Thursday, April 14, 2011

Boss Fight - Surviving the Surgery

I apologize for my silence, friends.  Last week, I prepared for a battle against a group of vampires.  I thought I was prepared - I'd armed myself, gathered my allies, and formed a strategy for attack.  But I didn't anticipate their numbers, or encountering a Master Vampire.  I'd only fought a Master once before, about six years ago, and he nearly destroyed me.  With the help of my allies, I managed to defeat those bastards and escape, if somewhat narrowly.  I spent three days recuperating, and I'm still not back to 100%.  In celebration of our victory, as soon as I was able to get on my feet, I took several days away with a few close allies.  We laughed and ate fine food, relishing our brief respite, for this battle may be won, but the war goes on...


Twitter post April 5: Battle time. My allies are gathered, & I even have a soundtrack.

Last Tuesday, April 5, was my surgery.  The plan was to go in and remove any unhealthy bone - as my surgeon described it, if the bone didn't bleed right, he was going to cut it out.  This was because both the surgeon and the infectious disease doctor believed the necrotic and diseased bone prevented the antibiotics from being delivered to the infected site, since there was no healthy bloodflow to those areas.  By removing anything that appeared unhealthy, we hope that this time the antibiotics can more easily reach the affected areas.  He removed a significant portion of my upper mandible, and another big part of my lower mandible.  I lost another tooth (bringing the total to four now) because there wasn't enough bone underneath it to hold it in place.  The jaw part of the surgery went well, but because I'm me, and can't do anything simply, there were other complications.

Soon after the anesthesiologist put me under, my lungs started having problems.  My oxygen levels dropped really low, and I went into tachycardia - the medical term for increased heart rate.  This happens when the heart is under distress, and can sometimes indicate imminent heart failure.  I didn't flatline or anything, but I significantly scared the surgeon and the anesthesiologist that they almost stopped the surgery.  They were able to stabilize me, and the surgeon made the decision to go ahead and operate and just try to get me out from under the anesthesia as quickly as possible.  When I woke up, I told them that my right arm hurt (which had nothing but an IV in it) and that I couldn't breathe.  Fearing that I had thrown another clot and was suffering a pulmonary embolism again, the surgeon and the OR team rushed me to have a CT of my chest.  The scan showed no embolism, but rather a condition called atelectasis - basically, my lungs had partially collapsed.  So I was placed on oxygen, and there was talk of putting me in the ICU.  In the end, they put me in the progressive care unit, which is for patients who are slightly better than those in the ICU but still in need of considerable monitoring and care.

As my dad said in response to me telling him all this, apparently I don't do anything halfway.  Including scaring the bejeesus out of my surgeon.  I'm told I'm medically famous now, as doctors warn each other about me and the weird stuff that seems to always happen to me.

I went through Tuesday night on pressurized oxygen, with my heart hooked up to a portable EKG, a pulseox monitor on my hand to monitor my oxygen levels, compression machines on my legs to mitigate the risk of further blood clots, and a new IV in my left arm - they had to pull the one in the right due to what we later discovered was, you guessed it, more blood clots.  Needless to say, it wasn't a very restful or comfortable night.  My throat was also really sore from the intubation tube.  The doctors came into tell me that my bloodwork showed low dispersion of oxygen in my blood and an elevated level of troponin, a protein secreted by the heart when it is under stress.  My levels weren't crazy high - I think the said the upper threshold of normal was like 5 or something, and people who are having a heart attack are at 20 or 30.  So it wasn't super severe, but given that I had no known heart conditions, the hospital wanted to keep me until they could ascertain that the distress in my heart and lungs was caused by the anesthesia and not something else.  Which I appreciate, because if I went home and felt sick, that's one thing, but if they sent me home with an underlying cardiac or pulmonary problem, well, that could end not so well for me.

Five million tests later (I'm sure this is an exaggeration, but this is what it felt like), including an ultrasound of both my arms before placing a PICC line to ensure there were no major clots in my large veins, I was told the doctors were satisfied with the test results and would be letting me go.  I did have another PICC placed, as I'm back on a super ridiculous IV "antibiotic of last resort" called vancomycin, which had to be placed in my right arm.  The brachial vein in my right arm is apparently FAR larger than the one in my left - this means that it was much, much easier to place the PICC this time, and a lot less painful.  It also means that I can't lift anything heavier than 10lbs with my right hand, which is my dominant side, which is kind of inconvenient and annoying, but c'est la vie.

The doctors discharged me late Thursday afternoon, after which I accompanied Matt, while doped up on liquid Vicodin (it tastes like 99 Bananas, I swear - and as Matt said, that's not a good way to discourage drug addiction, haha), to the airport to pick up two friends who were visiting.  I was really anxious about not being able to be a good hostess and show them a good time due to being Swelly McSurgeryFace, but the weekend went extremely well.  I had a ton of fun, and probably wore myself out a little too much, but it was well worth it.  I'm still off work for a few weeks, so I can catch up on rest during that time - being with friends is incredibly energizing for me, even when it tires me out.  It makes me feel hopeful and strong and unconquerable, because I have such a large number of fantastic people pulling for me.  The posts on my Facebook wall and Twitter, the texts, the emails sent to me by so many people -- I honestly feel like I wouldn't have come out of that surgery as well as I did without all these wonderful people from across the world spending a few moments to send prayers, good vibes, and meditative thoughts my way.

Additionally, this game really helped too.  The mission from Erin to list positive outcomes from the surgery helped me to not be so anxious and worried during pre-op.  I brought up the list on my Blackberry and just kept looking at it when I would start to think bad thoughts.  I told the nurses about SuperBetter, and they all thought it was a fabulous idea.  Several commented that they thought it could really help other patients.  Maybe when I'm well, I can try to set up some kind of program for patients at the hospital.

The missions from last week and this week, the achievements - all of these help me to not feel alone, to find ways to defeat my "bad guys" (some of which I am still discovering), and to not feel like a lazy bum when my Type A side starts wailing that I'm not being active enough.  I am so incredibly glad to have had this in place before the surgery, and to help me with my recovery.

Overall, I'm okay.  My face is still partially numb, because the surgeon had to move my nerve to operate on the bone and thus bruised it slightly.  The numbness should be temporary, and I already am feeling pins and needles in the area.  I'm mostly just really exhausted.  I'm working on giving myself permission to do nothing and rest without feeling guilty or like I'm "wasting time." This is also why I appreciate Courtney's mission to watch the movies and TV shows you all suggested - it makes me feel like I'm still doing something (I'm questing!) while sitting on the couch.  My right arm is feeling better - the clots had made it super, super sore over the weekend.  I also randomly burst a vein or something in my side, reaching down for a water bottle on the floor.  I am awesome.

My breathing is better, my heart seems to be fine, and my jaw looks like it's healing well.  Let's keep our fingers cross that this surgery and the new antibiotic will kick this thing for good.  Thank you SO MUCH to everyone who wished me well and sent healing thoughts to me this last week.  I am stronger because of you!

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