Update 9:00 p.m. Marissa asked me to take and post a picture of Day 1 of her recovery to help you understand what is going on right now. As I write this I’m truly amazed she is still awake, given she’s on a combination of eight different pain meds, which includes an epidural. A true testimony to what being sick for 20 years has done to her body’s tolerance levels. Needless to say, she is still in tremendous amounts of pain. From the time surgery ended around Noon, until well after 5:00 p.m., they could not get her pain under control. Finally, about 5:30, they figured out a drug cocktail that appeared to take the edge off. Even though she is on all this pain medicine she still says it feels like her gut is burning. The really nice part of working with Dr. Sudan’s team is being provided with a personal coordinator for each case. Marissa’s coordinator, Kristen Schultz, is a wonderful nurse partner for us. Kristen was able to give us a much better understanding of Marissa’s surgery- and why she’s currently in so much pain. The exploratory laparotomy was considerably more invasive than I first realized. The midline incision actually goes from the bottom of her breastbone all the way down to her pelvis. When Dr. Sudan opened her up, and explored, she did not just fix what was causing the obstruction. [See an earlier post where I describe Dr. Sudan’s reasoning for removing Marissa’s pancreas/ scar tissue & draining her ovarian cysts.] To perform the exploratory surgery, Dr. Sudan actually had to move around many of Marissa’s internal organs. That included unrolling the remainder of Marissa’s intestine out of her body to make sure there were no problems, then re-rolling it back into her body. While I mentioned this morning her stoma potentially had to be revised…that thankfully did not end up happening. But Dr. Sudan did run a catheter through it. Already tonight a great early sign: her ileostomy appears to be working again after this long obstructive period. As you notice in the picture, she also has lots of tubes. They went ahead and put the Peripherally Inserted Central Catheter, known as a PICC line.” The PICC line’s point is to takes the place of an IV. And, it lasts a lot longer. Since Marissa’s veins are horrible, and typically don’t support IVs, hopefully the PICC will prevent her from becoming a further pincushion. After surgery they went ahead an inserted the PICC. This is a long, slender, small flexible tube they put into her right upper arm’s peripheral vein...and then they advance it until it meets the large vein near her heart. Because she continues to be on so many medicines, IV nutrition and fluids…she also has to have two additional IVs in each arm. (She needs IVs because there just aren’t enough lines between her port and her PICC to support all the lines she currently needs.) She has to wear an oxygen mask because the high medicine amounts controlling her pain can also slow her breathing. That’s in addition to the NG tube still being in her nose and her having to have a catheter. (They discovered she has a urinary tract infection, so she’s on antibiotics for that.) Kristen says because Marissa also has the remaining anesthesia in her system today, her pain is likely to be at its worst the next couple days. As we were warned, and have been preparing for, this is going to be a rough recovery at times. In the big picture, when the rough days subside in the coming weeks, Dr. Sudan feels confidant Marissa should be onto a much better quality of life.
Posted on: Tue, 01 Jul 2014 01:01:36 +0000
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