Monday, July 29, 2019

Post-Op Complications - Or Not?

I am back in the hospital but hope to be getting out today.

My surgery recovery was progressing reasonably normally, but I was more "draggy" than I thought I should be and also, I was running a bit of a temperature. My appetite was way down. This situation did not seem to be getting better day by day.

Finally, on Thursday, Jul, my 25 primary care doctor told me that I should go back to BWH where I had had my surgery.

BWH ran a bunch of tests. First, they discovered that my blood pressure was quite low - 90 / 60. Next, they did a CT scan of the surgery site. Good news there. No sign of any infection or "leakage". All indications are that the surgery site has been healing nicely. This goes along with the fact that my jelly belly has been feeling better every day.

The bad news is that they don't have any idea why I have these symptoms which include:

  • Wanting to sleep a lot
  • Elevated temperature
  • Low blood pressure
  • Greatly reduced appetite
  • Overall feeling very "draggy". 
Saturday, I suggested to the surgical team that has been monitoring me that my symptoms might be unrelated to the surgery. They could be due to a virus that I picked up somewhere that my immunocompromised body is having trouble dealing with or that I am dealing with long term effects of my cancer or my chemotherapy. The surgical team told me that they had independently come up with the same theory.

So, they handed me off to the oncology team and the oncology team has decided there is no real reason to keep my in hospital. They plan to give me the boot later today. My blood pressure is up to something reasonable. I am feeling a bit better. My temperature is only slightly high. So, I am looking forward to getting outta here.

Barbara and I plan to head to NH. We hope to be there a week and a half before we have to come back to the Boston area.

So, that is the latest update.

Friday, July 19, 2019

Appendix is finally gone

After my last two posts, you might have thought that our trip / appendicitis adventure was finally complete and that you would not have to read about it any more. That is certainly what I thought. I could not have been more wrong.

The short version is this: On Friday, July 12, they removed my appendix along with about 8" of bowel. I have been recovering normally since then. I got out of the hospital yesterday, July 18 with no further complications.

That is the short version. For anyone who wants a longer version, keep reading.

On Wednesday, July 10, I went for my normal chemo appointment. I felt pretty good. Certainly no abdominal discomfort. My oncologist insisted that I consult with a general surgeon. I made arrangements to do that, but the surgeon insisted on a CT scan before he would see me. I managed to get the CT scan that same day. Barbara and I left happy after that very long day at Dana Farber.

The next day as I was literally packing the car for our first visit to NH, I got a call from the Nurse Practitioner that I had gotten to order the CT scan. She told me that the radiologist did not like what he saw and that I should get myself to the BWH Emergency Room as quickly as possible and "let them deal with it."

So, Barbara and I headed to "The Brigham" as we call it. The checked me in and told me that they would operate at the end of the day (Thursday).

They didn't. At the last minute, they decided to delay due to my having injected myself with blood thinners that morning. By this time, I was getting sick of cooling my heels there, especially since there was no discomfort in my abdomen. I sat in a hospital room all day Friday. Late in the afternoon, they came for me. They explained that they would try to remove the appendix laparoscopically which means through a small incision assisted by a couple of tiny poke holes and that this should take about 90 minutes. They also explained that if things looked worse once they got in there, they might have to make a full incision and that this could take about 3 hours.

They tell me that they carved on me for about 6 hours. The removed not only the ruptured appendix, but also about 4" of bowel on either side of the appendix. Barbara, finally went home exhausted.

I did not feel too good, the next day, but it was not all that bad. By Sunday, I had developed severe indigestion. By the time they gave me a pill, it did not do much good. Eventually they installed an "NG Tube". It took them 7 tries. This was unpleasant, but relieved the indigestion.

From there it was onward and upward. On Tuesday or so, they started allowing me to eat liquids. On Wednesday, I could eat solids and on Thursday, they kicked me out.

Barbara, needless to say, was terrific all the way through.

So, we are currently at Fox Hill Village, I am pretty draggy, and my belly has a 5" incision that looks like it was stapled shut by a 3 year old using a power stapler for the first time. I am trying to psychologically deal with the realization that I will never again look quite as good in a Speedo.

So, hopefully, this is now behind us. I have thought this before, so we are keeping our fingers crossed.

Normally, I like to liven up my posts with photos, but I decided to spare you.

Tuesday, July 9, 2019

Trip Summary

Since my previous blog summary as well as a couple of Facebook Posting plus some individual emails, many thoughtful friends have sent me their well wishes and words of support. I have decided to write up the entire story in one place. Here it is. I will try to be brief, but you know me. . .

You might be thinking, "I can't believe he expects us to read all this."  You would be right. I won't be offended if you don't read it. But here it is, just in case.

Our saga started with our planned cruise of the Baltic Sea with Overseas Adventure Travel.

At first, things started out well. We flew from Boston to Stockholm where we spent a couple of days before boarding our ship, the M/V Cleo. We sailed overnight to Helsinki where we spent a couple of hours on a bus tour and then went to St. Petersburg where we spend two days visiting glorious palaces. A lovely city. From there we sailed to spend a day each in Tallinn Estonia and Riga Latvia. Both of these are distinguished by extraordinary architecture.

My birthday happened while we were on the Cleo. I wanted to avoid that whole singing waiters thing, so I had not told anyone that it was my big day. Unfortunately, I was betrayed by my wife. How could I have thought that she would keep the secret? I was presented with a cake that included high intensity pyrotechnics along with a card signed by all members of our tour group. Meanwhile our cabin had been decorated with towels folded like cute little animals. So, all in all, it was very nice.

From there, I am told that the boat sailed to a small town named Visby on the Island of Gotland which is part of Sweden. I came down with some sort of illness. I can't say for sure because I was pretty much "out of it". Apparently, I agreed to skip the tour of the island. There were a couple of times when I slipped off the bed onto the floor. I was too weak to get up off the floor by myself.

Mostly, I was very weak and tired with some pains in my abdomen. The ships doctor was called. I asked her if perhaps I had appendicitis and she said that was impossible since my pain was on the right side and the appendix is on the left. Now, this was news to me, but who am I to argue with a doctor.

I have been told that further discussions took place out of my hearing range and next thing I knew a couple of EMTs showed up, loaded me into an ambulance and took me to the local hospital. They ran blood tests and gave me a CT scan and told me that I definitely had Appendicitis. The doctors jaws dropped (literally) when I told them that the ship's doctor thought the appendix was on the left. It really was fun to watch their faces, No matter. By now the ship was on its way to Poland leaving both me and my appendix (still attached) in Visby, not to mention Barbara.

After some small discussion, and in view of the fact that my appendicitis did not seem critical, they decided to try treating me with antibiotics.

Meanwhile, what about Barbara? Turns out that there were zero hotel rooms in Visby. Rather than put Barbara out onto the street, they brought a second bed into my room "just for one night". She ended up staying for the entire visit.

The doctor there was particularly fond of a test called "C Reactive Protein" (CRP) and after the first day, this had dropped nicely. They said surgery would not be needed. But after the second day, it failed to drop any more and they were again thinking of separating my from my poor, not totally innocent, appendix. They did another CT scan and found that yes there was still some appendicitis, but that my intestine looked healthy. They still recommended extracting the appendix. BUT, before they got out the carving set, they were going to check with an older more experienced doctor.

And what did I think of this? Truth be told: by this time, I really didn't care much one way or the other. There was almost no pain in my abdomen, I felt tired, but mostly pretty good. I had serious doubts that it was necessary to separate me from my appendix. But, on the other hand, I figured that if this was going to get me out of there any faster, then by all means cut it. I could not think of anything in particular that I needed the appendix for, so what the heck.

But a new doctor came in the next day, he said he did not think the appendix should come out. He thought that the failure of the CRP (crap?) to come down was likely due to other factors and that the antibiotics were working they way they should.

They kept me for another couple of days on IV and oral antibiotics. Yesterday, they switched me over to oral only and this morning, (Sunday), they loaded me up with enough giant pills to complete the cycle and set me on my way.

We had been in Visby for around 5 days - huddled in a shared hospital room. On the last day, we decided to go out for a walk. It turned out that the hospital was about a half kilometer from the "Old Town" which was surrounded by walls 30 feet high. We wandered around the village for a half hour or so and enjoyed it greatly. It was frustrating that I did not have more energy; I was pretty beat by the time we hobbled back to the hospital, but at least we had gotten to see the most important part of the island. One point of satisfaction is that when the ship's company visited, it was pouring down rain. We had a very nice day. As nice as it was to be visiting the old ruins, the best part was being outdoors in a beautiful park with the peaceful surroundings.

We left early for the airport and got there before it opened. Literally. The taxi dropped us off in front of the departures door. It was locked and there was no sign of any activity. After about 15 minutes standing out there in the wind, someone came by and let us in. We got on our flight to Stockholm and from there we got a flight to Copenhagen. We got to our hotel at around 5:00 PM. We were at the Admiral Hotel which is very nicely situated in Copenhagen.

Because it was unlikely to get dark before we went to sleep, we decided to try another walk. While I was mostly recovered, I was still taking giant antibiotic pills and these were tiring me. Still, we walked along the shore for a mile or so. We got as far as the mermaid statue and saw many other beautiful points of interest, although I have no idea what they were. Still it was another very pleasant walk. By the time we got back to the hotel, I was totally wiped out. We ate at the hotel.

The next morning, it was pouring down rain and we despaired of any additional sightseeing. However, we ran into the remains of our OAT tour group who were doing the "Extension" in Copenhagen. While chatting with them, we discovered that the rain was really not bad. We went on another walk, this time in the opposite direction and ran across the famous old canal area called Nyhavn. Again, this was a beautiful walk and a very pleasant way to spend the hour we had remaining before leaving for our flight.

As I finalize this, we are on the airplane to Keflavik and we expect to be back in Boston by the end of the day.

I will wrap up with some "take-away" thoughts.

* Overall, the trip was fun. We got to visit many interesting cities and even the hospital was an adventure. It is interesting that I am not angry or particularly upset by the way things turned out. Perhaps I am becoming more mellow with age. I do feel very bad for Barbara.

* The Swedish hospital was excellent. It was very modern, absolutely spotlessly clean and nicer than any hospital I have seen in the states. It was very large and laid out in curves with a good deal of art decorating it. Very pleasant.

* The doctors were excellent. I am slightly bothered by the fact that the younger surgeon was all set to separate me from my appendix based on one test result. But he wisely decided to consult with someone more experienced and they changed their minds. I think all the doctors we dealt with were outstanding.

* The nurses were also terrific. There seemed to be plenty of them, though at one point at around 4:00 AM, I went out of my room for something and could not find a one. After about 5 minutes, one of them wandered back.

* We could not be more thankful for their allowing Barbara to move in with me for the five days we were there. As I said earlier, there were no hotel rooms available, but still, it was very accommodating of them.

* At the end, they provided me with the meds I would use. They mentioned that normally, they would provide a prescription, but in view of our situation, they felt that it was better to just give us the meds. Again, very accommodating.

* The food in the hospital was also great. At first they brought it to me, but later they showed me where to get it myself. They would bring a portable food cart every day at 12:00 and 5:00 where they served a wonderful hot meal that really was excellent.

* I am not sure what to say about the ship's doctor. How could she not know where a patient's appendix is located? On the other hand, she was very nice. Barbara tells me that the decision to move me to the hospital was made by the Captain. You would hope and expect the captain of a ship to be a good and decisive decision maker. He was.

* This cruise was different from others we have been on. The greater distance between ports meant less time in the port city - often as little as two hours on the ground. There was no time to relax and enjoy the environment.

That's all for now. I want to get this thing posted. I will try to organize some photos for posting later on.

Friday, July 5, 2019

Travel Complications

Our cruise to the Baltic ran into some complications.

We are currently in a hospital in Visby Sweden on the Island of Gotland.

We were having a great time on t cruise around the Baltic Sea when I became ill. Mostly, I was very weak and very tired. I had some discomfort in my abdomen. They moved me to the local hospital where I have been ever since. They tell me that I have appendicitis.

They have been treating me with oral and IV antibiotics with the idea of avoiding surgery. After the first day, this seemed to be knocking down the disease, but there was no further progress on the third day as hoped. As of yesterday, they seemed to be leaning toward the surgery - which is apparently no big deal. At least not to them.

There is a big convention on the island, so there are no hotel rooms available. The room they gave me is beautiful with an ocean view. It is large, so they moved in a second bed which they are allowing Barbara to use. Very nice of them.

I am not feeling all that bad. I am tired and spend a lot of time sleeping, but I am not in pain. We are being treated very well. The hospital seems excellent and we are hoping to be back in the Boston / NH area soon.

As I write this, it is 8:30 AM and we are waiting for the doctors to come by. they took blood samples at 6:00 and I think they will want those results before they decide whether or not to operate. We have been in contact with doctors in Boston - both our primary doctor and my Multiple Myeloma doctor. They agree that whacking out the appendix is probably the best solution at this time.

I will try to use this blog as a means of letting people know what is going on.