River: State of the FlowerCat Episode 9 probably
Aside -- this post is being composed somewhat in real time over the course of the weekend. Don't expect verb tenses and words like "yesterday" to be consistent. Or even make sense.
Colleen came home from a month of rehab on June 16th. She was a lot weaker than she'd led us to believe, and after a couple of days was unable to transfer out of her wheelchair and into bed.
On July 2nd, she went back into the hospital, after a catheter change that basically didn't work. It was pretty clear that she was likely to need surgery, and that the best place for it would be UW. She was in the ER for five days getting IV antibiotics and waiting for a bed to open up in UW's surgical unit. (It still hasn't.) They finally admitted her to WhidbeyHealth on the 6th and started doing tests.
Friday the 9th they did a CT scan which showed that:
- The fistula between her bladder and intestine had never completely closed, and in fact had probably been there and getting larger for a long time. I was strongly reminded of the water-line break we'd had fixed last October, which also had been there much longer and much worse than we'd thought. That explained why the catheter kept getting stuck through it.
- She appeared to have a bowel perforation. It wasn't hurting as much as it would if it really was one, though.
N came up from Seattle Friday evening to keep me company. Or as she puts it "make sure I take care of myself." Since I often don't.
Friday night around 3am her pain increased a lot. They took some X-rays. Perforation very likely. She also appears to have a bowel obstruction. Ugh. They've scheduled a CT scan with contrast for Saturday at 9pm, in hopes of finding out exactly how bad things are. She may need emergency surgery tonight.
They came to take her to the CT scanner right about 9pm. They'd stopped giving her contrast solution because it was making her nauseous, probably because of the obstruction. She'll get more rectally. (Ugh. I remember having a barium enema X-ray; I think I was somewhere around four years old, give or take a couple. One of the imaging techs agreed that it's not something one forgets.)
After the scan and a physical exam afterwards the surgeon and Dr. Rangel, the hospitalist who had saved her life back in April 2019, agreed that while it didn't look she had a perforation, there were definitely bad things going on, and scheduled surgery for Sunday afternoon.
...
Sunday morning Colleen called to say that she was headed in to surgery; N and I didn't quite manage to get to Coupeville before she went in. The ICU nurse, Ellen, told us that her white count had gone way up, indicating dangerous levels of infection, so they decided to operate immediately rather than waiting until the afternoon. (Eeep.) (We found out in April 2019 just how shockingly fast toxic shock from a major infection can strike.)
They're not going to be able to do all the repair work that needs doing here on Whidbey; they're a small hospital and don't have the experts in urology, nephrology, and gastroenterology that they have at UW. So they'll just do damage control -- clean out the infection and the worst of the damaged parts -- then keep her sedated and on life support until she can get to UW and get put back together properly. SCARY AS HELL. But it gives her the best chance.
Whidbey has an advantage at this point just because it is a small country hospital -- the people here know her and care about her. Most of the nurses and some of the doctors have known Colleen for years. It makes a huge difference in the kind of care she's getting. "The lady with purple hair who rides a scooter" is pretty memorable.
...
She got out of surgery around 3:15, Dr. Yousef came out first to give us the good news and quick update, and (surgeon)Dr. Angelos gave us the details later. She was a mess inside, and he did a lot. Partial list: Stitches to the bladder to close the fistula, removing ~7cm of bowel (which she was way short on to begin with), strictureplasty (widen narrow spot), remove calcified, probably-infected mesh from earlier hernia repair, adhesions, loop colostomy, other cleanup. 3-way call with UW around 5pm. The next 12-24 hours will be the most dangerous time. She's going to need more work when she gets to UW. Call with UW scheduled for 5pm; rumor has it that there _is_ a bed available.
[Crossposted from mdlbear.dreamwidth.org, where it has
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