Wednesday, May 4, 2011

Morphine -- It's A Good Thing

     As I sit here in a hospital room beside my husband's bed tonight, different room but same hospital as three weeks ago, and reflect on the events of the day, I'm a little weary.  The kids and a friend of ours just left, and I was very much ready to go with them as well, but there was just something in Harris's voice that told me I needed to stay just a little bit longer.  He's already sleeping soundly, which is a very good thing, but now all of a sudden, instead of feeling the effects of being up very early, there is a bit of renewed energy in me that probably wouldn't allow me to shut down for the night until after I've shared my thoughts here.  This writing stuff is very good therapy for me. 

     The bowel preparation didn't go so well yesterday.  He's never thrown up once throughout this whole experience until after he took another 32 ounces in last night.  It didn't take long for it all to come rushing back out with a vengeance.  It was a short night with one long bathroom break at 3 a.m., and by 4:50 the alarm was sounding so that we could get up and make our way to Genesis West for the colonoscopy.  Finally around 7:45 a.m., he was taken back for the procedure, and the GI doctor and the nurses couldn't have been more accomodating and kind.  They took time to answer every single one of my questions, and afterwards one nurse in particular even dug through the trash to show me something that they had used.

     What they discovered when they went in with the scope was a stricture, a narrowing, at the point of anastomosis, the place where the two pieces of colon had been stapled together three weeks ago, that was less than 6mm wide.  Keep in mind that the colon was big enough to house a 4.5cm mass before it was taken out, so obviously this was a huge problem.  They performed a balloon dilatation procedure that stretched the tissues to 10mm wide, but that's as far as they dared to go for fear that if they went any further, there was a greater chance of perforation.  There was scar tissue in there that had developed around this new juncture, and it was close to blocking off the passageway completely. 

     As the next few hours passed, Harris became increasingly uncomfortable.  The air they pumped in him from his bottom side combined with the blockage on top all the way down to the site of the stricture made for a pretty miserable existence.  He had been miserable the last week and a half, but he said this made that look pretty easy.  Nothing seemed to relieve him of the pain, and the nurse noticed that his stomach felt very hard to the touch, and she was quite concerned.  She conferred with the GI doctor, and together they decided that it was time to admit him, get an IV in him to hydrate him, and get an x-ray done of his abdomen. 

     We were at Genesis West, and they needed us to be at Genesis East for any potential surgery, so they arranged for an ambulance to take him there.  After they had him situated in the room and the x-ray was done, they administered some morphine, and that was finally what was able to bring some relief.  It was so incredibly comforting to me to finally be able to watch him sleep peacefully.  The key to the morphine, though, is that he needs to ask for it, and he can actually have it every hour.  Two or three hours probably passed before he asked for some, and by the time he did, he was in a lot of pain again.  The bodily fluids were all trying to get out, and the only method of escape was through the mouth.  What a horrible experience.  Haley saw the whole thing happen, and the tears were flowing.  He did finally feel a bit better, though, and then a little more morphine made things a lot better.  He hadn't spoken much all day, but when that dose came, he was talking up a storm and even telling the nurse a blond joke!  It was rather hilarious to hear him interact with her, and I'm sure he doesn't remember a thing of it.  She was so gracious to just pull up a chair and let him tell her whatever was flooding his mind in those moments. 

     Haley brought several things with her when she came, including lunch, and then she sat with me here all afternoon.  Right before she left, the surgeon, same one who did the surgery on April 12, came in to visit with us, and we just kept asking him questions.  Basically what has happened with this stricture thing is pretty rare.  He said that when he ordered the CT scan on Monday, he didn't expect to have any problem reported at all and was completely shocked when he saw the results.  The whole stricture thing has to do with the blood supply and some other stuff that got lost on me, and he said that when he did the operation, everything went very well, and he would not have guessed at all that this would have happened. 

     So where do we go from here?  Well, he could have surgery today or tomorrow and will if he spikes a fever and gets an infection or if the pain is just too unbearable, but if he has it too early, then there is a greater chance of him needing a colostomy bag, even if it's only temporarily.  The surgeon would prefer to use tomorrow to give his colon a chance to heal a little from all the trauma and to give him a chance to get cleaned out a little better.  After he threw up this afternoon, they put a nasal gastric tube into his nose and down the back side of his throat and into his stomach, and it has been busy transporting fluids out of his body all afternoon and evening.  It's rather gross, but it's much better than the alternative. 

     The surgeon's plan is on Friday to take the anastomosis out that was created three weeks ago and then reattach the two ends of the colon together again, but this time he'll use a different procedure and make it probably twice as big.  That way if it shrinks down again, hopefully the opening won't become as small and impassable as it did previously.  He's very hopeful and confident that Harris won't need a third surgery, but the bottom line is that we really don't know.  He didn't see the second surgery coming either.  He will go in through the same incision, but this time the incision will be much longer than the original 8cm and will extend down past his belly button. 

     Basically we're starting all over again, only this time we're starting with two extra days in the hospital, and he'll probably have to stay longer than he did the last time.  The surgeon said there was nothing that we could have or should have done differently, but we'll just be monitoring everything a little bit closer next time.  We're dealing with a man who's about 20 pounds lighter and a lot more weakened than when he went in the first time, so the recovery will be every bit as long or longer. 

     To say we're disappointed and frustrated would be the understatement of the year, but we just have no choice but to spend some beautiful May days in the hospital.  It wasn't so hard when those April days were cold and crummy, but this hurts just that much more.  Our Tulip Time and Mother's Day plans just got thrown out the window, and business as usual just got put on hold that much longer.  But on the bright side, we know that God is good, He is faithful, and He has a plan through all of this.  We're very thankful for doctors and nurses who can help us through all these things and for family and friends who pick up the slack on our behalf.  Vance and Steph, you deserve a huge shout-out right about now!  You've taken on a lot of responsibility, and we appreciate it so much. 

   And finally, let me just say how very thankful I am for my healthy, functioning digestive tract that I've always taken for granted and for morphine for Harris.  It really is a good thing.

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