Mar 26, 2011

Day After Surgery

Roger's first day after surgery proved to be an extremely busy day. I just got back to my room about 12:15am. It started out better than his first night. He moved from a liquid diet to a soft diet. For breakfast he had a hardboiled egg, bacon (of course!), orange slices, honeynut cheerioes with 2% milk and apple juice. Dr. Lang came to visit him and ordered his foley catheter removed and his magnesium and potassium IV's removed. He also said he could move out of ICU when the next bed became available. We thought that would be a while.

Physical Therapy came to evaluate him. A PT came and helped him get out of bed and sit in a chair. They did some exercises on his legs to see if he needs to go to the rehab floor for a bit or just stay on the regular floor. His left side was good, but his right side was slow. The second set of exercises they did on the right leg went faster and better than the first. He was still not able to move his right foot or ankle. As a result of this he can not walk without assistance. If he does go down to PT they'll probably do some electrical stimulation for that. It worked on his right lower leg after his first craniotomy caused him paralysis. Shortly after the PT left a Rehabilitation Services person came to evaluate his self care and home care abilities and if he would need therapy in those areas. He told us they would be evaluating him again and by early next week as he rested and more movement & abilities returned they would know what rehab and therapy he would need. He was super tired after all this.

If you know Roger, you know he had a strategy for choosing his lunch options so he could have better options for dinner. He had an MRI scheduled for 9:00pm and he wanted to eat before his MRI so he wanted to save the big meal for dinner. For lunch he had cream of mushroom soup, a philly cheesesteak sandwich, green peas and the root beer he didn't drink the night before. Well, they moved him to a room on the regular floor and the rest of the day was spent dealing with the move, getting situated then being sent off for the MRI between 6:00-6:30pm earlier than planned. He was taken to the 3rd floor in-patient MRI department and as soon as they tried to put his head in the forms for the MRI it hurt his incision again. So his new nurse on the regular floor who he had not even met yet had to come down from the 8th floor to give him some dilaudid. He didn't return from the MRI until 8:50pm which caused a problem with eating dinner as dining services stops taking orders at 9:45pm and closes at 10:00pm. So as soon as he got back in the room, I had to get him to decide what he wanted to eat (they are given a menu) and call the order in asap. They always say the order will arrive in the room in less than 45 minutes so we were pushing it. As we waited for dinner to arrive, Roger's nurse was literally running around trying to get everything that every patient needed done done. It was crazy busy in there. As she was trying to get one anti-seizure med via IV, stool softener & another anti-seizure med in pill form to Roger she noticed his IV hand was swollen. She knew his IV had gone bad and needed to not only switch it to his other hand which had another IV in it but she needed to remove the bad one completely and she noticed he hadn't gone to the bathroom for a while.

So she unhooked him from the bad IV so it wouldn't keep going into his skin but then she got called to another patient. When she came back she did a bladder ultrasound on him real quick and it showed his bladder was filled to 800 units and told us anything over 250 should have the foley put back in. She got called to another patient and Roger tried to urinate while she was gone. And he tried really hard because he did not want the foley back in. He had been trying for a while when she returned and he convinced her to let him try standing up. So she held his right, weak side while I held his left side so he could try standing up. It took forever and he was able to slowly get rid of 400 units. We talked him into taking a break and trying again later as she and I both were getting exhausted. At this time it was 10:00pm and his dinner had not shown up yet. She told me to try and call dining services but they may not answer. So I called and got a recording. They were closed. I opened the door to his room and looked around to see if maybe they brought it and just set it outside the door. Nothing. Then I saw a tuxedo clad dining services person coming down the hall. What a relief. Roger got his fancy dinner of Greek salad with Greek vinaigrette, stuffed shrimp with lobster sauce, wheat dinner roll, Sprite and angel food cake with fresh strawberries. He said it was delicious.

And he was able to urinate again and get rid of the remaining 400 units. It was a little easier this time and we didn't have to hold him up. His nurse was also finally able to get rid of the old bad IV for good. We got him all situated again and ready for bed. Now I'm off to bed finally myself. So glad too, I'm super tired.

~Holly
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