Monday, August 15, 2016

Speaking too soon

Today, I laid another foundation stone of gratitude, added five smaller stones bearing questions. 

Thank you, but why? We thought we were sailing through this one. We thought we were free and clear.

My last post went up 240 hours ago.

He woke up at 8:30 a.m. a week ago without a neck. It ballooned in the night to roughly the same circumference as his head, and his incision site bulged like an ugly claw waiting to strike. His voice, which in the days since the thyroidectomy transitioned from Marlon Brando to Christian Bale's Batman, gurgled and rasped with each gasping breath like Star War's Chewbacca. The panicked glint in his eye told me the pain was intense. I gave him two Percocet and combed my house for the missing hospital discharge instructions hoping they offered insight into this new development. Our aide arrived at 9 a.m. to give Mr. PNU his shower. By then my husband had erupted in a cold sweat that drenched his clothing and his breathing continued to be labored. I feared heart attack. The aide helped me dress and wheel him to the car.

At the emergency room his blood pressure registered at 90/50, an alarming change from the 165/105 hypertension he was experiencing before initial discharge from the hospital four days earlier. His oxygen saturation levels hovered around 83%. Nurses quickly designated him a priority patient and he was wheeled into a room where his chest was affixed with telemetry monitors and his veins accessed for IV. 

Inside the incision site a blood vessel had burst through the clotting, filling the cavity and surrounding tissue with clotted blood, or hematoma. The culprit: Lovenox, the medication that ensured Mr. PNU didn't experience blood clots after discontinuing blood thinners for the thyroidectomy. Our surgeon arrived, and after calling for a 50cc syringe, told my husband to brace himself. He plunged the needle into Mr. PNU's neck and began drawing out syringe after syringe of the pooled, clotted blood—300cc's worth—to relieve the extensive swelling. A nurse brought green towels to pack the puncture site, and the surgeon held them in place to stop the bleeding. After a few minutes, he stopped applying pressure, checked Mr. PNU's neck, and announced that the area was simply refilling with blood. The only way to stop the increase of pressure was to reopen the site, drain off the blood, and cauterize the offending vessel. He called for an anesthesiologist, excused himself to prep for emergency surgery, and a hospitalist took his place to gather my husband's medical history for an extended admission to the hospital.

On Tuesday, five days after his initial operation, Mr. PNU underwent emergency surgery to save his life. 

I read extensive medical literature to inform myself about possible side-effects and complications coincident to all medications and procedures my husband receives. I knew that the likelihood of hematoma following thyroidectomy is .3 to 1%, and most patients who experience hematoma do so within 6-24 hours following thyroidectomy. Neck hematomas cause airway obstruction and potential asphyxiation. Thursday afternoon the hospital released Mr. PNU back into my care. The drainage site is a collar bruised nearly black just above the curve of my husband's throat like he'd escaped an attempted garroting, or aggressively necked with the devil. The bass in his voice evades him, but with each new day he's much less raspy. 

Somehow we're back to joking about our bad luck, back to toting an oxygen canister everywhere until someone with a medical degree says otherwise, back to sharing blissful habitation in the duplex on the south side of Provo City a block from the cemetery. By all accounts we have the option of relaxing now, but this afternoon on our way home from the clinic to check his INR levels (blood clotting speed) he confessed, again, that he's tired. And if this blog is confessional, I am too.

We thought we'd cleared the storm. We were ready to settle in for a gradual recovery and a new comfortable stasis where hemiplegia is a gentle guest we've learned to accept. Somehow we made the mistake of thinking this go round we had luck on our side. I don't mean to sound melodramatic. I promise that I am as weary of the constant drama in this narrative as my readers. I'm ready to garden, read ancient Greek, hike Slate Canyon, collect and make art, spin a few poems out of the last sixteen months, and take long naps next to my eternal philosopher boyfriend. I'm ready to be happy and grateful and content without repeat reminder of the frailty of the body and the briefness of remaining time.

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