Rejuvenated?? Notsomuch!
Posted: March 4, 2011 Filed under: breast cancer, Surgery | Tags: breast cancer, DIEP, IV, Methodist Hospital, morphine, new boobs, post-mastectomy, recovery, Vancomycin 7 Comments“It’s been a LOOOOONNNNNNGGGGGG day!” Those are Nancy’s words but this is Amy typing once again.
Nancy had a crazy morning….. Laura checked in; Dr. Spiegel’s resident, Dr McKnight checked in; Jennifer the PA checked in; then all three of the plastic surgery team (Dr. Spiegel, Jennifer and Dr. McKnight) popped in again. Trevor got here bearing gifts: peanut butter and toast–the only thing that has seemed appetizing and would you believe they don’t have that in the hospital cafeteria? Christie came by, too.
But wait, before she had her IV discontinued and got that “Take a Shower. Take a Hike” show on the road, she still had one last infusion of the IV antibiotic, Vancomycin. That took 2 hours so Nancy was able to sit in the chair and enjoy the smoothie that Christie brought. Mr. Morphine Pump and the rest of his crew are yet again dust in the wind. Nancy is free of anything that follows her on a pole. She does have 6 drains and 2 doppler wires, plus her central line access port, so she’s still got a little gear.
It was nearly 11 before there was serious movement to the shower. Well, all I have good to say about that shower is that Nancy is clean. One word I could use to describe how Nancy tolerated the event was that she was speechless. So, suffice it to say that the stomach pain reached out and grabbed hold of her with a lot of help from her shower assistant. It took a while but she was able to settle down from that episode (thank you, Ativan) and caught her breath. We then enticed her with a hummus sandwich from the cafeteria downstairs. She wolfed that sandwich down and then had a bit of a siesta. Thank Goodness! By that time she had recovered enough to find her voice and exclaim, “That’s not happening again! I’m clean enough!” Nancy had a little more to say about the shower, not so much the shower itself, but the way she felt manhandled by one of the helpers. Let’s just say it was rough going and it took a while for her to recover.
Nancy & I rested for some of the afternoon while Trevor took care of some work on his laptop.
Her infectious disease doctor also showed up and was happy to report that all her lab cultures have so far showed nothing…..but they will keep an eye on them for quite some time since it was such a slow growing bacterium.
So, Nancy has at this point taken 2 hikes and her one and ONLY shower and has had 2 sessions of chair time today. She is moving well, although a bit stiff and hunched over. The name Quasimodo does come to mind. She is sitting in the chair waiting on her dinner that Trevor is going downstairs to fetch. After she eats she will settle in for the night. She has commented that she can’t believe she’s napping so much, but GOOD NIGHT she hasn’t had a good night’s sleep in 3 days! She’ll end her evening with a dispensing of Norco, Ativan, Ambien and Flexeril. Not all at the same time, mind you–a staggered dispensing, but I think she’ll be able to sleep better tonight with this drug regimen and also since her “flap checks” (that’s what the hospital crew calls them) are now every 2 hours.
More updates in the morning.
Oh, the doctors will assess discharge in the morning with Nancy’s input and go from there. I think the thought is that she wants to see how she feels in the morning.
The Morning Report
Posted: March 4, 2011 Filed under: breast cancer, Surgery | Tags: cancer battle, DIEP, hospital, Houston medical center, morphine, new boobs, norco, plastic surgery, post-mastectomy, reconstruction, recovery, Vancomycin 4 CommentsNancy had a restful night–as restful as being woken every hour can be. A shout-out to her nurse, Amira, who was extremely capable and attentive. Nancy did snooze very soundly when she was able. The combination of Norco and more Norco seemed to diminish her headache, although it’s not completely gone. The pain is still there and is being managed by the Norco also. This morning a bit of muscle tightness and tenderness in the stomach area reared its ugly head and has taken the forefront in the battle for attention. While Nancy hasn’t actually called it pain, I think that may be the best word for it, and she did say it was a new sensation that came up today. I bet the other stuff has diminished enough that this now gets to grab her attention. She has bruising around the hip to hip “free tummy tuck” incision and Jennifer, Dr. Spiegel’s PA, says that they did have to work hard with her muscle layer there as well as on her chest wall so this is to be expected. She has been given Flexeril (a muscle relaxer) to help with this and the added benefit is that it makes you VEEEERRRYYY sleepy. So, even though at 5:15 AM, Nancy was confident that she was up for the day and we did the teeth brushing and face washing that comes with a new day, she was within minutes back to sawing logs. Good Girl! She has been dreaming out loud and woke asking me, “Is that due tomorrow?” You can take the Mom out of the home but you can’t take the Home out of the Mom!
The fever is no longer an issue. Nancy did a great job with her breathing exercises and coughing so those nurses must have been right about the phlegm.
Today is a going to be a busy day. It started with a flurry of people in and out at shift change. Dr. Spiegel specifically trains the nursing staff that takes care of her patients so there is only a handful of nurses who are qualified to be Nancy’s caregivers. Her new nurse is Karina. There are promises of getting rid of her IV and a few other constant companions since she’s had the surgery. Once that is done, she will get a shower and be expected to walk the halls at least 3 times today. Nancy is looking forward to that since the compression stockings can be taken off during this time.
Mr. Morphine Pump has become just an extra appendage. Nancy last summoned his prowess on yesterday’s second and final “sitting trial.” She’s planning to shed him when she sheds the other hangers on.
It’s going to be a good day. The staff is quite certain that the shower and ambulation will bring strong feelings of rejuvenation. It has been mentioned twice already that she may be ready to be discharged tomorrow. We’ll see how she feels later today and as Laura mentioned when she popped in for a quick Hi this morning, “Knowing Nancy, it might be better for her to stay until Sunday, just to keep her from doing too much.” Yep, Laura, you are probably right about that!
We’ll keep you posted.
Utter Exhaustion
Posted: March 3, 2011 Filed under: breast cancer, Surgery | Tags: breast cancer, cancer battle, DIEP, hospital, Methodist Hospital, morphine, new boobs, plastic surgery, recovery 12 CommentsHi, 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
Posted: March 3, 2011 Filed under: breast cancer, Surgery | Tags: breast cancer, cancer battle, DIEP, hospital, ICU, Methodist Hospital, microsurgery, new boobs, reconstruction, recovery 8 CommentsHi 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
Posted: March 3, 2011 Filed under: Surgery | Tags: breast cancer, cancer battle, cancer diagnosis, DIEP, hospital, ICU, Methodist Hospital, microsurgery, new boobs, plastic surgery, reconstruction 1 CommentNancy 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
Posted: March 3, 2011 Filed under: breast cancer, Surgery | Tags: breast cancer, cancer battle, cancer diagnosis, DIEP, hospital, Houston, ICU, Methodist Hospital, microsurgery, new boobs, plastic surgery, recovery, surgery, Vancomycin 3 CommentsI 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
Posted: March 2, 2011 Filed under: breast cancer, Surgery | Tags: breast cancer, cancer battle, cancer diagnosis, DIEP, hospital, Methodist Hospital, microsurgery, new boobs, plastic surgeon, reconstruction 5 CommentsShe 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
Posted: March 2, 2011 Filed under: breast cancer | Tags: breast cancer, cancer battle, cancer diagnosis, DIEP, hospital, ICU, microsurgery, new boobs, plastic surgery, reconstruction, recovery, surgery 6 CommentsI 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
Posted: March 2, 2011 Filed under: breast cancer, Surgery | Tags: breast cancer, DIEP, hospital, Houston, Methodist Hospital, microsurgery, new boobs, plastic surgery, reconstruction Leave a commentAs 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
Posted: March 2, 2011 Filed under: breast cancer | Tags: breast cancer, cancer battle, DIEP, hospital, microsurgery, new boobs, plastic surgery, reconstruction 2 CommentsAll – 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.
