NG and SMILE

Karen has been nauseous on and off since the last update. She did vomit once more at night and again this morning. The doctors decided the best thing to do at this point was to put the NG tube back in and drain the contents of her stomach. She really hates the NG tube, but she was tired of the nausea and was ready to try anything.

Despite being fairly miserable overall, Karen's had a couple good hours here and there yesterday. She won $12 in gift cards for the gift shop playing BINGO SMILE. (And, of course, I won nothing.) We did do a lot of walking together, which is always nice. Sometimes we even went for 30 minutes at a time. Her incision is looking better and she was quite pleased to be allowed to shower for the first time since Tuesday's surgery.

Tough Going

Karen's been vomiting about once an hour and pretty much everything that went in has come back out. The doctors feel this is an ileus, and the bowels haven't completely woken up from her last surgery. They were overly optimistic in allowing her solid foods so soon. So for now she's been taken off liquids and solids, with the exception of a few small sips of water.

She was taken off the IV pain meds this afternoon as scheduled yesterday when they saw her pain level dropping. But with her puking up all her oral pain meds, she's in more pain than usual. They did eventually realize the problem and they gave her something intravenous. They're also pretty sure she's puked up everything she ate, and so that's over with. Once her stomach has calmed down a bit more, she will start back with a liquid diet again.

Bump in the Road

Karen finally got to eat some solid food yesterday; so that was 12 days without solid food. Unfortunately it made her nauseous and one of the anti nausea drugs made her loopy and dizzy, which left her stomach feeling unsettled. Needless to say, she didn't get much sleep last night. When they brought her breakfast, she lost her dinner. Skipped breakfast, and it happened again a couple hours later.

Yesterday I was happy to see her heart rate so much lower than it had been, but it slowly went back up throughout the day. Starting just below 100 when sleeping, hanging around the low 100s in the early morning, and climbing back to the 120s by evening. It didn't drop as much last night with the lack of sleep and stomach issues. Someone said another HIPEC patient had such a fast heart rate for so long they finally sent him home on beta blockers.

Progress

Karen's pain level has slowly been coming down, and she's had one of her best nights yet. Her resting heart rate has been in and around the 120s since the initial surgery on the 9th, and was as high as 145 yesterday, but is finally dropping below 100. And she's eating broth now - the breakfast of champions - and if things continue as they are, she might get to eat some semi-solid foods by the end of the day. Karen hasn't had solid food since the 7th, a few days before surgery due to a preoperative diet. Other than a bit of a fever at night still, things are looking great.

Another One of Those

Karen is back to her nights of broken sleep. The pain is, as you'd expect, worse than before the surgery. But she has a PCA again, so she can push a button to get morphine when the pain picks up. The downside is waking up after a short time in a lot of pain because you haven't been getting the morphine. Her heart rate is also more elevated than usual, but they say it's from the surgery.

Also, because she got the blood transfusions, she is even more immunodeficient than before, so even when she's out of intermediate care, they're asking for no visitors who are coughing or sneezing.

Out of Recovery

Karen's now out of recovery and in the intermediate care unit. She seems to be doing alright on pain. Her vitals are certainly better this time around. She also says she's able to breath better now; so maybe the air leaking into her abdomen was pushing up against her diaphragm before this?

Surgery Complete

The doctor says Karen's surgery went well. They found the source of the leak. It turned out to be her colon after all. It was in a section where they had removed a large tumor, and with the chemo from the HIPEC, it was unable to heal completely and had reopened. Her body was doing an amazing job keeping it in check, but the doctor said leaving it to see if it healed on it's own was added risk - and pain - Karen didn't need. They performed a colostomy an ileostomy, and she will need to have the stoma for 3 months. After which, they can reattach all the plumbing and things should work as they originally did.