Monday, June 20, 2011

Not Easy.


Not easy!

Recovering from the May 24 escape from Cancerstan has not been easy and communications from my end difficult…in fact this is written under the cover of some painkillers.

So yes, this is the first message in about three weeks.  Most of our time has been spent in drug assisted R & R at the Wish spa in the village of Portland.  Been spending lots of time counting the time to the next drug hit along with recording each output of liquid and near liquid from this wounded body.  Several times, I have left the spa to see local doctors along with one short trip to attend a presentation on Nicaragua.

In case you are interested, in the paragraphs below, mostly in chronological order, are some of the details of the recovery thus far.
Sleep has been the big happening these past many days.  I remember little of the first week of June except it was pretty much a continuation of being cared for by those expert nurses & family members Mary Ann and Annie. After Annie departed June 7, my worry about excess fluid in the surgically implanted “drain” let me to the surgeon’s assistant who on June 9 removed abdominal staples told me that perhaps my new drain pipe (aka “Ileal conduit”) was leaking urine into the abdominal cavity but if so it could be repaired with a short visit back to surgery.  Wonderful, that only added to my worries of real and imagined complications.  And, worry as many of you know, leads me to every more thoughts and obsessions.  June 14 was the official first post op during which time the two-meter long kidney catheters were quickly YANKED …yikes.  Bracketing that fun time, were two trips to the Ostomy clinic where Susan, the overworked and harried nurse, replaced my bag not once but twice as the first began leaking in just two hours.   A new appointment was set for two weeks as they were so busy couldn’t see me before then.   
(Sidebar:  The bag and the attachment mechanisms are   designed to be replaced every 4-7 days.  For more information see: http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/Ostomies/UrostomyGuide/ Yes, I continue to worry of another leak…most likely at inconvenient times.  Oh yes, Portland’s Ostomy nurse specialists are available only during regular M-F office hours and we were advised that few nurses or docs in emergency rooms have any recent experience in dealing with such issues…In USA there are Ostomy nurses available by phone IF we are on their subscription plan for the ongoing expendable supplies.)
Next day was our second visit to the medical Oncologist, Dr. Marcus Braun who reviewed the surgery, the pathology report (stage 3a, N0, M0 ) wants us back in three weeks to determine whether the body will then be recovered enough for setting a start date for a likely recommended four rounds of Chemo consisting of three weeks each
With plus or minus three weeks between courses.  Also, Dr. Braun discovered angry skin near the bag and suggested we visit an Ostomy nurse.  ---Called to see if we could get in but could find no room at that inn.  (See above)  However, another hospital’s Ostomy nurse did graciously allow an appointment 3pm Friday.
(Sidebar:  IN the meantime, we will be trying to find a Palliative Care specialist who will advise our options as bladder cancer is not very susceptible to Chemo AND around half of us cancerstan bladder neighbors have over 50% survive five years in any case.) 
Friends continue their visits (as controlled by Mary Ann, scheduler)

Thursday the surgical drain was pulled and so now a collection bag is hanging on the right side only.  J    Friday morning, June 17, urine began leaking and so Mary Ann tried a bag replacement and we found skin and adhesive was in some places seemingly irretrievably connected…so long before appointment time, we headed to the hospital for help from the Ostomy nurse who showed us how to separate skin and adhesive.  She introduced us to and laid on a layer of skin protection/second skin covering and we were all sealed up with a new bag…Weekend was more worry, sleep, visits and on Sunday family dinner fixed by John F., Rachelle and Lisa. 

Revelations continue…
For the next year, extensive tests will be required every three months as well as anytime there is blood in the urine (and I have been told, all radical cystectomy survivors will now and again have blood in the urine.)
A powder & spray combo is available to keep skin from becoming angry or torn.
As I now understand, if we do recommended chemo it make take more than six months. 


Sleep continues to be fitful and episodic.
Through it all, cancerstan continues to teach me.  Slowly, ever so slowly, I have gained some added mobility

Hopefully, this is the week I will combine some more exploring of the local area along with exercises to build up the body. The exercises include walking (beyond the 0.5 mile I’ve been doing the last 10 days), repetitive cycles of leg lifts along with arm strengthening arm exercises of biceps and triceps using 2.5# weights.

That’s some of the news from near cancerstan on June 20, 2011

-30-

Wednesday, June 1, 2011

Out of Cancerstan...really??


Out of cancerstan…but really?

May 24, 2011, while prostrated by Dr. McBride’s epidural, most of me left cancerstan.  Dr. Bruce Lowe and his team kept my bladder, my prostate, an unknown number of lymph nodes, and a little blood. 

Wednesday and Thursday brought Dr. Lowe for short visits, it was Friday when Mandy, Dr. Lowe’s PA delivered the pathologist’s news which seemed both good and bad.
1.    No evidence of cancer in lymph nodes and margins of the (?) tumor were “were clean” BUT
2.    The tumor had penetrated through the muscle into the fat around the bladder.

I was never alone!  J   However, I was not allowed to eat or drink nor leave the hospital until I farted and pooped.  Mary Ann and our granddaughter   the brand new BSN, accompanied me on the trip out of cancerstan.  Fortunately, one or both of them were always there with me at Good Samaritan Hospital room 651.  Over the weekend, added help came from Lisa.  And, because of those three I was actually doing the medically requested hourly deep breathing exercises to clear the lungs along with the four or five daily long walks around the hospital from Tuesday night onwards.  Given help from the ladies of mercy both from the family and the staff those two important and necessary exercises were easily accomplished…however, sleep was difficult.  And, I couldn’t FART.


I lost it twice…Twice, I COULD NOT ACCEPT WHAT WAS.
a.    Thursday (?) the Ostomy Nurse, scheduled to change my new external plastic bladder (AKA urostomy bag) at 10am arrived at 11 and promptly freaked out at the appearance of some greenish/brown sludge within my new external plastic bladder.  She threw up her hands making some comment about me not being her only patient.  She needed advice and approval from the surgeon who was unavailable …around 1pm he showed up in suit and tie and leaning over me, suggested it was probably just some sterilized fecal material that had not gotten completely washed out of the folds within the ileum as they were creating the new ileal conduit.  So, go ahead and change the bag and instruct us how to do so on our own June 1 or 2.  Do watch and report any more strange stuff.  If so, further but “simple surgery” might be necessary.  OH NO!
But the heavens opened and my first guardian angel showed up to accompany me on the journey   
b.    Friday (?) the IV failed (from the doctor ordered (and unneeded?) Potassium drip?  The irritation was painful and producing a red streak up my left arm.  That IV needed to be removed.  My nurse called a nice lady from IV central to insert a new IV on the right hand…it failed, Nice Lady returned a couple hours later and put a new IV on the right forearm.  My nurse continued pushing 100 (ml? per hr.?)  Of the potassium drip…it hurt!  Around 10pm IV central’s night time specialist showed up and an hour and half later, (midnight) got a new IV line…pushing just saline at a rate of 50.  Still had trouble accepting what was.  Finally, with the help of pills and a shot, from Sophie, my second guardian angel I was able to get some sleep.

Saturday daytime appeared and the guts were rumbling and finally I was allowed something more than chipped ice.  I was allowed four ounces of clear liquid every 12 hours.  Rumblings continued, burps began with both helped along by walks. Saturday, evening permissible liquid intake was increased to 500 ml every 12 hours… lots of rumblings…sure sign, I was told, that the bowels were waking. 
Wakeful bowels would soon, I was told produce farts and poops…with farts and poops I could eat drink and go home.

Saturday night fitful sleep…lots of rumblings in the bowels…
No farts no poops.  L

Sunday lots of rumblings…lots of walk…lots of unease….
FINALLY, SUNDAY afternoon I was released from the hospital prison to the good home care of wife, daughter and, granddaughter.