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[cancer] Let the medical TMI begin - Lakeshore
An author of no particular popularity

Jay Lake
Date: 2009-12-06 06:25
Subject: [cancer] Let the medical TMI begin
Security: Public
Tags:calendula, cancer, health, personal, photos
Ah, post-operative recovery, sloshing is thy name. Y'all knew I couldn't leave this stuff alone for long.

Last year's surgery, a colonic resectioning, left me with a nearly foot long abdominal incision running vertically from my belly button to my pubic bone. In order to reach my colon, the surgical team had removed or otherwise relocated many other organs. This meant that the two overriding physical sensations of post-operative recovery were the muscle issues of having a completely severed abdominal wall, and the general weirdness of having my internal integuments reknitting their usual connections.

This year's surgery was a thoracotomy. I quote Wikipedia, "Thoracotomies are thought to be one of the hardest surgical incisions to deal with post-op, because they are extremely painful and the pain can prevent the patient from breathing effectively." As my thoracic surgeon said, the insult to the body is an order of magnitude less severe than last year's surgery, but the pain scale is comparable.

As a result, I expected this recovery to be physically easier, characterized by pain management rather than the severe mobility and functional impairments of last year's. This has been true, up to a point. I've been rocking the Dilaudid, though I cut my dosage by a third yesterday without dramatic ill effect, which has done wonders for my mental acuity. And as my adventures in walking have testified, my mobility has been strong. I've been limited largely by my lung functionality, which seems to be making a rapid comeback.

The overriding physical sensation, however, has been one of extreme discomfort with respect to swelling in and around the surgical site.

After the operation, I had a chest drain in, from Wednesday 11/25 through Saturday 11/28.

IMG_0663

© 2009 Shannon Page

The drain was profoundly uncomfortable — over a foot of tubing big around as my thumb looped inside my chest. (Its removal is a tale for another time.) But it did something important. My first day out of the O/R, my body put out almost 500 ml of fluids. They wouldn't remove the drain until I was putting out < 100 ml per day.

So Saturday the tube came out. Very strange, a bit difficult, over swiftly. And the fluid buildup began.

By Sunday, I felt as if someone had duct-taped a grapefruit to my left chest. I couldn't hang my left arm straight down. The actual appearance of the swelling was far less dramatic, as calendula_witch can attest to my asking about three dozen times per day. But I have continued through this past week to get a wide array of very strange sensations from it.

What we've worked out over time is that the fluids inside my chest are at least somewhat mobile. Which is to say, if I'm lying down for a while, they reach an equilibrium which feels very strange when I stand back up. If I'm on my feet for a while, the reverse happens. So every time I change my body orientation, the distribution of fluid changes, and I get a lot of strange sensory impressions. Proprioceptive hallucinations, as it were. Heat, cold, pressure, point-source pain, a sense of being gripped from outside — all manner of weird things. As I've been healing, the fluid volume has been reduced, but the body cavity has not yet reached its normal state, so these past few days the sensations have increased as the fluid has been ever more free to move around. Plus as the nerves around the surgery site continue to heal, this effect has been amplified. Icing the swelling helps, but removing the ice only seems to increase the odd sensations and false neural signalling.

This, not the pain or the wound healing, has been my single biggest impairment. Because I have what amounts to a burst bag of fluid reaching from my left shoulder blade to my left nipple, sitting in a car is difficult. The significant discomforts are associated with the swelling and the fluids sloshing about slowly within. Likewise the generalized weirdness.

Who knew? This wasn't even on the pre-op "what to expect" list.

Tomorrow, we're off to see the thoracic surgeon for a post-op consult, and to have some stitches removed from the drain site. Once this swelling goes down more noticeably, I'll be a much happier camper.

IMG_0670

© 2009 Shelly Rae Clift

Creative Commons License

This work by Shannon Page and Shelly Rae Clift is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.

Post A Comment | 12 Comments | | Link






Kelly Green
User: saycestsay
Date: 2009-12-06 15:14 (UTC)
Subject: (no subject)
Oh joy, swelling. Much sympathy, sweets. Great pics :)
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Elizabeth Coleman
User: criada
Date: 2009-12-06 18:10 (UTC)
Subject: (no subject)
That is so fascinating. Thanks for sharing, and I hope your pain gets better.
I've got a playlist entitled "pain" in iTunes that was used when I had a week of inexplicable and excruciating back pain. Mostly The Doors and Depeche Mode (Suffer Well!). Focusing the pain through emotional corridors like music (as opposed to intellectual ones like reading anything other than rhythmic poetry) seemed to help.
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shelly_rae: Bleeding Hearts
User: shelly_rae
Date: 2009-12-06 18:41 (UTC)
Subject: (no subject)
Keyword:Bleeding Hearts
You've come a long way in a short time. It's working...
Anon
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Dan/Дмитрий
User: icedrake
Date: 2009-12-06 19:08 (UTC)
Subject: (no subject)
First of all, thank you for sharing. My family has recently had a rather unpleasant (though less severe in terms of implications) experience with fluids inside one's body cavity, and I've learned that said fluids are an officially Not Good Thing(tm).

One question though: If you were draining just under 100mL/day at the time of the removal of the shunt, there's at the very least 100mL of liquid inside your body. (if your leakage decreased by half every consecutive day, you're still somewhere around 200mL by the end of it all). While it does get reabsorbed eventually, the liquid puts a significant strain on your body's resources. Why did they not leave the shunt in longer? Or would the presence of the shunt have meant having to stay in the hospital, or at the very least immobile, for a longer period?
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Jay Lake
User: jaylake
Date: 2009-12-07 13:15 (UTC)
Subject: (no subject)
I think the infection risk from the shunt, and the general irritation to my body, had to be balanced against the issues of fluid retention.
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User: quantuminsanity
Date: 2009-12-06 22:30 (UTC)
Subject: (no subject)
I'm just curious, what happens to all that fluid? Where does it eventually GO?
I hope you keep on feeling better.
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Jay Lake
User: jaylake
Date: 2009-12-07 13:16 (UTC)
Subject: (no subject)
It's eventually absorbed by the body. And there's always a small amount of fluid present in the thoracic cavity, apparently.
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mcjulie
User: mcjulie
Date: 2009-12-06 22:35 (UTC)
Subject: (no subject)
Ow.

But thanks for sharing. Someday it may help somebody going through something similar.
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Kari Sperring
User: la_marquise_de_
Date: 2009-12-06 22:41 (UTC)
Subject: (no subject)
That sounds very uncomfortable. (But writer-me wonders if you slosh?) I hope it goes down soon. (I have some experience of fluid-filled injuries, from an ankle problem. Not nice at all, and yours in a far worse place.)
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Jay Lake
User: jaylake
Date: 2009-12-07 13:16 (UTC)
Subject: (no subject)
I don't literally slosh. (I did last year.) The fluid definitely migrates, however, depending on my body orientation.
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Grant Kruger
User: thirdworld
Date: 2009-12-07 07:39 (UTC)
Subject: (no subject)
It's good to hear about steady progress and it's not TMI. Sharing the details is good for those who want to know about you, but will also help others in the same position.
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Jay Lake
User: jaylake
Date: 2009-12-07 13:17 (UTC)
Subject: (no subject)
Well, yes. You take my point. ;)
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