Anniversaries Part III

Day 13 of our marriage: 

Thursday morning and daytime carried on with some of the previous days' routine, poke me in the chest, be worried about how much pain, shoot me in the belly with Heparin, which was now resulting in bruising, take my vitals, take more blood. Now, my IV, placed in Tuesday night was causing so much pain that we decided to find a new spot. That took more poking in the afternoon. At this point I had been given the same day time nurse two days in a row, Lori. She had seen me through my feverish mess on Wednesday and we were getting to know her more and more.

Joseph finished school early and the doctor came by in late afternoon. He took a seat this time. Huh...that seemed different. He started to talk. He started to lay out what we were facing.

It wasn't clear yet if the antibiotics were working. He was honest. People die from this and my heart and lungs were at risk. If those tissues were damaged I was facing a major surgery to try to reduce the damage done and then a long healing process. I could need a PICC line which is basically a semi-permanent IV placed in your arm with a line up into the heart that would allow for IV antibiotics to be delivered for 6-8 weeks. If damage was done to my organs I was looking at months away from work and a long healing process. And on the better end of the spectrum I could get better in the next week or so. The surgeon would be in the next morning and he/she could determine if I needed invasive surgery to clean out the infection and repair damaged tissues.

WE WERE SCARED. Flat out, no messing around this was terrifying. Once the doctor left the room we began a flurry of discussion and phone calls. Thank goodness my head had cleared from how it was Wednesday. At the same time I was on enough pain killers that clarity of thought was not exactly easy. We knew we needed a game plan. Ketchikan, though it has a hospital, does not have a community of specialists. The whole town is 10,000 people and the only way off is a plane or a boat. Seattle is a two hour flight and the closest high quality medical care. Joseph began calling family, trying to get their ideas and my precious Aunt called my insurance to find out what was covered, what long term care could look like. He and I talked about what was our line to tell the doctors that we were going to Seattle. We decided that we would do the surgical consult but not allow them to do any major surgery. I would not have an invasive, anesthesia needed surgery in Ketchikan. We weren't exactly sure how it would work and after some inquires with nurses we knew that we could ask to be transferred and that I could board a plane with my IV's and go to Swedish Medical Center. At this point I was not "sick enough" to have a Medivac transport. If the surgeon had good news then we'd stay.

We settled into bed with a plan, all centered around what the surgeon would say in the morning. My body was aching from the terrible beds and days spent laying on my back. I wanted so much for just a short time to be on my stomach. So I got some pillows to try to cushion my chest and bared the pain and attempted to settle for a few minutes. Which is about when the small opening that had been made on Monday and pushed on all week began to expel the gunk...ah gravity. But it was a bizarre kind of hopeful moment. I went to get the nurse. I hoped that perhaps if we could get enough out to relieve some of the pressure I felt that I would get some pain relief. So I clutched Joseph's hand about 10 pm as she pushed and I wriggled and tried not to scream. And sorry for those who are squeamish but my liquified tissues came out. (That is the horror of this infection, it is considered flesh-eating) At least enough came out to make me not so miserable.

After middle of the night vitals and another dose of IV antibiotics I could not sleep and Joseph couldn't either. I began crying, he started crying and neither of us could say our worst fears except in short sentences. But what was going to happen? Would I die? Would I be sick for months? He started praying and saying scripture. Which soothed me enough to slow my tears. He found worship music on my computer and we both tried to let the songs ease our fears. It was a terrifying night, but I was not alone, my dear husband who was facing his worst fears, having to be in a hospital day after day, was staying beside me every night, no matter the nurses encouragement for him to go home and sleep. We were together and God was there and somehow we would get through each moment. I had never felt so close to another person in my whole life. There was a oneness in our fear, in our hopes and dreams for the future and in our resolve to get through it together.

Friday morning, day 13 of our new life as husband and wife. Joseph had gone up to school early in the morning to try to make up what he missed during the week. We had no idea what time the surgeon would come by and knew he had to get school work done. Lori, our nurse was aware of our plan and let us know that she would give us as much warning as possible about the surgeon coming. She gave me the heads up about 930, I called Joseph. He was coming. The surgeon came breezing in and wanted to get started before he arrived. I thought she would just be assessing so again the baring my chest, which at this point I had no modesty left, but the poking was so painful that I squirmed away. The surgeon scolded me with "stay still" and "it can't hurt that bad" To which I burst into tears shaking and unable to calm down. Thank God Lori was holding my hand on one side and within a few seconds Joseph came flying through the door.

The surgeon wanted to open me up right there, in the room. Since I was infected, there was no need for a sterile environment, just clean equipment and minimizing exposure to more bacteria. She was describing a couple inch incision to clean out the infection and check for tunneling.  She had already called for morphine when I was crying out at her poking. Joseph and I talked very quickly and felt that this minor procedure could be done but if she wanted to do anything more extensive and we would say no thanks and head to the airport. The surgeon had left to get some gowns on and the staff started filling the room, I was given morphine. Joseph was made to leave by the surgeon. He didn't want to but Lori, thank goodness, kept assuring him that she would be with me and it would be okay. He stood at the door, held back with a nurse. Once the morphine was on board I was somewhat better, although I got a second dose before the procedure which eased me into a very hazy state. Shots of Lidocaine around the site and she completed a two inch incision and began exploring. Thank goodness for the medication. I didn't notice most of it. Her verdict was the infection had most likely stopped progressing. There were two small pockets on the edge of the main cavity, which needed to be watched and there was no entry into my ribs, or the protective lining between flesh and my lungs. The final step was filling the cavity with sterile gauze. Three feet of quarter inch wide gauze tape was packed into the opening.

The surgeon stated that tomorrow morning the gauze would need to be removed by Lori and she needed to visually inspect the cavity. If there were no signs of further tissue loss then we could be fairly certain that the infection had ceased. So for Friday we held onto hope. We knew that the situation was looking better and by Saturday morning we would have an even greater degree of certainty about making a full recovery.