Wednesday, July 18, 2012

Day 3


I was surprised at how little pain there was... until there was pain.

Monday, surgery day, was taken care of by that miraculous spinal morphine.  I felt like I could have skipped about town.  And Tuesday morning felt pretty good too as liquids were started.  But the chest cavity pain gradually increased during the day until by 3 in the afternoon it was pretty uncomfortable. We're drinking a lot of liquid (in little sips) and the air from that does not escape easily, so there's an overfull sensation that could be fixed easily with a burp--but burps don't come (presumably because of the swelling). Add to that the hiccups and spasms that occur, each of which kind of pressurizes the painful area causing a twang of discomfort, and it's hard to relax.  We try to keep our breathing exercises going--which are more painful--plus adequate walking, when you really just want to lay down and snooze.

Eventually, about 8:PM, I got a sublingual pain pill and a crushed sleeping pill and I was quite comfortable all night. This morning I'm a bit less sore--though still pretty tender--and have been up making my walking rounds and sipping at my liquids. It's the staple line, of course, that's the sorest thing. I assume that's what makes it painful to breathe very deeply. And this pain gets in the way of sneezing of coughing, since you naturally try to intake a big breath for those actions. But I can see that all this is on the mend and we'll soon be left with our regular selves and a pain-free, restrictive stomach.

This morning: our final leak check and a visualization of our new digestive tract courtesy of barium and an x-ray machine. The barium is a thin, white chalky liquid faintly flavored of strawberry. We sip this on command while standing in front of an x-ray plate with a transmitter in front of you.  So a little motion x-ray picture is made of your chest cavity--and displayed on a screen in front of you--while you drink the liquid and watch its progress down the esophagus and through the new stomach and on into the upper intestine.  Took about 90 seconds. Fascinating.  The doc stands there next to you in a lead apron watching the monitor with you and telling you what you see (and checking his work). The first thing that strikes me is that so much on the screen is in motion: With the the spinal column basically stationary in the center of the picture, everything else (mostly shadowed on the screen) is wiggling around to your breathing and heartbeat. And then comes this dark streak of fluid which winds down and around, kind of snaking along as the new stomach moves a bit. Doesn't really look like three separate components: esophagus, stomach, intestine; it all just looks like a single tube that spirals a bit.

And you only see that tube while the barium is passing through. You see little flat spots and shallow pockets where fluid has a tendency to pool, and the little burps and spasms we've felt all our lives play out now in this tubular world with a visual component. Odd but very cool.  The doctor liked what he saw--as of course did I--so I've now graduated to...

Chicken broth!  Good. I find that apple juice and water both go down without too many issues, though trapped air bubbles make things a bit uncomfortable. Those other two options--a kind of flavored tea and a mild, warm green tea--just don't do much for me. More Gatorade, please! [Oh, and the chicken broth? Awesome. My new favorite food!]

I sense that I have turned a corner and I'm now in recuperation mode. Last night I just felt sore and stiff, like things were not all happy. I'm still stiff and sore this morning, but it feels like I'm on the mend.


I'm curious how they manage the timing of everything. One naturally arrives thinking about one's own schedule, thinking that everyone is oriented around the things being done to you during your odyssey here.  But this is a 7-day-a-week operation (there are no actual bariatric procedures on Sunday, but the second- and third-day stuff continues) and you come to realize that the various meetings you have with the staff are wedged in--for them--between the other meetings with the previous days' patients, meetings that will occur in your own schedule over the next three days. Everybody gets a dye test, everybody gets a barium test, everybody gets various juices and broths, everybody's blood pressure and temp are taken five times a day, everybody gets their drain removed, everybody gets a series of followup checks. It's like a clockwork where everything hums along, each thing linked to the adjacent thing.

The doctors in particular seem to work very long hours. Aceves, the surgeon, shows up at all times day or night, and he's never in his scrubs; so much of his job--performing the surgeries--is invisible to us. Campos, the nutritionist, is here sunup to sundown. It all makes for some very full days for the key players. The nursing staff is young and quite casual. Little English spoken among these folks, but enough to get the job done. Everyone is helpful and cheerful, very professional.


Next up, the drain removal. Somehow I thought this would be the worst thing of all--pulling a long piece of rubber from among my innards. And while it certainly felt... odd and not entirely pleasant, it might almost have passed unnoticed.  The worst part, with the drain and several other little tack-on probes on my abdomen, was that it was all stuck over copious amounts of hair. THAT part of hurt like the dickens.

But that's it. Drain gone; IV port removed. Only four little pieces of tape over the four smaller holes remain, and they're to stay until they fall off on their own. The big hole is just covered with gauze and left alone. Wash gently with good soap once a day and re-bandage; it'll close up when it's ready.

Tomorrow morning we drive away and re-enter normal life. This little chapter will close, and a new landscape awaits.

Laytex glove on L. hand covers IV port for my shower,
and then got removed right after the shower.  Go figure.

There's the damage. Hard to imagine that big one doesn't need a stitch.
But I guess they know what they're doing!


Mike said...

Is that the scare just below the pecs? I see tape all over, so I assume each of those is another opening?

Really glad all is going well. How long until you can start eating solid foods and normal diet type foods? Safe travels back into the US.

wunelle said...

The line below my manboobs is a length of tape with a small hole under it. There are four of these small ones plus the bigger one. No pain from the small ones at all, and just a little from the bigger one. Most pain is internal, and it's still quite bearable.

I'm on only clear liquids for another 8 days, followed by 10 days of opaque liquids. Then 10 days of purreed / mushy food. Then, a month after surgery, I'm back to regular food, tho the composition of my diet will change.

Home tomorrow!

wunelle said...

It's the red spot in the middle of the left abdomen that's the drain hole. Just looks like a red nick. That's the main hole where the work was done. That one's just left to fend for itself (well, with a gauze covering over it--in this picture I've just exited the shower). There's still some drainage coming from this for several more days, so the dressing needs a daily changing.

(In case that wasn't clear in my description above.)

Vancouver Voyeur said...

I'm too empathetic, I felt queasy and pained for everything you went through. Glad it's all manageable for you. The operations of the staff and the facility seem like an orchestrated dance. They must have other staff so people can take a break? As for the barium drink, that brought back memories. I had to do that test when I was younger and I kept retching and gagging with each sip. I kept telling the doctor, "I think I'm going to throw up." He was very nasty and mean in his tone to me, treating me like I was an ignorant, annoying child (I was 16). He said, "everyone thinks that but they never do." Within seconds of my next sip this explosive flume of vomit erupted from my mouth and went all over that doctor, in his hair, his face, etc. He was pissed, he threw his notes down and yelled, "we're through here," as he stormed out of the room. I'll bet he could hear me say, "I told you I was going to throw up," as he left the room.

wunelle said...

Geez, what a dick!