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.


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.


The Big Dig

Yesterday was yet another trip to the medical center, for one last pre-op visit to Dr Spiegel before reconstruction. I really need to think of a catchy title for the surgery, something like Boston’s big construction project, the Big Dig. Come to think of it, there are some similarities between the Big Dig and my surgery: both relate to the Central Artery and Tunneling (in fact, the official name of the Big Dig is the CA/T Project). Both are complicated, involve lots of people, and take a mighty long time to complete. But unlike the Big Dig, which replaced the 6-lane elevated Central Artery (I-93) with  a 3.5-mile long underground tunnel, my surgery won’t cost $22 billion. Hopefully. My insurance company, which has been mighty nice so far, might just stroke out about that figure. 

The Big Dig sounded like a great idea and was intended to be a tremendous boon to an already kick-ass city. But mismanagement, scandal, and skyrocketing costs quickly dominated headlines, and my second-favorite city had a big mess on its hands. Congressman Barney Frank quipped, “Wouldn’t it be cheaper to raise the city than depress the artery?”

Say what you will about Barney, but that’s a good line.

But back to the update on the doctor visit. This was Trevor’s day to meet the lovely Dr Spiegel, her ultra-energetic PA, Jen, and her trusty nurse Sonia. My friend Laura, who is a nurse practitioner in the liver transplant unit at Methodist, met us there, too. Dr Spiegel wanted to brief my caregivers on what to expect post-surgery, and Laura kindly offered to help out. In her white coat and super-stylish glasses, she brought a nice element of professional gravitas to the occasion. She told Dr Spiegel that she’s done some match-making for me and picked out an anesthesiologist she likes and trusts, and Dr Spiegel agrees that Dr Ashmore is the guy for me. Laura and Sonia recognized each other right away, then she and Jen hugged and high-fived, happy to be collaborating on my case. It’s good to have connections.

The visit itself was pretty uneventful. I like uneventful at the doctor’s office. Dr Spiegel  went over a few basics with us but since we were pretty much up to speed on everything, there weren’t any new developments. I’m finished with all the pre-op testing (bloodwork, blood donation, x-rays, EKG, CT-scan), and just need to watch the video consultation on Dr Spiegel’s website to get a more detailed overview of the procedure. I’m not saying I’m scared to do that, but after watching a video on youtube of an actual surgery, on an actual person, I’m not in a big hurry. Ick.

The one topic we did need to cover, though, was the infection. I wanted to bring it up in a way that seemed breezy and conversational, as opposed to, “How the sam hell are you going to keep this bloody nightmare from recurring, lady?” I was pretty sure that wouldn’t go over too well.

I’m not the most diplomatic person, and I tend to say what I really think, even if it’s not pretty or may be hard to hear. It’s a blessing and a curse. Believe it or not, I actually do put a lot of thought into what I say and how I say things, but because I’m pretty direct, sometimes things come out a bit, um, harsher than I intend.

Sorta like, “Are you outta your mind??? You’re not really going to wear that are you?” or “Clearly that person has neither friends nor a mirror; why else would one go out in public looking like that???” as opposed to “Have you thought about what to wear?” Those kinds of niceties take a bit of work on my part. My instinct is to just blurt out whatever needs to be said, and let the chips fall where they may. We’re all grown-ups, right?

Right. Except I really don’t want to tick off the nice lady with the very sharp scalpels. That would be bad. So I fumbled around and probably sounded idiotic by saying, Um, so, uh, like, how worried do we need to be about the um, you know, infection? You know, like, um, during the uh, reconstruction?

She smiled knowingly, and if she’d been sitting closer might have patted my hand and said, there there.  She reminded me that my case isn’t exactly normal, and I tried not to tell her that “normal” is pejorative and listened to what she had to say.

She has a plan, of course, and it sounds like a good one. Usually, in cases of infection, she would wait to do reconstruction, to be sure the infection is truly gone. But in my case, which again is not normal, we need to get in there sooner rather than later and clean up the mess,  i.e., excise the damaged tissue and replace it with some new, fresh meat. And by meat I mean my own flesh. Fresh flesh. Yum.

The plan is to work on the infected side last, and she promised to take her time and wash it all out thoroughly with 6 liters of antibacterial solution. That’s way more than usual. She’ll have separate fields of instruments, and once the instruments touch the infected area, they’ll be classified as contaminated. Remember the scene in the movie ET at the end, when the little guy was dying, and the family home was a warren of plastic sheeting populated by feds in Haz-mat gear? I’m having visions of the Haz-mat suits. But hopefully no aliens. Although I do kinda like the polka-dotted kiddie pools in this scene.

So we’re on track, on schedule, and presumably ready to go. She estimates the surgery will last 8 hours, not 12-15 like I’d originally heard. Of course, we won’t know what we’re dealing with until she actually gets in there and starts cutting and scraping away, but I’m going to be optimistic.

Meanwhile, I’ll be thinking of a name for my own personal Big Dig (if you have ideas, send them em!), and can’t wait to post before and after pictures like this:

Except, I won’t make you look at the before pics, because they’re pretty gross, and that would just be mean.