My day began at about 3:30am. I began drinking water and had about 32 oz in me when it was time to take a chrlorhexidine shower. Using a special sponge soaked in chlorhexidine you scrub down once the night before and once again about an hour prior to the surgery.
They give you a clearfast drink with 50g of carbohydrates and it has to be consumed 1hr before you show up for the surgery. I had to be at the surgicalwaiting room by 5:15am for the 7:14AM surgery.
This time there were no COVID restrictions so my wife got to join me in the waiting room. We had to visit with the Financial counselor and provide insurance information. and shortly after I was called to the back room, weighed and asked dozens of questions about my health history. It was really too early to recall all the details so they helpfully read them to me from my chart. Jeez grandpa, what are you asking me these questions for anyway, if you know the answers?
Next they place an IV in my left arm and to give the nurse credit, she did it on one try which was a whole lot better than the last surgery where it took three attempts. They tested my blood sugar, which was 225. They thought that alarming but I didn’t because 50g of carbs in a drink after 10 hours of empty stomach tends to do that king of thing to your blood sugar.
They called me wife in for a short while but sent her out again when it was time to place the epidural. I thought this was going to be no big deal since last time it was expertly placed in a few seconds. This time, however, involved 5 different attempts which I could feel the hurt inside my spine as they punctured it. Two nurses were comforting me by giving me their hands to hold and I hope I didn’t cause them permanent damage. By the time they got the 5th one in, I was sweating like I haven’t sweated since running cross-country in high school in the August heat. I was dripping wet and the Tegaderm patch they put over the tubing was wet and clammy on my skin. I was leaned back and wheeled into the operating room, where the anesthesologists and nurses chatted with me for a while before putting a mask on my face and I remembered no more.
I woke up in the recovery room in excruciating pain, as is now usual for surgery with me. They explained that my epidural “fell out” and they were using instead going to use dilaudid to manage my pain now. Unfortunately it only worked but so well, it only reduced the pain level down to the 6s and giving me one memorable day of pain that I wish I could forget. It was a rough day, and the pain was not even the chief concern. The biggest problem was that my blood O2 levels were in the 80s even on high flow oxygen, and that had to be worked out.
I got a portable chest X-ray in my bed, where they slide a plate into the mattress behind your back, and after the surgeons and radiologists looked at it carefully they said my lower right lung was “junky” and the embolism in the lower part of my left lung was a bit smaller but still present. I was having severe pain whenever I drew in more than 500ml of breath, so to make that better I was given an incentive spirometer to exercise with 10 times an hour. Calling the thing an incentive spirometer is a bit of a misnomer, since the only incentive you have for using it is the hope of staying alive. Whenever I inhaled with it, it used a vacuum to lift a little piston to the level you are capable of inhaling, in my case this was 250-500ml which is apparently, pretty unsatisfactory.
After the junky chest x-ray came a CT scan, at a guess this was my 14th. I got a lovely joyride in my bed through the various atriums and glass-walled corridors between hospital buildings, which was a treat seeing the sunshine and being on my own tour of the halls, which since I presume my amusement park days are at a close, is a special exciting treat. Except for the 1/2 mile per hour speed, but still a treat.
The CT scan machine was nice and new. sleek like a Porsche, and fast too, which was a godsend because I could neither breathe deeply nor hold my breath for long when asked to. After a couple dry passes, an enormous syringe squirts about 150ml of iodine into your IV for contrast. You get all warm and tingly inside, and then they do another pass.
As usual if the news is good you never hear about it until later, and I think it was at the next morning’s surgical rounds that I heard my lung didn’t have a new embolism (the one on the lower lobe of the left side is still there), but instead has a pleural effusion in the lower right side. This is a mass of fluid that built up during the surgery, probably from the presence of excess hydration. We will have to work hard in the next few days to get my lungs back into shape through walking and breathing exercises.
I got a dilaudid button dispenser the first day and the first night was the worst night of sleep I have had in a very long time. I would be asleep when the button lit up and could be pressed again, so I would miss it until the pain woke me up and I pressed the button. I was behind the whole night until 4am when the nurse got me permission for a bolus infusion, which got me ahead of the pain again and I was able to sleep much easier. at least until 6am rounds, when five surgeons came to ask me a lot of questions.
This wraps up the first day’s events. I am behind because honestly getting better is hard work, and I am super tired the rest of the time. Feel free to post questions in the comments and I will try to answer them or make updates as I am able!