kevin mchugh

mmm…. scars..

ok, so that was about two days after getting out of the hospital.  click on that image.. and you can see the last xray they took before they decided to hack into me to create the above scarring.

recovery so far has been a battle.  it’s amazing how difficult it is to not use your arms for anything.  to not put your arms outside, away from your chest with any weight.  can’t hold anything heavier than a gallon of milk, and that’s in front of me, with both arms equally supporting the weight.  oh, and no reaching over you head!

after doing nothing but walking, trying to gain any kind of weight, sleeping, taking lots of pain meds and staring at the four walls in my house.  to have the help of my mom staying with me, making sure i eat well, eat correctly and am not over exerting myself.

at first, i could hardly walk 15 minutes.  a week later, i was walking a solid 30 minutes at once.  not much later, i was walking twice a day for nearly 40 minutes.  the walking helped keep the blood moving, and kept the pain down.  i was taking a lot of pain meds.  plenty of oxy coupled with tylenol and ibuprofen per the doctors recommendations.  the walks definitely aided in keeping the pain down.

the big issue with taking that many pain meds is the lack of quality sleep i could get.  it was fitful sleep constantly.  i had to continue sleeping only on my back.  i tried to take ambien per the prescriptions i was given, but that only resulted in me falling asleep well.  didn’t do much for staying asleep.

after only a couple of weeks, i couldn’t take it any longer.  i had to get out of the house.  so i tried going into work for a few half days.  it was great, but after only a few hours, i was pretty wasted.  a week later, i managed to get in three full days, and it felt great!

i also decided to take up learning something new.  i decided to do as my parents do, and play the guitar.  it’s been a great way to distract myself during the evenings.  yes, i have the tv, but really, there isn’t much on tv these days.  and learning another musical instrument has been great.  it’s been well over a decade since i last played an instrument, of any kind.  so it is a great mental exercise to learn something again.  i’m struggling quite a bit, but it’s still a blast.

so, now it’s been five weeks since surgery.  technically i have one more week to go before getting the clearance from the surgical team to start to move my body around more.  i’ve been working hard to keep a good posture and pull my shoulders back so as to not allow my tendons and muscles get used to a bad setup.  i can certainly feel the stretching going on.  i have to admit, i have pushed myself a bit here and there.  but i’ve been fortunate to have a body that rebounds well and the next day, i feel even better.

i’m completely off all drugs.  and i can sleep finally.  taking melatonin really helped out.  and i’ve gained three whole pounds!  so now i’m only minus 32 pounds from where i started out on this adventure.  as a number of friends have pointed out, i definitely have the upper hand in some respect.  instead of trying to lose whatever winter weight i’ve gained while trying to increase muscle mass…. i’m basically starting from skeleton and not much muscle.  so into the gym i go with a recovery program that will hopefully see me back on the bike and out paddling and surfing soon.  alas, i know recoveries can really screw you up, so i have to be quite focused on listening to my body and making sure i stop when something is causing some pain.

it’s a mental relief to get my life going again.  i am not sure what is worse… waiting to hear if you have cancer or waiting for the green light to start going again after a bout of intense inactivity for recovery.  either way, i’m still over the waiting hump, and into the recovery.  i’m also stoked to learn how to smile in the face of fear, pain and distress.  even when i feel down, remembering to smile has helped me tremendously.

hope you are all having a great january, i look forward to being back out there with you all soon!

ok.  first things first.

the mass is not cancerous.  biopsy showed it to fail all tests of that nature.

secondly, because the mass is of non-neoplastic nature, chances of it regrowing are very low.  it’s mostly cystic nature, and because they did a full thymectomy [total removal of the thymus] chances of me regrowing a thymic cyst are again very low.

this is all most excellent news.  also, though i’ve been working hard on my recovery, the doctors stuck by their recommendation of 6 weeks before starting to move into other physical realms.  they said i would be limited by pain, and that i should definitely be aware of the pain and listen to it.  screwing myself up between now and the next few months would be horrible and a major set back.

i will continue to write here on this blog with updates of how i’m feeling and what i’m doing.  i have made it through some most difficult road blocks, and i truly would not have been able to do it without everyone’s support.  many thanks to my family, bromley, brian and marijana, travis and kelly, curtis and margen, justine and dave, brooke, jd, my wonderful coworkers [AV and Westin!], sail sandpoint outrigger canoe club, all the oc paddlers in hawaii, all my friends spread out all over the place, from montreal to oz.  i’ve shed a few tears, i won’t deny, along the road, but you’ve all managed to keep my spirits up and stay positive.  i still have a long road ahead of me to regain my strength, weight [i'm down 35 pounds], appetite and mobility.  i look forward to seeing everyone, either out on the water, on the trail, in the surf, on the snow, on the beach, in the mountains… it’s like i got a restart on life.

i go in for another checkup in 4 weeks, and if i’m clear then as well, then the surgeons said don’t come back.  i hope that is what they tell me!

mahalo, kev

so… being home again, and out of the hospital has helped my recovery tremendously.  in the two weeks since my surgery, i’m able to take multiple walks a day [45 minutes was my longest to date].  i’m able to sleep reasonably well and can focus on getting my mind back on interesting topics rather than just contemplating and waiting.

first off, there are many things they dont’ tell you about this surgery beforehand.  i had asked them to not sugar coat the procedure nor the post-op activity.  unfortunately, the average age of this procedure is quite a bit more than me.  i’m 30.  most all the people on my floor were in their 70′s and above.  no offense to my readers who are that age, or close to it, but that’s twice my age.

i would consider myself a healthy and fit person, before all this health issue began.  i’ve been struggling quite a bit with post-op recovery.  i cannot fathom how difficult it must be for those who are older, in less shape and less capable of handling the pain.  my hats off to them for managing through it all as well.

right, so back to the post-op.  i did not know the chest tubes would be so painful.  i mean painful.  pain i’ve never been able to have in my life.  i can’t explain it other than imagine the picture of all the muscles on a skeleton.  now, all those muscles that you can feel?  yeah… no biggie.  you bump them often.  now imagine all those muscles inside your rib cage.  they never get bumped.  well, that’s where the chest tubes were residing, and with every movement, they rubbed against those nice and sensitive muscles.   it’s not a nice feeling.

also, being sutured up with no pain meds, a la fisherman style, is one where i would recommend you put  your mind in another place.  preferably a happy place.  it’ll be over soon enough.

previous to this whole episode, i was working with a great chiropractor to alleviate some spinal discontent.  all that work is out the window, so it’ll be starting over again once i can lay down on my stomach.  sleeping on my back isn’t bad, but i look forward to the day i can roll on my side for a little change of pace.

i’ve been able to gain strength with each day throughout this post-discharge phase.  i’ve had a few really hard days.  it’s amazing how your physical and emotional pain are so intertwined.  when the physical pain gets too much, it really feels like the emotional pain comes dumping down on top of you all at once.

going through an ordeal such as this, where i’ve seen my life flash before my eyes, to being told i have cancer and then to survive a traumatic surgery… it really makes you realize what is and what is not important in your life.  i’ve had to relive a lot the past six weeks.  and i’ve had to relearn what is important in my life, and what i’ve really missed out on.  it’s been a huge growing period for me.

also, i’ve had the good fortune to never be down for more than a week or two physically in my life.  this is a major step towards being forced patience.  and oh boy is it painful to learn that.  to know i have 10 more weeks of being patient is incredibly difficult to swallow.  to not have a physical outlet to blow steam off with, or curb my emotions with is going to be a major test of my mental ability.  it already has in many regards.

i’ve also had the fortune to have such an amazing supportive cast of friends and family.  without my family here to support me all the way i would be flailing.  and without the constant and positive support from my friends, i would be hard pressed to be as positive as i am.

i go in to meet with the surgical team this afternoon for a post-op analysis.  i hope to find out how fast or slow i am recovering.  i also hope to find out the results of my biopsy, should it be done by today.  now, i haven’t been cleared of cancer 100% just yet, so i’m not out of the woods.  i hope i am clear of that possibility, but i know in the back of my mind i have to be concerned.

i’ll post an update on what the surgeons say here shortly…kev

friday.  day after xmas.  doctors came in and were impressed enough with my xrays and recovery to that point to discharge me.  my oxygen saturation was high enough [fluctuating between 90-92], my ability to move around was good [doing big laps now without a walker] and showing a sign of life again.

having no chest tubes does wonders for you.

a handful of PT’s came in to make sure i would be able to cope with post-op life at home.  i’m not allowed to lift anything over 10 pounds.  cannot reach my hands behind me, for any reason.  cannot sleep with my hands behind my head.  cannot raise my hands above my head, or elbows above my shoulder.  it’s amazing what these simple things will do to you.  try it sometime.  try remembering you can’t do something that you’ve done all your life.  don’t pull the door behind you, turn around and face the door while you pull it shut.

showering is interesting too.  no bending over further than your head to your stomach height.  do not be immobile for more than 15 minutes at a time.  walk, often.  as often as you can.  use your induced spirometer every hour.  the single hardest part was learning how to get in and out of bed.  it’s this weird twist and roll method where you hold on for dear life to a firm pillow for support so you dont’ feel like your chest is going to explode, roll and swing your legs to sit up right.

amazingly difficult and painful actually.

so, i was extremely fortunate to have travis, my mom and sister all there during my discharge.  travis actually came to my house and shoveled my walkway and a parking spot for the cars so we could just pull right in.  it was great.  then my sister and mom showed up with lots of groceries to keep me well fed for days.

without their support i would have had a difficult time.  that first day home, i was a mess.  really tired, fatigued, i slept pretty well.  slept solidly for the first time in over a month.  it was great.  other than having to wake up every three hours to take more pills.

so, i’m home, out of the hospital.  i have a meeting with the surgical team in approx 2 weeks where i hopefully will find out the nature of the mass.  it was much bigger than expected.  basically wrapping around my heart and getting up to 3 inches thick.  my windpipe was getting dangerously close to my spine.  i’ll be keeping updates from home when i can.  luckily for me, comcast screwed up [amazing, truly the WORST company in the world] so my internet is pretty much shot for a bit.  hope everyone is doing well, and can’t thank you all for the support.

mmm… christmas.  i think it was still snowing outside.  wasn’t sure.  the hydromorphone coupled with really dirty windows and crappy shades didn’t allow for me to be clear on what was happening outside. we’ll just say it was a white christmas.

doctors came in and said… time to take the tubes out.  ok, cool.  are you sure i’ve drained enough?  yeah, you have, and any excess fluid should be reabsorbed by your body pretty quickly as long as you keep moving around. ok.

but first… the catheter.  now, i’m not sure if any of you have had a catheter before.  they suck.  but they can be kinda nice.  i mean, you don’t have to get up to pee.  ever.  but, then you also have a tube in your… anyways… i had heard how it was to come out.  nurse came in and was trying to be all courteous by not lifting my gown or blankets.  after a week of the most intense pain of my life… you just don’t care about decency.  out comes this massive needle.  apparently there is a balloon [skip to the next paragraph if you don't want to know the rest of this bit] that is inflated with water inside your bladder.  that keep the tube in there.  so, she’s going to extract the water out of the balloon and then on the count of three just pull on the tube.  now, i had also heard that the reproduction of the interior lining of the whole setup down there is rapid.  like half a day rapid.  that means… it could be somewhat attached to the tubing.  which means pain.  down there.  yes, down there.  whatever… fuck it.

it wasn’t that bad really.  ok, but now you have a major issue on your hands. for days, you’ve not had to know or care if you had to pee.  but it didn’t matter cus you really had no control.  there was a tube in the way to cut off control.  but now, no tube, and you don’t know if your body will remember how to control.  or know if you have an urge.  just to be safe, i stuck a urinal between my legs for the rest of the afternoon.  i mean… c’mon!  what if i just started to pee and i had no clue?  that would be warm, yes, but also stinky and then i’d have to get my bed changed.  i’d look like an invalid in front of all the nurses.  it would be not cool.

about this time, my pca ran out.  it said i had used up all my dosage.  so i dial up the nurse.  she comes in, and i tell her the pca is out again.  she brings in another nurse and they dick around with the pca, clearly not understanding how it works.  they finally tell me i had used too much over the previous four hours.  excuse me?  how could i have done that if the first hour i was sleeping, so i wasn’t even using the pca, and the rest of the time i was just doing it every six minutes like i’ve been doing the whole week.  well… they told me it didn’t matter, the machine was saying i had used my maximum.

now, earlier, before surgery, the anaesthesiologist had asked if i wanted an epidural or to use the pca. i said pca, cus the epidural isn’t fun to get either.  now, the way it was explained to me is that with a pca, you get a maximum dosage per time frame, and then they break it down so that every six minutes, you get enough to last you the entire time frame.  thus you can never go “over” your maximum dosage.  guess i was “wrong”.

anyways… up next was the tube extraction.  with no pain meds.

the doctor finally comes in to extract my tubes.  it’s now been three hours since i last had any pain meds.  this should be fun.  first up is the tube they installed on my side.  now, i had no clue how much pain i was in for.  the doctor said it wouldn’t be bad at all.  i’ve heard that before.

first he has to cut the stitches that hold the tubes in place.  that was pretty painful.  and 1-2-3 hummmmmmmmmm.  out he pulls the tube.  it wasn’t that long, but now you can hear yourself “breathing” through a hole in your chest.  your diaphragm is still working, so the pressure difference is still there.  the hole on the side just starts destroying my bed.  shooting massive amounts of bodily fluids and blood everywhere.  the doctor was shocked it was so bad, so he took some gauze, and handed it to me and asked me to cover the hole up and hold it.  um, what?  ok.  he left to go get a suture kit.  came back and sutured me up with stitches.  now… i’ve gotten plenty of stitches before.  they were never too bad, but i had pain meds.  this time, not so lucky.  it hurt.  really really fucking hurt.  that’s the best i can explain it.  now were the other two.  now, i was expecting these chest tubes to be pretty short as well.  not so fortunate.

pause.  the humming.  doctor asked me to take a big deep breath and hum while he pulled on the tube.  it is supposed to help you relax the muscles and then the tube can be slid out easier.  well, on the second hole, my breath wasn’t that big, and i hummed a little fast.  so halfway through pulling the tube out, i had to breath again and hum again.  i could only see his arms moving, and it was like he was reeling in a fish.  these tubes were long.  they went all the way up to my heart.  the holes are just above my belly button.

the third and final hole, i was told to try and not stop humming.  just keep humming until the tube is all the way out. ok, i did that.  now the third and final hole was also “breathing” while i was breathing.  it was really freaky.  he didn’t suture this one up.  instead, on the front two holes he applied vaseline infused gauze and a foam tape.  that’s it.  then he left.

it was a bit shocking.  that’s it?  now i have three holes in my chest, and that’s it?  hmmm.

about an hour later a nurse comes in and says i have to head downstairs to radiology to get some xrays done.  um… can i please get some pain meds?  please?  just get the pca working again.  the nurse said the pca should be working again.  i hit it once.

i didn’t feel normal for hours after that.  apparently, i got grossly over medicated from the pca.  it must have built up.  but now i had just been handed a few grams of hydromorphone.  i was useless.  upon my return from radiology, all i wanted to do was sit in the wheelchair and just pass out.  no offense to users, but i’m totally not cut out for drug use.  i hated it.  it wasn’t until the early morning hours that i started to feel ok again.  it was not fun.  i think i ate some food before passing out, but then the night sweats started again and it was gonna be a long night.

ok, sorry for the delay everyone.  yes, i am ok.  a little “mixup” with seattle’s finest cable and internet service provider caused me to lose my internet connection when at home, so i can only update the blog when around a connection, such as right now.

ok, and now back to the fun.

after getting chest tube #3 installed, i was in a bit of pain.  my mom stayed with me the second night.  on the third day, being wednesday, my dad was scheduled to fly back to san diego to meet up with his wife linda, and for them to figure out what the next steps were.  they were just about to cross the border to go on their normal winter trip to baja for a surfing, painting and kiteboarding extravaganza when they got word i was having some difficulties with my health.  much appreciation to both linda and my dad for being patient and sticking it out for nearly a month while my health was sorted out.  i was fine after surgery, but it was difficult to see my dad leave after him being by my side for nearly three weeks straight.  he certainly helped keep my head upright and offer some wise advice.  i told them to head on with their trip.  get in some sun and warmth this winter.  have an adventure and think of me while catching some waves.

wednesday was somewhat of a blur to be honest.  i think brian and marijana stopped by, but i was in such pain i really wasn’t up for seeing anyone.  the nurses were great and very understanding of my predicament.  they were very careful to listen to my requests and i was thankful for their promptness.

two physical therapists came in to get me up and out of bed for the first time since i had walked into pre-op.  i was to use some big mechanical walker to get up and start moving around.  first they had to sort out the spiderweb of tubes.  let’s see if i can remember this right.  i had O2, IV, chest tube 1, 2, 3 and a catheter.  i also had a package that was sending telemetry to the main office.  it was connected up via five wires to patches on my chest, monitoring my heart rate, as well as making sure i wasn’t dying or something like that.  a lot of wires and tubes.

after getting the spiderweb untangled, i had three boxes for drainage and one sac for my catheter hanging off this big walker machine.  i had a physical therapist on either side of me, and my mom behind pushing the IV and pca dolly.  it was kinda comical.  i’m sure it was quite the site.  they said if i could make it to the door and back, that’s a pretty good start.  i wasn’t ready for that.  i went to the door and just kept walking.  mind you, i had no use of my arms, so it was quite awkward to have four people moving in sync, as every step was making the tubes move around, or things getting tight and then slack.

i went straight for the double doors which i would say were 20 feet from my room.  they were shocked. but hey, i want to recover as fast as possible.  i can’t stand being down for long.  it’s already been a month since i was able to do anything other than sit and sleep.

later on that evening, one of the nurses came in and after i had eaten dinner asked if i wanted to go on another walk.  i was a little trepid.  the first walking trip was hard.  and a lot of people, and it wasn’t very comfortable.  she told me i’d be fine and to get ready.

ok.  i got as ready as i could.  she brought in the big walker unit, hooked up all the bags to it and off we went with my mom courteously pushing my IV bags down the hall behind me.  did a big loop.  the nurse was smart to keep watch of my eyes and when she noticed i would start to daze, she would stop me and have me recover and catch my breath.  it was really smart of her.  otherwise i would have never made it through the entire loop.

after that i was pretty gassed.  what a christmas eve.  i think i got to eat some jello for dessert.

so.  surgery was a bit rough.  and then my first night was completely restless.

with chest tubes installed, entering at my diaphragm and extending all the way up to my heart, it was volatile to move in any direction without massive shots of pain moving across my body.  even with the PCA, i was struggling to maintain the pain.  as usualy, the nurses were constantly coming in to check up and take my vitals to make sure i was alive and doing ok.  i had to sleep sitting up in order for the chest tubes to drain properly as well as minimize the chance my partially collapsed lungs would fill with fluid.  i had an induced spirometer that i was to use as often as possible in order to re-inflate parts of my lung that were still not fully expanded.

my dad stayed with me that first night, and i was thankful to have someone there by my side.  upon waking up [didn't really sleep, but in the early morning hours...] the doctors came in to see how i was doing.  i had an xray through the night, and they were highly concerned about the massive pooling of fluid around my right lung that was not reducing in size, rather expanding by the hour.  they said they would have to install a third drain tube along the right side of my rib cage.

would i get put under?  no.  would i get extra pain management? kinda, use your pca.  dr’s cheng and quade showed up to do the procedure.  dr quade did not hide the fact that this procedure would be highly painful.  just then bromley and her dad showed up for a visit.  what timing.

the procedure was going to happen in my hospital room.  and it seemed as though the room was packed full of people right then.  i knew i would have a tough time, so i asked bromley if i could hold her hand during the procedure.  i promised i would do my best not to crush her hand if the pain got really bad.  thanks for being there for me bromley.  sorry you had to watch that.

as for the procedure, i could feel every single action.  from the scalpal cutting me open, to the doctors both having their fingers inside me to feel out the best path for the tube to go with the muscle and bone structure.  i want to say i passed out at this point, but i didn’t.  i can’t even describe the pain.  i wanted to be anywhere else, anywhere besides on that table right then.  the tube they stuck in me was porous, allowing all fluids to drain into it.

now, these tubes are just left in there to freely float around.  they are stitched into your skin so they do not slide out inadvertantly.  the minute they sealed up the cut on my side and stitched in my tube, mostly blood started to fill up the tank almost immediately.  it was impressive.

so now i had three tubes to deal with when trying to move around on my bed.  don’t forget.. i still had a foley catheter in me, so i was really bed bound.  for those of you who’ve never had the profound pleasure of having a foley catheter… it’s a mixed bag.  i mean, on one hand, you don’t even think about going pee.  on the other hand, it’s kinda weird to look at the tube and notice you’re peeing, but you had no clue.  the fear factor only increases when you think about it coming out.  don’t think about it.  just don’t.  fill your mind with other painful thoughts… like how your chest feels extremely tight from being clamped back together with stainless cabling.

the rest of the day was spent holding onto the PCA for dear life and trying to force food down my throat.  needless to say, i didn’t sleep much again.

oh, and the 16 gauge catheter for the IV that was on my left hand?  it was literally about to leap out of my skin.. they swiftly took care of that and stuck me with an IV right in the crease of my right elbow.  worst spot possible.  everytime i would move my right hand to scratch an itch, or lift water to my mouth, the catheter would poke itself around in my elbow.  not pleasant.  i was beginning to see it would be quite a pain filled weekend.  i was useless.

ok, so brian already gave an update, but i thought i’d fill in here with the full nitty gritty of what went down at the hospital.

to start things off…. they gave me this soap to cleanse with both the night before surgery, and the morning of.  it was some heavy duty antibacterial stuff.  once i started to apply it, i knew why they said ‘do not use above your neck!’ as it was some stinging potent mix.  and it really dried your skin.

after showering and getting my bag together, headed out to the car to make sure the snow that had fallen since saturday wasn’t too much.  driving around, with chains on, it was obvious that i still needed to go easy and take it slow.  upon return to pick up the family, the drivers side windows started to fall again.  for those that didn’t get the reasoning on this, a few weeks back, the window regulator had failed during my CT scan, and the glass was just resting inside the door until the mech at the dealer managed to pull hte glass and just jam it into place as a temp fix until i could get it truly resolved. and now the temp fix was failing.  i really didn’t want to have any potential stress after the surgery.  last thing i needed was to wake up from surgery and find my car had been f*cked with.  so we called the back up driver.

dave showed up in just a few minutes and safely got all of us [mom, dad, sis and i] to the surgery pavilion of the hospital with time to spare.  upon checking in, i was handed another pamplet of papers to entertain myself with and was asked to wait until the surgeon was ready for me in pre-op.

i managed to keep my cool for the entire waiting period until right at the end, when i finally broke down.  it was hellish.  not only was i a mess, but the dry air caused me to get a bloody nose.  so here i am, in tears and bleeding all over my shirt and the guy walks out and starts to call my name.  it was a mess.  so the dude proceeds to walk us all to the real waiting room and i say my goodbyes and head with him to pre-op.

upon walking into pre-op, i noticed my name on the board, but no station number next to my name.  this caused a whole panic with the nurses.  turns out they had called me in too early.  so i was asked to wait with my family in the waiting room.  then a few minutes later, i was asked to wait back in the surgery pavilion waiting area until they were ready for me.  so i went back and waited.  it was real cool.

finally they came to get me.  said my goodbyes again and off i went into pre-op.  laying there on the table, i couldn’t help but listen to the patient next to me.  it sounded really really bad.  and painful.  and complicated.  all it did was get my mind spinning and i started to get really nervous again.  finally a nurse showed up and started to prep me.  they covered me with an air blanket that was hooked up to a heater to keep me super warm before surgery [i was told it helps to prevent infections, as the surgery rooms are usually so cool]. i was asked all the usual questions by multiple people, how old are you, what’s your birthday, who’s your surgeon, when did you eat last, what is the procedure you’re here for, what time was your last drink of water at….

then the anaesthesiologist shows up.  nice german dude.  i ask how big a catheter they are gonna use today.  he says 16 gauge.  16 gauge! i think to myself.  shit… that’s huge.  last surgery they used a 20 gauge and i thought that was plenty enough.  then.. he just skips the needle, and proceeds to numb the back of my hand and just went for it with this huge IV catheter.  it was both painful and impressive that he got it in, and it stayed in.  about this time i started to freak again, and i asked him if it was normal for people to get nervous before this operation.  he stated ‘we would be more nervous if you weren’t nervous’ then he left and came back with a big needle of stuff.  he injected it into me, gave me a wink and said ‘this should help you mellow out’ and whaddya know?  i felt fine almost immediately.

got wheeled into the surgery room, strapped down, asked a ton more questions by the other anaesthesiologist, and that’s all i remember.

waking up was a bit more difficult than during my biopsy procedure.  my biopsy procedure i was up and fine in just a few minutes.  waking up from the median sternotomy was a whole different ordeal.  i could hear the doctors and nurses arguing on whether i should be in the ICU or not.  giving this reason and that reason.  i was starting to get nervous again.  finally i was able to open my eyes, and i tugged on the nurses shirt and asked her what was up.  how long have i been in post-op?  why am i in so much pain and bloated feeling.

turns out a few complications had occurred.  first, i was severly dehydrated, even though they had pumped me full of fluids through the IV during the procedure [they do this to keep your HR and BP steady throughout].  secondly, they couldn’t tell if i was recognizing all the fluids, as nothing was being drained out [i had a foley catheter in place by this point].  lastly, they were fearing i was losing BP [blood pressure] due to internal bleeding, but couldn’t figure out where from.

finally they found a way to stabilize me, and off to my room i went.  eight hours in post-op.  it was torture.  upon making it to my room, my family were all there.  i was feeling pretty shitty.  it had been a super long day, i was super drugged up and i was just wanting to sleep.  my dad stayed the night with me, to make sure everything was ok.  the typical every hour checkup woke me up, but it was fine.  it kept me on top of my PCA [patient controlled analgesia] which was hydromorphone.  supposedly 10x stronger than morphine.  it was hardly keeping the pain at bay.

i had two chest tubes coming out from below my rib cage, and every movement i made caused them to move inside my chest.  it was hell.

i hadn’t been told, but the surgeon had informed my family after the surgery about the procedure.  he was glad they had chosen the more invasive method, as it allowed them to get in and extract all the cyst.  he was also glad that the cyst had started to grow behind the phrenic nerve, which made removal even easier without affecting the main nerve that drives your diaphragm.  he did mention that he had never seen a cyst like the one inside of me in all his years of being a surgeon.  it was both sticky, fatty and nodular.  the entire thing is in the hands of pathology right now to confirm that there is nothing of cancerous origin there.

follow up on the fun of day 2 to come shortly.

Kevin’s all drugged up and writhing in pain. I’ve been instructed to give a quick update so that people don’t get too worried.

First of all, and most importantly, the mass has been successfully removed from Kevin’s chest. Everybody (Kevin included) can now breathe a big sigh of relief. He’s cleared the biggest hurdle and things are looking up.

The surgery went well, although the doctors are still stumped about what exactly the mass in his chest was (my money’s still on chestbursters). There was a little drama after surgery because Kev was alternately dehydrated and freaked out. After about 8 hours in post-op — endured stoically by Kevin’s mom and sister — the doctors settled on the right mix of fluids and sedatives and he was assigned a room.

Not long thereafter, fluid was discovered in his chest cavity. To tap the pressure building up inside, his doctors cut a hole (quite graphically, I’m told) in his side and snaked a drain tube in. This new addition brings his catheter and tube total to 4: one for each lung, one for his chest, and one for his doodle. He’s also being encouraged by the nursing staff to belch and fart as much as possible.

The dude is more bagpipe than human right now.

As one might imagine, the potent combination of excitement, trauma, drugs and pain have rendered Kevin less than lively company. People are encouraged not to barrage him with email or phone his hospital room (he hasn’t had any rest in days). Instead, please direct your calls to Carissa or me, and/or leave encouraging words here on the blog. The next few days are going to suck, so I’m sure he’d appreciate all the support you can give him.

Kisses,

Brian

well… with minimal fuss from the weather [was forecasted to snow all night last night and all day today.  it did neither.] i managed to finally meet the surgeon.  without prancing around the issue… the mass is so large, and is on the wrong side of my heart to allow for a minimally invasive surgery.  thus, my option is to have a median sternotomy, or a median sternotomy.

what does this involve you might ask?  well… they cut from above the sternum down my chest.  then they pull out a little saw [i haven't found out if it's a push or pull style.  i was hoping for a japanese hand saw] and cut me in half.  spread my rib cage, using the spinal area as a hinge… and wham!  they get full access to me.

the lungs will collapse during the surgery.  i will wake up with little tubes coming out of me that will allow fluid to drain from my lungs while i cough and breathe deeply to get them open again.  apparently, i get a special coughing pillow cus the pain sucks so bad.  fun.

anyways… it’s a horrible sounding procedure, but it’s done all the time.  i mean all the time.  and i’m in good hands.  the chief surgeon at uw who specializes in lung transplants will be doing the work.  and his team will be there.  so i’m really not nervous of that.

i will be doing all this monday dec 22.  i will be in the hospital for 2-4 days until i get released to come home.  they say that i will be able to move around and start to feel human again pretty quickly.  i’m not allowed to lift anything greater than a few pounds for six weeks.

i just wanted to send out an update, i’ll write more later.  i’ll be fine, and i’ll get through this with flying colors!

mahalo, kev

ps… if anyone wants to see what the beginning of the median sternotomy looks like… and you’ve got no squeamish actions.. you can see a quick clip of it here on youtube