Wednesday was a very low key day. I had to do a bowel prep, and I also worked remotely from NYC. My wife spent the day doing low key things around the city, mostly trying to avoid our cramped room and giving me some room to work.
By 6:00 p.m., the bowel prep was mostly done. My wife was back and I was starving. There were a few things that I was allowed that would take the edge off the hunger, so we headed out, looking for some bone broth and some frozen fruit juice popsicles. This took longer than I expected to find, but we were finally successful. And, by 8:30, my wife and I were in bed, watching the Warriors vs. the Cavaliers on TV. I was dozing off, but kept waking up to see the Warriors gradually increasing their lead en route to a 3-0 series lead.
Morning, as it always does on a surgery day, seemed to arrive extra early. I was allowed 12 oz. of black coffee, and I was very happy about that. We got some coffee, I took some meds (including pain meds and anti-anxiety meds) and started the walk to the hospital. We were due at the hospital by 10:00 and we got there maybe 15 minutes early.
Regretfully, my surgeon's first case of the day lasted longer than planned, so we waited for hours. I tried to relax and just doze, rather than thinking about what was in front of me. Finally, around 2:00, I was escorted to the OR. I remember that it was freezing in the OR. And then, I had some gas and I was asleep. It's great to get knocked out so quickly, so you aren't awake as you are intubated and have a catheter inserted and have a number of IVs inserted. I slept through all of that plus the surgery.
The next thing I remember is being somewhat awake, although I couldn't really see anything. I could talk and hear but my vision seemed to be non-functional for a while. The nurses in PACU got me some blankets to warm me up, and after a while, they brought my wife into the room. She told me that surgery had gone well, with one little issue, and that the surgeon was happy with the outcome.
We spent the next couple hours trying to get my pain under control. For me, Fentanyl just doesn't seem to work very well. Just like the previous surgery, escalating doses of Fentanyl did not knock down the pain. I reminded the anesthesiologist that I tend to do better with Dilaudid than Fentanyl, something I'd told him before surgery, so they switched over and we got the pain under control fairly quickly.
I was also informed that the hospital was way overbooked and that I'd be spending the night in PACU rather than in a room.
At some point, the surgeon stopped by. I don't really remember it, but he gave me a rundown. All the new tumors were gone with good margins, but he'd had to remove a fair amount of the colon and a lot of what was left of my right psoas major muscle. I was immediately concerned about needing a colostomy bag, but he said it was nowhere close to that. I will have to see how this loss of muscle tissue plays out in the gym in the future. I needed a few months of physical therapy after losing part of the muscle in my previous surgery. The surgeon also said that he'd been unable to remove the tumor that was irradiated last December. The tissues were too fused together, and he was afraid of damaging the inferior vena cava or the duodenum, and so he took segments of the tumor, but not all of it. However, he considered the tumor to be quite dead from the radiation and he said he had no concerns about leaving that tissue behind.
I slept fitfully that night, dealing with pain and constant vitals signs checks from the nurses. The next morning, I was finally transferred to a room on the 15th floor of the main hospital, where Dr. Singer likes his patients to be housed.
From there, the primary focus was the healing process. The doctors wanted me out of bed and walking that first day, but I firmly declined, saying that I'd gotten out of surgery late the day before and I simply needed to rest that first day. Surprisingly, they didn't really argue with me. The doctors' biggest concern was my heart rate, which was sitting at 120-130 - way too high.
The next day, we did an x-ray and a CT scan (both very painful due to how I had to move) to see if we could isolate the cause of the tachycardia. Other than some distension in my intestines, nothing showed up. They briefly considered an NG tube, which I very much did not want, but eventually decided that I should just be up and walking as much as possible. So, I got up and in three different sessions, I walked 20 laps around the ward. I could feel air passing from my stomach as I did this, so I was hoping this would help.
Over the next few days, I increased my laps to 65 and then 70 and then 102, and my heart rate gradually decreased. Overall, I was surprised that I seemed to be recovering faster than my previous surgery. I was taken off the PCA button (Patient Controlled Analgesia) earlier than normal, although this did happen a bit too soon and I lost control of the pain for 24 hours or so. They finally upped the dosage of oxycodone and this resolved everything. I had a bowel movement faster than my previous hospitalization, despite having lost a good chunk of colon. I was then allowed to start eating simple foods - frozen fruit juice, jello, broth, etc.
The surgery had been on Thursday, and I was expecting to be in the hospital until the following Thursday or Friday. I was surprised when they used the word "discharge" on Monday. It turned out that Tuesday was way too early to go home, but they did schedule discharge for Wednesday. I got out of the hospital late that afternoon and headed to a hotel for the night, planning a train ride home the next day.
I'll write more on some post-discharge "issues" later.