The aftermath of that whole mess (part one)

8 Nov

Grizzly medical detail ahead, guys. We’re dealing with intestines and infected tissues, it’ll get gross. You’ve been warned.

We left off with me at home with the baby and being a happy family after we left the hospital, after nine days of being there.

My memories are fuzzy. We came home and ordered a pizza, which was way better than the hospital food. I tried to keep up with the triple feeds to keep Petit Four nursing and to bump up my milk supply. This involved having the baby on the boob with a tube taped to it that fed in formula at the same time, and then after that I would pump. It was exhausting.

We knew before I left the hospital that my incision had started to go sideways. I was sent home with oral antibiotics and pain meds since they cultured it and knew what the infection was (e coli). There was a problem with this, because almost nothing stayed in my system long enough to be absorbed. I would go to the bathroom and see whole pills. Over the course of the next three months I lost sixty pounds, if that tells you anything.  

Fortunately, my mom was well equipped to do wound care and would pack and unpack the dressing as it drained while we were home. I then went to the surgeon for a follow up. I had a fever and my abdomen was tender and he could feel abcesses so I went to get a CT scan. Abcesses were found and I went marching back to the hospital.

They drained the three largest abcesses with a CT guided drain, where they put you in the CT and then use a needle to drain the abcess, and they also left a couple of JP Drains and I spent the rest of my five day visit draining and with IV antibiotics. Fever went away, I got better, and back home I went.

It was clear the wound wasn’t going to heal up on its own, so I was set up with a home health nurse and a wound vac. A wound vac is pretty much what it sounds like, a hoover attached to your wound to pull tissue together and wick away drainage, so I had a not-optional shoulder bag and a tether of about 8′. Just enough to give you the illusion that maybe you can make it across the room without carrying the bag (spoiler alert: you can’t). I had that gottdamn thing for three months.

I was sick sick sick, but I went back to work anyway, vac and all. I walked around like a high-tech zombie and did as best I could. One day, I had a constant fever, was weak and in more pain than I should have been, so my surgeon sent me for another CT. MORE abcesses. Awesome. I went pretty much straight from work to the hospital, where I walked in and asked for a wheelchair in the ER to get up to the surgical floor. Once they did my bloodwork, they were shocked I walked anywhere, that I was even conscious. My potassium had bottomed out and my red blood cell count was scary low. 12 is normal, I was at about a 6. I won’t even give my WBC count. I was given three more units of blood and some plasma.

During this trip, I started getting strange looking drainage through the VAC, not the blood-tinged fluid but more tan. I started having the same drainage flowing heavily vaginally, as well. They tried the CT guided drain again to no avail, I had formed a phlegmon, which is like a giant ball of silly putty, and can only be removed through surgery or antibiotics. This was the darkest hospital visit. The surgeon was worried, and when I asked him what the worst case scenario was, he lied and said a small bowel transplant, because if he went in surgically now, he wasn’t sure he could save much. He told my mom what the real worst case was. I typically don’t ask a question without an idea of the answer. I knew that death was a real option.  

If you’re wondering where the baby was, she was at home with whoever came to help from far away. We were fortunate to have near-constant coverage of my mom and in-laws so that Horrible didn’t have to go it alone. She would come visit me in the hospital and we would half-ass breastfeeding. My mother-in-law joked about Petit Four having conversations with “Aunt Eyevee”, because honest to god she would stare at the IV stand and coo at it.

At this point, we knew that the connection of the pieces of bowel had failed somewhat. The drainage was either intestinal contents from a fistula or fluid from the infection from the phlegmon finding escape routes through surgical sites (the incision in my belly and the incision in my uterus). Fortunately, after another week on IV antibiotics through a PICC line (a central line that is inserted in your arm instead of your chest), everything seemed to clear up enough for me to go home, but this time I was sent home with antibiotics through the IV four times a day, spaced EXACTLY six hours apart. This was about as fun as it sounds, particularly with the VAC to contend with, too.

I went back to work again. I looked RIDICULOUS. It seems absurd to me now that I went back to work, but really, I didn’t have a choice.

I can’t accurately describe the irony of what I was feeling. I spent three months, essentially, with a constant high fever, well over 101. The peritonitis hadn’t gone away. The irony comes into play that I was super pregnant during the hottest summer on record in Austin where my office A/C didn’t quite work (daily highs of 105, people), and it just started to cool off when I had Petit Four. Then I come home and have a constant fever and radical weight loss and I’m freezing to death all the time. It was an awful and unfunny cosmic joke.

We had planned on travelling the 9 hours home for Petit Four’s first Christmas. This, it goes without saying, was inadvisable. We stayed home and had our first Christmas as a family with just the three of us. It was bittersweet.

I had another fever and went straight back to the hospital for another week. The wound was making progress. I could stand to look at the naked wound without the fear of seeing my abdominal wall. It turned out to be a PICC line infection so they switched sides and I went home for several more weeks of IV antibiotics at home. Finally, FINALLY, just before New Year’s, my blood was clean. The infection was GONE. The PICC line came out and stayed out.

I was still my wound’s little bitch, however.

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