First Day Post Op - walking, walking, sitting sitting, oh and EATING

Morning the day after surgery.

Getting ready to get up for the first time...

First time standing up!

First walk in hall, LESS wobbly than before surgery....

I couldn't contain my joy at seeing
her walk LESS than 12 hours after surgery...

And sitting in the chair, instead of BED.

Umm.  These drooping eyelids and the attitude
SHOULD have been my first indication that
the narcs were  getting to be a little too much....

Drawing or coloring is ALWAYS a favorite...

Knocked Out.....

9 May 2019 - POST OP, Day 1

• Raring to go!  Walked first thing.
• Pancakes and bacon for breakfast.
• Pushing the pain pump 27 times....the ice pack is our "other" best friend.
• Someone likes to draw and color while watching the "X-Files"
• Sorry Lena I know you are post op but I gotta take this history final....
• A few indicators before the night time that she was having some issues.
• Respiratory depression, the MET team, and a change in pain PCA...

Jen's tedious version of events....9 May 2019-

Raring to go!  Walked first thing- Lena actually woke up a couple times during the night already talking about getting out of bed.  I explained that, "we may want to wait until the catheter comes out honey...."  Somehow I placated her until early morning.  Luckily, Lena had a great nurse and the foley was out early in the morning, clothes were changed and she was up and off!  She did SO well.  She wasn't even wobbly.  Her legs were sturdier than even in the airport on the way here!  We had worried about a cane, or walker, etc...but the "IV tree" is enough for now. 

Pancakes and bacon for breakfast - She had a few bites of pancakes, hot chocolate, and some bacon for breakfast!  NO PAIN WITH EATING.  I went down to the cafeteria and made friends with the cook, ordering a bacon omelette (FORESHADOWING:  Omelettes would be my morning nutrition for days to come...)  The cashier told me I looked like a "regular"... wasn't sure that was a good thing?  Anyway Lena settled in for a day of walking and healing.  She walked two more times before bedtime.

Pushing the pain pump 27 times....the ice pack is our "other" best friend - Soooo pushing the Dilaudid pain pump every 15 minutes wasn't quite keeping her pain at bay...so they were augmenting with Toradol.  She was doing so well, I just figured we'd keep with that until someone wanted to get her on oral meds...around day 2.  BUT the two times later that she walked, she would get right to the bed or chair and pass OUT.  Like drool down her chin passed out.  Also the ice packs on the incision were a must...just enough cold pressure that she really avoided any swelling! 

Someone likes to draw and color while watching the "X-Files" - In between walking, peeing, and naps was Lena's drawing and X-Files time.  I never watched X Files.  The main characters kinda bugged me.  Plus I ain't got time for series TV.   I just was wondering, wouldn't the loopy meds make the wierdo plotlines kinda freaky?  Not sure, and I keep forgetting to ask her....

Sorry Lena I know you are post op but I gotta take this history final - So I had ONE more online final to take...over 9 chapters and a bunch of supplemental info the professor told us to watch (that I hadn't had time to watch)...so all throughout Lena's first night and this day....I was studying 20th and 21st century history and taking notes for the 2 hour final.  I maybe mentioned it once, twice or 27 times as we prepared for surgery because one of the first things Lena said upon waking up from the surgery was, "Did you take your final?"  I finally found a 2 hour opportunity during one of Lena's drool naps - I got 188 out of 200 points....and then an opportunity for 12 extra credit points made for a 100%....got a 98 in that class.  DONE WITH THE SEMESTER.  Lena actually took one of her final exams in the RMH before her surgery...and she actually has one more English Essay to complete by next week....she tried on this day - but her vision was so blurry....

A few indicators before the night time that she was having some issues - By mid day,  Lena was experiencing some obvious side effects from the narcotics:  Itchy eyes and face, rashing a bit on face and incision, super droopy eyes, and low respiration.  She had been having a hard time taking deep breaths ever since the surgery...which is a concern because fluid and inflammation can result if you are laying down alot.  Each time she would fall asleep, Bleeping Betty would sound after too long...that she wasn't takine enough breaths per minute.  Her CO2 reading was generally always between 43 to 52 (we had been warned to watch for anything consistently above 45.)  I took a few pics before she passed out for a mid evening nap....and looking back at them - I maybe should have had an inkling of what was to transpire...

Respiratory depression, the MET team, and a change in pain PCA...So as we got into that second night...Lena's eyes were really red (the skin around them was really irritated).  And although Benadryl had been suggested, her eyelids were so heavy and droopy, we had opted to wait until she was about to go to bed.  It got to be about 11:00pm and she just sort of told me she couldn't breathe deeply, or keep her eyes open, and she sort of folded back onto the bed and was super slow to respond.  In conjunction with that, the EtCO2 "Bleeping Betty" was showing numbers above 50 for her CO2 and her breathes were shallow, rushed and sometimes depressed.  I called the nurse who didnt seem to know what to do.  She tried to call both the surgeon, his PA and the pain management doctore, but no one answered.  Once Lena indicated she was having trouble taking deep breaths, the nurse called the Mobile Emergency Team.  Within minutes Lena's room was FULL of medical personnell, the Respiratory Therapist, etc.

They drew blood from her wrist (she moaned alot, ouch!)  And then from her arm.  Pulse-Ox reading showed she was getting 100% Oxygenation - but she could barely respond.  When she did, she was saying it hurt alot to breathe. There were maybe 8 medical personell all looking at each other trying to decide what to do (she obviously wasn't gonna need "ER" attention.)  Finally, it was decided that the PCA Dilaudid was just delivering TOO MUCH medication for her little body...that she was too drugged and the result was a "respiratory depression."  

Problem was:  She was due SOME KIND of pain med at midnight - and since she'd  been on the Dilaudid every 15 minutes since recovery, plus Toradol because the Dilaudid wasn't quite covering all the pain....the nurse decided she'd better quit both UNTIL ONE OF THE DRs COULD CONTACT HER.   So by 12:30am Milena had NO pain meds in her at all.  They are drawing blood etc and she is clearly in pain.  Mama bear was starting to emerge.  Finally they gave her the Toradol and then some Tylenol.  Her #2 IV in her right hand had some problem after they dosed the Toradol and she was like, "HURTS".  SO the nurse removed it immediately.  She never really fell back to sleep and was basically at a "9" the rest of the night.  It sucked big time.  What had started as a really positive day, ended up terrible. 

We have been learning that this journey is really hour to hour.  Lots of ups and ups, then down and a step back, then a step forward.....