Ten days & two stents later…

When we last left our heroine and her not-so-helpful mate, he had, well, to paraphrase the line from a medical device tv ad, ‘he’d fallen and he couldn’t get up.’

The fall had dislodged the stent, which began leaking at the point of insertion. So, off we went to the hospital on Tuesday to have the stent checked. He fell getting out of my car, and was wheeled about in a wheelchair.

The stent needed replacement and the doctor did it then with a local to dull the pain. My husband was not pleased. As I’ve mentioned, he’s pain-phobic. He gasped and groaned all the way home and for hours afterward–even after I returned from taking my mom to her doctor’s appointment–but his pain turned out to be the least of our problem.

The doctor decided, since there was leakage in the stomach cavity, to vent the bile externally, through that tube part of the stent. The doctor preferred we leave it that way, emptying or changing the bag. He felt it was better going forward.

Well, going forward to sometime in the early hours of this past Saturday morning, we find our heroine being called around 6-ish in the morning. “What’s up?” I yell downstairs.

“We have a situation,” my hubby says.

“What happened?” I say as I hobble downstairs on sleep-numbed legs, leaning heavily on my cane.

“I pulled the stent out in my sleep.” The whole stent. He pulled the whole stent, which was attached to the external tube and bag, out of his body. Bile wept from the incision.

I called the IR resident on call. The short of it–the doctor called back within the hour. We determined that, since authorization was necessary for a “reinstallation” (hubby hates that term. Makes him think of tires.) and since doctor knew we’d be sitting in Emergency all day and possibly into the next trying to get authorization on the weekend, we decided doctor would call our insurance carrier for authorization on Monday and let us know when we were good to go–with, as hubby insisted–anesthesia. Turns out installation day was yesterday, Tuesday.

This left us with three days of a bile-weeping wound. What was the best way to contain it, since bandages soaked through in 10 minutes and the bile irritated his skin? It took only an hour to determine that the best way was not to bandage at all, but to absorb it with clean towels rolled into flattened tubes, wrapped around his torso from stomach to back, and changed two to three times a day, along with his shirts and sweatshirts. Lots of laundry, and luckily, I have a stash of bleached towels I keep for non-public display, well, actually, for bathing the dogs and mopping up clothes washer overflows.

Tuesday morning came earlier than I wanted it to, with my husband calling me from the kitchen. He’d fallen and couldn’t get up. We spent half an hour trying various scenarios–too low or high and he has no leverage. We tried chair seats, stools, a case of dog food. Nothing put him in a position where I could lift him. In the end, I had to call our neighbor, who came on the double and had my husband up on his feet in seconds. Heaven bless the man! I know we women have lower body strength, but it was upper body strength needed here, and I just didn’t have it.

After that, my husband and I arrived at the hospital bright and early–well, early-ish and in the pouring rain. He had to have blood drawn for testing prior to the procedure. I pushed him in a wheelchair to avoid another fall. The day was long. It usually is when he demands anesthesia as the wake up time, lengthy as a matter of course, seems more protracted with each procedure. This time, he was out of procedure well before 1pm, but wasn’t alert enough to leave until 3pm. He kept asking me how he got there. I’d tell him but he couldn’t remember. That part’s scary. Dressing took forever. He’s still very weak and required help to dress and to stand. Otherwise, everything went without a hitch.

My hopes were higher as we left the hospital, as we had the stent issue solved and we’ve finally stemmed the diarrhea tide. To do that, however, we had to stop both oral chemo drugs and put him on tincture of opium. It’s a small amount–0.6ml every six hours–but it works. Thankfully.

I keep saying he’s still very weak. Part of that is his doing. He refused the therapeutic vitamins meant to add muscle. He refuses to walk in the house or outside (for November the weather’s glorious–60s with strong sun), and tells me to leave him alone when I try to reason with him, but expects me to help him rise from couch or toilet as needed.

In the hospital yesterday, I met a woman whose husband was in remission from his myeloma. Her sister has dementia. She wept explaining her frustration at being pulled in two directions, then listened as I vented and cried as well. I’m not so weepy today, only frustrated that hubby won’t move more.

I’d hoped to do some sort of comparison with Danny here, but, although I know precisely what I want to say, I’ve gone on too long already, and will save it for tomorrow.

Will our heroine maintain her sanity until then? Will she coerce her mate into exercising? Or will he fall again? Will she push him down the stairs? Be sure to tune in, folks, to find out.

Baby steps forward

On Monday, the IR group announced their intention to implant a third biliary stent the next day. Upon hearing that, I became suspicious, even angry. How could they have botched two previous procedures?

Well, it wasn’t them at all. It was my husband, who shifted in his hospital bed careless of the stent’s drain, and walked to the bathroom with that external drain–a bag about 5″ by 3″ tethered to the drain–swinging freely like a clock’s pendulum. As it collected the bile and pancreatic enzymes in it, it became heavier, and pulled the internal part of the stent out of place. When I told the IR doctor what I’d observed, he promised to tape this new bag to my husband’s torso. And when I told my husband that his carelessness meant a longer stay in hospital and another procedure, he took greater care with external stent.

The stent was changed on Tuesday, and on Wednesday the doctors observed the output and capped the external stent, allowing the bile and enzymes to flow internally where they aid the intestines and colon in digestion and elimination.

I was pleased to collect my husband on Thursday and bring him home. He was very weak, and unable to climb the stairs to our bedroom, and so we set him up in our den, on the couch he usually claims to watch TV. There were medications (meds) to gather, instructions to read, visiting nurse services to follow up with. He needed help rising, and sitting, and walked slowly with a walker. The slightest activity left him exhausted, though at the end of the first day home, I couldn’t say who was more tired, him or me.

By Friday’s end, we seem to have developed a pattern. (Thankfully, his appetite has returned, in no small measure due to the fact that his abdominal pain has disappeared.) I’d rise with the dogs, as usual, to go outside. Back in the house, I helped my husband to the bathroom, made breakfast for him and the dogs, administered meds, and yes, annoyed him into walking around the house on his walker. Lunch, with more meds, a bit more activity, and then dinner at home with a friend, and more pills ended his day. He slept through the night.

Today, he’s walking slowly without the aid of the walker, and even went into the basement to check on his fish tanks. Of course, this bit of exertion cost him dearly, and he sat on the basement stairs to rest for some minutes, but he climbed them himself with no aid and rested outside on the patio with lunch.

In the name of transparency, I can admit that I’m not as grouchy today as I was Thursday, when seeing him so helpless at home was a shock. Intellectually, I knew he’d be weak and need help. Practically, I was prepared to handle what ever was needed. Emotionally, I wasn’t prepared. While he was in hospital, home was my refuge from the cancer. Now, I’d brought it home with him. I needed to toughen up. Fast. Hopefully, I’m doing that.

For the next few days, I’ll have to help him to be more active. He needs physical therapy, especially as one ankle is swollen. If it continues despite his escalating activity, I’ll call the doctor.

Next Wednesday, we have an oncology appointment, and, fingers crossed, will schedule or perhaps even have his first chemo treatment.

But for now, so far, so good. Baby steps.