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Surgery 1.0

Today is day 13 post op.

I was hoping to get a surgical update on to the blog a bit sooner than this, but the size of the surgery, and its length of recovery time whilst known, perhaps did not truly register with me.

The surgery itself went for 6.5 hours on the 14th of February, its a valentines day I’m sure I wont forget in a hurry. I was taken into theatre about 0830 in the morning, and the anesthetists took some time prepping me for surgery. They apparently had some trouble trying to get in the epidural, although I only have vague recollections of this as by this time they had already hit me with midazolam and fentanyl in not-insignificant quantities. In fact, shortly after the epidural, the next thing I remember is waking up in recovery. The anaethetists also had some trouble trying to insert a central line, as my right IJV was thrombosed 3 years ago, and not particularly helpful,whilst my left IJV currently has a portacath in it. In the end, they opted for a right subclavian line.

I woke up to the news that the surgeons successfully managed to resect the para-aortic node without needing to graft the IVC or the aorta, and that they also managed to successfully resect the node behind the left renal vein without having to remove the left kidney. Both were intra-operative decisions that would/could have significantly impacted on the length of recovery. The final node, which was located in up behind the crux of the diaphragm was the most technically difficult, but that was successfully resected as well.

All in all, it was considered a pretty successful surgery. The rest of the work is left up to me in recovering from it. I initially spent 2 nights in the surgical HDU, having lost about 1200mls of blood during the surgery, and resuscitated with about 9 liters of fluid. For the first 12 hours or so, there were issues with maintaining my epidural block, as well as my blood pressure. The epidural was managed with various concoctions of anesthetics and opiates until an effective combination was found. The low blood pressure required the use of inotropes, in this case dopamine, to help maintain a mean arterial pressure over 70mmHg, which was initially dropping to as low as 50. They also gave me over 10 units of Albumin during this time to help support my vascular volume.

After 2 days in the HDU, I was transferred to ward 73 which is the urology ward. Basically the emphasis from that point has been about managing pain, and awaiting the bowels to work again. One of the main complications of this surgery is an ileus, which is where the bowel, after being asked to sit on my chest wall for 5 hours during surgery, go into a state of shock and stop working. An Ileus can last as short as a day or as long as a couple of months before it resolves and bowels return to normal working order. Its very hard to predict how long it will last for, and in extreme cases, IV nutrition is used since the patient can’t eat. Currently, my bowels are working, but not in stellar shape. I still have difficulty eating and holding down food, and can really only eat small quantities at a time. My abdomen has been really distended, but that is slowly improving over time.

During the surgery, there was a drain placed in my abdomen that drained over 2L of fluid over the 36hrs after the surgery. The drain was then removed and the wound dressed. I only mention this cos 2 days later, at about 4.30am, I awoke and noticed that it was a little damp around my dressing. The nurse removed the dressing to inspect the wound, and literally, fluid was bubbling out of my wound… we promptly replaced the dressing with a bag and my abdomen drained a further 1500mls over the next few hours.
Outside of all of this, I have done pretty well, and was discharged day 10 post op. I had some subsequent nausea and vomiting afterwards, but this seems to now have settled, and I’m feeling a lot better. I’m still really really tender, and this won’t change in hurry, i’m also quite anaemic from the blood loss, both of which will improve over the coming months.

So, that was my surgery!

Till next time…

  1. Christy Rolfe
    February 27, 2012 at 11:17 am

    Jared, thankyou for your comprehensive blog, its so interesting to know the details but most of all I was filled with delight to know you came through to the extent you could write it so soon. I have been thinking of you a lot and sending up strong ones, Will continue to do so as you go int the next stage of surgical recovery.

  2. Renee
    February 27, 2012 at 11:22 am

    All the best Jared, praying for a complete recovery and restoration of health.

  3. Maree
    February 27, 2012 at 5:25 pm

    Hi Jared and Hannah,

    Thank you for the update – our home-group have been praying for you, so good to hear about your surgery and the successful removal of the nodes without having to perform a graft or removal of your kidney etc! We will continue to pray for you during your recovery phase, happy to hear that you are feeling better and the nausea has settled.

    Thinking of you,

    love and blessings to you both,
    M 🙂

  4. Tony
    February 27, 2012 at 7:54 pm

    Glad to see your back blogging a very good sign indeed. Blessings on you and Hanna.

  5. Shannon
    February 27, 2012 at 9:54 pm

    Hi Jared, I do not know you personally but found your blog through Kristian’s blog. I have been following for a little while, and am quite relieved to see your post today. I have been wondering how it all went and am really pleased for you that all has gone well. Looking forward to many more installments as you recover.

    February 27, 2012 at 11:15 pm

    Thanks for the update, praying for you and yours.

  7. Michelle
    February 29, 2012 at 9:44 am

    Really glad to hear your surgery was successful, praying for a speedy recovery for you

  8. February 29, 2012 at 10:16 am

    Hi Jared – we are so thrilled that all seems to have gone well. We will continue to pray for a complete healing for you. Linda & David Marriott

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