Sunday, May 12, 2013

Post-Op hospital stay

I stayed on the 6th floor of Legacy Good Samaritan Hospital, here are pictures of the Surgical Specialties unit I stayed in:

 
I don't remember waking up from surgery or much of anything of the day after surgery.  Apparently the first thing I did after waking up was pull off the sheets and gown and expose my belly to see the scars! Matt reports that I was feeling great, laughing and joking right away (thanks pain meds, ha) Here is a picture of me just after surgery with my special surgery buddy that my Mom and Dad gave me during my first surgery last year:

 
The next morning I was still feeling good so the nurses decided to advance my diet and I was allowed some sips of orange juice that went down ok! Day two is still a blur, all I know is that Matt said I was feeling good, and not complaining of any pain, thanks to the epidural. Here I am trying to figure out my spriometer all drugged up (I don't remember this):
 
Soon it was time to get up and start walking.  I do remember this hurting and the nurses had to sit me up and get me out of bed.  I made it to the doorway of my room to peek down the hall and then it was back to bed. Look no NG tube yet! Ha!  And the nurse is hiding out of the picture, I steadied myself against my "walker" enough for a quick picture, I was determined to look "helathy":
 
The day after surgery the nurse took my bladder catheter out. Later I was screaming in pain because my bladder was over full (used a bladder scanner to see it over full) and the nurses had to straight cath me and she ended up removing the equivalent of "3 IV bags of fluid from my bladder" she told me later. We went through this process two more times and finally ended up putting the foley back in.
 
After surgery the spinal caused me to be super itchy all over my body and i was itching my skin off! Benadryl in large doses and special lotion were my best friend. Itching was a constant battle the entire hospital stay. We determined that removing my colon had messed with my immune system and everything was upsetting it.  I had an allergic reaction to the bedding and gowns.  I developed a red rash over half of my face from the magnesium.  And the bad reactions just kept coming. 

One morning I remember the surgeon coming in and talking with me about what went on during surgery.  Surgery went well and the surgeon said that my colon was very long (the longest colon he had ever seen) it ended up being twice the normal length about 10 ft and had many extra loops in it. He also stated that my colon was extremely floppy which meant that the nerves and muscles of the colon had not been working for a long time, which was something he had not seen before either. I really wish I had them take a picture of that nasty colon so I could see it, I had contemplated it before admittion to the hospital but I thought they would think I was some crazy sadistic person, so I skipped it. That same morning the pain and nausea set in and they upped my pain medications (morphine) and reassured me that the nausea was most likely from the pain meds and not to worry.  The surgeon suggested that I eat something little to see if we could get things moving (I still had not passed any stool and could not urinate on my own). So I decided upon pancakes.
 

I remember texting Matt a picture of my pancakes, I think he had left the hospital to go shower and get something to eat. I was so happy to be able to eat again, and ready to start my "new life" filled with EATING!! I was so wrong...within minutes of eating i started vomiting.  It was dark green bile and I was vomiting all over myself and the nurses, my family and my bed.  It hurt at my incisions and especially inside my abdomen when I would vomit.  It felt like my insides were ripping. 
 
What was happening was that my small intestine had shut down and was creating a blockage and nothing could pass. Bile had been backing up into my stomach for days.  
 
I vomited violently like this for hours, they gave me medication to sedate me but I just kept vomiting.  I was so thankful that Matt and my Daddy where there to help out.  I one point I was in so much pain, cyring and vomiting.
 
The next thing I remember was a group of nurses coming in with orders from my surgeon to place a nasogstric tube (this is a tube they insert into your nose and it gets pushed down until it reaches your stomach) they forced my family out of the room and began to hold me down while I vomited all over them, myself and my bedding while they began to insert the NG tube.  I was so angry that they were holding me down, but I could not do anything about it because I just kept vomiting.  It hurt so bad and they could not get the large tube past my septum for the longest time. Finally they got the NG tube in.    My memory of the vomiting and NG tube is pretty foggy but I defenately remember some "big" parts, I'm guessing my memory of these events is a little stronger because when I started vomiting they stopped giving me pain medication to see if I was having a bad reaction to the pain meds, well it turns out I wasn't.
 
I had developed a severe prolonged postoperative paretic ileus (ileus lasting over 6 days) which they confirmed by in room xrays.  They alos took xrays to confirm the NG tube had been placed correctly by my surgeon. Even with the NG tube in to suction out the bile and IV injections of ondansetron (Zofran), Haloperidol (Haldol), and Promethazine (Phenergan), I still was vomiting unrentlessly through the night and into the next day. Because of the prolonged ileus I had increased pain, delayed bowel sounds, delayed defication and delayed wound healing. In order to go home I was required to keep down food and liquid, pass uring on my own, and pass gas and stool. 
 
In the middle of the night I remember a new nurse coming on duty who insisted that I get up and walk.  Between vomiting fits I pleaded with him to let me stay in bed, but he refused.  For a moment the vomiting slowed down and he was certain the vomiting was done and I told him "if I stand up I will vomit".  He made me stand up, guess what, I vomited into the nice blue chux bag he was holding.  He continued forcing me to walk, I got to the hallway and stopped because I was about to pass out, my legs gave in and the nurse had to catch me and in that same moment I began to vomit, it went everywhere!!! Still holding me up and with me vomiting in the hallway he immediately called out to the other nurses at the desk to call the doctor ASAP! haha, I did warn him. He quick got me back into bed and didn't bother trying to get me to walk all night!  Instead he sat with me most of the night while I continued to vomit.  Then they tried keeping me sedated but I just continued to vomit while being extremely sleepy. Nothing like vomiting in your sleep... UGH
 
That morning my surgeon and my surgery team came to assess the situation along with the supervising floor nurse. Apparently he had never been sent a copy of the the first x-rays to approve placement of the NG tube and he became super mad at the nurses. Upon examining the x-rays he found that the NG tube had been place to far down and was actually pushed into my small intestine so it was not suctioning much of anything.  My surgeon pulled the tube up and took more xrays in my room and the NG tube was finally in the right spot and by the end of the day the vomiting had slowed.  UGH! Tube stayed in until the day before Ileft the hospital. I was miserable.



 
I also had developed intense swelling on the sides of my body from my ribcage down to my thighs which turned out to be excess fluid that had accumulated due to an infection, and I also developed a high fever. I was so swollen that I was double as wide as I normally am, i looked ridiculous and it hurt bad. Not only was the sides of my abdomen and hips swollen but red and painful due to the infection.  They put me on IV antibiotics to heal up the infection 

They took blood every day to watch and monitor my infection and nutritional levels since i was not allowed to eat anything by moth for 9 days.  My magnesium, potassium and iron levels fell drastically low during and after surgery so I was given these through IV. I had a bad allergic reaction at my IV site when the magnesium was given my arm was instantly swollen, red and burning and started itching! Over the 10 days in the hospital I had over 8 IV's placed, each at a different site due to IV fluid leaking into the tissue outside of the vein (infiltration),  inflammation of the vein (Phlebitis), and blood clotting in the veins surrounding the IV catheter. 

I tried walking as much as I could tolerate, on one of my last days I was able to make it across the hall to the elevator that took me down and right to the garden.I was determiined to get to that garden after passing a guy in the hallway who had to be in his 90's (and was lapping me by the way) mentioned how he had gone down and sat in the garden for a while. If he could do it and make it back, I had to be able to.  Finally on my last day I finally pushed myself to do it, I got tired on the way and stopped a few times to sit down.  I walked with very slow steady movemts and all I was all hunched over (my abdomen hurt so bad to walk I could not stand up straight yet) and I shuffeled my feet! I was so happy to be outside! Matt and my family would come and go during the day heading to work, taking walks and leaving for meals or to sleep at home for the night, it was nice to have the quiet time, and who wants to be stuck at a hospital for that long anywas? But I was very jealous that they got to leave! I was having bad anxiety beeing stuck in that room and stuck in my bed all the time, which is crazy because I was only awake for a few minutes at a time.  Here I am on one of my walks all hooked up, I posed by myself for the picture.  During my walks I was usually held up by a nurse on one side and a family member, or two on the other:






 
The garden I finally made it to:

The next day they allowed me to try drinking sips of water, the first thing to enter my mouth for 9 days! With the NG tube in I remember being so uncomfortable with dry mouth and all i wanted was to have some liquid in my mouth, it was torture. They gave me these little green sponges attached to sticks and a cup of water, I was only allowed to wet my lips, and the nurse had to supervise me to make sure I was not sucking water off the teeny tine sponge.  Even if I did I don't think there was even enough liquid on the sponge to swallow.  

The fever made me super uncomfortable and compounded with the pain, vomiting and itching I was miserable beyond belif. Many times I thought relif would never come. At one point I was itiching myself so hard at one point I started bleeding.  We tried everyting to make the itching stop, special lotions and creams, benadryl and other alergy medication that just made me super sleepy but nothing really helpe.  But we figured out that the epidrual can cause you to be very itchy and it turned out that I was aving a bad reaction to the laudry detergent they use at Legacy.  They gave me special allergy bedding that is wased specially for people with skin irrations and it helped! Another great thing were the heated blankets and hot packs they would put on my sore belly.  I'm pretty sure I had one constantly and it helped to ease the pain some. When my fever was at it's worst it felt so good to have ice packs on my head.  But that's about all the comfort measures the hospital had. 

I remember trying to watch TV at one point in my stay but it was just too much.  Talking and holding conversations was exhausting and frustrating so I mostly layed in bed holding my family members hands and closing my eyes when I was awake.  I was so fortunate to have lots of family visit me during my stay.  During some of my roughest moments the only thing that kept me fighting was my family!  Thank YOU!!!!!!  As you can see in the pictures my room quickly became filled with cards, flowers, plants and stuffed animals from my friends and family!

One afternoon the nurse cam in and said "lets get you a shower".  I'm assuming I was super stinky if the nurse had to point it out, pluss I'm sure I still had vomit in my hair.  Funny how quickly you don't care if your clean when your in pain!  Most days spent there I was sure I was dying.  Showering turned out to be a horrible, exhausting mess. I was still all hooked up to all my different IV's, catheter, and had my NG tube in, all this had to be brought into the shower with me.  Thank goodness for the kind, patient, caring nurses.  I was so exhausted I just layed in bed while she got everything ready to transport. She pulled me out of the bed and helped me "walk" to the bathroom and into the shower.  She did everything for me while I stood there holding onto my "walker" all hooked up with everying.  By the time my shower finished I was exhausted.  She got me dressed and back into bed and I was out.  Most of my time in the hospital was spend sleeping. 

My saving grace for this hospital stay was a round neck pillow and headphones!  The nurses had to check on me every 30 minutes max during my stay.  And each time they would wake me up.  With the headphones on if they came in to change an IV bag or empty my NG suction I would not be woken up!!! YAY

During my stay I had a couple of wonderful nurses.  One in particular night nurse was amazing and I had her for a few nights in a row.  She was so gentle and reassuring.  In the middle of the night when I as sleeping she would greet me for my shots (heparin shots for blod clots, and another one I can't remember) by softly stroking my forehead and simply saying "sweetheart I'm here with you".  That statement I found very comforting.  To have someone acknowledge that they are WITH you was just what I needed. She was so gentle and rubbed my swollen and infected belly before gently giving me my shots and then she would stay with me for a while afterward making sure I was comfortably tucked back in.  Before leaving she would place a comforting hand on my head and say "sleep now my sweet".  Every time it was the same sweet reasuring interaction with her and I was so thankful to have her. Many times nurses would hustle in in the middle of the night loudly, give my arm a quick forceful shake and practically yell "time for your shots and meds" to make sure they had fully scared me awake and then proceed to pull back the covers and stab me in the belly (heparin shots for blod clots) before I even knew what was going on.

I had a few other bumps in the road with student nurses, antibiotic side effects, severe dehydration, walking, continuing ileus, not being able to pass stool or urine, and then when I did go I was pooping blood and bile (not good), I also developed intense pain at anastomosis site, encountered more medication complications and handful of other issues. But my memory of these issues are pretty foggy.

I was just so thankful when the vomiting stopped and my surgeon finally came in and said we could take the NG tube out!  It was not a fun experience with the NG tube in, they are very painful and cause a lot of irritaion in you nose and throat.  With the NG tube in place it hurt to talk and swallow, I was given some numbing throat spray to help ease the discomfort but I was horrible at squirting it into my mouth and all it did was make my toung numb, but it was liquid in my mouth.  Throat spray had never tasted so good, HA! The NG tube also hurts inside your nose and caused sores deep inside my nose and on the outside where they had taped it to my nose for so long.  I started to get a stuffy nose and I was not able to blow my nose because of the NG tube and that caused everything to become even more irritated. 

I remember overhearing a nurse go to each room on my floor with a menu and saying she would be badk to take their order.  She never came to my room becaue of the ileus and I was so mad, I just wanted to be given a menu, just to look at and dream about the food. Well not really I guess because I was so natous.  But I wanted to be included in the basic human process of eating.  I wanted to feel normal.  My family was great about not eating in front of me much but really I didn't care if they ate in the room because I was not hungry at all.

When one of the members of the surgical team came in and hinted that I might be able to leave that day I was thrilled and all I could say was how quickly can we leave! I had my family imediately start packing and taking things out to the car.  I could not get out of there fast enough.  They had to give me another set of IV medications because the morning blood work came back bad again and then a while after the IV's they would run the blood again and if the levels had normalized I could go home.  So all that was left to do was wait and get my perscriptions to take home with me filled.  I'm pretty sure I layed in bed and slept with my go home outfit and shoes on for a few hours.  I was so ready to get out of there and to finally be able to go home that when I heard that there might be a chance I got myself ready in an instant.  Getting dressed hurt so bad, I had forgotten to bring a shirt the buttoned in the from and having to pull a shirt over my head was excrusiatingly painful.  After a few hours they ran the blood tests and I had passed, my levels looked good and we got the OK to leave.  After hearing all my discharde insturctions and meeting with the doctor one last time I was wheeled out of my room and through the hospital.  I always find it funny that they make you sit out in front of this bid hospital all sickly after surgery and wait for you family to pull up the car.  Once we reached the entrance to the hospital and we went outside into the sunlight I remember instantly becoming very scared.  I wanted to go back up to my room where my wonderful nurses could continue to take care of me, I was scared to go home and be on my own.  I was scared I was not ready to go home and looking back I probably wasent.  I was still in a lot of pain and hadent really eaten much or drank much and I had only had the NG tube out for about a day max.