So surgery went pretty well. They took out over a third of my colon, about half my rectum, several pounds of lymph/soft tissue, my uterus and my cervix. Apparently the surgeon couldn't get my descending colon to reattach to what was left of my rectum, so she had to remove the whole descending piece and reattach the transverse colon. So, as I understand it, my colon now goes up and then comes right back down again in an inverted V-shape, rather than up and over and then down like everyone else's.
I don't remember much of the first few days in the hospital, because I was on very heavy drugs. I do remember being terribly itchy from the dilaudid in my epidural, so they took the dilaudid out and gave me a morphine pump. Very early every morning the team with all the students would come by and spend maybe 2 min talking about me, rarely to me. There was a very nice doctor on the pain team who would stop by later in the morning - I really liked her and she seemed to be actually invested in me unlike the attending and the residents. Mostly I slept a lot. My mom was there most of the time to keep me company, which was great. And Greg was there a lot of the time as well. It was so much easier being in the hospital with folks to talk to. Whenever I was awake and no one was around it was very lonely. We went ahead and sprung for nice Bose noise-cancelling headphones, and they were SOO worth it. I could listen to music or watch hulu on my ipad without having to deal with all of the ambient noise of the hospital. I found them even easier to fall asleep with than my regular earplugs (because my regular earplugs amplify my heartbeat and breathing sounds so much). I got lots of IV benadryl for the itching, so I didn't have trouble sleeping most of the time.
The nurses were great, but I do wish there was more continuity. I think I had the same day nurse once and the same night nurse twice, but other than that it was a new nurse every day and every evening, which was a little confusing. It seemed unnecessary as well, as often I would see the nurse I'd had the day before on the floor but assigned to a different patient.
Measuring urine output was a big deal in the hospital. For the first few days when I had a catheter (because I couldn't get up to go to the bathroom) it was fairly unobtrusive, they'd just check how much urine was in my lovely catheter bag and write it down. After I got the catheter out, on day 3 I believe, then whenever I wanted to go to the bathroom, I'd have to alert my nurse to put my "hat" in the toilet (the "hat" was a white plastic thing that looked like an inverted top hat with measuring lines in it), and then alert them again when I was done so that they could measure and empty it. Initially, this was not a big deal at all because I couldn't get out of bed or move 10 ft without assistance, so I'd have to page the nurse anyhow. Towards the end, however, when I was more mobile, it was quite a drag to have to page the nurse and wait for her to show up and whatnot. Also, I have never had so many people interested in my farts before! Apparently passing gas is a big milestone after bowel surgery, so every day at least six or seven people would ask me if I had passed any gas. When I finally did, my nurse literally applauded.
The first evening after surgery, I had a really rough time. I had been NPO since midnight the night before (no food or liquids) and was still not allowed to eat or drink anything, even tiny sips of water. Unfortunately, when they intubated me for the general anesthesia, they nicked my uvula (the tiny flap of flesh that hangs down in the back of your throat), so it was elongated and swollen and was resting on the back of my throat. This was causing me to gag repeatedly (basically any time I tried to talk, swallow or breathe through my mouth I would gag), which was extremely painful because I was contracting my abdominal muscles every time I gagged. Eventually, it got so bad that I was sobbing and hyperventilating and barely able to ask for something to numb my throat. So many doctors were called in, everyone was freaking out; they even brought in a crash cart. All I remember is getting hysterical that no one would get me some chloraseptic to numb my throat so that I could swallow without causing myself excruciating pain due to gagging. Eventually they figured it out and I got my chloraseptic and sure enough, I was fine afterwards, but it was apparently VERY scary for poor Greg and my mom. The only liquid I was allowed were these sponge swabs that could get dipped in water and then run over my tongue and gums to try and keep them moist. There was never enough liquid to swallow, which only made the gagging that much worse. I believe I wasn't allowed to actually drink liquids until day 3, but that first glass of apple juice was just about the tastiest thing I had ever consumed.
For several days I was on clear liquids only. So all meals consisted of broth, juice, jello and frozen lemon ice. After I finally passed gas, I was allowed to start on solid food, around day 5. The hospital has a rather insane menu of things to choose from and it's like room service: they deliver it right to your room. Unfortunately, everything I tried from their seemingly huge menu was rather terrible. I know they always say hospital food is terrible, but they had such diverse options I couldn't believe it would all be bad, but it was. By the last day, there was nothing on the menu that sounded in any way appealing, but they wouldn't discharge me until I ate something. Thankfully Greg's dad volunteered to go get me a sandwich from Au Bon Pain nearby, so that I could have something appetizing to eat to satisfy my keepers that I could go home.
The transition off of the morphine pump and on to oral painkillers was the other horrible piece. When I had my clot, my doctors initially treated the pain with more and more oxycodone, until I was taking 20-25mg/dose and at that level it lead to projectile vomiting. When they announced that they were going to transition me to oxycodone, I explained that a month ago I had been on oxycodone and it hadn't gone well, so they eventually had to switch me to MS Contin (continuous release morphine sulfate). But it didn't matter - they were going to start me at 5mg of oxycodone and see how I did. Unfortunately, the 5 mg of oxycodone was completely insufficient to tackle my pain, as was 10mg, 15mg, and 20mg. The nurse finally got approval to go up to 25mg in the middle of the night, and then I promptly threw up maybe 10 min after getting my meds. Let me just say that throwing up after major abdominal surgery is perhaps the most painful and horrible thing you can imagine. Throwing up is miserable regardless, but then the overwhelming pain from my incision made me even more nauseous than I'd been before, creating a vicious cycle that lasted for what seemed like forever. But because the nurse didn't see the oxycodone pills in my vomit, she couldn't give me any more drugs for several hours (because the oxycodone may have been absorbed). That was definitely the low point of the entire experience. And crying hurt like hell, but I couldn't stop myself, so I was just a crying, screaming, vomiting mess that night. Eventually, they were able to give me some more benadryl and put me back on the IV morphine so that I could get some sleep (it was probably 4 in the morning by this point).
The next morning, when the team came through, I explained again about my previous experiences with oxycodone and how well MS Contin had worked for me, but they insisted on putting me on oral dilaudid first. And the oral dilaudid knocked me out so I basically don't remember that day at all. And I'm missing something, because that night I threw up again, and finally insisted on MS Contin, but the resident wouldn't give it to me because I was in "acute pain" and MS Contin was a long-acting drug (each dose lasts 12 hrs). The argument that a) I've tried everything else they wanted to throw at me and have thrown it back up, b) MS Contin has been proven to work for me, and c) there was a 0.0005% chance I wouldn't be in pain in 12 hrs had no sway with this resident in the middle of the night. I'm sure I was very nasty to him, but I still don't understand why someone couldn't have made that happen for me. But I did convince him that morphine was the way to go, so then I got MS IR (instant release morphine sulfate), which is basically the same thing as MS Contin but with a shorter half-life. But spending two nights throwing up because the powers that be felt like I should go through their standard procedure was exceptionally frustrating.
Can you tell my memories of this time are all jumbled? They don't go in chronological order at all. So I apologize for the jumbled nature of all of this.
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