Will it be happy?

Today, we don't have any major news.  However, over all, things seem to be moving in the right direction.

First, Matthew got to lose his catheter today.  One less tube!

Second, although he is not fever free, it does seem to be trending down.  His temperature is not stable, but was 98.4 around 1pm, 100.5 at 3pm, and 98.4 at 8pm.  At least it seems be trying to move down.  None of his cultures (and they culture everything), is growing anything.  So the temperature is a bit of a puzzle. His pain also seems to be down a bit.  He was on the maximum dose of his pain pill every two hours and a pain shot every four hours. Today at 1:00 he had only had 1 pain pill and 1 shot since 4:30 in the morning.  He is still having some spikes of pain in the 8 to 10 level on the pain scale, but overall it seems better.

His chest x-ray today looked good.  He is scheduled for a CT scan tomorrow.  The drains have slowed to a trickle, so it is possible they may decide to pull one after the scan tomorrow.

They are losing one of the doctor's on the case, as she is rotating to a different unit.  Hope that her replacement is just as good!

Although Matthew seems to be improving, his mood is not.  He seems to be running low on emotional reserves.  Tomorrow will be his 33rd birthday.  I will be more than happy to share any wishes, forward any emails, etc.... from anyone that has birthday wishes for him.  I am sure that his main wish is to feel better and get out of that joint!!

Emily sent this to me yesterday, and since then, I have seen it on several people's Facebook pages.  So forgive me if you have seen it, but it seems kind of appropriate right now.  Today's improvement makes us hopeful that tomorrow will be better (and Happy!)!

Afternoon Update

I got most of this information from my Dad earlier this afternoon.

Dr. A came by at 1:00 PM.  Dad wouldn't accept a simple “We have to wait and see” answer.So he got him to be explicit about the decision criteria associated with the tubes.  This is the information from that conversation.

First, the two tubes are in different places, one above and one below the diaphragm. The tubes did what they were supposed to do – a big initial gush followed by a slow trickle.

One of the tubes is in the liver cavity. What we have to watch for on that one is for a greenish fluid – bile. The bile watch will go on for about 3 days.  The bile complication rate is low, 1 in 20. And even if he gets a bile leak it can usually be fixed endoscopically, no need for another slice and dice.

His fever went down to 98.6, but now has returned to 101.1 and  his heart rate had decreased as well.  His heart rate had come down to 95 while resting, but currently is still sitting around 125.  This is my nonprofessional input, but I am sure the stress to his body, pain, fever, etc...is driving his heartrate up.

I thought a little humor might be helpful...this what all the nurses say...

Yuck!

Matthew came out of his procedure with not one, but two drains.  Some of the update below is from earlier today...

Mom talked to Dr. A (the chief surgeon) a little before Mom and Dad swapped at 5pm, and Dad talked to Dr. R (his other surgeon) earlier this evening.

The drainage tube team did a complete CT scan before starting and then did the procedure while he was in a CT machine. The second drain tube was a surprise. I asked Dr. R. about it and even she didn’t know for sure exactly why the second was inserted because the drainage team (a drainage team...yuck!)  hadn't entered their case notes yet. It could have been because they spotted some additional fluid accumulation outside his lungs, or it could have been because the fluid accumulation was so big that they wanted to drain it from both the top and bottom. Dr. R. did say that neither of the drainages looked like what you usually get from around the lungs. And right now the upper drain bag is way ahead of the lower drain bag – 400 ccs to 200 ccs.

Matt is still uncomfortable but is still doing a lot  better than on Monday. His biggest pain issue at the moment

is hic-ups. And this afternoon he finally got a therapist to do a back massage. I had been pushing for that since

Monday. His back muscles were cramping  up so badly that his back hurt as much as his front. But the setup for this is a little weird. The therapists that can do this are actually on the MDA staff, but treating surgery patients is outside their official duties and they do the surgery patients voluntarily when time is available.  I guess we can’t complain to much about that since back massages aren’t routinely part of post-surgical care (or even needed i n most cases).

For the procedure, Matthew was sedated to the max you can be and still be conscious. The relatively high sedation level was necessary in case they had to add a breathing tube (he didn’t need one). Matthew reports that  he had a pretty vivid dream/hallucination  as he was coming out of the procedure. He was in the car and we were driving up here to MDA – but we had some parrots with us! And they were eating worms (or maybe grubs).

The discharge time line depends on how quickly the drainage dries up. They will probably not pull both tubes on the same day, though.

I spoke with my Dad a little while again.  He reported that overall, Matthew seemed to be a bit more comfortable.  However, he was having spikes of pain.  The drainage (I know yuck!) had slowed quite a bit.  My dad said that they pretty much all feel about like the cartoon below.