Ma was transferred to a regular room yesterday. The nurses had set aside a private room for her. All her previous rooms had been private (or semi-private but no roommate), but her new room is the biggest room in the unit. The bathroom is large enough for wheelchair users. It's nice to have connections. Did I mention I'm glad Dorothy's back? :)
Ma's pain is under control. Around breakfast time she had bad pain despite both the Toradol and Dilaudid, but Darvocet brought it under control. The rest of the day, Toradol kept her comfortable enough that she hardly used the Dilaudid (on PCA). I don't know why her doctor didn't do this kind of pain control for her after her first surgery. It would have kept her more comfortable.
Some friends visited with Ma early in the afternoon. Then Ate Vicky & Ate Beth arrived with Tita Belen and Tito Pepe. They brought dim sum. Yum! I mean, Ma said they were delicious. I wouldn't know.
Monday, June 30, 2008
Sunday, June 29, 2008
Cirrhosis
Ma was in surgery from 7:50-9:30 Saturday morning. That's twice as long as her first surgery. The surgeon, Dr. Stanten, said that Ma's CT scan showed she has liver cirrhosis, and that's probably what's causing the fluid build-up. The fluid is pushing through her diaphram and into the lung area.
For now, Ma is in the CPU (Cardio-Pulmonary Unit), similar to the ICU. She has two tubes coming out of her chest again. This time she has a PCA (Patient-Controlled Analgesia), a device that lets Ma self-administer her own pain medication with a push of a button. She is getting Dilaudid through the PCA. She was given Zofran for nausea just once, so I told her to tell the nurse immediately if she starts feeling nausea after the Zofran wears off. In addition, she gets shots of another painkiller called Toradol every few hours. Between the PCA and Toradol, maybe she'll have better pain control this time.
Ate Eva & Raymond stopped by with some food -- lugaw, okoy and pancit palabok. Ma is on a liquid diet though and was really disappointed she couldn't eat the food.
Kit flew home yesterday. Since we knew Ma would spend most of the time sleeping right after surgery, Pa & I took went ahead and took Kit to the airport ourselves and kept her company till it was time to go through security. The food at the International Terminal is actually pretty good. We had lunch over there -- noodle soup with BBQ duck, unagi bowl, and sushi (soft-shell crab, unagi rolls and salmon skin rolls).
I failed to mention before that Ma's previous CT scans and PET scans showed cirrhosis. No one ever suggested doing anything about it, maybe because her breast cancer is more important. Ma has tested negative for hepatitis, so I don't know how she ended up with cirrhosis. Hmm, is Ma a closet drinker??? The only symptom she seems to have is edema. Maybe she can see a liver specialist on Monday.
Here's where I get confused. Ma's breast cancer did not cause the cirrhosis. The cirrhosis caused the pleural effusion. Her pleural effusion is probably not malignant then, just as her tests always indicate. Does this mean all these problems she's been having have nothing to do with breast cancer?
For now, Ma is in the CPU (Cardio-Pulmonary Unit), similar to the ICU. She has two tubes coming out of her chest again. This time she has a PCA (Patient-Controlled Analgesia), a device that lets Ma self-administer her own pain medication with a push of a button. She is getting Dilaudid through the PCA. She was given Zofran for nausea just once, so I told her to tell the nurse immediately if she starts feeling nausea after the Zofran wears off. In addition, she gets shots of another painkiller called Toradol every few hours. Between the PCA and Toradol, maybe she'll have better pain control this time.
Ate Eva & Raymond stopped by with some food -- lugaw, okoy and pancit palabok. Ma is on a liquid diet though and was really disappointed she couldn't eat the food.
Kit flew home yesterday. Since we knew Ma would spend most of the time sleeping right after surgery, Pa & I took went ahead and took Kit to the airport ourselves and kept her company till it was time to go through security. The food at the International Terminal is actually pretty good. We had lunch over there -- noodle soup with BBQ duck, unagi bowl, and sushi (soft-shell crab, unagi rolls and salmon skin rolls).
I failed to mention before that Ma's previous CT scans and PET scans showed cirrhosis. No one ever suggested doing anything about it, maybe because her breast cancer is more important. Ma has tested negative for hepatitis, so I don't know how she ended up with cirrhosis. Hmm, is Ma a closet drinker??? The only symptom she seems to have is edema. Maybe she can see a liver specialist on Monday.
Here's where I get confused. Ma's breast cancer did not cause the cirrhosis. The cirrhosis caused the pleural effusion. Her pleural effusion is probably not malignant then, just as her tests always indicate. Does this mean all these problems she's been having have nothing to do with breast cancer?
Saturday, June 28, 2008
Photos 6/27/08
Ma & Kit. You can see the Pleur-evac (the canister connected to Ma's chest tube) in the left foreground.
Ma & Pa
(Clockwise) Isa, Kit, Ma & Lou
Friday, June 27, 2008
Repeat Surgery Tomorrow
Ma is scheduled for surgery at 7:30am tomorrow. She had a CT scan of her chest this afternoon. The ultrasound yesterday didn't show anything abnormal. The surgeon was concerned that Ma might have ascites due to the amount of fluid she's producing, but the ultrasound was negative.
The fluid has been draining into a canister that holds 2.5L. It took 4.5 days to fill the first canister, 29 hours to fill the second canister, and 27 hours to fill the third. She's on her fourth canister. The surgeon said he's never seen anyone with so much fluid. I hope tomorrow's surgery works because I don't think the surgeon knows what else to do. There is something called a Pleurx Pleural Catheter that allows you to drain the fluids from home, but the amount of fluid Ma produces would overwhelm the system.
The fluid has been draining into a canister that holds 2.5L. It took 4.5 days to fill the first canister, 29 hours to fill the second canister, and 27 hours to fill the third. She's on her fourth canister. The surgeon said he's never seen anyone with so much fluid. I hope tomorrow's surgery works because I don't think the surgeon knows what else to do. There is something called a Pleurx Pleural Catheter that allows you to drain the fluids from home, but the amount of fluid Ma produces would overwhelm the system.
Thursday, June 26, 2008
Possibly More Surgery
One of the thoracic surgeons stopped by. He said if Ma's fluids don't clear up by tomorrow, she will need surgery again. It's going to be the same procedures as before -- VATS and pleurodesis. This afternoon she had an ultrasound done on her abdomen. I don't know what the doctor expects to find.
I don't like Ma's new day shift nurse. Maybe she was just too busy today, but she seems easily flustered. This morning, it took her almost two hours to give Ma her pain medication. Then she gave Ma the antibiotic IV for another patient. As Ma pointed out to her, she should have checked the name on the IV bag against Ma's ID bracelet. I know she was busy, but isn't that why they have these cross-checking procedures -- so that they don't make mistakes like this especially when they're busy? Fortunately, the other patient's medicine is the same as Ma's. Nevertheless, if they assign her to Ma again tomorrow, I will ask for another nurse.
There was a little excitement today. As I was walking down the hall, the fire alarms started ringing, and the intercom announced, "Code Red, Code Red!" Doors everywhere started closing automatically. I thought I was trapped in the hallway, but the doors were actually unlocked, and I managed to get back to Ma's room. Ten to fifteen minutes later, the All Clear was given. It turned out the alarm was triggered by someone smoking on the first floor.
I don't like Ma's new day shift nurse. Maybe she was just too busy today, but she seems easily flustered. This morning, it took her almost two hours to give Ma her pain medication. Then she gave Ma the antibiotic IV for another patient. As Ma pointed out to her, she should have checked the name on the IV bag against Ma's ID bracelet. I know she was busy, but isn't that why they have these cross-checking procedures -- so that they don't make mistakes like this especially when they're busy? Fortunately, the other patient's medicine is the same as Ma's. Nevertheless, if they assign her to Ma again tomorrow, I will ask for another nurse.
There was a little excitement today. As I was walking down the hall, the fire alarms started ringing, and the intercom announced, "Code Red, Code Red!" Doors everywhere started closing automatically. I thought I was trapped in the hallway, but the doors were actually unlocked, and I managed to get back to Ma's room. Ten to fifteen minutes later, the All Clear was given. It turned out the alarm was triggered by someone smoking on the first floor.
Wednesday, June 25, 2008
Breathing Exercises
I just found out that wi-fi is available at the hospital. Woohoo! The other hospital didn't have it, and neither did the other hospitals I've visited in the area, so I assumed Summit would be the same way. I'm happy to find out otherwise.
The physical therapist made Ma walk without a walker. She was able to do it with a little help. Hopefully she'll be able to walk unassisted by the time she goes home.
The amount of fluid draining from Ma's lung is worrisome. Her surgeon is on vacation. Maybe we can catch his backup tomorrow and ask him about it.
Her nurse ordered an incentive spirometer so that Ma can exercise her lungs. I thought they usually give you one right after surgery. I don't know why it took so long to get one. Ma is having trouble getting the hang of it. I run out of breath myself just watching her try to use it. She breathes too fast and seems unable to hold her breath. Kit told her to pinch her nostrils when inhaling, and that seems to help.
The physical therapist made Ma walk without a walker. She was able to do it with a little help. Hopefully she'll be able to walk unassisted by the time she goes home.
The amount of fluid draining from Ma's lung is worrisome. Her surgeon is on vacation. Maybe we can catch his backup tomorrow and ask him about it.
Her nurse ordered an incentive spirometer so that Ma can exercise her lungs. I thought they usually give you one right after surgery. I don't know why it took so long to get one. Ma is having trouble getting the hang of it. I run out of breath myself just watching her try to use it. She breathes too fast and seems unable to hold her breath. Kit told her to pinch her nostrils when inhaling, and that seems to help.
Tuesday, June 24, 2008
Still Draining
Ma's remaining chest tube is still draining her lung. Unfortunately, it shows no signs of letting up. There has been no further estimate on when Ma can go home. I'm afraid her doctor is going to say that the pleurodesis failed again, and she'll need more surgery.
Other than the fluid, Ma is doing well. They're making her walk around the cardio unit 4x a day. She's able to use the toilet instead of the commode, and she brushes her teeth at the sink. And her appetite is good. Kit sneaked in some fried quail and boiled peanuts for her today.
Other than the fluid, Ma is doing well. They're making her walk around the cardio unit 4x a day. She's able to use the toilet instead of the commode, and she brushes her teeth at the sink. And her appetite is good. Kit sneaked in some fried quail and boiled peanuts for her today.
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