Home!
L did great with his morning and afternoon physical therapy. No, it wasn't fun at all, and he did it. Dr. Anderson came in the afternoon and talked with L about how he was feeling. He removed the dressings, checked the incision site, checked the drain site, discussed PT and declared L fit to go home.
The ride home was a little rough, but he gritted his teeth and got through it. At home, he met his new mattress, new sheets and 5 new pillows. The hubby man got him settled while I went off to Walgreens to get L's home drugs. His narcotic pain pills were $10. ($23 without the insurance discount) His muscle relaxant was $40 for 1/3rd the pills. ($113 without insurance) I'll never understand drug pricing.
Anyway, it's wonderful to be home. Especially since last night was hell night. L's been building up gas since the surgery. When you get too bloated, it hurts like hell while moving through you. Add that to an active day with 2 PT sessions and a lot of getting up and down and you've got hell. There's no drug that alleviates gas pain. They can knock you out so that you don't feel it. But that slows down your bowels and creates more gas. Better to suffer through it.
So he did. And I stayed near him and kept him company. (and helped him shift around and listened to his moans and visited the 24 hour cafeteria to buy him food to nibble on or reject. I was able to acquire a Krispy Kreme doughnut fresh off the delivery rack at around 4:30 am. This pleased him. A lot.
Saturday, October 18, 2008
Friday, October 17, 2008
Recovery Watch, Day 5
So much has happened! It's hard to believe it's Friday already. His second night in PICU he developed a fever. That's pretty expected for all those hours of anesthesia, all the work they did on him, and all that laying around. So he got a chest x-ray. No pneumonia. The lower part of his lungs weren't being mini balloons, they were compressed. So he had some breathing therapy. Which pushed more air into his stomach than into his lungs. They decided that he was doing good enough using the inspirometer instead. For the next two days, someone would come and listen to his bowels and press on his belly and ask if there was any pain. Then they'd comment on the gas or noise down there and say that his bowels were moving and that was good.
He had a flat stomach when he went in. Yesterday he had a beer belly, except it was all bloating from gas. Last night, he was starting to deflate and look more like himself.
In PACU (recovery): The anesthesia made him forgetful. He kept checking to see what was attached to him. I found out why the morphene is kept in a locked box. It's because in the past, hospitals have had a problem with staff siphoning off some of the strong drugs for their own use. Locking it makes sure the patient gets all of it. It's sad, and it happens. I can't criticize people I don't know for self medicating to cope with a high stress job or whatever. And I'm glad my son got what he needed and didn't hurt.
In PICU:
Every hour or two they would shift him. He says his pain levels were between 1 and 3 (on a scale of 1-10) when he was resting. When they "log rolled" him to one side or the other, it would go up to 6 or so. Log rolling isn't as bad as I thought it would be. They have a pad under him. Two nurses would grab the pad at his shoulder and hip and gently lift and push while guiding his back and legs. They'd get him about 30 degrees sideways then stuff pillows under and gently roll him onto the pillows. And hour later, they'd pull the pillows out. And hour after that, they'd log roll him on the other side and bepillow that side. So he cycled through left, flat, right, flat, etc. On day two, the rolling to add pillows was accompanied with a little IV painkiller before they moved him. On day 3, they removed his arterial line. Then somebody came round a few hours later to draw some blood.
The whole point of the art line was to 1) rigorously monitor his pulse and blood oxygen and 2) so they wouldn't need to stick him with a needle. He has a strong needle phobia. Actually, needles don't scare him. knowing the needle is going into his flesh is what makes him panic. He can now actually LOOK at the needles the nurses use, and watch them remove the needle and plug the syringe into his IV.
He's being great about his pain. If he hurts, he hits the nurse call. When they ask his pain level during a check up, he tells them. He's not being tough and sucking it up; and he's maintaining a tolerable level of discomfort.
Now for the fun parts!
Dr. Anderson came to change his dressings yesterday afternoon. Everything looked great. He's got 50 million steri strips holding his back closed. They're so much more comfortable than stitches, although he's got stitches underneath that will dissolve over time. There's only one incision. Dr. Anderson didn't cut him a second time to chisel bone scraps off his hip for the fusion graft; he just cut a longer stripe down the back. L doesn't have any discomfort at all where they took a piece of his hip. His blood count is low, but not low enough to need transfusion. He'll be taking a multivitamin with iron for a good long while because his body is making lots and lots of half grown red blood cells to replace what he lost. Once his body decides he's got enough blood, it'll go back to growing big blood cells. Anyway... Dr. Anderson changed the dressing, decided everything looked wonderful, and removed the drain and epidural. Drain removal was neat and didn't hurt at all. It was cool watching them press around the hole and seeing fluid spurt, then dribble out. The last few presses, his drain site made a noise like a whoopie cushion. Taking out the epidural wasn't so fun. They used a stretchy tape to hold that tiny catheter tube in place, stuck right over the incision. Dr. Anderson had to pull off about 6 inches of tape before he could free the epidural cath. L was not happy about that. But! With the epidural out, they could remove the foley catheter too. No more pee tube! Which had been taped to a nice hairy part of his thigh. Sheesh, don't they LOOK where they're putting tape? The nurses took it off as fast and gently as they could.
Freed from all those tubes and tapes, L progressed rapidly. In the last 24 hours he's gone from bedridden in PICU with all kinds of monitoring devices to walking (walking!!! On his own!!!) to the bathroom, sitting up, reaching for and holding his own drinks and pudding cups, and swallowing pills instead of getting a drip. He's on percoset instead of morphene now.
Today, He's getting his first solid food since Sunday evening. And he's going down to physical therapy for an hour. He will learn to log roll and get out of bed without assistance, and show that he can go up and down at least one step. Some time today, they're taking out the active IV. They'll leave the inactive IV just in case they need it. Removing the IV is the last link in the chain. Unless he backslides, he's coming home tomorrow. 6 days of hospital, 6 weeks of recovery, 6 months of no heavy lifting. And then my MIL wants to take him on a trip somewhere. I wonder if he'll pick Japan?
So much has happened! It's hard to believe it's Friday already. His second night in PICU he developed a fever. That's pretty expected for all those hours of anesthesia, all the work they did on him, and all that laying around. So he got a chest x-ray. No pneumonia. The lower part of his lungs weren't being mini balloons, they were compressed. So he had some breathing therapy. Which pushed more air into his stomach than into his lungs. They decided that he was doing good enough using the inspirometer instead. For the next two days, someone would come and listen to his bowels and press on his belly and ask if there was any pain. Then they'd comment on the gas or noise down there and say that his bowels were moving and that was good.
He had a flat stomach when he went in. Yesterday he had a beer belly, except it was all bloating from gas. Last night, he was starting to deflate and look more like himself.
In PACU (recovery): The anesthesia made him forgetful. He kept checking to see what was attached to him. I found out why the morphene is kept in a locked box. It's because in the past, hospitals have had a problem with staff siphoning off some of the strong drugs for their own use. Locking it makes sure the patient gets all of it. It's sad, and it happens. I can't criticize people I don't know for self medicating to cope with a high stress job or whatever. And I'm glad my son got what he needed and didn't hurt.
In PICU:
Every hour or two they would shift him. He says his pain levels were between 1 and 3 (on a scale of 1-10) when he was resting. When they "log rolled" him to one side or the other, it would go up to 6 or so. Log rolling isn't as bad as I thought it would be. They have a pad under him. Two nurses would grab the pad at his shoulder and hip and gently lift and push while guiding his back and legs. They'd get him about 30 degrees sideways then stuff pillows under and gently roll him onto the pillows. And hour later, they'd pull the pillows out. And hour after that, they'd log roll him on the other side and bepillow that side. So he cycled through left, flat, right, flat, etc. On day two, the rolling to add pillows was accompanied with a little IV painkiller before they moved him. On day 3, they removed his arterial line. Then somebody came round a few hours later to draw some blood.
The whole point of the art line was to 1) rigorously monitor his pulse and blood oxygen and 2) so they wouldn't need to stick him with a needle. He has a strong needle phobia. Actually, needles don't scare him. knowing the needle is going into his flesh is what makes him panic. He can now actually LOOK at the needles the nurses use, and watch them remove the needle and plug the syringe into his IV.
He's being great about his pain. If he hurts, he hits the nurse call. When they ask his pain level during a check up, he tells them. He's not being tough and sucking it up; and he's maintaining a tolerable level of discomfort.
Now for the fun parts!
Dr. Anderson came to change his dressings yesterday afternoon. Everything looked great. He's got 50 million steri strips holding his back closed. They're so much more comfortable than stitches, although he's got stitches underneath that will dissolve over time. There's only one incision. Dr. Anderson didn't cut him a second time to chisel bone scraps off his hip for the fusion graft; he just cut a longer stripe down the back. L doesn't have any discomfort at all where they took a piece of his hip. His blood count is low, but not low enough to need transfusion. He'll be taking a multivitamin with iron for a good long while because his body is making lots and lots of half grown red blood cells to replace what he lost. Once his body decides he's got enough blood, it'll go back to growing big blood cells. Anyway... Dr. Anderson changed the dressing, decided everything looked wonderful, and removed the drain and epidural. Drain removal was neat and didn't hurt at all. It was cool watching them press around the hole and seeing fluid spurt, then dribble out. The last few presses, his drain site made a noise like a whoopie cushion. Taking out the epidural wasn't so fun. They used a stretchy tape to hold that tiny catheter tube in place, stuck right over the incision. Dr. Anderson had to pull off about 6 inches of tape before he could free the epidural cath. L was not happy about that. But! With the epidural out, they could remove the foley catheter too. No more pee tube! Which had been taped to a nice hairy part of his thigh. Sheesh, don't they LOOK where they're putting tape? The nurses took it off as fast and gently as they could.
Freed from all those tubes and tapes, L progressed rapidly. In the last 24 hours he's gone from bedridden in PICU with all kinds of monitoring devices to walking (walking!!! On his own!!!) to the bathroom, sitting up, reaching for and holding his own drinks and pudding cups, and swallowing pills instead of getting a drip. He's on percoset instead of morphene now.
Today, He's getting his first solid food since Sunday evening. And he's going down to physical therapy for an hour. He will learn to log roll and get out of bed without assistance, and show that he can go up and down at least one step. Some time today, they're taking out the active IV. They'll leave the inactive IV just in case they need it. Removing the IV is the last link in the chain. Unless he backslides, he's coming home tomorrow. 6 days of hospital, 6 weeks of recovery, 6 months of no heavy lifting. And then my MIL wants to take him on a trip somewhere. I wonder if he'll pick Japan?
Monday, October 13, 2008
All Is Well
.
We got to the hospital around 5:15 am. The next 2 hours were spent waiting, getting a room, waiting, meeting the very kind anesthesiologist, meeting someone with paperwork, meeting the surgeon, meeting the pain management team, meeting the spinal cord specialist who's sole job was to spend today monitoring for damage or paralysis, and meeting somebody else, who I forgot.
It was a long day.
The anesthesiologist made a deal with L. She said, "I'll stick you twice. Once with a shot that will feel like a pinch that numbs the area, and once to put in you IV. I won't stick you again while you're awake." L's rejoinder was "I can do that. If I can have an ice pack to cover my eyes with."
An ice pack was procured and the shot and IV were given. She covered the IV with a gauze bandage so he wouldn't have to look at it, and covered the whole thing with a cloth until she was done. After we met doctor after doctor and were reassured that they were all competent and ready for the day, she injected some happy drugs into the IV and they took him away and sent us off to the Surgery Waiting Room with a thingie that rings and flashes when they have an update for us. Just like a restaurant coaster pager, without the coaster. It flashed and chimed at 8:30 and we were told surgery had begun. It flashed and chimed at 9:30 and we were told everything was going well. From there on, every hour it flashed and chimed and we were updated that everything was going well. Except it didn't go off at 12:30. We got a little nervous, but figured the surgery team was busy. Around 1 o'clock, we stopped by the desk and said we were heading off to eat lunch, and got another update. Everything was going well. After lunch, we were told that the rods were being put in. Good. The most dangerous part was over. About an hour later, our pager flashed and chimed and we found out they were closing him up and Dr. Anderson would be out to talk with us soon.
And he was!
The surgery went very very smoothly. He did not need a blood transfusion during surgery. They were able to recover 500ml of L's blood and give it back to him. They were able to straighten his spine more than they had hoped, although we won't know the degrees until they get an x-ray. They did not need to wake him during surgery to check for damage or paralysis. All was good.
When L was in recovery, he could have one person with him. He asked for me. Win for Mom! so I got to see him with his face all puffy and his eyes gummed shut, and asking a million questions and doing things he shouldn't have been able to do
Like lifting his head and turning his neck to look at his IV's. He kept asking what was on him, then forgetting what it was. And there was a lot of stuff on him. He's got 3 separate IV's. Two vein IV's and one that's pretty much the same thing, except it's in an artery. He's also got an epidural in his spine and a blood pressure cuff, and squeezy things on his legs, and a heart monitor, and a monitor attached to a finger.
He's responsive and self aware and doing wonderfully. I think the 4 kinds of pain meds they're giving him help with that.
And... His morphene drip is in a clear box with two kinds of locks on it. But it has a handy carry strap.
More news after I've had some sleep.
.
We got to the hospital around 5:15 am. The next 2 hours were spent waiting, getting a room, waiting, meeting the very kind anesthesiologist, meeting someone with paperwork, meeting the surgeon, meeting the pain management team, meeting the spinal cord specialist who's sole job was to spend today monitoring for damage or paralysis, and meeting somebody else, who I forgot.
It was a long day.
The anesthesiologist made a deal with L. She said, "I'll stick you twice. Once with a shot that will feel like a pinch that numbs the area, and once to put in you IV. I won't stick you again while you're awake." L's rejoinder was "I can do that. If I can have an ice pack to cover my eyes with."
An ice pack was procured and the shot and IV were given. She covered the IV with a gauze bandage so he wouldn't have to look at it, and covered the whole thing with a cloth until she was done. After we met doctor after doctor and were reassured that they were all competent and ready for the day, she injected some happy drugs into the IV and they took him away and sent us off to the Surgery Waiting Room with a thingie that rings and flashes when they have an update for us. Just like a restaurant coaster pager, without the coaster. It flashed and chimed at 8:30 and we were told surgery had begun. It flashed and chimed at 9:30 and we were told everything was going well. From there on, every hour it flashed and chimed and we were updated that everything was going well. Except it didn't go off at 12:30. We got a little nervous, but figured the surgery team was busy. Around 1 o'clock, we stopped by the desk and said we were heading off to eat lunch, and got another update. Everything was going well. After lunch, we were told that the rods were being put in. Good. The most dangerous part was over. About an hour later, our pager flashed and chimed and we found out they were closing him up and Dr. Anderson would be out to talk with us soon.
And he was!
The surgery went very very smoothly. He did not need a blood transfusion during surgery. They were able to recover 500ml of L's blood and give it back to him. They were able to straighten his spine more than they had hoped, although we won't know the degrees until they get an x-ray. They did not need to wake him during surgery to check for damage or paralysis. All was good.
When L was in recovery, he could have one person with him. He asked for me. Win for Mom! so I got to see him with his face all puffy and his eyes gummed shut, and asking a million questions and doing things he shouldn't have been able to do
Like lifting his head and turning his neck to look at his IV's. He kept asking what was on him, then forgetting what it was. And there was a lot of stuff on him. He's got 3 separate IV's. Two vein IV's and one that's pretty much the same thing, except it's in an artery. He's also got an epidural in his spine and a blood pressure cuff, and squeezy things on his legs, and a heart monitor, and a monitor attached to a finger.
He's responsive and self aware and doing wonderfully. I think the 4 kinds of pain meds they're giving him help with that.
And... His morphene drip is in a clear box with two kinds of locks on it. But it has a handy carry strap.
More news after I've had some sleep.
Sunday, October 12, 2008
In Lieu of Flowers, Please Send POCKY
.
Today is L's last day of mobility for quite a while. Early tomorrow morning we'll be yawning at the hospital, then he's off to have his spine fused. Seriously, they want us there at 5:30 am.
I'm overwhelmed by the number of people who are keeping him (and the whole family) in their thoughts. I'm also overwhelmed by some of the ways people try to be helpful. Like offering a cane or pair of crutches.
...
He's, um, having his spine fused. He won't be able to use a cane or crutches.Both use your back muscles... The helpful suggestions of a wheelchair or home hospital bed, Those are good suggestions. IF he wants them. Right now he connects wheelchair or motorized bed with being disabled. Since he doesn't see himself as disabled, and his goal is to be enabled as soon as possible; he doesn't want either.
He does have one request.
In lieu of flowers, please send POCKY.
You've got time :D He'll be in ICU for at least the first day, maybe longer.
Today's pain relief methods are amazing. They're going to use an epidural for the first day and a half or so, then switch him over to vicoden. He'll come home with percoset. That's the plan, at least. He knows (cuz I told him so) that the effectiveness of pain meds depends on your genes. If the vicoden works, great! If it doesn't work, ask for something different. Part of "being brave" is speaking up and letting your caregivers know if you're hurting, if you need help going to the bathroom, if you are uncomfortable being bathed by a certain nurse, etc etc etc.
Good feedback doesn't make you a whiner. Caregivers want to give you the best care possible. Feedback enables them to give you the best care possible.
I'll be asking "What's that?" for every single thing the nurses bring in. And I'll ask in my usual cutely curious, I love to learn, way. Because I love to learn. And because sometimes medications and IV things go to someone they weren't intended for. Which is why nurses check and double check your wristband. Asking what it is never hurts.
The closer we get to surgery, the less happy we are. And it is what it is. Post-op, our time will be divided between the hospital and completely sterilizing the house. Thank heavens for hard wood floors! Oh, and he's getting a new mattress set, too.
Now then. I know I can't make the house completely sterile. And by the time they release him, his wounds will be closed over and healing pretty well. And he doesn't *need* a new mattress because he had back surgery.
He needs a new mattress because the one he's got is like, 20 years old. (ewwww)
And scrubbing the house will give me something to do. Besides, we're converting the living room into his space for the next several months. Lots of room, a straight shot from the living room to the bathroom, and a wheelchair will fit down the hall. If all goes according to plan, he won't need a wheelchair, but he can have one if he wants it.
I'm rambling. Anyay, surgery is early tomorrow morning at St. John's Mercy Medical. Prayers, thoughts, and Pocky are gratefully accepted.
.
Today is L's last day of mobility for quite a while. Early tomorrow morning we'll be yawning at the hospital, then he's off to have his spine fused. Seriously, they want us there at 5:30 am.
I'm overwhelmed by the number of people who are keeping him (and the whole family) in their thoughts. I'm also overwhelmed by some of the ways people try to be helpful. Like offering a cane or pair of crutches.
...
He's, um, having his spine fused. He won't be able to use a cane or crutches.Both use your back muscles... The helpful suggestions of a wheelchair or home hospital bed, Those are good suggestions. IF he wants them. Right now he connects wheelchair or motorized bed with being disabled. Since he doesn't see himself as disabled, and his goal is to be enabled as soon as possible; he doesn't want either.
He does have one request.
In lieu of flowers, please send POCKY.
You've got time :D He'll be in ICU for at least the first day, maybe longer.
Today's pain relief methods are amazing. They're going to use an epidural for the first day and a half or so, then switch him over to vicoden. He'll come home with percoset. That's the plan, at least. He knows (cuz I told him so) that the effectiveness of pain meds depends on your genes. If the vicoden works, great! If it doesn't work, ask for something different. Part of "being brave" is speaking up and letting your caregivers know if you're hurting, if you need help going to the bathroom, if you are uncomfortable being bathed by a certain nurse, etc etc etc.
Good feedback doesn't make you a whiner. Caregivers want to give you the best care possible. Feedback enables them to give you the best care possible.
I'll be asking "What's that?" for every single thing the nurses bring in. And I'll ask in my usual cutely curious, I love to learn, way. Because I love to learn. And because sometimes medications and IV things go to someone they weren't intended for. Which is why nurses check and double check your wristband. Asking what it is never hurts.
The closer we get to surgery, the less happy we are. And it is what it is. Post-op, our time will be divided between the hospital and completely sterilizing the house. Thank heavens for hard wood floors! Oh, and he's getting a new mattress set, too.
Now then. I know I can't make the house completely sterile. And by the time they release him, his wounds will be closed over and healing pretty well. And he doesn't *need* a new mattress because he had back surgery.
He needs a new mattress because the one he's got is like, 20 years old. (ewwww)
And scrubbing the house will give me something to do. Besides, we're converting the living room into his space for the next several months. Lots of room, a straight shot from the living room to the bathroom, and a wheelchair will fit down the hall. If all goes according to plan, he won't need a wheelchair, but he can have one if he wants it.
I'm rambling. Anyay, surgery is early tomorrow morning at St. John's Mercy Medical. Prayers, thoughts, and Pocky are gratefully accepted.
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