Today, it is 6 weeks since James asked me, “Dad, what would you like for your last meal?” He knew there was a Boston Market 2 blocks from the Family House we stay in at the University of Pittsburgh Shadyside Hospital and he and his father love the chicken, mashed potatoes and gravy. I like the corn that comes with it, but that has been off the tolerance list for over a year, so he had my portion. The surgery went well, though I felt snugged in a corset as the 4 inch section of my abdominal wall that had been taken out was closed and reinforced with a Zen Mesh sheet and things would need some time to stretch before we could do sit ups, as Dr. Bartlett explained in the postoperative visit. Karen laughed as she does them faithfully each night, me, not so much.
We got home 11 days after the surgery and settled into trying to eat a little, but never could get more than 3 bites of cream of wheat or a few bites of mashed potatoes before feeling stuffed, so I can honestly say I have had less than one meal total in the last 6 weeks. I got the drains out of my belly at 19 days after surgery and that really helped the nerve pain in the left side of my belly, as that drain must have been sitting next to the nerve and the suction of the apparatus constantly irritated it. At 22 days after surgery, my temp was running low grade and my blood count bothersome and my wound started looking a bit red and puffy. I removed a bunch of staples (I had 60 or so total, a lot of fun to remove) and after a day, some brown liquid started to drain through the staple holes. Dr. Dan De Cook opened it up wider and that is when we found the intestinal contents in the wound. So, nothing by mouth since except for my antibiotics, Zantac for the heartburn and a heart rate regulating pill in a sip of Tylenol Adult Liquid. It is amazing what 500 mg of Tylenol at 8 am and 8 pm will do for the incisional pain if that is all you can get, and am thankful that Karen found this, so we substitute a sip of Tylenol for the sip of water with the pills. Dan also placed a suction drain in the inferior aspect of my pocket of fluid in my abdominal wall and we try to irrigate and empty that several times daily.to keep the intestinal juices from chewing on my belly wall.
The incision has healed otherwise and, after giving myself 2 units of blood 9 days ago, I feel I am gaining some strength and endurance every day. My TPN gives me 2530 calories each day, plus I give myself 2 liters of Lactated Ringers to stay hydrated as the short gut syndrome I have inherited makes for at least 9 – 10 mad dashes to the rest room for rather watery stools and I need to replace those fluids. I have been able to work 5 hours daily in the clinic, which gives Karen a break from her needy husband and a chance to work on her multiple flower beds, yard, etc. It also gives me distractions from the incisional discomfort and the questions about the future of the fistula. So, we continue to pray daily and earnestly that the fistula will heal by itself, as allegedly about 60% do in 3 months, as the alternative would be surgery, surely a minefield of trouble for the surgeon as we cannot even see the fistula on the CT scan, undoubtedly I have tons of scar tissue to navigate, a potential to cause another hole in the process of trying to find and fix this one, and one often has to resect some small bowel in the area of the fistula and I have none to spare by this stage of the game.
I am thankful that Dr. James Webb, a retired general surgeon friend from Fremont I have known since the 80’s when I used to moonlight in the Gerber ER during my surgical training, has agreed to cover the surgery responsibilities at CSL for June and July. Dr. Fred Brown, who spent years training surgeons at Bonne Fin in the past, has graciously agreed to cover August and September and I hope, by the grace of God, to be able to return after that. I hope to be physically able to do more before that, but am in this experimental study where I have to return a week a month to Pittsburgh to have the vaccine injected on Monday and get 3 different chemotherapeutic agents given to me for the rest of the week and then repeat the cycle a month later. So, cannot be gone from the office in Jenison 2 weeks a month as that really cripples our ability to see our patients properly and also keep the office functioning, especially as Dr. Lugthart loves some time on the water in the summertime also.
Dr. William is hoping that the governmental hospital strike will end June 1 and that he can return to the residency program and get on with the show. We paid the government electrical company to run a wire to his apartment, but so far, no one has done so. It does make for difficult studying at night if you do have some time off to do so. The water seems to not be able to be arranged, so will have to purchase and haul water up to the apartment to clean himself (one does not drink that water, not advisable). We certainly are blessed when we can just drink water from the faucet in abundance both at the hospital (we have our own deep well) and in the US. Dr. Moise and Jon Bed have held the hospital down and now that Dr. Adulte dropped out of the residency due to health issues and is back at the hospital, I hope that will function smoothly even in my absence. Tom Failing and Dave Weener from BCBC (our home church) will join Dr. Webb on the 18th of June to do repairs, a never ending job at CSL, while he does surgery with Dr. Moise. Pray for wisdom for them and us as we try to negotiate the speed bumps on the road for the Haitian Donkey and his friends to arrive at the goal of doing God’s Work at CSL in a fashion acceptable to Him and for His Glory.
In His Service,
Bill, Karen, Rachel, James and Jenn Ten Haaf and the encouraging Haitian Team