Hospital Update

Please forgive any typos or grammatical errors. I am working on this at 4:45 am.  Why 4:45 am?  Because that's when hospital staff starts their days.  That's when the nurse needs to do something.  That's when the x-ray tech comes in to get my chest x-ray.  So, Good Morning! We're all awake now!

I just thought I could send out a note for everyone that explains a little more thoroughly what's been going on since I got here. In my last post, I had mentioned that on Wednesday, the 8th, I woke up with bad shoulder pain.  You can read more about that HERE.   One week later, I was on the phone with my mom when even worse pain hit.  Mom summed it up very nicely in a Facebook post that said: "she [that'd be me, Jessica] experienced a strangulated hernia. What we NOW know is that her diaphragm was slightly torn 2-1/2 years ago in the car wreck. It went undetected at that time. Over time, the tear slowly increased and a small pocket of her stomach herniated through it. The hernia probably happened a couple of weeks ago (possibly even before that). Then yesterday morning, the small part of the stomach ruptured. It was instant excruciating pain and difficulty breathing. She had emergency surgery yesterday evening and she's now recovering in ICU with an uncomfortable drainage tube and a lot of residual pain. To manage the pain better, they just put in an epidural so she doesn't have to have as much opioid medication. She is VERY fortunate that only a small amount of stomach had to be cut out (golf ball size at most) and infection had not set in and no feeding tube had to be put in. This could have been so much worse. Pain management will be the big deal, and she is anxious to eat, but nothing by mouth for a couple of days."

Since then, I've learned more, can elaborate a little more and can explain what they have planned for me over the next couple of days.  Some have asked if the shoulder issue and the hernia were related.  The answer to that is, yes.  I do have a collar bone that is no longer attached to my shoulder, but the pain nearly two weeks ago was "too much" to be just that.  What I know NOW is that the diaphragm refers pain to the shoulder.  For anyone who has experienced gall bladder pain or issues, this may sound familiar.  The gall bladder will make your shoulder hurt, too.

With these sort of situations, it is very hard for a doctor to guess exactly when everything took place.  Even though I was here last Friday and received x-rays, the hernia did not show up.  My case isn't something that walks into ERs every day.  Do they happen? certainly.  My first nurse in the ICU said that in his 10 years, he's seen 1 case like mine.  They were finally able to see what was going on with a CT scan of the chest.  That's when they made the decision to have the emergency surgery.  The cardio-thoracic surgeon assigned is spoken of in the highest regards.  He was very detailed in his explanation of this surgery and was still humble enough to say, "Ya know what? I don't do a whole lot of these. I'm asking for another big gun to take the reigns on this."  Maybe that's not a direct quote and I could be paraphrasing.  Either way, I really, REALLY respect him for that.

What they saw in the CT was the strangulated hernia.  What they also knew was that they were going to require a scope down my throat to decide on the best way to operate.  For the CJ Hood's of the world and anyone else wanting to grow up to be a surgeon, that type of scope is called an endoscopy.  That was surgical phase one.  That gave them the ability to see how much of the stomach had herniated and decide whether they were going in through my side/rib cage or from the front, abdominal area.  What's the difference and why?  I am not not sure.  I do know that they preferred the side and got what they wanted.

This is the part that gets detailed and we will be discussing guts.  If you ask me later what happened, and I say "It was in my blog" and you tell me that you thought it was gross, I will tell you that my verbal response will no different.  So, let's chat about GUTS!  The CT scan showed stomach.  After getting in there, they discovered that my omentum had herniated the diaphragm with a small portion of my stomach.  I would like like to explain omentum to you in the same way my surgeon did.  It is the ...... Wait for it.... fatty curtain  *OH YEAH*  that surrounds our abdominal area.  When it sensed that my stomach was in danger, it went to its rescue.  

The small piece of my stomach that had made it through had also ruptured and what we know now is that is where my sudden pain came from.  As everyone knows, stomach contents don't belong in chest cavities and this created some issues.  The hole in my diaphragm was about the size of a golf ball when he went in initially.  He had to clean up the stomach contents, cut away and clean up the part of the omentum that was necrotic, then cut out the part of the stomach that had ruptured, which was about the size of a knuckle.  Once he was finished with the clean up, he had to open up the hole in the diaphragm a little more to push everything back into the abdomen.  Then he was able to sew up the diaphragm.

Scars are like tattoos with better stories

That, in a nut shell, was this past Wednesday. I came to ICU with chest tubes, a pain pump and they added an epidural.  It's not the kind you think of with pregnancies,  I can walk.  There is zero numbness or tingling sensations.  It's actually up higher.  So that it blocks the pain where the incision and the chest tubes are.

Here's a photo for ya.  What's on my back in the plastic wrap and tape that protect the epidural.  The top bandage is the incision.  The bottom mess of gauze and tape is the tube.  This bandage has grown each day and has started taking on a life of it's own.

Here is the hope for today.  I hope that the chest tube can come out.  There is no longer any more output.  Once that is out, the epidural can come out.  Once those two things are out, I can move out of ICU.

And the biggest of them all, as if this all weren't enough, once I am out of ICU, I can shower!
HOLLUHHHHHHHHHHHH!!!!!!!!!!

So say some prayers that this day goes smoothly.  I would really like for it to.  I do not expect it to happen without discomfort, bumps or hiccups, but I'd really like a shower.  If all goes well, I will be headed home Monday or Tuesday.  More news to come of release.  Meanwhile, I love you all so much and I'm so grateful for the outpouring of love and support.  I have the best people in my life.  HANDS DOWN!!!!!


Just a side note for everyone.  It took me almost 2 hours to post this.  It's 6:35.  I think I'm about to see some doctors!!!!