Infection = Bad: The last 48 hours

Boy. That’ll teach me for being bored. A lot has happened in the last 2 days (days 9 and 10) so I’ll cover everything in bullet form so this doesn’t become biblical. Before I do here’s a quick synopsis to bring you up to speed.

In a nutshell:

Some of you will remember my right-side drain leaked on Day 6, we tried to save it, but it looked like it was on the way out so we removed it on Day 7.

I woke up on Day 8 to find my right boob had swollen up and felt like a water balloon.  I freaked out because I’ve repeatedly been told fluid in the breast cavity is bad, fluid can lead to infection, infection = bad! Ultimate consequence, removal of the expander that is sitting behind my pectoral muscle, we have to wait until it heals, we can then run this show all over again.

Both the plastics and breast surgeons didn’t feel I had anything to worry about. The fluid wasn’t much, it would in all likelihood dissipate through my body in time, otherwise they’d drain it with a needle…

Got it? Now we can begin:

48 hours

Day 9

8am – 10am

  • I woke up and updated my Twitter and Facebook status claiming that today was a think positive day.
  • Nice breast surgeon from Manchester came to see me. He checked my right boob, said it was OK and unless I was in pain, to leave it. Looked at my left side drain and said if plastics were happy, I could go home today or tomorrow. IMMENSE!
  • My lead breast surgeon comes. He agrees with what everyone has said. Offers to overrule everyone and take out my left-side drain and discharge me there and then. I may be a bit bolshy at times, but I don’t like breaking rules so I say no. If it wasn’t for the fluid build-up in the right side I would have jumped at the chance and agreed.

12pm

  • Plastics team come to see me. They are less enthusiastic about the discharge chat, but agree that the right boob still looks fine and IF, IF, my drains are low enough tomorrow, I can go home.
  • I hit rock bottom, cancel my visitors for the afternoon, but head out to meet Mr F for lunch. There are no trips to the beach today, just up to my usual coffee shop around the corner.
  • Lunch – I cannot stop crying. Mr F has a rubbish lunch.
  • I come back and try to read but am too woozy so I got to bed for a couple of hours. Wake up shivering  Put some more clothes on and get back into bed. My chest is really tight so I loosen up my binder and try to go back to sleep.

6pm

  • Can’t sleep, still shivering, I feel sick and my chest tightness is becoming unbearable. I can’t breathe and I’m having sharp pains down my back.
  • I call the nurse and ask her to take my temperature. She does and it’s fine. However I can’t sit still long enough for her to take my blood pressure and run to the toilet thinking I’m going to be sick. No vomit.
  • My breathing and pain in my back becoming worse. My most matronly like, and Welsh, nurse tries to run an ECG but my back pain is too bad to sit still. She calls a Dr.

7pm

  • Before I know it I have 3 Drs in the room asking me questions. They have felt my right boob again and still don’t think that’s the culprit. I have blood taken from 3 different places. A 4th Dr comes, lots of questions, finally an ECG, and they take my temperature again. My heart rate is 100 beats per minute and my temperature is 39.3.

8pm

  • They want to take a chest X Ray and ask if there’s any chance I might be pregnant. It’s very unlikely, but this whole surgery thing has played havoc with my cycle so is there any chance? A minute one, possibly? I think I could maybe sue them if I am and my unborn baby is damaged by the X Ray radiation? So, I take a test… Not pregnant! Don’t worry; X Ray commence.

10pm

  • Cut a long story short, it is determined that I have some sort of infection, they pump a lot of antibiotics in me and my temperature comes down. By this point I’ve called Mr F to hospital from the pub. He is lovely, concerned and smells a little of beer.
  • I am shattered and terrified.

Day 10

8am

  • Wake up feeling better than I did, txt my friend who I had cancelled on to tell her about my infection, she calls straight away, I can’t stop crying.
  • She calls my ward and requests to break visiting hours protocol to come and sit with me.

9am

  • She brings me breakfast and sits with me to do crossword puzzles.
  • My nice Manchunian breast surgeon comes, he looks at my right breast. He’s not happy. The fluid has increased and my breast is red. He recommends we do an ultra-sound to determine how much fluid in there. We’ll stick a needle in to drain the fluid (remember, plastics don’t like this as it’s a foreign body, which also may risk infection).

10am

  • My Child Plastic Surgeon (CPS, who I now really like but I need consistency in my names so you know who I’m talking about) comes. He also thinks we need an ultra sound, but at the same time he is concerned. Wants another urine sample. I am forced to drink a lot, quickly, in short succession. I pee on demand and, sorry this is gross, but it’s boiling hot!

11am

  • CPS returns to say he has spoken to a plastic surgeon (not my main guy, but another guy who I don’t rate for reasons too long to discuss) who recommends that I go back into surgery, they open me up, remove the expander, clean out my cavity, sew me back up again and add another drain. I ask CPS what the chances are of this not working and me losing my expander – he says’ there’s a 15 – 30% chance I will lose it. CPS is clearly a glass half full kinda man, and I think he’s made up these stats.
  • The surgery can’t be until 5pm as my lovely friend just brought me breakfast.

11.30am

  • Mr F arrives with a Cadbury’s Whisper Easter Egg, which of course I can’t eat as I’m nil by mouth. My temperature fluctuates throughout the day and my chest is still tight, making it difficult to breathe.
  • I have a moment where I question everything and wonder what the hell I’ve done. I’ve mutilated my body on the off-chance I might get cancer, and now I’m about to go back into surgery which may or may not increase the chances of this whole thing failing?

6pm

  • I’ll be honest with you, I’m still not in a great place as we head into surgery. Just as we are about to go through the double doors into theatre, CPS tells me that he has spoken to my main silver-fox plastic surgeon and he doesn’t want to remove the expander and just wants CPS to open my right chest cavity, drain it and give it a good clean. Everyone seems really pleased about this and is implying I should be too. In retrospect I understand it’s a much less risky procedure.

8.30pm

  • I return. CPS says it went well and the infection had’t spread to my muscle and my chest expander. My temperature is down and I can breathe a little easier.

So, as I was saying, a lot can happen in 48 hours. What happens next is anyone’s guess. All I know is I’m going to sit very still, not move very far from my bed and hope for the best.

Time

Day 8: What Happens After Drain Removal?

Yesterday was Good Friday, 8 days after my operation and 8 days in the wonderful Royal Hospital for Women.

The day started well as I accepted the ward breakfast for the first time since I’ve been here. This featured a very hard, yet tasty, hot cross bun. The reason for it being my first ward breakfast is partly because I’m an incredible food snob and also, I have started to combine my morning walk with a lush Campos coffee and nice sourdough toast and Vegemite – as opposed to processed white bread and instant coffee. Please don’t judge me.

Campos

I was still on a high from the removal of my right-side drain the day before. And despite the drain levels on my left side doubling from the previous night, the left-side fluid had turned very pale so I was confident that it was doing its thing.

Riding on my wave of positivity, I was about to embark on my first half-shower in 8 days, when I took a peek at my blossoming foobs (http://www.urbandictionary.com/define.php?term=Foobs).  After a slow start I’m pretty good with them now and have become increasingly familiar with them over the last few days. So imagine my surprise when my right boob looks like it’s got a blister on the side of it and feels like a water balloon to touch.

red_water_balloon

For the past week the many surgeons who come to visit me, breast and plastic, have stressed how bad it is if my smeggy bodily fluid collects in my breast cavity. The unwavering message I have taken from multiple conversations is fluid (or smeg), in breast cavity = bad!

So the only natural reaction from someone who’s still on a quite strong meds, has been cooped up in a hospital for 8 days, and has a dramatic disposition at the best of time is to FREAK OUT!

I ask my lovely nurse, who is a small women in her 60’s with an Australian accent like someone from 80’s soap opera, Sons and Daughters, seems a little concerned. However, when I ask her to call a Dr she nervously says we should wait until they come round this morning. Hmm, I have already mentioned how Australia officially closes on Good Friday and I imagine that applies to surgeons too, so waiting is not really an option I want to entertain.

Next step, call Mr F crying, saying my boob looks like a water balloon. He’s just woken up. Is not a Dr and is not really sure how to help me.

Destination number 3, go to ballsy, 20-something Irish nurse who’s been saying I should be allowed to go home since day 3. This is a good stop. She looks at it and says, don’t panic, I’ll call the Dr. Great response.

I sit and wait, cry a bit more, and eventually a plastic surgeon, who I have never met and looks around 23, arrives. My relief is minimal. My plastic’s team aren’t the warmest bunch, but at least I know them.

Child plastic surgeon (CPS) looks at my boob. I am holding my breath and waiting for the worst until he shrugs his shoulders and says… well, it’s quite normal for a bit of fluid to collect after your drain is removed. It will disperse over time.

WHAT?

This clearly wasn’t the answer I was expecting and I hate to say it, but work Trisha comes out to play. (Brief summary; work Trisha can be very nice, but she’s also quite pushy, doesn’t like to be taken for a ride and generally wants to know that people aren’t taking the piss. Sounds like a dream, right?) So I begin to quiz CPS on his diagnosis. I use words such as ‘with all due respect’, ‘please try to appreciate where my concern lies’ and ‘I’m sure you know what you know what you’re talking about, but please understand, I’ve never met you before.’

He clearly thinks I’m a bit of a dick, but reassures me that it’s not a lot of fluid. They could drain it out but that involves sticking a needle in my boob, which involves sticking a foreign object in there, which increases the risk of infection = the pinnacle of  this is a bad thing and something you don’t want to happen. OK. He leaves and the ballsy Irish nurse tells me that he is good and he’s older than he looks. She also makes a valid point that if he gives me bad advice and gets it wrong, his boss, my main silver-fox plastic surgeon, will be pretty peeved.

My lovely 2IC breast surgeon then comes shortly after that and confirms that he is not worried by the fluid. He then recommends I start applying Betadine to my bruised looking nipples, once a day. It makes them look more bruised in the short-term but I trust this is an effective way of keeping them infection free!

So everyone leaves and I’m reassured (I’ve also triple and quadruple checked with my friend from Pink Hope http://pinkhope.org.au/and my step mum, who is also a breast surgeon), but still a little teary. It’s at this point the nurses urge me to escape from hospital for a few hours. They can clearly see I’m going slightly mental and losing the plot. So with more information and less tears I call Mr F and ask him to break me out!

And here I am, patient on the run, complete with name tag and smegggy drain bag at the beautiful Bronte Beach, Australia. One large skimmed latte, poached eggs and avocado on sourdough please. And order is restored.

Breakout

 

 

One Down One to Go: Expulsion of a Post-Mastectomy Drain Revealed

Well someone or something has to get out of here at some point. And if it can’t be me, it may as well be my right drain.

donald-trump-youre-fired

After Smeg-Gate yesterday, my fluid secretion on my right-side decreased a lot. Despite 4 Drs telling me it would come out tomorrow, the big honcho, plastic surgeon boss over-ruled them all and ordered it to be expelled immediately!

A couple of things you should know before I go on. Drain-Gate is still in full swing and despite the smeg from my left side becoming much paler in colour, the fluid levels are still pretty high. Even higher than yesterday. So I’m still quite upset about this as it means, as my Drs bugger off for Easter (I don’t know if they all are yet but I reckon they will), I am definitely here until at least Monday, maybe even Tuesday! 12 days! I wouldn’t spend that long on holiday in Port Douglas and I really like that place.

The other thing I need to warn you about is, what you are about to see is pretty gross. I’m not going to go on about it for ages, but the following pictures may upset you,especially if you are currently devouring an Easter Egg. You have been warned.

Expulsion of a Post-Mastectomy Drain Revealed

Low fluid levels… check. Hurrah.

Drain

Empty suction ball…check. Gross but yey!

Bubble

Part of the drain that was very much INSIDE my body – check out the stitch that was attached to my body to see how long it is. It’s about 6 inches. And a real 6 inches gentlemen, thank you very much.

innertube

And here, a little bit blurry, is the hole in my arm-pit where the drain resided. Apparently it closes in 24 hours. I said to my lovely nurse, “a bit like a tongue ring?”. She couldn’t confirm or deny this, and to be honest I’m 33, what do I know about tongue rings?

armpithole

And at the end of all this, I am left with this rather fetching drain bag, currently up for grabs to the highest bidder.

Drainbag

The Patience of Being a Patient


Patience1
I went for a walk today and felt something smeg-like on my arm. I looked at my arm pit and I had a mini freak out that my right drain – the previously well behaved one – had fallen out.

I pegged it back to the ward and no, it hadn’t fallen out, but it had come out a bit from where it should be and has stopped sucking the smeg out of my right breast cavity.

The Dr tried to plug this up but it didn’t seem to work. This would be OK if my drain amounts were low enough not to worry. They weren’t. There are several potential outcomes as a result of smeg-gate:

a)      My body fixes itself and gets rid of this waste by itself and all is well with the world

b)      The fluid builds up in my cavity and they have to drain it with a needle

c)       The fluid builds up in my cavity and they have to go in and drain it with an operation

How will I know which one will happen? I can’t. I simply have to be patient.

None of these things sound too bad, until you get to the potential sub-outcomes of b and c. You see, both b and c increase the risk of infection and if I get and infection, the likely sub outcome is, they have to remove my expanders, I am fully boobless (even more so than now) for some time and I have to come back in and have another, stage 1 operation, and new boobs are quite a way off.

How will I know if this will happen? I don’t. I just have to be patient.

So that’s smeg-gate. Combine this with drain-gate on my left side, which doesn’t seem to be abating…

Me: Hi plastic surgeon. If after 10 days, if my left drain is still going, what happens?

Plastic Surgeon: Nothing

Me: I’m not getting out of here for ages am I?

Plastic Surgeon: I’ll get you out of here within a month

INSERT > EMPTY SILENCE

Tumbleweed_rolling_2

The Power of Patience

DalaiLama

For me, the boobs were the easy part, something in my control that involved action. This part however, that I have no control over and as an otherwise healthy and able person, just have to let it take its course, is taking me to limits of my puny patience.

With even more time on my hands I decided to look at the definitions of what it means to be ‘patient’, versus what it means to be ‘a patient’, to see if I can pick up any pointers on how to be better at both.

Patient

Definition 1. Bearing or enduring pain, difficulty, provocation, or annoyance with calmness.

Trisha’s Patient Barometer: Trisha is enduring pain, difficulty, provocation from her annoying drains and smeg and the annoyance of being in hospital with limited calmness.

Patient Verdict: Fail.

Definition 2. Tolerant; understanding: 

Trisha’s Patient Barometer: Trisha is tolerant to pain but shows very little understanding for the fact that the body will do what the body will do.

Patient Verdict: Fail.

Definition 3. Persevering; constant.

Trisha’s Patient Barometer: Trisha is constantly persevering (to try and go home).

Patient Verdict: Pass (questionable).

Definition 4. Capable of calmly awaiting an outcome or result; not hasty or impulsive.

Trisha’s Patient Barometer: Trisha is incapable of calmly awaiting the outcome of drain and smeg-gate. She is hastily trying to behave like a normal person and impulsively crying.

Patient Verdict: Fail.

Being A Patient

Definition 1. One who receives medical attention, care, or treatment.

Trisha’s Patient Barometer: Trisha is definitely receiving medical attention, care and treatment.

Being a Patient Verdict: Pass.

Definition 2. One who suffers.

……

According to the above I am rubbish at being patient but really good at being a patient. So, with my prognosis unclear and my exit date, within this month, I have decided to seek guidance and motivation from the Dali Lama. He says:

“The practice of patience guards us against losing our presence of mind. It enables us to remain undisturbed, even when the situation is really difficult. It gives us a certain amount of inner peace, which allows us some self-control, so that we can choose to respond to situations in an appropriate and compassionate manner, rather than being driven by our disturbing emotions.”

Roger that, Dali. What’s another week between friends, eh?

Patience2