Friday, January 8, 2010

Jan. 8th Hospital Update

So on the morning of Monday the 5th, the day after the sinus operation to fix the first sinus operation, Tanya's transplant surgeon's nurse practitioner came to the room, and said let's take out those JP tubes. The JP or "Jackson-Pratt drain" is a long rubber tube placed inside the chest cavity during surgery with something like an ear bulb that hangs outside the body for excess fluid and blood to drain into. She had these tubes for transplant and both post-transplant thoracotomies. Having these tubes pulled out, while painful, is great news. For one thing, having a tube placed between your lung and chest wall causes pain every time you breathe because you have this foreign object scraping up against the inside of your ribs, and for another thing, having the tubes pulled out means you're far enough along in the healing process to go home soon.

We were happy that she was about to have her JP's taken out. This was one of the major things we had been waiting for, one of the last hurdles to jump before getting out of the hospital. They told us we had to wait two weeks after her thoracotomy surgery, because one of the JP's was stitched in with a dissolvable suture, and it would take that long for the suture to be absorbed and allow the tube to be pulled out. She had experienced moderate pain with all the previous times they removed the JP's, but it never lasted long, and was nowhere near the magnitude of all the other pain she had gone through. This time, I knew there was something wrong when the nurse pulled one of the tubes and Tanya started screaming. It wasn't a fill-your-lungs-with-air-and-belt-it-out scream. It was the scream of someone breathing short and shallow because of shock. The JP tube the nurse was pulling was the one that was put in the space that was occupied by the abscess they removed in surgery. It was stretching out of Tanya's side like a rubber band, and contracting back in- it wasn't coming out. Tanya said later that it felt like her insides were being pulled out. The nurse was surprised and made nervous by this happening, and said "let me try to pull out the other one," and pulled it out with no problem. The nurse said maybe the stitch hasn't dissolved yet, "I'll try twisting it." I couldn't hold Tanya's hand anymore at this point, because I was on the verge of fainting and falling face-first on her. It was too much for me, the combination of Tanya's labored screaming, the rattling of the bedrail from her trembling, and watching this JP tube being yanked like a lawn mower pull-cord. After way too much of this, eventually Tanya heard a "pop" and the tube came out, and we went from overwhelming pain to overwhelming fear. The end of the tube that came out of Tanya's torso was much shorter that that of the other tube. This raised the question: was the stitch still there, and make a popping sound by breaking, or did the end of the JP tube break off inside Tanya's chest? "No problem" the nurse said "if a piece broke off we'll just go back in and get it." Back in and get it. Back to the OR. Back on the ventilator, back under the knife, back to ICU and back to having chest tubes and JP drains AGAIN. So the nurse practitioner ordered a stat x-ray and another CT scan (which is bad for you), and once again we were left to wait, wondering and worrying. Luckily we didn't have to wait long for these results, and there was no JP fragment to be found in either the x-ray or CT scan. As it happened, the stitch that was holding the JP tube down hadn't dissolved in the slightest OR broken off, and whatever tissue in Tanya's chest it was sewn to had given way and that was what made the popping sound. Everything's going to be ok, they said.

After waiting another day to make sure the bleeding from her sinuses was under control (she actually did start bleeding again, this time out her left nostril and eye-but not nearly as much), Tanya finally came home from the hospital on the 7th of January, one day before her five month transplant anniversary (which is today). After spending a month in the hospital, such a simple thing as walking through your front door becomes just as much a cause for celebration as pretty much any holiday of the year. The docs say she's doing very well, and discontinued all of her IV antibiotics. Now it's back to healing and catching up on sleep (which she's doing right now) and making up for missed holidays.
She's had some stomach pain today, but I think maybe when she tasted some real, non-hospital food, she probably ate a little more than she was ready for.

Sinus surgery recovery room

From Tanya's nose

The length of the tubes from the black stitches(near her right hand) to the other ends that she's holding in her left hand are the portions of the tubes that were inside Tanya's chest cavity, with the bulbs hanging outside her body.

The picc line that was in Tanya's vein from her arm almost to her heart.

Waiting to leave. The blue plastic gown is a precaution against germs.

How beautiful!!

Thursday, January 7, 2010

Jan. 7th Hospital Update

A lot of things have happened since the last blog post. I wish I had the ability to make everyone understand fully just how much pain and horror Tanya has gone through, even though you'd never know by speaking to her. Tanya wants to make you smile, not cry, and most people will laugh and joke with her without ever having any idea how much agony she's in, but when you leave the room, she'll say "I need my pain medicine, I can't stand it anymore."

I'll just do my best to describe these latest nightmares, and start where I left off. As I mentioned before, the sinus "roto-rooter" surgery was a simple procedure. After the surgery the doctor came out and told us that she "did good" and that he cleared out a lot of junk from her sinuses. She had to stay in recovery until her blood pressure went down some, and they told us that the severe headache and bleeding from her nose was normal and should stop in a day or two. She was saturating a gauze sponge with blood from her nose every fifteen minutes for the first couple hours. Her cheeks were getting raw from having the gauze tape peeled off over and over again. Over the course of the day the bleeding finally slowed down, and we were able to watch the New Year's fireworks out her hospital window without a single gauze change. The next day continued much the same, still having enough bleeding to necessitate gauze but not enough to be considered "not normal," and the next day, finally, the gauze came off altogether. We thought she was pretty much over this "simple procedure." Then on Sunday night she started bleeding again, this time PROFUSELY. Do you think that having blood pour out of your nose is a scary thing? Tanya had blood flowing freely from her nose, down the back of her throat and out her mouth, and out her right eye. She filled up three puke basins with blood soaked sponges and tissues, and was still going. This was the point where the bleeding had finally crossed the line and had become "not normal," and her nurse and doctor were pretty much freaked out. So on Monday morning she went back downstairs for another surgery, the seventh one in the last six months. The doctor did a little cauterizing and sprayed some medicine and left a pack in her sinus, but was still pretty much baffled as to why she was still bleeding. He came out after the surgery and told me "she did good" again, and to let him know if the bleeding kept up.

I'm going to finish this tomorrow.