kcowles

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I better get this written before my 59 year old mind loses all the details.  Already the first couple days are beginning to fade.  Be forewarned, I’m going to tell you the gory details, some pretty yucky stuff, so if you don’t want to hear that, abort now! (I wont mind, honest!)

Since my surgery was about an hour from home and I had to be at the hospital at 6:30 AM for a 9:00 surgery, DH and I headed to Grand Rapids last Monday evening right after having the family over for a Memorial Day cookout.  I, of course, stuck to my supplements but did not have to stop food or drink before 9 PM that evening.  We stayed at a motel and went out for a little puzzle geocaching to pass the time (PM me if you’re interested in learning more about geocaching, it’s a fun, addictive sport/game that gets us out in all sorts of places we wouldn’t ordinarily go, looking for small treasures). 

We got to the hospital in the morning right on time and I was called back to start preparations within minutes.  I was oddly calm.  I went through the intake formalities, had a blood draw, and then waited for the host of people to come talk with me.  I saw a couple nurses, the PA, the surgeon and the anesthesiologist.  (Hint: this was a good time to ask for a private room.)  All went smoothly except the anesthesiologist.  I have veins that roll and collapse.  So I have a lot of experience with that happening and I know where the safest places are to tap a vein for an IV.  Well she didn’t listen.  She finally tapped the right vein after blowing out 2 veins in other places.  I now have a nasty bruise on my right forearm that is 4 inches long and 1 ½ inches wide which I suspect will last for a month or more.  The other thing this person did not seem to be concerned about was my propensity to get extremely nauseous from anesthesia and pain meds/narcotics of all sorts.  So, this may have been a big factor in what was to follow.  Needless to say, I wish I had asked for a different anesthesiologist, but at a time like that I really didn’t want to offend the person who would be responsible for keeping me alive for the next couple hours.

The only thing I remember after that was seeing the surgeon briefly and being asked to skootch over to a very skinny table/guerney sort of thing and then I was out.  I’m guessing they started a sedative at that point.  I do not recall being taken to the OR.  Next thing I was waking up, someone said it was all over and I was then riding down a hallway, and saw my DH approaching.  I greeted him with a big smile.  I don’t recall a lot of pain at that point, some though in my abdomen and I had a drainage tube coming out of there.  I was actually pleased to be feeling surprisingly good, though I had this big sensation of pressure in my chest, just under my breast bone.  Surgery had begun around 10AM and took 2 hours.  I had a hiatal hernia repair which the doc thought would take a half hour longer than the 1 hour VSG, but he said it turned out to be pretty big and he wound up taking extra time to wrap it with a mesh to make sure it doesn’t reoccur later on.  So things were looking pretty good.  I was sucking on ice chips and feeling very little pain, though I was beginning to feel nauseous.  I did have a pain pump that I think I used once that afternoon when a nurse told me to.  DH headed home in the evening and called everyone to tell them how well I was doing.

Well, this is where things got interesting (agonizingly so).  The nausea overtook me.  It started coming in rapid waves.  I began vomiting blood that went on and on and became dry wretching very quickly since I had next to nothing in me.  I was given all kinds of anti-nausea meds through my IV, but nothing would touch it.  I began to refuse any and all meds after this went on awhile because I didn’t know what was causing this and didn’t want to risk worsening what was fast becoming intolerable.  This went on all night long.  I got maybe 20 minutes of sleep all night, only from sheer exhaustion.  I could not lay back even the slightest without feeling exceedingly ill, sitting upright and leaning forward a bit gave me the slightest bit of relief.  So I wound up putting a pillow on my bed table and resting my head on that….all…..night……long.  The pain under my breast bone was worsening, so I kept tapping hard on my chest all night to try to ease that.  Oh and all this time, since I first was checked into the hospital, I had these booties on that would deliver a blast of air every 6 seconds or so, alternating feet, that would sort of whap my soles.  Try sleeping with that going on!  I had 2 or 3 bouts of wretching through the night though the blood in it decreased and then disappeared.

Very early the next morning I was taken to radiology for an upper GI.  This is where things start getting really nasty.  I had to take swallows of this nasty tasting stuff so they could watch it go through my stomach.  Needless to say, that triggered violent wretching and I had big gobs of phlegm and bubbles pouring out of me and all over the x-ray machine platform I was standing on.  I peed on it, not a whole lot I don’t think, but enough to feel just mortified.  The radiologist ended the exam very quickly, after only 3 small swallows, and I was off to my room.  The surgeon came in shortly after and said I had a blockage, nothing was getting through.  He said he made my stomach very tight, hoping I’d not regain weight in the long run, and the hernia repair was also tight.  He said he kinda wished he had made it a little looser now.  I thought “oh great!  I’m totally messed up now and need more surgery!”  I asked “what are my options?”  He said he may need to go back in and loosen a few stitches on the mesh he put around my esophagus to hold my hernia tight.  He said he’d first like to try an NG tube down my nose, through my throat and into my stomach that can drain out the phlegm that has built up in there and isn’t moving through.  He said the other option is to just wait, keep trying to get ice melt down and the swelling should begin to go down and hopefully reopen a channel through my stomach.  Basically, what little stomach I had was blocked by all this foamy phlegm that was sitting there like a block of cement.  I couldn’t bear to get the NG tube so I declined that and opted to wait and keep sucking on ice cubes and beating on my chest.

So that went on all morning.  DH came by around noon and then was off to an afternoon meeting.  I was sobbing by this time.  I was sooooooooo soooooooo sick and could see no end to it.  At that point I would have given anything, ANYTHING, to get my stomach back and never pass this way again.  I for a brief moment thought death would be better than this.  I have never regretted anything so much in my life.  So……….mid afternoon the PA came in and asked if I was ready for the tube and I said yes.  Within half an hour I was wheeled away in this enormous wheelchair to the NG tube getting place.  Now……… this is the worst folks….. so if you have a weak stomach abort here…………..

So remember, I am at the height of nausea here, couldn’t be sicker if….. well….couldn’t be sicker than I was.  In order to insert this tube in your nose and through your throat they spray a nasty tasting substance into your nostril and you have to inhale it so that it reaches all the way to your throat to numb it and hopefully prevent the gag response.  So spray spray sniff sniff…. I’m managing this…… then they lay the table down, bad sign.  They start this tube up into my nose and down into my throat and that was it.  I began vomiting violently.  Out came these gobs and gobs of bubbles and phlegm.  They were pouring out, over and over wretching again and again.  It went all over the table, all over my face, my hair, they were mopping it up with towels and it just kept coming.  It was just disgusting!!!  It ended with a few rounds of dry heaves by which time the tube was in my stomach and I then had a permanent sensation of something awful in my throat, every time I swallowed I felt this object in there.  But, you know, the tube was a GODSEND because it broke the dam.  All that crap down there was keeping me nauseous.  Once that happened, the nausea began to abate.  Finally, I could see relief in my future, albeit with this yucky sore throat feeling, but relief from the awful sick feeling.  That’s when things began turning around.

DH saw a big change in me when he returned later that day.  I could focus on things other than my misery.  I got some sleep that night, although they woke me almost every hour for one thing or another…vitals taken, get up and walk, blood draw at 3 AM!  You’d think they would have let me sleep considering all I’d been through, but they have an agenda they must follow.  I was so happy to be losing the nausea that I was totally compliant and even grateful for the care I was getting.  Early the next morning (this is day 3 now) I was wheeled away once again for another upper GI.  This time it went much much much better.  I did not throw up.  I got down a few swallows of that nasty stuff and then a couple more.  They took about 3 times the amount of time they did the previous day and laid me back for more looking.  The results….”it’s a little better.”

So day 3 was all about trying to get down ice cubes and waiting for the swelling in my stomach to subside.  My doctors were encouraged.  Each ice cube still made more foam, but the NG tube sucked it right away into this clear pitcher that was just filled with the gross bubbly gunk.  With the nausea relieved, the incisional pain, which had taken a way way back seat to the nausea, began to present.  All the nurses and doctors tried to persuade me to use my pain pump but there was no way.  Not knowing exactly what triggered the nausea, I wasn’t about to go back there, not on your life.  The pain was so much more tolerable than the nausea had been.  So I toughed that out.  By this time though, the NG tube was a major annoyance and my throat was getting more sore by the swallow.  That was my new misery….though tolerable and it brought welcomed relief.  It was kind of a “choose your poison” perspective.  That evening I slept better than I had since the night before surgery.

Day 4 was a wonderful day!  The NG tube came out!  The drain tube in my belly came out!  I got to take a shower!  I asked for and got liquid Tylenol for the pain.  I was able to swallow ice melt without too much foam, though still enough to keep me very wary about swallowing more than the tiniest amount.  I began battling the foamies and the pain they caused in my chest…..learning to sip ever so slightly and spacing it out.  I did a lot of meditating on moving through the blocks that formed, not letting them get too big, and did a lot of rubbing and tapping on my sternum as well as walking whenever a clog did occur.  They started me late that day on some Carnation Instant Breakfast.  They require patients to drink 4 ounces within 4 hours to be released.  I didn’t even get close.  I got in one ounce and generated a foam clog that lasted for hours….tapping….trying to burp (I’ve become a world class burper by the way!)….walking…more walking.  I went to sleep that night DETERMINED to go home the next day, though the docs said it wasn’t likely.  I woke up early the next day and started my instant breakfast before 7 AM.  It was a struggle, with numerous blocks to work through, but I did it.  I was released at around 2:30 that afternoon! 

So that’s it really.  Since Saturday I have been increasing my intake of protein and water.  I’m not yet to the 64 ounces of water and 60 grams of protein (4 supplements) they require, but I may hit that today.  I took a half hour walk this morning and felt good….. really good.  A word to the wise pre-op:  start getting your legs back (that’s what I call it when I’ve gotten to the point where walking is a chore) NOW.  The better shape you go into surgery, the faster your recovery will be.  Yesterday I could only walk 15 minutes, today a half hour.

I just want to say the nursing staff at Blodgett Hospital in Grand Rapids, Michigan is extraordinary.  I’ve never seen a kinder, more caring group of people in my life.  On day 2 when I was in such misery one of the nurses aids gave me a back rub.  They felt so bad for me and couldn’t do enough to try to ease my agony.  The doctors at MMPC are also wonderful.  Every day I was visited by at least one surgeon and several times by a PA.  They took such incredibly good care of me and I am so grateful.  My hat’s off to those of you who had an easy surgery with little need for medical attention.  You are a fortunate bunch!  I’m afraid I would not have survived going home any sooner than they allowed me to.