After a week of decreasing output, things reversed themselves on the weekend and it is obvious that the perforation has not healed. I spoke (texted) with Dr. Boudreaux this morning and he wants to delay surgery for a while to ensure that he does not create any more holes while trying to fix this one. I don't know how long it will be but will be waiting another month to get a status.
While we wait, the perforation is doing less than 200ml/day which is not too bad and we are starting a second round of antibiotics to address the infection. I start 250mg of Keflex 3x/day on Tuesday and hope that it takes care of the abscess.
We have increased the protein in my TPN to try and increase the healing and reduce the edema that I still have. We have had to start doing an additional 500ml of saline/day to address dehydration and the protein in the TPN may help push the fluid out of the tissue and back into the veins. If we can achieve that, fluid can then be addressed through diuretics and my unhappy kidneys.
Obviously, this delays recovery more and more. I don't know what we would do if we didn't have such good health and disability insurance, not to mention a company that is just phenomenal. Keep me up to date as to what is going on in your worlds and I will continue to update you as to what is going on in my little fishbowl.
Monday, August 15, 2016
Thursday, August 11, 2016
Perforation healing?
On July 16th, it was definitively determined that I had a perforated bowel that formed a fistula through the surgical scar. At that time, it was leaking quite rapidly, putting out several hundred milliliters a day and we captured the output in an ostomy bag which has been difficult to get right.
On August 5th, we addressed an abscess that formed on the left side of the incision and was incredibly painful to the touch. It ruptured through a different place in my surgical scar and we spent the morning at the doctor's office, draining the abscess and then extending the current ostomy bag to cover both the old fistula as well as the abscess drainage location. I started on antibiotics to address the infection and am hoping that it heals.
We had scheduled surgery for August 24th in NOLA to repair the perforated bowel but it may be healing on its own. The amount of drainage has dropped significantly and we are just going to start monitoring and watching it for now.
This puts us in a funny place. Surgery was not something we wanted but it was a time and place on which we could focus. Wait and watch is not a fun place to be but it looks like that is what we have to do at this point. I imagine we will be doing another CT with oral contrast at some point if only to see if it has healed or if the contrast goes into my abdomen or not.
I am still getting about 1900 calories/day from TPN and we just increased the amount of protein that is provided, hopefully to encourage some of that healing. I am getting a bit dehydrated and that is frustrating because I am also retaining fluid. Hopefully the increased protein will help strengthen my blood vessels and reduce the amount of fluid that weighs down my body.
I have the G tube connected to a drainage bag 24/7 and look forward to being able to eat something at some point without watching it go directly into the bag. I have sampled watermelon and grapes using the chew and spit method but was surprised at the amount of seeds and pulp that I still swallow. We have a new Vitamix, just sitting there, waiting for me to be able to use it and we will be freezing some fruit that I can use in it when I am allowed to really eat.
I have no idea what this means about my recovery as my legs get totally exhausted after a short 3/4 or 1 mile walk. I can do them but it really beats me down. I am just going to try and continue to extend my walks and improve as best as I can over the next weeks/months.
Two steps forward, three to the left, one back, two to the left and one back. At least that is what it feels like. Hopefully the total output is forward but it is really causing some struggles right now.
On August 5th, we addressed an abscess that formed on the left side of the incision and was incredibly painful to the touch. It ruptured through a different place in my surgical scar and we spent the morning at the doctor's office, draining the abscess and then extending the current ostomy bag to cover both the old fistula as well as the abscess drainage location. I started on antibiotics to address the infection and am hoping that it heals.
We had scheduled surgery for August 24th in NOLA to repair the perforated bowel but it may be healing on its own. The amount of drainage has dropped significantly and we are just going to start monitoring and watching it for now.
This puts us in a funny place. Surgery was not something we wanted but it was a time and place on which we could focus. Wait and watch is not a fun place to be but it looks like that is what we have to do at this point. I imagine we will be doing another CT with oral contrast at some point if only to see if it has healed or if the contrast goes into my abdomen or not.
I am still getting about 1900 calories/day from TPN and we just increased the amount of protein that is provided, hopefully to encourage some of that healing. I am getting a bit dehydrated and that is frustrating because I am also retaining fluid. Hopefully the increased protein will help strengthen my blood vessels and reduce the amount of fluid that weighs down my body.
I have the G tube connected to a drainage bag 24/7 and look forward to being able to eat something at some point without watching it go directly into the bag. I have sampled watermelon and grapes using the chew and spit method but was surprised at the amount of seeds and pulp that I still swallow. We have a new Vitamix, just sitting there, waiting for me to be able to use it and we will be freezing some fruit that I can use in it when I am allowed to really eat.
I have no idea what this means about my recovery as my legs get totally exhausted after a short 3/4 or 1 mile walk. I can do them but it really beats me down. I am just going to try and continue to extend my walks and improve as best as I can over the next weeks/months.
Two steps forward, three to the left, one back, two to the left and one back. At least that is what it feels like. Hopefully the total output is forward but it is really causing some struggles right now.
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