One Year Anniversary!

One year ago today (Nov 20, 2017), Bob went into the hospital for a medically necessary surgery, a right ascending hemicolectomy. We never imagined the operation would lead to him very nearly losing his life. It was the scariest Thanksgiving we'd ever experienced. 

A year later, we have so much to be thankful for! Bob has spent the last 52 weeks overcoming rehab obstacles, recuperating, healing and learning to live his "new normal". We were fortunate to spend much of this past year reuniting with friends and family - some that we hadn't seen for many, many years. We are sharing pictures of some of those visits on today's blog post.

It's difficult to always remember that life really is precious. For us, this one year anniversary is a reminder to look for the good things; to be grateful for the people in our lives and the experiences we live. 

Day 61

Nothing but Good Stuff
   *Today is the end of the first week Bob has been back to work. He has stayed at the office for anywhere from 4 to 7 hours each day! When he begins to have some abdominal cramping and aching, he leans back in his desk chair (semi-reclines) and is also taking walking breaks every hour or so to change from a sitting position. He's quite sore and tired when he gets back home, and sighs a big sigh of relief when he lays back in his hospital bed. But he's a real trooper and I'm very proud of his determination!

2018 selfie taken in front of a white board at work.

   *I do his dressing change each morning after his shower, and he's very meticulous now about documenting daily wound measurements. BIG news...the depth of his wound now measures ZERO, because the wound bed has filled in and meets up to the level of his skin! Now just waiting for the length and width to close up completely.

(click to enlarge)

For the metrically challenged, here's a healing comparison in inches:

Today (1/19/18): 3.7" long x 0.75" wide x 0" deep

Day #8 (11/27/17): 8" long x 3" wide x 2" deep

Day 51

Returning back to "normal":
   Today Bob and I visited his office to get paperwork arranged for his return to work. He's starting back tomorrow (Wed, 1/10) to try things out, to see how many hours he can comfortably work while being "vertical", and to start catching up on what he's missed over the past almost two months. We'll see how he does. Of course he'll have to build up his endurance and stamina to working full-time hours again, but mentally he needs to get back into a groove of schedule and purpose, and this will be the start.
   As the home health care nurse visited our house today to do Bob's final wound assessment and complete his official discharge, she reminded him that his body is not yet completely healed (he does still have an open wound that gets a dressing change every day), that he needs to avoid large crowds and people who appear to be sick, and remember that when he feels tired or sore, to listen to his body and not overdo it. 
   Note: Today Bob wore the T-shirt that Jessica & Bruce gave him for Christmas!

~ Visiting with friends at Aeronix today ~

Day 47

Sayonara, sponges!
   After a visit with Bob's primary doctor yesterday, and his surgeon today, the consensus is no infection, but rather just sloughing of some dead tissue (gross, I know). In fact, today his surgeon said he sees epithelial tissue growing around the inside edges, so NO MORE VACUUM DRESSINGS! Bob still has an open defect, but it is now less than 0.5cm deep, a little shorter than 14cm long and fewer than 2.5cm wide. We'll be doing daily gauze dressing changes from now on (and more frequently, when needed) and using topical antibiotic ointment in the wound bed. Surgeon told us the final scar could take up to one year to totally close and fill in to be completely level with Bob's existing skin! But hopefully he won't have to wear continuous dressings for more than the next 2 to 3 months.

Lunch!
    We celebrated Bob's freedom from "the leash" and went out to lunch together today. He's steadily increasing the number of hours he can spend in a vertical sitting position, defying the odds and continuing to improve each and every day.

~Out to lunch at Apollo's Diner~

Texting with the home health care nurse to let her know 

doctor ordered discontinuation of vacuum treatment!

Day 45

Happy New Year! ~ Adios, 2017!

Wound

   Vacuum sponge changes are still happening every 48-72 hours, but there were a few instances over the holidays that the time between nurse visits was prolonged due to staff scheduling. So we hit a small speed bump during this morning's dressing change, and are going to see the doctor tomorrow to confirm if there is or is not a slight infection brewing (which could have happened due to the extended times between dressing changes over the holidays). Bob's also having some skin breakdown, which is likely a reaction to the skin barrier liquid that is applied to the skin before the clear draping is glued down to hold the sponge in place. 

   With the possibility of a wound infection combined with the skin breakdown issue, the nurse decided to remove the vacuum dressing until tomorrow morning's doctor visit. So for the rest of today, there is only a wet-to-dry gauze dressing on Bob's wound, which gives his skin a chance to breathe for a bit.  

Today's bandage shows how the wound has really decreased in size!

Overall, the wound's healing has been progressing great. Here's the latest measurements as of 1/1/18 (depth is under 0.5cm now!):

Happy 2018!

Days 35 & 36 ~ Merry Christmas!

Red Meat
   Bob's anemia is still plaguing him. One of his wound nurses said he needs to eat some good ol' red meat! So on Christmas Eve, we ran to Downtown Produce (just 5 minutes away), went in, bought 4 NY strip steaks and some fresh broccoli, and were back home in under 20 minutes. It was Bob's first official "outing" (can't count doctor's appointments) since the surgery debacle began.

Bob headed straight for the meat case. 

Hoping to get a little more color into that pale skin.

Christmas dinner
   What a great Christmas gift - having a steak dinner at home with Bob by my side.

Wishing the happiest of Hanukkahs and merriest of Christmases to everyone! 

Day 34

Wound Healing   

   As previously shared in this blog, we've been keeping track of the wound measurements taken during wound-vac dressing changes. I don't post the actual (graphic) pictures of the wound here, but for those of you interested, here's a chart Bob asked me to make. He wants to see the trend of growth and be able to visualize the actual improvements. 

Impatient

   Some days are harder than others now - healing, re-growing tissue and building back muscle can be a slow and tiring effort. Bob continues walking daily, his appetite's slowly improving, and he's getting lots of rest, but I think he's becoming impatient with the pace of his recuperation. Small steps every day. I remind him this is still part of the marathon; this was never a sprint.

Watching YouTube TV on his phone.

Days 29 & 30

Saw the Surgeon Tuesday
   Bob is healing well and doesn't have to go back to see his surgeon for a month now! No more weekly appointments.

Healing 
   He's walking more, slowly getting stronger, building his endurance, and only has pain if he's been sitting up too long or has to have the wound-vac dressing changed. Every day is a little bit better than the day before.

Still anemic...
   ...but his hemoglobin is up to 8.9 now - the highest it's been since this surgery journey began a month ago. We're pushing protein so his body can continue to heal.

It's so nice that I just have a few happy bits to share, and no long, drawn out narrative of worries and bad vital signs to be posted. We're really starting to feel like he's on the other side of this thing for good.

Ready for his morning walk. There's 38 pounds less of Bob now!

Waiting to see the surgeon. If you couldn't guess, Bob really dislikes his "tether".

Days 27 & 28

First Weekend Back Home

   We're working towards some normalcy around the house. Life seems to still be moving at an unnatural rhythm, but we're focusing on mastering the everyday typical stuff (showering, meals, etc), to try to get back into the swing of things.

Saturday

   Kindred Home Health came and did their initial assessments (nursing and physical therapy). Each activity needs a followup rest and/or nap, which is a healthy and necessary trade-off.

Wound nurse trying to stop a slight wound-vac leak.

Physical therapist assessing Bob's balance strength.

Sunday

   We took a 15-minute walk down our cul-de-sac this morning. Bob's walking pace is half as fast as it used to be, which is perfect for me, since now he walks at the same speed I always have! He insisted on checking the mailbox; again, striving to get back to "normal" life. (You can really see his 35-pound weight loss in these photos: his clothes are literally hanging off him now)

This coming week will have wound care visiting us on M/W/F, a surgeon's post-op office visit on Tuesday, and some physical therapy visits (either two or three times). Maybe, if we're able, a tiny bit of Amazon Christmas shopping, too.

Grateful and Thankful!

So many people have been so wonderful through this entire experience. Meals, cards, gifts, emails, visits, pictures, phone calls, notes, facebook posts, chore-doers, dog-sitters, lawn-mowers, house-cleaners...the list goes on and on. We've been blessed with such outpourings of kindness, support and love. We're forever thankful and grateful for all of our family and friends and co-workers that have lifted us up, and appreciate the continued good thoughts as Bob keeps healing and improving. 

Thank you, each and every one of you, for keeping us in your hearts!

Day 26, Home!

Finally!
   Hard to believe Bob's condition was critical with sepsis, a fever of 105F, tachycardia, dangerously low BP, an open, infected abdominal cavity and 18 pounds of extra fluid filling his body, all just 21 days ago! We've started talking about everything he went through, and he's really astonished to hear about it. He's got strong memories about trying to get that ventilator tube out of his throat (he said his mind kept telling him they didn't put it in right), but other than that, most of those ICU days are lost to him. I'm very thankful for that!

Here's a few photos to sum up our day so far:

Waiting for discharge, after dressing change done

and transfer to home wound-vac unit complete.

Ready to go! 

Except they had to go find a wheelchair to bring him out to the car...

😦

Bob got all armored up with a pillow over his belly,

but an excited Dingo was a good boy and just gave him a few kisses 

and got lots of rubs and pats - no jumps.

   So we're back home, waiting for the hospital bed to be delivered early this evening. In the meantime, Bob's been relaxing in his recliner. We'll now be transitioning to the weeks of home health care. Life is very, very good!

Update (7pm): 

   Best recuperating spot in the entire house! Only a few steps from a bathroom, adjustable lounging hospital bed, huge TV screen just a few feet away, a computer and cell phone on one side table and a wound-vac pump on the other. Plus, weeks of wound dressing supplies stacked neatly in boxes on the mantle - how festive!

Recuperating room (fka TV room)

The most comfortable Bob's been in a long time.

Day 25 ~ Room 125, 4pm

Flurry of Activity 

   Today Bob had his last hours of inpatient OT and PT at Sea Pines. He will still have home health care coming to the house to provide therapy, and may possibly continue to attend outpatient therapy at Sea Pines, too.

   The representative from Kindred Hospital met with us today to confirm they will be providing wound care for Bob at home. His nurse will come to assess on Saturday, and the regular visits for dressing changes will begin next week Monday (changes will still happen three times a week, M/W/F).

   The representative from KCI (the vac therapy company) met with us today, assigned the portable vacuum unit to us, and trained us on how to operate the ActiVAC model that will be going home with Bob tomorrow. In addition to the unit, he also gave us supplies for 5 dressing changes. The boxes are large, but very light. I brought home as much as I could from his room today, so that we won't have too much to carry besides these boxes with us tomorrow.

Our "to-go" wound vac pile for Friday.

Wound Vac Therapy
  Quite a few people have asked us about the wound vac therapy and how/why it's effective. Below is a 3-minute animated video that explains how the dressings are applied and how the system promotes faster healing while greatly reducing chance of infection. Bob's wound is still 18.3cm/7.2" long x 5.8cm/2.3" wide x 1.7cm/.67" deep, so when the sponge is removed and then replaced, he still has considerable pain, especially when the vacuum is turned back on over the newly packed dressing. 

   Considering Bob's wound itself has already reduced 2.1cm/0.83" in width and 2.3cm/0.9" in depth over the past weeks using wound vac therapy, with no infection at all, I think the system is great!

Promise, only animation, no real stuff.

Day 24 ~ Room 125, 6pm

Thankful for Visitors

   Today Bob had his OT from 9-10, his first PT session from 10-11, and his second PT after lunch, from 1-2. Some visitors from work caught him out and about, walking without assistance!

Tim and Bob as the patient *walks himself* to PT!

   Then, after a full day of therapy, a shower followed by a very thorough wound clean and a sponge-vac change, Bob had a few more visitors this evening. This entire experience has really emphasized how fortunate we are to have so many good friends and caring family members in our lives!

Terry visiting with Bob...who's already in bed after a busy day.

Wound-Vac Dressing Change #7 

   For those keeping track 😉, below are the latest measurements:

   *Dressing change #7 (12/13, today): 18.3cm long x 5.8cm wide x 1.7cm deep

   *Dressing change #6 (12/11, Mon): 18.5cm long x 7cm wide x 1.7cm deep

Getting Ready

   I spent a large part of my day today arranging things for Bob's Friday discharge. I scheduled his final inpatient wound dressing change at Sea Pines to happen Friday morning at 10am so he could be home hopefully by lunchtime. I also made sure that today's and Friday's dressing changes were being done by one specific nurse instead of another. (I had to meet with the charge nurse, nursing supervisor, case manager and finally the wound-care supervisor, but my request to remove one of the two wound-care nurses from Bob's care was coordinated and I felt so much better after that- every once in a while you come across a health care worker who should really be doing something other than providing health care, you know?)
   I also arranged a hospital bed to be delivered at home on Friday and scheduled the 3-times-a-week home health care visits for wound dressing changes starting next week Monday. I confirmed with our case manager and our insurance company that the portable wound-vac unit ordered yesterday wound be delivered tomorrow (Thur) to Sea Pines so Bob will leave the rehab hospital connected to his own home wound vac system when he leaves on Friday. I setup Bob's next two weekly post-op appt's with his surgeon, and also stopped and picked up an XL mattress topper, sheets, etc for the hospital bed.
   Absolutely no complaints here! Would rather be making all of these plans and arrangements than feeling heartbroken and helpless with him critical in the ICU. He's come a long, long way in a relatively short time! ~ Talk about blessings ~

Day 23 ~ Room 125, 5pm

Waiting

   One of Bob's least favorite pastimes is waiting. Wait for the dietician to bring food. Wait for the nurse to answer the call bell. Wait for the transport van to pick you up and take you to your doctor's appt. Wait in your surgeon's office for him to come in and examine you, while your muscles are aching and you're exhausted just from the trip.

Hating the waiting at the surgeon's office today.

   And more waiting today: Wait for the care team's weekly meeting to determine a discharge date.Then they decided Bob will be able to go home this Friday! So in our house, Christmas is coming a little early... We'll be doing our happy dance (or maybe just some jazz hands) on  Friday, December 15th!

Home Health Care
   Bob will be going to outpatient OT and PT, and home health care will be coming to do vacuum wound dressing changes at home on M/W/F. No word yet on how much longer he'll be using the negative pressure wound healing system.

Weight Loss
   I do not recommend Bob's weight loss method that was utilized over the last 22 days, and neither does he. He's lost 29 pounds! Unfortunately, some of that was muscle, but he'll be working on getting back into shape.