Wednesday Hump Day

Monday was rough.  I didn't have the numbness in my torso like last year.  So after multiple trips to the OR, having the drains removed was frankly, excruciating.  Adhesions made it unreal on the right.  Adhesions and too much trauma on the left was searing pain.  I felt like a hot poker from the fire had been scored over me.  With my body having tried to slow the rate at which it drained the blood, and then removing the drain - well you can imagine the rest.  I am wrung out and laying low.  My wits are buried underneath all the wrapping and compression corset for a bit.

“Drains? We ain’t got no drains. We don’t need no drains! I don’t have to show you any stinking drains.”

Gold Hat probably didn’t say it quite like that, but it fits. (don't ask me who Gold Hat is, please)

No more Drains, hooray!

It was a good day in many respects – Tracy had her drains pulled (literally) today.  Many tears (Tracy’s) however as - holy smokes – they were a lot longer than I remembered.  For a minute or two I thought Susan was going to pull Tracy’s toes out through the sides of her chest wall.  Did you ever see Braveheart?  If you have, you sort of get the idea. Freedom! 

I know we talked about these medieval things last year, and again a week or so ago, but here’s the drill:

Jackson-Pratt Drain Care 101.

Perform the following b.i.d. (Morning / Evening)  (that's "twice a day" for you non-med types)

1.       Place biohazard disposal bag next to drainer's chair (i.e. a Shaw’s plastic bag from the recycling bin), opposite from the drainee.

2.   Wash hands

3.   Ask patient to stop fidgeting.

4.       Lay out a (sterile?) field (two layers unused paper towels)

5.       Place out on the field:

a. Measuring cup (really)

b. Sterile extra-long cotton tipped swabs (two sets)

c. Sterile gauze 4x4’s (two sets)

d. Sterile gauze 2x2’s (two sets

e. Sterile bulk poofy gauze batts (2 sets)

f. Dixie cup w/hydrogen peroxide

g. Bacitracin

6.       Sneeze (then start over at step 1, however, may skip step 2).      

7.       Ask patient to stop fidgeting. Again.

8.       Release the corset / binder, retaining full control at all times so as to avoid getting an eye poked out on the backlash if you inadvertently let go of one side

9.       Unzip the front-loader, paying special attention to the zipper and any gauze attached to the drain koozie Velcro.

a. DO NOT EVER: (even if unintentional)

                                              i.   Snap bra straps (not even to be funny – because – it isn’t. Oops)

                                             ii.   Tug at stuck gauze (it's stuck to something FOR A REASON)

                                            iii.   Forget to support drain koozies after unzipping (they are heavy and are attached to plastic lines which are attached to the patient with thread needled through her skin)

                                           iv.   Pluck at *anything* which looks like a loose thread, because it isn’t loose)

10.     Perform fully for each side in order:

a. Inspect the drain through-hulls for any redness, swelling, oozing, or anything else which does not look “normal”

b. Remove Jackson-Pratt grenade from its respective koozie

c. While maintaining *light* pressure on the bulb, remove the drain plug

d. Empty the exudate (see lesson plan for Thursday, August 26, 2010) into the measuring cup and note the amount in CCs.

e. Swab the area with hydrogen peroxide soaked swab paying particular attention to the drain line retaining sutures. (see step #9.a.iv)

f. Discard swab#1

g. Daub off any remaining hydrogen peroxide with a sterile 2x2 (again, with 9.a.iv in mind)

h. Load up second swab w/Bacitracin

i. Swab area around through-hull thoroughly, paying really special attention now to 9.a.iv.

j. Discard swab#2

k. Take two 4x4s, double them over on each other, placing one under the drain line adjacent to the through-hull, and the other doubled-over 4x4 on top forming a 4x4 sandwich (yes, it takes two hands)

l. While holding them in place, position one poofy gauze batt up against the doubled over 4x4s

m. Carefully, bring around one half of the front-loader to hold gauze in place, watching for any kinked / trapped drain lines

11.     Zip up front loader

12.     Stretch (a lot – to the point of wincing) the corset around the patient and wrap everything back up the way you found it (see #8)

13.     Wrap up biohazard bag and dispose of properly (toss in trash)

14.     Return unused supplies to the cabinet

15.     Empty exudate into the sanitary receptacle (toilet) as it stains man-made solid surface sink material.  Oops.

16.     Rinse (Empty) measuring cup w/Hydrogen Peroxide, dry, and return with other supplies

Special Note:

DO NOT mix the exudate directly with the left over hydrogen peroxide from the Dixie Cup. If you do, you end up with what can only be best described as a hand-held Exudate Volcano.  It is red, foamy, and unstoppable. Trust me on this one. Oh – and it stings.

17.     Hand patient a tissue

18.     Log exudate numbers into Excel, and plot a new progress chart (actual chart below)

This is a drain koozie.  There are two of them, one on each side.

Drains Drains Go Away

Bill is gentle and patient as ever and talks and loves me through the process.  The effort of emptying of the drains and cleaning of the sites in the mornings truly isn't as bad as last year.  I do seem to still hit my window of opportunity in the early evening and the window slams shut for the most uncalculated moments.  I just need to have a moderation of meds and being not too tired to sit through the process.  I truly know how fortunate I am to be given a clean bill of health, be done with treatment and moving ahead all my pieces coming together.  It is the unpredicted look at the altered body, the drains themselves, the mess of a popped drain cap, the leftover surgical writing on my torso, a general reflection of 20 months that sometimes requires an emotional purge.  I always get back to the clean bill of health and how blessed I am to be on a great path to great health.  I got to spend a nice holiday with my three favorite guys and got to hear tales of current events and plans for the coming months.  Don't worry any purges I have are truly fortifying the person I fought to get back to.  I'm a happy person.  Drain check first thing Monday morning with Dr. Marble.  Keep the positive thoughts coming, maybe one can come out! 

Happy Thanksgiving!

Slept through the night without anyone checking my drains and taking vitals!  Bill the science guy on duty with me and that feels wonderful.  Knew what to expect this time around so able to get drains done without the heightened emotions of last year.  After 4 days and two trips to the OR got my first sponge bath today.  Deborah loaned me the queen's bath chair and my take home tub from the hospital did the trick.  Both boys are actually awake and Bill has most of the dinner ready for us this afternoon.  On tap is a smaller turkey and at the boys requested lobsters.  A perfect excuse for Bill to get a gimondo burner to rapidly cook the lobsters outside.  It's a little weird to not see all the rest of the Rands and Pelletiers today but it's still a great day for giving thanks.  Thank you all again for all the support you have given to us.  Enjoy the day!

Happy Feet

Not much else to say at the moment. Tracy's home, Taylor's home, and Jeremy is home. Happy Feet all the way around. Tracy is settled into her chemo-recliner with ice-packs perched a top her, and I've just finished prepping the turkey for tomorrow as well as tucking in the cranberry sauce into the ‘fridge to cool down. Lobsters are in a refrigerator-induced pre-feast stupor, pies are baked, and all that's left for tomorrow is to snap the beans, peel and bake the sweet potatoes, steam the Brussels Sprouts, slice and roast the acorn squash, and steam and mash the potatoes.  Maybe a drink or two in there somewhere too. 

Ice Storm

Well got home about an hour ago.  Dr. Mckee just called to see how I was doing and to give me wonderful news.  All tissue samples tested from surgery on Monday came back benign.  I have already settled into the recliner with my ice packs across my chest.  It helps tremendously with swelling.  The boys are both here and helping Bill unload the car as he went Thanksgiving shopping promptly after dropping me off at home.  I'll rest and rest some more.  Good day!

Tap, tap,tap, tap, tap, tap, tap.....

Yes, that is the sound of Tracy's feet..   One more viewing by Dr. McKee - and we can officially leave!  Unless I post again, you may assume that we will have hit the road around 12:30 or so..  One stop at the pharmacy, then to Post Road.

Another night out on the town...

The verdict is:  Tracy is not going home with Eddie, and will be staying another night at Chez Exeter.   Also, in another one of those strange moments in Recovery, I saw something I couldn't quite put my finger on until I got back up here and on the ‘net.  Then it clicked.

What do you think?  Yes? No? Maybe?  I think it’s pretty close..

Thinking of Eddie...

Dr. Marble (deja vu - wearing the same fleece and carrying the same canvas bag as last night) just came by and said Tracy was fine and in recovery (again).  Will be heading over there shortly and they back up to 352W for some assessment time...  Will know later this evening if I am taking her home tonight.  Hopefully, if  I have done this properly, you now have Eddie Money rattling around in your heads and will not be able to get rid of him for a few hours.

You're welcome.

(oh - and a medical side note.  If you come in from the cold and you're shivering - Demerol fixes that real good apparently...)

Hematoma haiku

Hematoma now,
Soon to surgery we go.
Home tonight we hope.

Recovery redux.

Ok – so contrary to the published itinerary we got from the Cruise Director, we’re not home – yet.  Yes, we were expecting to be back in North Hampton by mid-day, but due to a slight wrinkle (a hematoma, actually), Tracy is still here up on the 3rd Floor of the west wing.  This comes under the category of not a common thing, but also not unexpected.  Fortunately, the protocols which are in place to help ensure patient’s fitness for release caught this, and we’re patiently (ha) waiting.  Or – rather I’m patiently waiting.  Tracy is back in drug-induced LaLaLand for the time being..  We're expecting a decision by the surgeons sometime late this afternoon if they want to take back down under for a draining or if it has reduced enough on it's own over the course of today in order for us to get out of Dodge.

More later…

Recovery - update #2

Just saw Dr. Marble, and was informed that Tracy is in recovery (2:45 PM-ish) and I should be able to go in a little while.  Since she will still be unable to fend off any camera's pointed in her direction, I'll try to get something "acceptable" and will post later on this afternoon.  I have already been asked (prior to her becoming unconscious) to ensure that she didn't have "wild hair".  I'll have to go see if the gift shop has any Dapper Dan or Fop.

And - yes - I was using her gurney as a backstop for her iPad while we were in pre-op.  It made for a convenient iPad stand while I was catching up on the twitterverse..

Pre-Op Update #1

Tracy *before* Versed

We had a relatively uneventful morning, other than the fact that I overslept and almost missed my TRX (http://www.trxtraining.com) session.  When i arrived back at the house around 7:45 or so, Tracy was already up.  I had some breakfast, Tracy did not.  Yes - I did ask if it was Ok.   We arrived at Exeter Hospital around 10:30, and by 10:45, we were in the pre-op staging area, where Tracy got into her johnny, and got some drugs, after first confirming her name and date of birth about 15 times to various folks.  Unfortunately, I left the camera in the car, but I had my cellphone and snapped a couple of pics.  Versed, by the way is the brand name for Midazolam (http://en.wikipedia.org/wiki/Midazolam).  Right pon schedule, Tracy was wheeled into the OR.  She rolled to the right, I walked to the left back out to the waiting area.

Tracy *after* Versed.  Much happier.

Bill

Monday, Moon's Day, First Day Of The Work Week

So all I have for work today is to get myself showered, dressed and off the hospital.  It is the work of Drs. McKee and Marble to put me back together again.  The little shopping cart of boobs is at the ready.  It is fitting since this is cyber Monday.  I have already put my order in so they will be ready for an nontraditional type of customer pickup.  Can't you hear the new Christmas song...  All I want for Christmas is my two new boobs, my two new boobs, my two new boobs...

Protein Power

Well that Bill guy is already helping me get prepped for tomorrow.  I have often been the one to order a smoothie instead of coffee down at the local coffee shop.  Now that he has been on the fitness track he is exploring all kinds of flavors.  I asked for pineapple with banana today with greek pineapple yogurt.  He adds the Kashi Crunch and some organic fat free milk.  Delicious!  Tomorrow will come along and we will head over to the hospital to check in around 10:30a.m.  My surgery is slated for 12:30p.m.  I don't expect to even get to recovery until around 5p.m.  So don't worry if you don't hear from Bill for a bit.  A later start then I can settle in there for another sleepover with my morphine clicker at the ready.  It's been a long week so today is a day at home prepping and resting.  My mom got to St. Ann's in Dover yesterday shortly after 4.  We helped her settle in and then they were getting her some dinner and she would be assessed by nursing for the evening.  Dad is doing ok.  It's been a long week for him too.  It's going to be a better week.  Each day strength will come to each of us. 

Two Days

Well it's been a heck of a week.  Finished up being in the office yesterday.  Have some more files I want to send back but otherwise I am prepping myself at home.  My mom remains in the hospital and she'll be evaluated again this morning to see if this is the day she can go to rehab.  Bill and I will head to Dover shortly then tomorrow we will hunker down.

Four Days

Four days and counting.  Got my tasks cut out for me before Monday.  I'll finish up at work tomorrow.  You know how it is when everyone  knows you are heading out for vacation - well it's that times 8.  I am zonked tonight and gotta get to bed.  Mum did not move today.  They wanted some additional images of her before heading to rehab.  So it's really on for tomorrow for her.  She is still struggling and hopefully settling her into rehab will help.  Taking my meds and heading to bed.  All for now.

Hump Day Was A Humdinger

Got all the good thoughts at the forefront of my head for my surgery, but weighing heavily on my mind is my mom.  She will move into rehab tomorrow most likely, barring any other complications.  She is being well cared for, and the rest of the family will be the support she and my dad need.  I will continue to keep myself in good shape and stay as rested as possible.  I want to end my note tonight by sending out good vibes and prayers to Vinnie's wife who has a recurrence and is in Boston for treatment and to Joyce who is gonna be absorbing some rays starting tomorrow. 

It's Just A Day

I blasted through today with a full plate of Holy Macaroni.  Whoa.  So one day closer to Monday.  Good.  My mom remains in the hospital and that's not so good.  Hopefully some of the good vibes are helping her get back to herself. 

Life Happens

Well sadly my mother fell at the Strides Walk.  Worse she was just diagnosed this past Thursday with hairline fractures at the front of her pelvis.  She worsened this past Sunday and had to be admitted to the hospital.  Jenn and I have been running back and forth and they are going to keep her for another night to continue the assessment.  It'll be a hospital month for the Rand side of the family.  I'm still slated for next Monday and my dad will have a Mohs procedure on the right side of his face next Tuesday.  This is a recurrence for him.  I'll get out on Tuesday and hopefully all of us will be in healing mode for Thanksgiving.

Mind Control

I have thoughts of great health and great healing.  I have thoughts of wanting those who are also in treatment to have the same.  I have thoughts about those who have passed.  I have thoughts about those who are struggling with their battle.  I have thoughts about having great health, losing it, and what it took to get it back.  I have thoughts that life changes in the blink of an eye. I have thoughts about how much the body can be put through.  I have conflicting thoughts of wanting to control more but knowing in my core what can be controlled.  I have thoughts about how much support I have received.  I have thoughts of all of you with me at each turn.  I have thoughts of just trying to stay focused.  I have thoughts on how well I'm dong and that's where I will keep my thoughts.

Hands Off

So I was making noise about all the cooties I am trying to avoid.  Then I catch myself with my hands near my face. Holding my chin, starting to rub an eye...  Try it - focus on keeping your hands away from your face all day long, everyday, all day, for multiple weeks.  You know if everyone can keep their hands clean, and keep them to themselves I can do this easily!  LOL!   

Good Week

Lots of good vibes packed in this week.  We saw Taylor this weekend, got Jeremy's good vibes photo from Boston today (Boston Common's Swan Lake), Courtney's birthday yesterday, Janet's birthday today, full Beaver Moon tomorrow at 3:16pm...  I am trying to get things set in place for when surgery will set me in place.  I think it will take me the next 10 days just to get all the laundry done and put away.  Going to need a chemical aid tonight to sleep.  Got only 3 hours last night and who can do chores at the pace I need to if I don't sleep?  I'll just end up crazed with that laughing crying thing I do. They are only frustration purges, not feeling sorry for myself.  Purging is good for the soul. I have a good one and it is well supported by all of you.

On Track With More Paperwork

Geez Louise I can't save any trees!  Paperwork keeps rolling in for surgery.  Each office I go to still generates paper (with the exception of my pcp whom I'll see next week.)  Surprisingly still paper charts surround my care and everyone has consents, more consents, instructions and more instructions, oh and all my scripts.  I am trying to stay one step ahead of all the cooties I am surrounded by, sick staffs (two went home today) at work, all the medical offices I have to go to to get the checklist for surgery complete, and all the patients that come to the offices I work in.  No worries!  I am the Sani-cloth queen and my staffs do all they can to keep the areas healthy.  Hell just one nose picking shopper could leave behind the residual booger on a cart right?!  They have Sani-cloths at the supermarket.  Are those paper products?!  Geez Louise.

Walking Toward Surgery

Taughannock Falls

We headed out of town late on Friday and came to Ithaca College in Ithaca NY for parents weekend.  We crashed when we arrived.  That is a long drive for me and it still makes me surprisingly squirrely being in the car for 6.5 hours.  My body is coming along and it ticks me off when it starts some old chemo behaviors.  We connected with Taylor on Saturday and went out to brunch at the State Diner and then headed for a walk at the falls.  My walking is still not the best but we did it slowly and it was worth the trip.  Beautiful area and it was filled with lots of families with their students from Ithaca College, Cornell, Monroe College, and even a large caravan of Massachusetts Audubon Society folks bird watching in the gorges.  Had a great dinner out with Taylor, one his roomates Steve and his parents Jim and Janet.  It's wonderful to listen to plans for travel, graduation, and life in general.  It's great to say that I can do more of the planning pieces too for post-surgery.  I am carrying my temperature log and keeping that current for all the doctors who have to sign off for me for surgery.  Bill and I even worked out this morning!  Using the eliptical and the bike we are running toward a great new year in 2012.  Thank you all for the sweet and funny cards, prayers, and all the good vibes.  I am storing them up for surgical fortitude!