Mom checked herself out of the hospital on Tuesday, June 25th. She was so ready to come home! She left the unit at the hospital with all the nurses cheering for her, their Whipple Poster Child!
We had been told she would be getting released early afternoon so Kim and I made plans to go pick her up at 11am. At 8:07am we received a text: "Are you guys on your way? Let's go!". I rushed out of the house, picked up Kim and we were on our way. Next text from mom: "Going to pharmacy. Will meet you outside." I guess someone was in a hurry!
We arrived home an hour or so later and mom quickly made herself comfortable in her very own bed; so happy to be home.
That evening and the next day proved fairly uneventful. Mom was taking things slowly, lounging around, reading, watching TV and sleeping.
The night of Wednesday, June 26th, things started to change. I was getting ready to head to bed and mom came up the stairs saying that she seemed to be leaking at the incision site and after talking to Kim it was decided to head to the Emergency Room at the Maple Grove Hospital, where Kim would meet us. After a visit with the ER docs and nurses it was decided that there wasn't much to do but monitor it, keep the wound clean and get mom started on some antibiotics to ensure an infection wasn't brewing. We left and headed home, stopping at the 24-hour pharmacy to fill a couple of prescriptions.
Thursday, June 27th, Michel took Nan to Kim's clinic in Maple Grove where Kim planned to change the bandage, re-pack the wound and send mom on her way. What Kim found when she opened up the bandage though was not what she had expected. The wound had gotten much larger and Kim thought she could clearly see the bowel (yes, the bowel)! One of Kim's fellow OB-Gyn's came to take a look and agreed, this was not normal. Kim got on the phone with her medical school buddy turned chief surgical resident who instructed Kim to get mom to the U of MN ER as soon as possible so they could take a look.
After a long afternoon at the ER mom's regular surgical team decided basically the same thing they had said the night before: Pack the wound, might be a hernia but would need to repair that later, didn't seem to be a leak or any other issues. Call if any changes.
Friday, June 28th, is a bit of a blur. I got a call from Kim about 7:30am saying that Mom needed to go to the ER, she had been vomiting and in pain most of the night. I immediately headed downstairs to find mom laying on her bed. I asked what was going on and she said she had been "projectile vomiting" since 2am and was in a lot of pain. I told her I was going to get her to the ER where her surgical team was waiting for her. I went to help her up from the bed and she screamed in pain. She couldn't get up which meant I couldn't drive her to the ER.
911: We needed an ambulance. The drive to the U of MN seemed to take forever. Every bump we went over I could hear mom moan and this was after a dose of Fentanyl for the pain. Kim was waiting for us upon our arrival. We spent all day in the ER with what seemed like cup after cup of green chunky fluid leaking from mom's incision. After a long-awaited CT with contrast we were told there seemed to be a leak in the bowel (hence the green chunky fluid) but they weren't sure where it was exactly. They would need to go in and find the leak and hopefully repair it.
A few hours later we were back in the family surgical waiting lounge. This time it was only a short 2 and a half hours later that Dr. Vickers appeared to tell us that mom was out of surgery. The leak was at the junction of where they had put two parts of the bowel back together after the Whipple surgery. It seemed the sutures under the skin in the fascia had come out completely; the fascia seemingly disintegrated. Dr. V wasn't sure how this could have happened and hadn't ever seen anything like it; he speculated that maybe it was all those years on a harsh drug like Methotrexate but couldn't say for sure. Either way, because the sutures in the fascia had come out, the bowel had kinked, become blocked and caused the vomiting. The pressure from the kink had also caused a small hole which they had successfully repaired. Due to her fascia being so weak they had sutured it closed as usual and then used what is called "retention sutures" to apply the pressure of the wound to the skin and muscle rather than the fascia.
These retention sutures are like something out of a science fiction movie. They are basically plastic tubing laying on top of her skin, parallel to the incision (which is left open to heal). The plastic tubing is then stitched through her skin, muscle, fat and fascia. These will be left in for 2-3 weeks until we are confident that the fascia has healed. Dr. V explained that mom would spend a few nights in the ICU to ensure her blood pressure and vitals looked good. She was also now on a feeding tube so that we could give her bowels a rest. He said the pain would be worse than before and we would find a way to manage it for her. We breathed a sigh of relief that she was at least out of surgery and headed to see her.
She was in pain, groggy and uncomfortable. The ICU nurses quickly set about their tasks of making her as comfortable as possible, getting her pain under control and getting her to rest. We left our phone numbers and told them we would be in the family lounge just down the hall if they needed anything or if her status changed.
You'd think the ICU would have comfortable family lounges with cots and recliners since so many family members don't want to leave their loves ones alone all night. Not so. In fact, the chairs and couches in the surgery waiting lounge were more comfortable! Needless to say, neither Kim nor I were going to let comfort stand in the way of staying the night to be sure Mom was okay and nothing happened. We tucked ourselves in for a pretty sleepless night and hoped tomorrow would be a better day.
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