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post-op report


elyra

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Last week I joined this forum when my mother was facing a lobectomy to remove a malignant nsclc tumor from the upper lobe of her left lung. Yesterday was her surgery.

My mother came through her lobectomy with flying colors with no complications. The thorasic surgeon said that visually, everything looked normal with the lymph nodes he removed for testing. He said he's done enough of these procedures over the years that he's gotten pretty good at being able to tell if something is amiss. Of course, we won't know anything definite until the lab takes a look at it, but if he's right there's a good chance the tumor hadn't had time to spread yet and it was caught in Stage I. The surgeon came highly recommended, and I like the guy alot so I know she was in very good hands.

She had a rough time with the pain when she first came out of recovery, even with a epidural in place, but once the medication from the patient controled pump for pain management started to kick in, she was a lot more comfortable. They did have to give her a unit of blood because her hemoglobin had gotten too low, but otherwise everything was fine.

We expected her to be groggy and out of it all day, but after a little nap, she was awake and alert for the rest of the afternoon and early evening. In fact, we all went to lunch while she was napping, expecting her to still be out of it when we came back, but there she was, sitting up in bed and asking "Where were you? I was waiting for you!" So my brother and I stayed with her for another 4 hours until she finally started to fade again and need another nap.

The epidural is working wonderfully, and the nurses have been great about keeping her comfortable. There aren't too many other patients in ICU at the moment, so she's getting a lot of attention. They thought originally that she'd been in ICU for 2 or 3 days, but if she continues doing this well, she'll be out of there in no-time. Today they're going to make her get out of bed and into a chair though, so we'll see how that goes.

It was a rough day for the rest of the family and I. Every minute you're waiting for them to come out and tell you how surgery went seems like an hour. And seeing mom in so much pain afterwards was difficult too. But as I kept telling her, the worst is behind her, and once they take out the chest tube in a few days, she'll feel a lot better.

My mom is a thin, petite woman who looks like a strong gust of wind would knock her over, but underneath it she's a tough cookie. And she gave the doctors a good laugh in the OR. My mother is squeamish about needles, and was concerned that the epidural would hurt a lot when it was first put in her spine. But when the surgeon came out to talk to us after the operation, he told us that it hurt so little that my mom turned to the guy who did it and said "If I had my teeth in, I'd give you a kiss!" The surgeon thought that was pretty funny, but my mom didn't remember saying it later when we told her about it.

So all is well with my mom, and hopefully will continue to be so.

Laura

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Glad to hear your mom made it so well the first day of surgery. After they remove the morphine the pain will get a little worse...and she will start walking soon. Its not a piece of cake but your mom sounds like a doll and a tough cookie when it comes to pain. Loved the "kiss" story...hope the pathology report is like the surgeon thinks...that would be wonderful news...!

Nina

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Thanks to everyone for their good wishes.

Yesterday was a mixed day for my mom.

On the one hand, the doctors are amazed at how fast she's recovering. The surgeon said that she was doing better (on the day after surgery) than any other patient he's ever had in his nearly 20 years of doing the surgery. Not bad for a 72 year old woman! She didn't have any problem with sitting in a chair -- in fact, she kept trying to get up and walk! The nurses and my family constantly had to keep an eye on her so she wouldn't try to do it on her own and pull out some IVs and tubes.

But the drugs keeping the pain at bay have made her very confused and disoriented. She keeps forgetting where she is and why she's there. The nurses said it was fairly normal. She's hardly sleeping either, always awake and talking, usually not making a lot of sense. I don't know if the not sleeping is the drugs or just the environment in the hospital and the discomfort.

When I finally got her to sleep for a couple hours in the afternoon I was relieved, but when she woke up she was completely confused. She did not remember having surgery the day before, and refused to believe me. She was convinced that she was in the hospital because she was dying and we wouldn't tell her.

She got herself so worked up I think she had a panic attack -- her blood pressure and heart-rate went sky-high, and they had to call her surgeon and a cardiologist to take a look at her. They finally had to give her Cardizem (sp?) to get the heart rate down. After that she was ok, but it certainly scared the heck out of me!

I assume she was fine last night since I haven't heard anything yet this morning. Hopefully she got some sleep last night; it might make her a little less flaky and able to understand what's going on. I'm going back to the hospital later for my 'shift' -- we (my family) is trying to work out our schedules so one of us is there most of the time during the day.

Laura

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Laura,

Im SOOO happy to hear that your moms surgery went so well! My dad had his in June, and although he didnt have any complications at the hospital, he did end up with a few at home (nothing serious). Tell your mom were thinking of her, and wishing her the speediest recovery!

Jamie

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Dear Laura,

Sounds very much like what happened to my husband. He didn't get an epidural -- they tried, but it didn't work (not sure why -- perhaps because of three previous spinal surgeries?), but the morphine pump helped him through those awful two first days after surgery. But he too was rather disoriented and confused, then his blood pressure and heart rate went wonky and he was put on THREE drugs -- lopressor, cardizem and lisinopril. It took a day or so before they really took effect but he was fine. The surgeon and cardiologist whom he called in both told us that this was a common result of chest surgery and was probably temporary. He's been fine since, although he's still on all three medications; went to see the cardiologist two weeks after he got out of the hospital and she said she wanted to keep him on them for a while -- with chemo looming and other potential treatment, it seemed wiser to keep everything going the way they were rather than risk a change.

He goes back to her in October, and our pcp said they would probably start taking him off medications one at a time to see what happens. But right now his heart rate is slow but steady, no variations, and his blood pressure is incredible, averaging at 106/60!

His other complication, which it sounds as if your mother has avoided, was pulmonary distress the second day after surgery -- they put him on a ventilator (much to MY distress -- didn't know what was happening) and had him completely sedated, but that night he pulled the ventilator tube out himself and called me at five the next morning, very hoarse but very much himself.

They removed all the tubes the fourth day after surgery and got him out of the critical care unit on the fifth. When I came in to see him on the sixth day, in his nice single room, he had gotten up and moved all the furniture around (didn't like the way it was arranged). He went home on the 7th, and has done very well since.

Hope your mother continues recovering well...keep us posted.

Ellen

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Haaa..yea, my anesthesiologist says they use a amnesia inducing drug for the anesthesia, so I cant remember a lot of stuff my family told me about later, after surgery...also, my timeline was all messed up for the entire week in hosp....things that happened the 1st day, I thot happened the 3rd day, or last day, etc...weird gas.

::(I musta been a real basket case....surgeon called in the shrinks....I think to calm HIS nerves...hehehe_)

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