The C Word – A New Battle Day 5 - Milestone reached

For those in the PMP world, one of the most talked about topics is bowel movements.  Too little or too much is the bane of existence.  Trying to keep controlled is a fine line, balancing the needs of the human body as much as possible in order to lead as normal a life as is possible.

For many, the loss of parts of their intestinal tracts, usually means that they either must use dietary means to keep things under control or medications or a combination of the two.  On the flip side, due to the surgeries they have endured, they can be more prone to small bowel obstructions (SBO’s) which can required trips to the emergency room to help alleviate the problem and sometimes I see from postings by others with SBO that additional surgery can be required to rectify the situation. 

We knew there were going to be a couple of significant milestones after this surgery.  Priority one is managing pain adequately.  I think that’s pretty much complete.  Second is working on mobility.  Although George is weak, he is able to do short distances with the ultimate goal being able to get in and out of the house and to and from the bathroom.  I think he can do that, not easily yet, but he can.  Major milestone is release of gas and/or bodily fluids.  That was not only met at 2:30AM – but is now flowing very freely, almost too freely.  Not as bad (yet) as our worst two days ever the last time – but 9 times in 12 hours.  Is it too early to discuss an Immodium regime to slow it down a little bit??

However, in between those times he is doing one of two things:  Sleeping (and, from where I sit it looks like a pretty good slumber) or sitting up in his chair.  Well, 3 things – in and out of the bathroom because…. He can!  Today the tubes that made it cumbersome to move away from the bed were removed!  Woo hoo!  The only thing he is tethered to is his IV pole.  (The oxygen/heart rate machine is something I can disconnect whenever he needs to move away from the bed.)  He’s not feeling very well today – but he is trying to do the things he can.  And, my lesson learned from the last time is that I am not pushing things on him.  I ask him, but if the answer is no, I accept that and let him be the director as much as possible. 

Today the doctor removed the suction tape over the sutures so those are now exposed.  Ow, that hurt!  Tomorrow the JP drain will come out.  Day by day.  Diet is now changed from clear liquids to full liquid – so instead of chicken broth he can have pureed chicken noodles soup! LOL!  Oh, and pudding and ice cream and milk.  Those are his go to things, I think.  Probably will do this for a day or two and then bump it up a notch.

Next time we see the doctor we will ask if there is a time frame for going home. I’m not sure what final milestones will be.  They may want to see how he tolerates solid foods.  Maybe not.  Maybe soft easy foods can be done at home and a regiment that slowly adds things can be done.  Just not sure so that will be a question we may get answered tomorrow when we ask for an estimated or definitive timeline.  

I should probably see about meeting with a case worker as well to help determine what he will need when going home so we can order up the necessary items.  I think we have to arrange for a home health nurse to stop in periodically to check on things since we are going home with a feeding tube in place. 

I forgot to mention that yesterday the nurses on this surgical floor had first year nurses from a local school to mentor them.  Each nurse had one or two students assigned to them.  The girls were able to do some of the procedures with the help of their instructor and/or teaching supervisor.  The one with our nurse came in to do her first glucose stick so the instructor had to be with her.  As she looked around our room she noticed all the different machines we had and asked if she could bring all of them in at some point during the day to explain it all to them.  She was respectful and knew George was resting.  I asked them to come by after lunch as by then I thought George might be a little better after having meds adjusted and fluids pumped.  Before she brought them in I gave them some background about what has happened with George in the past two years and let them know why he was hooked up to so much equipment.  I then got to listen to the instructor as she told the girls about each item:  The3 IV pumps/monitor and why they were set up that way, the pain management device, the tube feeding and TPN (nourishment by IV), the Gastric (G) Drain and Foley, the suture “vacuum”, etc.  So, I benefitted from that little bit as well.  Not lost to me was the fact that my husband had a host of medical equipment all in one room that is atypical of most procedures those girls will see in their workplace.  Not that they won’t see them, just not very often. 

Had just two visitors today, Stan (former co-worker of George’s) and Kim (neighbor).  Visitors are more for me than George.  He doesn’t last too long and doesn’t participate in conversations too much.  He did try to for a bit, but even talking exhausts him.  If it weren’t for a few visitors sprinkled into the mix, it is very quiet for me as George does not “do” television in the hospital, not even for background noise.  I usually walk around most of the day with my earbuds in listening to music while I crochet, browse facebook or do some office work. 

Summary:  A productive day.  Hopefully a relatively peaceful night.  I imagine I will be woken up a few times for bathroom runs, but with luck there will be at least 2 hour gaps between them. 

No pathology report given to us just yet.  Patiently waiting for that.