This is Neil once again. I apologize for not posting again until now and leaving everyone hanging. So first things first, April is well.
April’s surgery took almost 2 hours and it was after midnight when the doctor came out and spoke with me. She told me the surgery went great and she had no issues. She also said that the surgery was most definitely warranted. The average cecum is about 4cm in diameter, but April’s on the CT was measuring 9cm. The doctor said that her cecum was quite impressive and even bigger than what the CT showed and it definitely needed to come out because it was getting close to the point of either rupturing or becoming ischemic causing dead bowel. The doctor said she ran her bowel and everything else looked healthy and normal, and that April had plenty of large bowel left so she should not have any issues going forward with nutrient absorption.
It was about 2am when April was transported from the recovery room back to our room. She had an NG tube placed (nasogastric tube), which is a tube that goes into her nose and down her throat into her stomach. It is hooked up to suction and basically just sucks out the gas and any fluids (mainly bile) from the stomach and small intestines.
It was a rough night. Since she couldn’t take any oral meds everything had to be IV, which is okay but that means none of the meds will be long acting. Originally they wanted her only on some IV Tylenol and the lowest dose of dilaudid that she would have to push a button for every 15 minutes. I knew this wouldn’t fly since she was on some serious meds for her scoliosis surgery. So after about an hour of asking for the appropriate level of meds I told the nurses, who were awesome with helping me, call the doctors from spine and colorectal and tell them to discuss with one another what she needs. They put her on some more appropriate meds and she started to feel better.
At 4am her pain started to get better and she fell asleep so I was able to sleep. Around 7am the doctors came rounding and I asked them to get the pain management team involved because her pain still was not controlled. They ordered some IV lidocaine as a continous drip and it did the trick. After a couple of hours her pain was back down to manageable levels.
Around 2pm our two girls came to visit with April’s mother and it was a welcome distraction. The girls brushed her hair and massaged her legs and April was feeling better. During their visit April started to have hallucinations, most likely caused by the IV dilaudid. The hallucinations were fun ones where she was happy and they were about the girls and the girls thought it was funny.
After the girls left the nurse was given the okay from the doctor to take out April’s NG tube which was a relief since they are super uncomfortable. April did not like they way it felt on the way out but she was relieved to be rid of it. At this point in the night April’s hallucinations became increasingly more vivid, frequent, and they became very dark. She started having some real bad hallucinations and would come out of it shaking and making all of her muscles in her body spasm and become tight, which in turn started causing a lot of pain. April really started “freaking out” but she did know reality from the visions at least, and she decided not to use her button for the pain meds anymore because she couldn’t take all the hallucinations. I had the pain team paged and a pain management doctor came down to talk with us. He reduced her dilaudid and gave her some anti anxiety meds to get her to calm down. After about an hour or so, about 2am this morning, April’s hallucinations were still there but they became a little more manageable and they weren’t of the dark nature. She finally fell asleep around 4am.
At 6am the spine team came and rounded on April to check in, then about an hour later the colorectal team came to see her. I was concerned about April’s nourishment and weight, as were they. She is already a very slender person and she has lost a lot of weight, and the people that truly know April, know that she can eat, and eat a lot. April is just one of those people with a crazy metabolism. The doctors decided to let her have clear liquids so she could start taking her oral pain meds which are much longer acting and less likely to cause hallucinations. April took her first round of oral meds and about an hour later it was time for PT. April sat up, but became instantly naseous. She ended up throwing up some bile and after sitting for a couple of minutes to compose herself she stood up. April was even able to take a few side steps with the assistance of the therapist. She is such a strong person. I don’t know anyone who could, 5 days ago, have a massive 11 hour scoliosis surgery where they lost 7 liters of blood, follow that up by not be able to eat because their bowels are twisted causing an insane amount of distention and pain which led to an emergency bowel resection and then 30 hours later, with no sleep, instead living a perpetual nightmare for hours, be asked to try and stand and walk, and oh ya throw up, then stand up. The therapist even told April “you don’t have to do this, you can lay back down and we’ll try again later.” April just looked at her and shook her head and said “I’m fine, I want to get up, I have four kids, I want to get better.” She is so strong and it was so emotional for me to watch her go through all this shit the past week and still have the strength and the will to get better and get back to her kids. I love her so much, she truly is a badass.
One more thing, just now we had a delivery of flowers from my Grandma Rae and April’s cousin Ann and family. Thank you so much, April loved them and said they were beautiful.
Here are a couple pics of April’s back and her abdominal incision followed by a couple more pics of April and the girls