Posted by Stephanie 11:30pm CST from the apartment Houston, TX
I can’t believe it’s been a whole week already since my surgery. My apologies for not getting on here sooner and writing a big update, I’ve just been soooo tired since surgery. I’d say I’m sleeping an average of 12-16 hours a day, which I’m sure my body needs as part of the recovery process. Just call me Rip van Stephanie.
Where to begin…..well, let’s see, I know Sammy gave brief updates during and after surgery. I guess I’ll start by picking up where he left off when he had to leave the prep room before they wheeled me back to the O.R. At that point, I hadn’t been given any sedatives, and was completely alert and wide-awake. The anesthesiologists in the operating room were a couple of hams, joking that as soon as I scooted onto the cold slab of a table that they’d start my “happy hour cocktail” (aka the sedative) so that I’d be semi-conscious during the insertion of the epidural. They couldn’t knock me out completely because I had to be hunched over in a certain position, but I’ll tell ya, once that was achieved, I don’t remember another thing.
I woke up in the PACU (post anesthesia recovery unit) after surgery, and the first thing I saw was Dr. Swisher leaning over my bed. It’s great that he feels driven to be there right away and let me know how things went, but what’s not great is that the first few minutes after waking up from anesthesia are the most disorienting and therefore the minutes when you remember the least of what is told to you. Here I am simply trying to figure out where I am and take inventory of what hurts the most, what I can and can’t move, where I have tubes sticking out, etc., and there’s the surgeon gabbing away—I felt like I was listening to the teacher in the Peanuts cartoons (wah wah wah wah). The best I could do was a) focus my eyes, b) not drool, and c) pretend that I was comprehending what was coming out of his mouth.
Usually, a patient spends a couple of hours in the PACU, then is taken up to their individual room. I have a history of spending a little more time in there because of pain management issues, and this surgery was no exception. After I became slightly more coherent and visited briefly with Sammy, his mom, my mom and sister, I realized that whatever pain medication they had me on wasn’t cutting it. I was told during my anesthesia consult earlier in the week that they usually use either Dilaudid or Fentanyl in the epidural pump (the patient has a button that they can push to release that medication bit by bit. Well, I.V. Dilaudid makes me itch something awful (thought it’s great in pill form), and I.V. Fentanyl has never been that effective. The anesthesia team knew this going into surgery, but I woke up with Fentanyl in my pain pump, and sure enough, it wasn’t working. The epidural was covering the incision area okay, but my left lower rib cage area where the chest tubes (yes, 2 of them) were was outside of the coverage area, as was my left shoulder, which hurt from its twisted placement during surgery. The pain team tried a nerve block in my shoulder—it didn’t work—and wouldn’t listen when Sammy and I tried to tell them we had dealt with these same problems in the past and how we had previously resolved it. I know the members of the pain team are knowledgeable and trained to know what works best for most people, but this is me we’re talking about, queen of the abnormal, and at the start of the evening they were rather rude, arrogant and implied that I didn’t know what I was talking about and should just give it more time. When I was still in the PACU seven hours after my surgery ended and still in intractable pain, they finally agreed to take me off the Fentanyl.
Once I got up to the room, a nice big corner room, I might add, they switched me over to a Morphine pump. Those of you who remember the Morphine-induced hallucinations that came with my liver surgery last fall might be wondering why they would do that, but have no fear—with a complete, functioning liver this time around, processing the Morphine would not be a problem. Though I had a few severe, teeth-chattering, whole body shaking pain flare-ups during the rest of my hospital stay last week, the morphine worked. I’ve said it before, I’ll say it again—if only they’d listen to me…..
So anyway, the first couple days/nights of the hospital stay are a bit of a blur, since I did a lot of sleeping. Morphine makes it very tough for me to stay awake—I often fell asleep mid-sentence (when I was the one speaking), or even sadder, between the time when I scooped ice out of a cup and the time it got to my mouth……I spilled a lot of ice chips and nearly spilled hot tea on myself numerous times. No matter how much I slept, that side effect never went away until I was taken off the morphine and put on an oral pain medication regiment (luckily, that was done after just a couple of days). I was up and walking (more like shuffling/dragging myself along) the morning after surgery, and had to walk at least four times a day, or else the nurses got after me. The rest of time I was awake I spent doing breathing exercises or getting breathing treatments to prevent pneumonia. Exciting, eh?
I must have been progressing well with everything (I certainly felt like I was doing better than my previous lung surgery), because the fluid coming out of my chest tubes was clearing up and had slowed down enough to come out on Saturday night, just two days after surgery. Those chest tubes were the source of so much of my pain and internal irritation, and once they were out, I felt sooo much better. The next morning my epidural was capped, I was switched to oral pain meds, and the catheter came out. THAT was the best part. I’ve talked about how much I despise those things. And, the catheter being out meant that I could put on real pajamas and not have to spend all my time in that hideous hospital gown. Quite a fashion statement, those gowns are….anyway, things were happening so quickly by Sunday afternoon that there was talk from the surgical team of possibly discharging me later that evening. I couldn’t imagine that actually happening—I had just been advanced to solid food from ice chips and clear liquids earlier that day, and we were still playing with the dosages on the oral pain meds to get just the right combination. As much as I would’ve loved to be out of there and recovering at the apartment, I knew I wasn’t quite ready to go, and thankfully, they realized that too. Monday morning, though, just 12 hours later, everything was still holding steady, and I was happily booted out of the hospital just four days after surgery. Pretty good, if I do say so myself.
Having the apartment to go back to, instead of a tiny hotel room, has been a real blessing. I made my nest right away in the big comfy recliner chair, and that’s where I’ve been ever since. I’m even sleeping in the recliner, with mom parked on the couch right next to me so that she can help during the night with anything I need. I have to sleep propped up for a couple of weeks while fluid continues to drain from my lungs, and even though I could prop myself up in bed, undoubtedly I would roll over on my side, which would not be good right now. Moving around has become easier day by day, and the pain has gotten better bit by bit. I’m still taking lots of pain medication, which has caused some nausea, and other fun side effects like constipation, but hopefully I can start to lower the dosage soon. My days this week have been a lot like the ones in the hospital--walks up and down the hallways inside the apartment building, breathing/coughing exercises to help speed up the lung healing process, and lots of napping. Again, terribly exciting, I know. I haven’t gotten out of my pajamas since Monday (how awesome is that?), except to shower on Tuesday night. I wasn’t allowed to shower at all until my chest tubes had been out at least 48 hours, and I wanted to wait an extra day to gain a little strength. Mom put a shower seat in the tub, and there'ss a removable shower head, but even with those modifications in my favor I still couldn’t move enough to bathe myself, so she had to do it for me. Even though we’ve been going through this for four years now, and she’s had to help with things like this (and much worse) that whole time, I still find it disheartening and embarrassing that at the age of 30, I am being bathed by my mother.
Overall, the surgery and recovery so far has gone well. Being semi-active and healthy (aside from the whole cancer thing) has helped me bounce back well. It’ll still be another week before I can do much of anything on my own, and several weeks after that before I’m back to myself, but so far so good. My appetite isn’t great, but I’m actually okay with that right now, since I need to lose a few pounds anyway. Don’t worry, I’m not starving myself—I’m just taking advantage of a decreased appetite to jump start things a little. 
I know Sammy mentioned in his post that the slice of rib they looked at under the microscope during surgery didn’t show any sign of disease, so we’re hoping when we get the path report back in the next few days, it will show the lung nodule as the only problem.
So, I’m certain that since it’s been a week since I posted, and a busy, important week at that, I’ve somehow managed to forget something important. But, this is a pretty good synopsis……it’s taken me two and a half hours to compose, and I’m tired and ready for bed! Now that I’m starting to be on the computer more, I’ll do some more frequent posting. Till then, night all!
--Steph
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