Utter Exhaustion

Hi,  It’s Amy again….

Nancy is utterly exhausted.  The nurse for the start of our night, Le, said that is the worst part of this particular surgery for Dr. Speigel’s patients.  The arterial blood flow HAS to be checked every hour….EVERY hour.  Nancy is tired….tired.

Now there is a tiny bit of a fever coming on…..the nurses aren’t too concerned but listened to her chest and said she has some phlegm in her lungs….not that big of a deal but after such a major surgery and after so much inactivity, it could progress to more of a concern.  Nancy has been tasked (see Daily Goal #3) with doing cough and deep breath exercises 10x per hour.  Now this is important because it keeps her lungs expanded and allows better air flow.  So now, instead of resting through the night and just having arterial checks to the new girls, she is also going to have to continue the breathing exercises every hour and not just when she’s awake.  She’s a trooper, though, and we worked through the first session after having the “you need to pay attention to this” talk and she was able to meet and then exceed the milliliters of airflow per deep inhalation….probably the last 6 of the ten times, and do her coughs, too.  She is working on this and knows it has to be done and is not complaining.

NOW….what she IS complaining about are 2 things.  And, mind you, she is not really complaining too much.  I’ve only had to charge her the $10 for “having to put up with your complaints fee” twice today.  As much as Nancy would like you to think she’s a troublesome patient, she is not, at all.  In fact, the staff enjoy her very much.  Her easy going nature was complimented today when she had to make the effort to get in the chair to sit for another hour.  Le, her nurse commented about how Nancy’s attitude really made her job easier.

Complaint number 1: This particular complaint is what brought on the $10 charge twice today.  The ICU room was hot, very hot.  In fact there were heaters brought in just for this purpose…two of them.  Seems that the stomach tissue that they harvested for her new breasticles doesn’t realize that it has to get it’s heat source from her body instead of the outside air now so for the next few weeks Nancy needs to have a warmer than normal outside air temperature.  I think Dr. Spiegel even mentioned not running the AC at her house but Nancy and I decided to let that one go over our heads.  The hot temp in the room coupled with Nancy’s hot flashes brought on by her medically induced but necessary menopause do not make a good combination.  She actually assessed herself the charge after I mentioned that I charge $10 at my house for being “grouchy, irritable, or just plain mean.”  Then she said, “And you can charge me another $10 for this one…..” as she launched into her next complaint about the heat.  We got icepacks for her neck and her legs and put cold washcloths on her feet.  Plus we got her the med that prevents hot flashes that had been overlooked on her orders…

Complaint number 2:  Headache.  A bad one.  She’s been dealing with this all day.  The nurses say she had a pretty major dose of morphine in the ICU so that is a side effect of morphine and it should work itself out as she uses less and less morphine.  Because of this, Nancy has decided that Mr. Morphine Pump may not be summoned for his duties at every thought of her becking and calling for him.  She’s thinking about it before she presses the button.  On one side there’s the headaches.  On the other side there’s the pain.  It’s a delicate seesaw to manage but she seems to have hit on a solution.  Norco.  That’s Tylenol laced with Codeine (or is it Codeine laced with Tylenol?).  She tried just plain Tylenol, but it didn’t help.  But the Norco seems to have hit the spot.  Instead of alternating Tylenol and Norco as was originally planned for this night, she will be alternating Norco and more Norco, every 4 hours.  Yay Norco!

She is resting comfortably now for the 55 minute catnap between arterial checks and breathing exercises.  I just put her sleeping mask on her to aid in not fully waking her for the checks/exercises.  She hasn’t called for the Ambien yet but it’s a matter of time.

Besides finding the Norco solution, the next bit of good news is that she managed to move from her bed to the recliner, sat for an hour, then ambulated back to the bed with only 1 morphine pump at the beginning of the whole scenario.  The nurses are impressed with how tough our girl is!  She really is doing remarkably well.  Another upside is that she doesn’t seem to be plagued by the nausea that chased her after her mastectomy and subsequent infection surgery.

Just so everyone knows, Nancy’s phone is with her but on silent and on the bedside table.  When she wakes up, we give it to her and she sees your texts, emails and Facebook posts.  Trevor & I have been reading the blog and Facebook comments to her and they just make her smile.  She is so appreciative of everyone’s support.  It means the world to her.  She is so exhausted that she just hasn’t been able to focus on responding, plus the drugs and the headache have her where she can’t really focus but just know that you are important to her and she is thankful.

On one last note.  Dr. S. called to check on her.  He called the room and I answered.  “Who is this?” he asked.  “Amy” I replied.  “Oh, Hi Amy, How’s Nancy?”  Dr. S. was glad to know she’s doing so well.  We talked about how good the results look and how healthy the skin looks and what great blood flow it all appears to have and how the doppler ultrasound (the hourly check) sounds so strong. I asked Nancy if she wanted to talk to him and she silently shrugged.  He must have heard the shrug because he asked incredulously, “Oh, she doesn’t want to talk to me??”  so she talked to him for a moment.  She complimented him on the symmetry of her new rack and said she figured he must have done the shaping, and she reiterated how happy she is with the results.

Here’s a snapshot of the board in Nancy’s room:  So does there look like a winner in the turf wars??  Just askin’….


So Long ICU

Hi Everybody,

It’s Amy Hoover here.  Nancy has been doing really well.  She’s super tired.  Come to find out her new breasticles have to have their arterial blood flow checked once an hour and it’s been that way since the surgery ended yesterday and will be through tomorrow…..so cat naps abound.  They made her get up and have a “sitting trial” time for an hour and she did really well.  To hear her tell the doctors about it, it was “hard” but as an observer she handled the “trial” with grit and humor–typical Nancy.  I think she handled it better than her first trip off the bed post mastectomy!

The people working at Methodist are doing a great job responding to her needs and that morphine pump responds at the touch of the button.  We just went over her “Daily goals/Patient needs” which are posted on her wall in her new room:

1.  pain control

2. regular diet

3. cough and deep breath 10x/hour

5.  SCD on legs

Yes, I know there’s no 4, but I call it like I see it!  (and we are not sure what SCD stands for, but she does have compression stockings on her legs and some pump thing to keep blood clots at bay). So….number one goal is pain control and Mr. Morphine pump is at the ready.  I reminded her that she’s not here to prove anything so not to try to wait it out but go ahead and push that button if she feels the pain.  Pain control is the NUMBER ONE goal!

Dr. S. called in today to check on her and Nancy got tickled because he had to wait on hold for quite a while for Nurse Carol who was busy taking care of Nancy.

Dr. Spiegel came by and checked out the results and is really, really pleased.  From my layman’s point of view, I agree.

She’s resting now and it is definitely quieter in this room, so hopefully it will be a good nap.  She has requested an Ambien to help her sleep tonight.  After her nap she will have to sit in the chair again.

Tomorrow’s plan is to do a little bit of walking and take a shower.  We expect to see the doctor in the early morning.


Out of ICU

Nancy is out of ICU and in her private room now. It took forever to get out of there, there just seemed to be always one more thing. They had to take blood and couldn’t get enough from the line in her hand despite much digging and infliction of pain. They finally just opened up her chemo port and had it done in a snap. Of course they had already packed her up for transport so the morphine pump was temporarily disconnected. But Nancy is a bad ass and toughed it out.

Thanks also to Laura Lessard for spending time with us today and taking me for lunch.

Life goes on for everyone else, I’m at Macy’s tennis lesson now. Payton has his season opening baseball game tonight. She is probably ready to post something herself but I accidentally left with her iPad. Like I said – trying to keep things normal.


Recovery

I arrived back at the ICU this morning with Amy Hoover who will be staying the night with Nancy tonight. Let me pause to thank Amy and Christy Burrmann for lunch yesterday and to Staci Martinez for sitting with me all day. That’s a lot to put up with.

Nancy is very alert today and in a very good mood. Her pain is under control and she is eating well. The nurses here have been terrific, Cindy and Carol have both been very attentive and helpful – they don’t mind applying chapstick. And David the PCA even fetched coffee for me and Amy. Overall this is the best care she has had during her hospital stays and it’s generally been pretty good.

They checked on her every hour last night so she didn’t get too much sleep though. They have ordered a room for her but they won’t let her out of ICU until she sits up in a chair for an hour. They just wheeled it in, this is gonna hurt.


Nancy is doing well

She wants to express her thanks for all the love, support and well wishes. She is still awake but in a bit of pain. They are not fooling around with it at least and they just upped her clicker along with a nice big slug of morphine. I’m going home once she is asleep.

The results do look fantastic, I can see why the Dr S’s were so proud. We have some tough days ahead while she recovers but everything looks great so far.

She does have limited mobility with her arms so you will likely be stuck with my dry updates for another day or two. Hopefully Nancy will bring her inimitable style back to this space real soon.


Surgery is complete

I just visited briefly with both Dr. S’s about Nancy’s surgery. They are done and she is having the surgery wounds dressed. I will get to see her in about an hour or two once she clears recovery and is moved to ICU. I will post another update once that happens.

Both doctors were all smiles and they expressed a lot of satisfaction with the outcome. I’m not going to post the details – do you really need to know how many grams each breast facsimile weighs? – but they seemed pretty proud of themselves about sculpting a nice new figure for Nancy. We shall see, Nancy has expressed that mostly she just doesn’t want to look like “ground under repair” anymore if I can borrow a golf term.

So it sounds like good news. Look for at least one more update tonight.

Update: I forgot to mention the surgeons did find some spots of active infection still after 200 days of antibiotics. Incredible. One benefit of this procedure should be to help by physically removing most or all of it. And it confirms the value of Nancy’s amazing persistence in never missing a dose. Unfortunately it also means the drug-taking will continue – and these aren’t the fun kind.


Update 3

As of about 2 pm central, they have finished one side and starting the other. I’m guessing another 2 to 3 hours to finish.


Surgery update

All – thanks for checking on Nancy. She was just wheeled off into the OR, I expect to have an update every few hours. She will be in surgery until late this afternoon and will stay the night in ICU. I’m not sure if she can have visitors other than me today.

She was in very good spirits, when they put the compression hose on her she asked for fishnet if they had it. OK actually that was me, but she is relaxed and ready to get this done. Dr. Spiegel told her the pain level from this won’t be too bad but she did pledge to load her up with the morphine (Nancy’s fave) the first two days.  Nancy is in very good hands.


Away we go…

Of course I’m up early on my big surgery day…you didn’t think I would actually sleep until the alarm went off, throw on some clothes and jump in the car when I could post one last time, did you?

It’s 4:15 a.m. and we’re set to leave the house for the med center at 5:30 for my 6 a.m. arrival. I sure hope that when we pull up, Dr S and Dr Spiegel aren’t fighting it out about who gets to do which part of the surgery and who’s in charge of follow-up care. Of course they wouldn’t be, and I’m 100 percent sure that every aspect of this procedure has been planned, checked, and double-checked to ensure excellence will result.

The last few days have been a whirlwind, with last-minute preparations and socializing. Yesterday afternoon and evening, my phones both rang off the hook, with calls and texts full of good wishes and genuine love. Several people have asked if I can feel the love, and the answer is YES! And THANK YOU! A huge part of why I am going into this big ol’ surgery with such peace is knowing that my posse has got my back. I appreciate each and every one of you. If you happen to come to the hospital for a visit and see me wretching uncontrollably, don’t worry: I didn’t have too much champagne or margartitas. Coming out of the anesthesia tends to make me barfy. Don’t panic. It’ll pass. Last time around I puked in front of lots of visitors; the kids in the room thought it was neat.

Yesterday was another perfect day: my last tennis drill with my team was spectacular. Mid-seventies and sunny with just enough warmth to get a sweat going, and birds singing like crazy because it feels like springtime. I made some good shots and thoroughly enjoyed my teammates’ company. Love those girls.

Loved them extra hard after this: 

Surprise champagne in the back of Julie’s SUV after drill. We tailgated in high style. It was such a fun treat, and I adore you girls for having such a brilliant idea and for sending me off in the most perfect way. I will be counting down the days until I can get back on the court with you.  Meanwhile, Go Alley Cats! Beat Westheimer Indoors today. Hit it where they ain’t!

The rest of the day yesterday was fantastic. Busy, but fantastic. My dad arrived, and  he took Macy to the pet store to buy the daily allotment of crickets for Cincko. That little gecko is on a major growing tear and has been eating at least 12 crickets every day. My dad will be interrim assistant zookeeper while I’m out of commission, so Macy broke him in with on-the-job training right away.
We had our belated birthday dinner for Dad, after a bottle of Vueve Cliquot (yes, I know I had champagne twice yesterday; at the tennis courts and at dinner. Why do you think it was such a great day??). Our Tuesday night tradition of watching “The Biggest Loser” was fun, as always, and there’s something especially satisfying about watching that show after a most delicious dinner.

It was all going swimmingly until Macy‘s bedtime, when I went to tuck  her in and she started crying. The big, rolling tears that linger and pool in the eye before breaking free and trailing down her face. Her ginormous eyelashes were soaked and matted, and the look of utter desolation on her face made my heart crack right in two. She was trying to be brave, but that well of genuine emotion that makes her the astoundingly compassionate little girl she is came gushing out when it was time for her to tell me good-bye. She was trying to be brave, but struggling. We talked for a long time about how mommies always come back, and even when they’re away for a while, they carry their kiddos in their hearts. I told her about my favorite e.e. cummings poem, i carry your heart with me, and how the words can certainly apply to anyone you love, whether a pet or a friend or the most amazing little girl ever. We talked about how she wouldn’t get to talk to me today, but tomorrow I expected a phone call as soon as she got home from school, so she can tell me all about her day. She cheered up a little bit when I told her that I need her to be in charge around here, and help my dad find the jelly in the door of the refrigerator, stay on schedule when driving the carpool, etc. She is on the job. She sent me off with Baby Snoopy, one of her most prized stuffed animals, to take along with me for company. She’s thoughtful like that.

Payton was busy, busy ignoring a math project that’s due Thursday, so he didn’t have much to say in the way of good-bye. Not surprisingly, as he is a man of few words. He too has instructions to call me Thursday with a full report on his first Little League game of the season. I need to see how long it takes him to “lose” his Yankees hat and replace it with a Red Sox version. It’s hard enough on him to have his mom in the hospital, but to have to don the dreaded Yankees uniform too? Poor guy.

I’ll leave you with the “before” photos. Don’t worry, I won’t publish the “after” photos —  you may just have to see them in person.

This is one of my favorite tennis tops. I have it in at least 3 colors, maybe more. Wear it all the time, hence the funky tan lines. Every time I wear it, I notice how seriously flat my chest is. Maybe because of the “V” neck of the shirt, I don’t know. I’ve had this uber-flat chest since May 13 and am quite used to it. In fact, if not for the mess left by the post-mastectomy infection, I could have envisioned not doing reconstruction at all, or waiting a lot longer. But, the mess must be cleaned up, so away we go. And yes, my chest really is that flat in person…until tomorrow!


Leavin’ on a jet plane

I’m not really leaving on a plane and my bag isn’t packed yet, but as I ready myself, my home, my kids, & my life for the next round of surgery, I find the lyrics to that song running through my head. Peter, Paul & Mary; Janis Joplin; and John Denver all recorded versions of this sappy little love song, with its catchy yet insidious chorus that will get stuck in your head for half the day if you’re not careful. It’s meant to be an ode for lovers, and I’m usually immune to sappy stuff and odes, but with the big surgery rapidly approaching, I must be going soft because this goofy tune is reminding me how hard it is to leave my family, endure a nasty procedure, and be cooped up in a hospital room. I am a terrible patient. No truer words have been written.

I have written a lot about what a terrible patient I am. Not that I won’t do what needs to be done to get to where I need to be in this “cancer journey” but that I hate every minute of it. I’ve also written my fair amount of scathing posts lately about stupid things people say, so I won’t go there now, but suffice to say if you were planning on telling me that at least I’ll be getting some rest, or to enjoy being waited on, you can skip it. I don’t like to rest and I really don’t like having someone wait on me. As a determined two-year-old might say, “Me do it.”

As terrible as I am as a patient, though, I’m ready. I’m at the point in which I’ve prepared all I can, and whatever doesn’t get done will just have to wait. I’ve been a busy little bee lately, feathering my nest and gearing up for what I know will be a hideously gross surgery followed by a long recovery. This process is akin to getting ready for vacation: at first the list of things to do seems miles long, then time ticks on and the list is whittled, and then you become exhausted from and sick to death of all the prep and can’t wait to just get going. While I’m not exactly going on vacation (!), I am done with all the prep and ready to just get going.

I still haven’t watched the video consultation that explains and illustrates the surgery I’m having tomorrow. Maybe I’ll just use my imagination. You know it’s a big deal with you get 12 pages of pre-op instructions, followed by a 3-page alphabetized list of medicines to avoid.

One of my instructions is to shower with Hibiclens, an antimicrobial wash, for 3 days prior to surgery. No problem. You know what a germaphobe I am. Some of the other text from the informed consent section of the paperwork made me laugh out loud, especially the parts about who’s not really a good candidate for this surgery: women who require more complex breast reconstruction (what’s more complex than this surgery??). Women who are good candidates are those who have inadequate chest wall tissue (me); those who have concerns about breast implants or tissue expanders (I wasn’t too concerned but my body apparently is); and those who may have contracted a post-surgical infection. Yep, that’s me.

The literature then goes on to explain that infection is very unusual after surgery. Yeah, maybe for some people. And that patients must inform the doctor if she has any other infections, “such as ingrown toenail, insect bite or urinary infection.” A bug bite? Really??Oh, mercy, if only it were that simple. How I would love to say I have an ingrown toenail instead of a mycobacterium fortuitum.

There’s also a lot of scolding in the section on bleeding: “Increased activity too soon after surgery can lead to increased change of bleeding and additional surgery. It is important to follow all postoperative instructions and limit exercise and strenuous activity for the instructed time.” Yeah, yeah. Blah, blah, blah.

Yesterday was a near-perfect day: I had a few hours at home to get things in order, then on to Beauty Envy to get the hot new shellac manicure. It’s supposed to last a couple or three weeks without chipping; we shall see. I’m not going to be doing any manual labor anytime soon, so the prognosis is good. Got my toes done, too, which is always nice. Even though my toenails are short as can be, they still take a mighty beating from tennis, but they are pink and shiny now. After the nails extravaganza, it was off to lunch to enjoy the sunshine and margaritas in the company of some first-rate girlfriends–a trifecta for sure. You can have your acai berries and super elixirs; for me, there’s nothing more fortifying than the sun on my face and a drink in my hand with my friends.

Today will be equally good with my last tennis drill of the season, then lunch with whichever members of the team are game for a little noontime tippling. I also gotta make a quick belated birthday meal for my dad, who recently turned 75 but looks a decade younger, easily (I’m hoping it’s genetic, but not very optimistic). I’m whipping up pastichio (Greek lasagna) and a pineapple upside-down cake, two of his favorites. He’ll be ferrying the kids to and fro and keeping up with Macy’s near-constant stream of chatter, so he’ll need a good meal. 

Speaking of Macy, she’s at it again: leaving me a note to find when I least expect it but am most likely to need a little pick-me-up. She’s a little apprehensive about me going back for more surgery, but the long summer of me and revolving hospital door must have toughened her up because instead of being sad she’s curious (which hospital? how long will you be there? can we come visit?) and stoic.

She needs a little work on the spelling (I assume that “Your asomest chid” means “Your awesome-est child”) and “Hopefuley” she will keep writing without regard for menial details like spelling. Most important is the message: if Macy says this is my last surgery, then I can go into it with a clear mind and a happy heart.