Reopened

Last night, while Karen was sleeping, she rolled over onto her side and her incision opened up in two places. Lots of puss, fluid, and blood came out. There wasn't any pain associated with the mess, and the openings themselves weren't pulling apart like they had done previously, but we were still alarmed. It had opened right along the incision in two places. One was just less than a centimeter long and the other about 2 centimeters. We called Mayo first thing in the morning and once again they got us in the same day.

At first there was talk of opening the incision back up to make sure it was entirely drained, but in the end they decided to just drain what they could, stitch it shut, and send us home with an antibiotic (Augmentin). Despite two syringes of lidocaine, Karen still had an incredibly tough time with the pain as they put the stitches in. She was shaking (convulsing?) at one point, even to the points of getting cramps in her arms. We figured they'd probably want to do something, and had thought about applying the lidocaine patches we had previously had so much luck with, but didn't, which turned out to be a big mistake. Karen took some oxycodone directly after the stitching and we sat for about 20 to 30 minutes before heading out. We have a follow up in a week.

On the bright side. Karen has been awake a lot more since dropping down to lower doses of the pain patches. She's awake at least as much now as she was back at the beginning of the year, maybe even more so, which is quite encouraging.

Month At Home

Karen has been doing fine since her stitches were removed. Everything has held together just fine, and there's no sign of trouble. She's been sleeping a lot still. Some day it seems she's only up 4 to 6 hours. I am a little concerned, but she's been on such heavy pain meds, I'm leaning towards those as the culprit. She does seem to be awake more often as we decrease the dose, just not by as much as I would have expected.

Karen was on a 25 mcg/hr fentanyl patch back before the surgery in February, and is only today dropping back down to 25 mcg. Even as far back as November, 25 mcg/h wasn't enough to sufficiently control her pain. She had tried the next step up, 37.5 mcg, but found she was sleeping most of the day and opted to be in a bit of pain rather sleep her days away. As the pain continued to slowly increase, she tried the 37.5 mcg on and off. This is actually a major part of what triggered the oncologist's suggestion back in December to see the surgeon about having the mass removed. On April 1st she left the hospital using a 100 mcg/hr fentanyl patch, and a lot of break through. So progress has certainly been made in returning to 25 mcg. Hopefully as we return to these lower doses she'll get back most of her day.

The only other thing worth mentioning is how much more careful we have to be with gluten now that Karen's using the full length of her intestines. While she had her ostomy we could get away with so much. I guess because the food leaves the body so quickly? Whatever the reason, we've gotten a bit spoiled, being able to cheat with wheat products without much of a reaction. Going back to a stricter diet is a bit disappointing and frustrating. We had hoped that part of the reason she had to have such a strict diet before the ostomy was due to the cancer that had been removed from her colon, and thought maybe things had eased up for good. Now that her ostomy is reversed, it would appear that isn't the case.