Update #179

The weekend was full of the "art form" of pain control. Saturday morning, Dave was miserable again. Pain was at an eight on a scale of one to ten, and the Pain Management "Team" consisted of one resident trying desperately to figure out how to at least relieve the worst of Dave's pain. Up with the dilaudid - both a bolus (one time larger dose boost) and an increase in Dave's PCA (personal control button) - and by 6:00 p.m. he was out of bed for the first time and in a chair.

Sunday morning, more pain. For some reason, it took us all that long to figure out that because the majority of Dave's dilaudid was coming from his PCA, and because most people are not capable of pushing a button every six minutes in their sleep, Dave was waking up with almost none of the most effective pain meds in his system. Another bolus, plus the addition of small continuous amount of dilaudid in addition to the PCA and the epidural (which never seemed to do much), and Dave was up and walking the halls, dragging a pole full of pumps and meds, Sunday afternoon.

Throughout this entire process, Dave was also dealing with the constant joy of an IV that just wouldn't stay put. One thing we've learned over the past year is that Dave's veins are almost impossible to stick. On Wednesday during the surgery, he had an IV in both wrists, one to receive meds, etc. and one as a backup. On Friday, the first IV started leaking, so the nurses switched the line to his other wrist. Fortunately no needle stick that time. Saturday night, Dave's left hand started swelling, a sign that the IV fluids were not going into his vein, so the IV was moved to his right elbow - according to one of Dave's nurses, the "lazy man's IV" because the vein is easy to hit, but the placement of the IV is extremely annoying the patient. Sure enough, less than 24 hours later, the needle in the IV was bent because of the movement of Dave's arm, and off to the right forearm we go. 12 hours later, Dave's hand was no longer swollen, but his left forearm made him look like Popeye - another missed vein, another removed IV. This time, however, there were no veins left. After three different nurses tried four different sticks, Dave told them to leave him alone (very politely, of course) and find another way to give him his meds.

So today, he's back on Oxycodone pills, off his IV, and as of 10:00 this morning, epidural free! The best news - assuming he doesn't experience withdrawal from the epidural meds, we should be heading home late this afternoon or early this evening! Like Dr. Muskat and Dr. Kitzmiller predicted, one week, and Dave is doing even better than they could have hoped. His incisions are healing nicely, his pain is almost under control, and unlike with his femur surgery, he is walking fairly long distances with very little problem.

Thanks again for all the prayers, emails, texts, phone calls and general support. On the whole, this has gone about as well as any major abdominal surgery could go. Continue praying that Dave's pain will remain under control as we go home and that the recovery goes quickly and smoothly from here on out.