Part 5 - Post-Op
Now that I was in a room, I was still wired up with all sorts of tubes and sensors: wireless monitor electrodes, nasal oxygen cannula, urinary catheter and reservoir, 4 chest tubes (installed during surgery) with reservoirs and IV drip lines. Breathing was difficult and painful and continued to be (but diminishing a little) for the rest of my hospital stay. In addition to the surgical trauma inside and on the surface of my chest, the discomfort and pressure caused by the presence of the 4 chest tubes and the upward pressure of my distended ascites belly was the worst part of the whole experience. Coughing was very painful but necessary in order to bring up some pretty nasty looking gunk that was in my lungs. I was trained to hold a pillow to my chest whenever I had to cough or whenever I was moved in bed. Lying flat in bed was impossible but all those months in the recliner at home had gotten me used to sleeping in a sitting position in bed. Pain meds and insulin were administered IV. I was given various breathing treatments by inhalation therapists and was instructed to exercise my lungs using a sprirometer as often as I could. I was started on a clear liquid diet that evening.
Days 2,3 & 4
Difficult days. I needed assistance in order to get in or out of bed, reposition myself, or to sit in a chair in the room for my meals. There was a lot of activity every hour of the night and day. Vital sign measurements, breathing treatments, hourly blood sugar tests, chest and abdomen xrays, medications to take, visits from doctors, body cleanup etc and I generally would get only an hour of sleep at a time. I loved the sleep because it was the only escape from the pain and discomfort I was feeling. I took my first walks and it took a village to make that happen because of all of the stuff I was hooked up to. I used a walker and had one person at my side dragging along an IV cart. Another person would drag along an oxygen canister on wheels. The various drainage reservoirs were hung on either the walker or the IV cart. But it worked and got me on my feet a few times each day. They pulled my catheter on Day 2 but had to insert a new one on Day 3 because my bladder was backing up. The two chest tubes that were draining the areas near my heart were pulled on Day 3 which helped ease the discomfort a little. I began having solid food on Day 2 but was switched back to clear liquids when my waste elimination systems went on strike.
There were complications brewing starting on Day 3. Blood tests showed that my kidneys were not happy. My blood pressure was too low as well. My wonderful wife, the nurse, was very concerned about this and spent several nights sleeping in my room in a sort of recliner that had been made available for the purpose. But all that improved when they backed off on getting some of the fluid out of me. Your body systems require a certain amount of water in order to function normally and I was just a bit on the dry side.
By the end of Day 4 I was spending more time out of bed in my chair which made subsequent walks and other mobilization easier. I still needed help getting in and out of bed and getting positioned properly when in bed.
Things were looking up. The third chest tube was pulled, leaving only one and its reservoir. Another attempt had been made to lose the catheter but I was still sporting my 3rd until mid day on Day 5. I managed to eliminate some solid waste and was back on solid food (which was very good by the way). I was able to sit up and get to my chair by myself and was able to walk by myself with assistance in getting my two reservoirs hung on the walker. I was able to get out of my chair to brush my teeth, shave, wash up and go to the bathroom on my own. I think I went for 8 walks on Day 5 and that evening. My breathing had improved and I was still getting various breathing treatments every 6 hours night and day. I didn't have to cough as much which lessened the number of those painful moments and when I did cough, there was not much gunk to cough up.
Getting better. They pulled the final chest tube and I could go for walks without anything attached to me. I worked with the physical therapist and switched to a cane for walking instead of the walker. I walked as much as I could that day, increasing the distance with each walk. I could get out of bed easily on my own but still needed occasional help getting back in. I tried to spend as little time as possible in bed. My wife brought me a laptop computer and I was able to catch up on communications with friends around the country and back home. It was pretty neat to be able to do a video chats from my room. it was time to start thinking about going home.
We met with a diabetes specialist. Starting with the morning of surgery, my regular diabetes pills (3 different drugs) were discontinued in favor of using insulin. It's not that the pills didn't work, they felt it best to give my liver and kidneys a break for 5 or 6 weeks. They gave me insulin while I was in the hospital and I was to continue using it until Dr Jones, my family physician, felt that it was OK to go back to the pills. So starting that day, I had to increase my blood sugar testing to before each meal and just before bed time. There are two different types of insulin that I have to inject. The number of units that I take is dependent on what my blood sugar is as compared to a reference chart that has doses for various ranges of blood sugar.
After having a final chest xray, getting the final go ahead from Dr Merrick, and a final breathing treatment, they "kicked me to the curb" (my wife the nurse calls being discarged that) and we were on the road headed home by 12:30. Since I'm not supposed to drive for at least a month, my wife was at the wheel. A precaution that was emphatically recommended by UCSF was that I should sit in the back seat with a pillow on my chest. It would not be good to get hammered by a deployed air bag and our front passenger side air bag can't be disabled. We removed the front seat head rest so I could see what was happening ahead. It was a beautiful day and traffic was light. We arrived home at 7:30 PM making stops only for lunch and hourly stretch breaks. 7 hours on the road was a bit much but I'm glad we did it all in one shot and could be back home where I was all set up to be as comfortable as possible. I did my bedtime blood test/insulin routine and was out cold in my recliner by 8 PM.
And so my new life began.