Wednesday, September 22, 2010

Post Surgery Journal

Post- Surgery Journal
Surgery Summary

Surgery Summary according to husband, Tommy: "Her nose is jacked up and the doctors are going to fix it."

Surgery Summary, paraphrased, from Surgical Report
Dr. Duncavage performs the computer-assisted stereotactic image-guided surgery, bilateral resection inferior terbinates, bilateral concha bullosectomies, and left endoscopic antrostomy with tissue removal. It went as expected EXCEPT the infection expected in the left maxillary sinus was actually a large CYST instead. This CYST was, according to Duncavage, the reason my sickness escalated.

Next up, Dr. Wm Russell Ries performs the repair of the vestibular stenosis via open approach with septoplasty and speader grafts placed. The cartilage would be harvested from the nasal septum. My septum was deviated to the left with a large spur posteriorly on the left.

Recovery Journal
Monday- surgery day; all apparently went well; Tommy brings me home around 5pm; gives me Oxycotin as soon as possible. I am a vision of beauty with my external nose cast, internal splints and mustache dressing (think folded gauze, taped hammock-style under nose). I eat soft serve ice cream and chicken noodle soup. I am suppose to keep my upper lip still which means no talking or smiling and very little chewing and that’s okay because these things are misery. Blaine (my 9 year old) comes in, eats dinner, showers, homework… calmly and quietly… because (as he tells me days later) he saw me and “he was so sad for me.” I doze in and out all night upright in the recliner; my sweet husband Tommy sleeps in a sleeping bag on the hardwood floor beside me- true love always. He wakes for medicating me, changing the nose dressing and anytime he hears a strange noise. My throat hurts during the night and my mouth is very dry. I drink lots of water. I decide to nasal mist my nose sometime during the night although the instructions say to start this on day two.

Tuesday- Don't expect anything witty or funny in this post becuase there is absolutely nothing charming about day two. Tommy walks Blaine to school. Nurse calls to check on me. Tommy asks for definition of ‘a lot of blood’…I don’t qualify… good…I eat bites of bagel for breakfast. My right nostril is now completely crusted over with blood and my mouth is the SAHARA… I am dozing with my mouth entirely open because I cannot breathe out of my nose. Tommy is working from home; he makes me a quesadilla for lunch. The Judds are on Oprah… very entertaining… Tommy and I have lots of Judd banter from various personal experience… have to keep banter at minimum today because I am not allowed to move my upper lip to laughsummary of day:all I do is sit in the recliner and obsess about crusted over nose and inability to sleep without waking to a sandpaper mouth. Tommy takes Blaine to football practice at 5pm; I eat a few slices of ham; I phone the doctor on call…beg him to let me irrigate my nose because of the crusting. He doesn’t give me a very confident answer; thinks I could remove some of the crusting that SHOULD be there and he doesn’t believe that I have nostril clearance for true irrigating. I mumble something through my hammock-style mustache dressing about learning the virtue ‘patience’… we discuss a little more and agree that I can irrigate VERY gently to try to address the crusting on the opening of the nostrils.

Tuesday night- absolutely miserable; still must be upright in the recliner with upper lip still, breathing out my mouth; I am using saline spray as much as possible and VERY gently irrigating with what seems no results. Only sleeping an hour at a time due to Saudi condition of mouth. I have a love-hate relationship with Percocet. There is dried blood in back of throat from drainage. Good times. I become an insomniac- dreading sleep because I wake to sand dunes in my mouth. Sleeping in upright position is also getting to me. Bruising under the eyes and some swelling now. I text sis a photo of me-with bruising and cast and mustache dressing-apparently this look hasn’t made it to the runways this season and she finds the condition quite alarming… her shocked response is a simple ‘OMG.’ I reply back that I am actually more miserable than the photo reveals. I thank her for keeping Drew (my 4 year old) for me.

Wednesday- I call doctor’s office at 9am. COMPLETELY crusted over right nostril; some air clearance now on the left but not enough to get my body to shut my mouth to sleep. In fact, the left nostril makes funny whizzing/ gurgling noises when I attempt to sleep which furthers my insomnia. Ries’s nurse tells me that I can use saline spray several times a day but no irrigating. She is SUPER but she and surgeons are obviously not fans of irrigation. I’m swelling very much now. I look like a pig and I remind myself of some character from Lord of the Rings but through the Oxycotin haze I cannot recall which one. I’m in no condition to google for a photo of my lookalike….daily summary: there’s no normal activity for me at this point. I only leave the recliner to treat nose with saline spray and visit bathroom; I don’t even have enough energy to turn on NetFlix. I am in a poorly executed rotation of pain meds, doze, drink water, treat crusting, change mustache dressing…and… later… ice packs… sometime today I get smart enough to add ice packs to the rotation. Tommy gets August and September Vogue out of the mailbox and announces, “September Vogue is above your approved weight limit.” He’s not kidding…. 720+ pages weighs well over 2lbs. I got a free subscription with a recent purchase and I have been waiting on these to arrive…. September Vogue issue confirms no mustache dressings on the runway this year. Lisa brings Drew home around noon and I am crying when she gets here- my second cry after surgery….don’t fret it’s just a general misery cry. Lisa really wants to do something for me and I tell her that she has done SO much by keeping Drew. She offers to take him back but I tell her it’s okay that he needs to be at home after three nights away and it’s really going to be okay. Did I mention that it's going to be okay?

Tommy feeds the kids and gets prepared to put Drew to bed; Drew ‘writes’ me a four page get well message which he proudly orates to me… three feet from my recliner… as if he’s officially presenting to a Queen. I give him a thumbs up from my recliner since I cannot really talk or smile or laugh. I can tell that he loved it at Aunt Lisa’s house and I am so thankful for this gift from her. Tommy puts Drew to bed and he helps Blaine do homework…then they play basketball outside. When they come in, I am dozing upright in recliner… I hear Blaine whisper “Awwww…. She looks so pitiful.”

Thursday- morning is a little crazy… I overhear Tommy bribe drew with a trip to Chick Fil A for breakfast if he’ll just get in his uniform. I moved to another recliner sometime during Wednesday night…I thought I’d go absolutely mental if I slept in recliner #1 for one more minute…. After all, isn’t upright sleeping a torture technique we aren’t allowed to use on terrorists? … I might have googled this in a normal Janey state but I haven’t touched my iPhone in days...except for the one very long email that I sent out to colleagues on Tuesday night which Tommy suggested that I preface with ‘this is a Percocet email’…. I watch three episodes of The Tudors on NetFlix in the afternoon from recliner #2. I am careful to have the TV off when the kids get here so they don’t feel like I am ignoring them. I pay them what my friend Lortab insists is scads of attention between dozing off and applying ice packs... in reality I recall that I simply said “Hi” to Blaine and ask him how his day was… I hold Drew’s hands and rub his face for a few brief moments. This is fine with the kids because they are heading out with Daddy to football practice and they can tell that I am pathetic and loopy. I remind Lortab that I recently took them to Disney for eight days all by myself and I’m not always such a loser mom. Snap, snap.

Friday- Drew wakes up complaining about his leg and Tommy sees a red, hot irritated bump. So, in addition to work and tending me and the kids, Tommy's now tasked with carting Drew off to the clinic. He calls me mid morning with a report that he has seen the doc, they have administered antibiotic, and he is in route with Drew to preschool. With the house empty, the Lortab and I decide that now is the perfect time for my first shower. Really? Really. We somehow survive this insane act of independence. I am still in my routine of rotating ice packs, pain meds, sleep, saline spray and crust removal. Still obsessing with the crust removal. I have air clearance through the left nostril- still with uber-annoying whizzing sounds- less crusting on the right side but I’m still bleeding out of the right nostril. Insomnia has stepped up it’s game and sleep is less and less attainable. I am backing off on the Oxycotin and trying to only use Lortab. I watch Harold and Maude on Netflix in the afternoon which I have never seen… it’s a good compliment to my Lortab comalet’s be honest that I am not really sleeping anymore and I’m really just in an intermittent Lortab coma… Tommy takes the kids to football practice and the Brentwood/ Ravenwood football game on Friday night… I flip through my Vogue magazines. When the family gets home, I announce that I am officially breaking it off with recliner #2 and have decided to move to the bed for the night… I will be beyond insane if I sleep in a chair for one more night. I sleep propped up in a nest of pillows and I get significantly more sleep than the usual Lortab coma allotment… but it is not without consequence…someone apparently batter-fried my mouth while I slept… a couple of times.

Saturday morning-5 days post-surgery- I complete my first normal task since surgery- I turn on the computer and place our weekly Harris Teeter grocery order. Tommy picks up ham biscuits from Brentwood market for our breakfast since we can’t make our usual Saturday morning breakfast trip there. Tommy then takes kids to football and soccer games and picks up groceries on the way home. I return to recliner #1 for TV and flipping through Vogue. I heat up homemade Italian meatball soup from the freezer. Tommy and the kids return mid afternoon. Blaine was triple teamed the entire football game so I didn’t miss much. Yes, tripled teamed and I tell him that he should be flattered by the opposing team's strategy. We order pizza from Nashville Pizza Co for dinner. On a whim, I call the doctor’s line… in the middle of my recitation of the list of surgeries I endured on Monday, I hear these words “You can irrigate.” What? Did I overdose on Lortab? Am I hallucinating? I say, “Excuse me? What did you say?” I hear it again “You can irrigate.” I babble about how I don’t understand why Duncavage and Reis don’t tell you this from the beginning, that I think that they are brillant but maybe they are just old school and not on the irrigation band wagon but it’s really sad because I am absolutely going crazy with this mouth breathing thing and I am near suicidal. He assures me that there’s “absolutely nothing that I am going to hurt by irrigating.” I will kiss this man on the mouth if I see him in the hallway at my next appointment. I irrigate. Which is not pretty but effective. I can suddenly breathe through BOTH nostrils. Tommy gets home with the pizza and I sit and eat with the family for the first time this week. In celebration, I have three slices of cheese pizza. About halfway through the meal, I issue a no talking warning… our normal family banter is making me laugh too much and I still must keep the upper lip still. Did I mention that I can now breathe out of both nostrils? I am so happy that I want to cry. I get out my crochet basket and Blaine, Tommy and I watch the Perfect Storm. I retire to my bed and although insomnia interferes at will, I sleep with my mouth closed for the first time in what seems a century. I log about 6 hours of random sleep.

Sunday- I MADE THE GRAVY. Getting up was hard, but much easier than days ago. We usually make a big breakfast on Sunday mornings and Tommy did most of the heavy lifting this morning but I MADE THE GRAVY. Let me give props to my Tommy here for a terrific breakfast- we had our usual Sunday morning sausage, biscuit, fried chicken with gravy, and omelets with peppers and onion. (Sidebar: we regularly keep a lot of the ingredients prepped in the freezer for these meals). I heart normalcy. I irrigate before we eat... amazing process. I eat at the family table and Drew tells me that I am soooo cute (I am holding ice packs on my face while I eat breakfast- and don't forget to paint the bruises and the nose cast into the picture). He is comic genius. Throughout the day, I begin to alternate Lortab and Tylenol. Drew plays matchbox cars in the room beside me as I rest- he separates them into teams- they play football…he insists that I clap and cheer at various times. I crochet throughout the day. I nap. I clip coupons. Tommy takes kids to park and during my afternoon nap time I can't sleep but I instead watch them play football from my bedroom window. I begin to wonder out loud what the nose will look like. In the evening, we watch the NFL Manning showdown: Payton vs. Eli. There’s a split screen of the brothers and I banter that it’s a split screen of my before and after nose shots- I propose that I originally had the Payton Manning nose and I’ll end up with the Eli Manning nose. I have to put my finger on top of my upper lip to keep my lip still while I laugh so hard that I cry. We watch Mad Men which is my absolute favorite TV hour of the week. Later, I get even more closed mouth sleep than the night before.

Monday- Drew sits on the bed with me in the morning before school- he knows this is very special because the bed has been off limits for him all week. I help him get dressed in his uniform and he is very careful and sweet with me. Tommy feeds the kids pancakes from the freezer stock and gets kids off to school. I have a new rotation....crochet, irrigate, ice pack, nap in bed, and breathe through my nose. Tommy has returned to work at the office today for the first time in a week. I spend the day distracted by crochet. Tree calls me and we have a great discussion… I sweep the floor while on the phone (again, I love normalcy). I take a long afternoon Jacuzzi bath with ice packs on my face. I now highly recommend this method even if you are not recovering from facial surgery. Later, it’s soccer practice night for Drew. Blaine is working out with Jack. I help Blaine through homework- we have to erase a lot so there are tears. I’m coming off the strong pain meds and am mostly converting to Tylenol and I am grumpy with everyone. Plus the stints and cast are finally getting to me. Tommy makes quesadillas for dinner at my request- I never knew he made such a MEAN quesadilla. YUM.

Tuesday- We are up at 6 am and I am in shower. I decide not to irrigate. I tell the kids that I am going to be grumpy because I haven't had medication all night and I have to wait to take a Lortab so it won’t wear off before they remove my cast and stints. We take kids through Chick Fil A drive through for breakfast and then drop them at school; we show up for my doctor’s appointment with Duncavage one hour early- and they take us back immediately. They spray my nose with numbing spray- it’s absolutely not bubble gum flavored. Icky. The nurse removes the cast. I mention casually that irrigation saved the day on Saturday and I can tell she thinks that I am talking about simple saline spray and I decide now is not the time to dive into details. Duncavage and his entourage enter the room, remove a couple of stitches and stints which is not very painful after all- I probably could have done without the Lortab. He then drives his video camera wand through my nose and along the way he uses a vacuum to suck out mucus and the like as he goes along. We discuss the large cyst in my left maxillary and how it was causing most of my sickly, horrible feelings. Duncavage tells me that I get an ‘A’ and I thank him and banter with him that most of the recovery instructions are against the Geneva convention…he finds this very amusing.

After the cast comes off, I think my nose looks like my nose only sculpted a bit. It's like Dr. Ries turned it into play dough...briefly...and decided to tidy it up a bit. I am suppose to keep the upper lip still and not touch the nose with any pressure for awhile. I see Dr. Ries next Tuesday for more instruction.

Blaine is off school at noon today...I crochet and help him with his practice math test and then play Contract Rummy with him in the afternoon. I take an hour long afternoon nap and then cook spaghetti... with Blaine as my assistant (hamburger meat was already prepped and in freezer). I tell Drew that he can stay home with me this evening instead of going with Dad and big brother to football practice. Tommy asks if I am sure and I tell him that I am just going to let him watch movies all evening. I write these blog entries beside him as he gleefully indulges in cartoon after cartoon on NetFlix. I ask Drew for a kiss at the end of the night and afterwards he says, “Mommy, we did kip lisses!” I said, “Yes, you have been really gentle with mommy and so sweet and we can do kip lisses (lip kisses) now because you are behaving like such a big boy.” He yells into the other room “Daddy! I can do kip lisses with mommy!”

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