Friday, March 2, 2012

Starting to feel a little better


Hello all.  Beware – very long post ahead.  J

Scott is feeling better today – he’s recovering very well from his surgery.  His incisions hurt, but that’s to be expected and should feel better in a few days.  He is starting to see a little pain relief from the pump and is able to move his leg in the bed a little bit.  They’ve had a compression stocking on his leg to help with the swelling. 

The Doctors are slowly decreasing the IV/Oral meds that he is on and will continue to even everything out over the next few days.  They are going to try to get him walking again today – even if it’s just a few steps.  I feel such a sense of relief that he got through surgery and we see a small amount of progress – any progress is good and we still have very high hopes that the pump ends up bringing a lot of relief.

He is still in the hospital and may be through next week, as well.  He’s still not mobile enough to come home and they still have to get his medicines adjusted to be able to be taken at home.  It’s been hard on all of us (Poor Neil is still there every day I’m at work and every night – he’s such a Trooper!) but as much as we want him to come home (and that is so so so so much!) we don’t’ want to rush things and him be uncomfortable.  Additionally, they really hope he can start chemotherapy on Monday.  Because that chemo will be hard on him (because of the side effects and because his body has been through so much in the past 3 weeks), keeping him in the hospital through those 5 days will allow them to constantly monitor him and help keep him comfortable.  I will keep you posted if chemo can start on Monday or not.  This remains the biggest goal after pain relief – we need to get back to treating the cancer systemically and address the tumors in his liver.  They are going to a scan before chemo starts so they have a baseline to measure the success of the chemo against.

He had his last radiation treatment yesterday.  They did have to sedate him again, but he’s done with those now and we’ll know more in a couple weeks about the effect that it had on the pelvic tumor. 

I wanted to share with you all more information about the pump and how it works.  Surgery ended up being a full 6 hours on Wednesday – 3 hours for the actual surgery, 2 hours of prep and 1 hour of recovery before we could see him.  (Those were some of the longest 6 hours of my life, but Neil and I got through it together).  The surgery took awhile because you don’t want to rush threading a catheter through one’s spine.  The pump itself was inserted into his abdomen, about an inch underneath his skin.  It looks like a tuna can (not kidding).  We probably won’t be able to see it under his skin, but on super skinny people, supposedly you can. 

He has three incisions – one in his abdomen from the pump, one on his side to assist them with threading the catheter, and one in his lower back for the same reason.  They are relatively small – the abdomen is the biggest one.  The pump is the 40ml (larger) one and is filled with Dilaudid, since he seems to respond well to that drug.  It constantly delivers medicine directly into the spine in the amount of .5mg Dilaudid per day (to start).  He gets 4 extra infusions each day (every 6 hours) to help with breakthrough pain (I call them “freebies”).  To get these extra infusions, he uses a remote.  He puts it on his skin right over the pump in his abdomen, pushes a couple buttons and waits for the beep.  It sounds so crazy, but that’s really how it works!  If he tries to do these before it’s time, the device will record the attempt, but not let him. 

When he gets an MRI or other magnetic scans, the device is setup to stop when the magnet is detected and will restart after it’s done.  The pump batteries can last for 4 – 7 years.  He will hear beeping when they get low, or if there any problems with memory, the device being empty, etc.  When its batteries are out, a new pump is inserted.  Obviously, we hope Scott won’t need it for anywhere near that long, but many people live with pumps many many years. 

It was pretty interesting to us that the reps from Medtronic (the company that makes this pump) were there to assist and oversee the insertion of the device during surgery.  We met them and they were the ones who told us how the remote and pump work.

The pump started delivering the medicine to his spine approximately a ½ hour after they turned it on.  He will have to go back periodically to get the pump refilled.  It will likely be around every couple months.  We he goes in, they access the pump in his abdomen via a needle and drain any excess medicine.  They then refill it with a needle, as well.




If you have any questions, feel free to let me know and I’ll try to answer them.

I hope you all have a good weekend!  I’ll be at the hospital all weekend again and will send another update Monday night to let you know what happens with chemo and how he’s feeling.


Love,
Amy

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