getting was being updated or revised so fast. Things have calmed down a little now.
Deb did get back to the ICU room around 15 minutes after I did. She immediately looked a lot better - more awake and aware - than she did yesterday, but she hadn't had as much of the 'magic button' painkiller yet. Even after, she has been more lucid than she was overnight or this morning.
We got a visit late afternoon by Dr. Paige and PA Jackie. They explained that when they went back in they discovered that one of the artery/vein pairs had somehow gotten moved around enough to cause a kink of sorts. The blood was getting through the artery due to higher pressure in, but the vein wasn't draining effectively. But they were able to rework everything and then close it back up, and the color and ultrasound Doppler indicated that flow was as it should be (we could hear that it wasn't quite right before). I think I finally let out that breath I've been holding in all morning and half of the afternoon.
Jackie came back again later and we'll also see her in the morning, but Deb was alert enough to discuss a Greek restaurant in Jackie's neighborhood that she needs to try (and I might have mentioned Tavern Law as well). I can tell that Jackie is more pleased with Deb's condition now, too.
But the post's title alludes to something that happened later. Around 1800 Eileen (the day nurse in ICU) came in and started helping Deb get ready to move over to the chair for a while (which entailed Deb straightening up enough to stand!) followed another 15 or so minutes later by Deb actually getting up and walking (with a walker, of course) all the way out of the room and across the hall to the nurses' station and back. That, my friends, is a huge step (even if taken - as it was - with baby-steps). Not exactly a walk in the park, but at the high end of the medical team's expectations for her. She returned to the chair for a while and was planning on getting back in the bed in 20 minutes when the nurses came for the next monitoring. That was when I left to come home, though, so I missed that part, but I was there for the most important part.
I've finished my dinner and our dog Betty has finished hers, so now I owe her some walk and play time before I head back to the hospital for the night. I won't post again tonight, but will post in the morning once we've seen Jackie (we may not see Dr. Paige tomorrow) and gotten a progress update.
But things are looking much better now than they did this morning.
[Whew]
Deb did get back to the ICU room around 15 minutes after I did. She immediately looked a lot better - more awake and aware - than she did yesterday, but she hadn't had as much of the 'magic button' painkiller yet. Even after, she has been more lucid than she was overnight or this morning.
We got a visit late afternoon by Dr. Paige and PA Jackie. They explained that when they went back in they discovered that one of the artery/vein pairs had somehow gotten moved around enough to cause a kink of sorts. The blood was getting through the artery due to higher pressure in, but the vein wasn't draining effectively. But they were able to rework everything and then close it back up, and the color and ultrasound Doppler indicated that flow was as it should be (we could hear that it wasn't quite right before). I think I finally let out that breath I've been holding in all morning and half of the afternoon.
Jackie came back again later and we'll also see her in the morning, but Deb was alert enough to discuss a Greek restaurant in Jackie's neighborhood that she needs to try (and I might have mentioned Tavern Law as well). I can tell that Jackie is more pleased with Deb's condition now, too.
But the post's title alludes to something that happened later. Around 1800 Eileen (the day nurse in ICU) came in and started helping Deb get ready to move over to the chair for a while (which entailed Deb straightening up enough to stand!) followed another 15 or so minutes later by Deb actually getting up and walking (with a walker, of course) all the way out of the room and across the hall to the nurses' station and back. That, my friends, is a huge step (even if taken - as it was - with baby-steps). Not exactly a walk in the park, but at the high end of the medical team's expectations for her. She returned to the chair for a while and was planning on getting back in the bed in 20 minutes when the nurses came for the next monitoring. That was when I left to come home, though, so I missed that part, but I was there for the most important part.
I've finished my dinner and our dog Betty has finished hers, so now I owe her some walk and play time before I head back to the hospital for the night. I won't post again tonight, but will post in the morning once we've seen Jackie (we may not see Dr. Paige tomorrow) and gotten a progress update.
But things are looking much better now than they did this morning.
[Whew]
Missed Connection
Deb is out of surgery and in recovery now, but not yet to a place I can see her. And I apparently missed seeing Dr. Paige by a few minutes while spiraling through hell the hospital underground parking garage searching for a spot where a vehicle other than a bicycle or Smart Car might actually fit without bending the laws of science to create a local tesseract field. I'm a scientist, but I haven't figured out how to fold space yet.
A few minutes later I got a voice mail from him, so I must have been down in Dante's garage when he tried to call. The message was that he thinks they've resolved the issue and that he'll see us when he gets done with the next surgery he was heading into. That may be as late as 1900 or so, but at least Deb will be awake.
I'm eating lunch now, but I hope Deb will be getting back to her room in ICU soon after I get back.
That's all for now. More to follow.
A few minutes later I got a voice mail from him, so I must have been down in Dante's garage when he tried to call. The message was that he thinks they've resolved the issue and that he'll see us when he gets done with the next surgery he was heading into. That may be as late as 1900 or so, but at least Deb will be awake.
I'm eating lunch now, but I hope Deb will be getting back to her room in ICU soon after I get back.
That's all for now. More to follow.
The Decision
Well, they are going back in for a look this morning. I am hopeful that it is something that they
can fix easily if there’s something actually amiss. Jackie (one of the surgical PA’s) has been
talking with us about the plan, and Dr. Paige told us he hopes it is a simple
thing. All that aside, I know that they
will do everything they can to ensure the success of the surgery and that Deb’s
overall health is paramount.
Pre-Surgery (initial anesthesia, etc) may started around
0830 or so when they wheeled her down to the same pre-surgical suite we were in
yesterday. We met a new Anesthesiologist and CRNA and the girl taking Rebecca’s
place on the surgical team, Darby.
Darby has my cell number and will be the one calling me from the OR to
update me.
If they can fix it, great.
If not, they remove that side’s work, close up, and we regroup later to
come up with another plan, be it taking tissue from another area or putting in
an expander for a later implant or whatever.
That’s what I know right now.
Wish us luck for the first part of that rather than the latter part.
Deb went back to the OR at around 0900. I then went and searched for my phone which
I’d misplaced (it was back in ICU where I figured it might be, but I had to
retrace my steps including finding the same elevator). Now I’ve run home to feed the dog and let her
out for a bit and I will head back to the hospital around 1100 or so. I likely won’t see Deb until noon or 1300,
but we will be back in the same room in ICU tonight.
So it begins again …
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.
Monday, September 12, 2016
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).
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?
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?
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