Monday, August 12, 2013

August 12

Poor H. I finally drag him to an appointment and it's a 3 hour long marathon where we met with numerous different doctors, bounced around to different departments, and got swamped with all sorts of not so fun information.

Normally I like to digest for a day before posting but things sound like they're going to be a whirlwind from here on out so I might as well get a jump on things.

Today I met with Dr. V, the reconstructive surgeon. I didn't even have to ask, he actually told me what the difference is between him and the Dr. V who was my plastic surgeon last time. He said that both he and Dr. M are cancer surgeons. So, for me, Dr. M will be doing the surgery and Dr. V will be in charge of the flap that's coming from my leg. But if I had gone to Dr. V as my surgeon then he would be doing the surgery and Dr. M would be in charge of the flap. I guess they are equals in the cancer/surgery world and are interchangeable. Old Dr. V from my previous surgery was only qualified to remove the flap from my arm.

So, where to start with information............

My hospital stay will be from 7-14 days. I once again asked about milestones for leaving the hospital and he said the biggest one is simply 'flap health'. Last summer they had a sonogram type machine and they were constantly checking the flap to make sure that it had blood flowing through it and that it was staying alive. Surgery happens on the basement floor of the hospital, I will then be moved into ICU for a couple of days, and my final stop should be on the 7th or 8th floor of Strong.

The surgery itself will take 8-10 hours.

Dr. M will likely have to remove one of my front, lower teeth before he saws my jawbone in half so that he doesn't accidentally cut through a tooth root. I will need to see my dentist some time after surgery to get the tooth replaced. Also, the part of my jaw that attachs to the skull doesn't break or unhinge, he said it just kind of rotates out.

They will not be able to do another PET scan on me until 8-12 weeks after surgery to see if the cancer spread during the 6 weeks that it took to get the surgery scheduled.

I'm going to have the feeding tube installed this Wednesday and will have to stay in the hospital overnight after the procedure. Here's Murphy's Law at work again. I only have my baby doll on Wednesday and Thursday night this week before he leaves for Myrtle Beach with his daughter on Saturday and by the time he comes back I will have been in the hospital for 4 days after my major surgery. I feel like fate is conspiring to keep us apart as much as possible! Anyway, I've lost 12 pounds in the past 2 months so they think it would be wise to at least stabilize me, if not bulk me up some before actual surgery. Plus, this gives me a chance to get used to the feeding tube before I have 800 other things that I have to get used to.

Nurse Jo Ann pulled out a kit and showed me how everything works. The tube gets changed out every 3 months. I should use the Jevity at room temperature otherwise it can cause a stomach ache. The feeding bag gets discarded every 24 hours. The syringes get discarded once a week. A feeding can be as fast as 10-15 minutes or could take as long as an hour every time. She told me to start slow and then slowly decrease the time to see what I'm comfortable with. I'm going to start out "eating" 3 cans on Thursday, then 4 cans on Friday, and then bump up to 5-6 cans on Saturday. They then want me eating 6 cans every day until surgery. This is on top of the 3-4 CBD's I've been drinking. She doesn't want me to stop doing those because a) it's extra nutritional intake which is good and b) she wants me to keep swallowing. One of the reasons Dr. A decided to forgo the feeding tube the first time around is because a lot of problems occur from not swallowing more than just your spit on a regular basis. I even got to take home a goody bag. Nurse Jo Ann sent me home with 6 cans of Jevity just to make sure I had some on hand. Once I'm discharged on Thursday, a nurse will be paying me a visit at home to give me more training and a supply place will be dropping off numerous cases of Jevity for me.

As it turns out, the ugly long tube hanging out of my stomach will only be for the first 3 months. They then put a 'low-profile' tube in that is flush with my skin and won't really show much under clothing. I was pretty excited about that. I had read on the web that the tube only has to be changed out like once a year but Nurse Jo Ann said I will be getting mine swapped out every 3 months.

Dr. V talked about the flap that they will be taking from my right thigh. The incision length that he showed me was twice the length that I was shown previously. He also said that if they end up needing more flesh to graft that they may need to take some from my pec. He's hoping they don't have to do that but he wanted me aware so that if I wake up with stitches in my boob, I'll know why. Also, he's not sure I have any viable vessels left to use on the right hand side of my neck so they may have to re-open the left hand side of my neck to 'hook up' this new flap.

Dr. V couldn't really answer my question about the likeliness of me needing pain meds or not after this surgery. His only advice was to definitely take them if I need them but I don't have to.

I handed off a list of phone numbers to Nurse Jo Ann. I told her that Justin will be the main contact once surgery is complete but I listed about 10 other people who are authorized to call in and get information about me.

Okay, that's about all that I can remember from this morning's appointment. After meeting with Dr. V, I was introduced to the speech/swallowing specialist (Michelle), then I had to go someplace else to give numerous vials of blood, then I had to go to yet another part of the hospital to pick up some barium that I will need to drink tomorrow night. H and I finally made our escape around 11:00 am this morning.

So, here's how the upcoming activity lays out:

Tuesday 8:00 AM - Meet with the anesthesiologist
Tuesday 8:00 PM - Drink Barium
Wednesday 11:30 PM - Report for surgical implant of feeding tube
Thursday PM - Get discharged from hospital, wait for visiting nurse and supplies delivery
Friday 3:00 PM - One last appointment with Dr. M
Wednesday 2:30 PM - Call to find out what time surgery is and last minute instructions.
Thursday - D-Day

 I would write about fun stuff but it's time for some pain meds and then I'm going to lay down and take a nap so that I have some energy for baby doll's quick visit tonight before he head's out to see his daughter. I can't believe that naps have become such a normal occurrence for me. I would blame it on Scott because he's a huge fan of the weekend naps but I find myself taking them without him more than with him nowadays. <sigh> Guess I'm just getting old. ;-P

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