HAPSHAW I hate blogs.

Oral Cancer – Part Three – ICU and Recovery

These are the first photos of me just out of surgery in ICU. It was hot as hell ( Dr's orders for the room for the first 3 days) and seemed rather small at the time.  I don't know why I remember thinking that but I'm sure the drugs effected my perceptions a bit.

First thing I remember, in semi conscious state, deep inside my mind.  I felt my body being flipped to the side and back again rather quickly with force.  I'm not a small person so I can understand if someone had to put a little effort into that task.  On the first flip which I think was on my side I heard someone say " Inserting Rectal Tube " to which later I learned was to monitor my temperature I believe.   Never the less hearing that even in the state I was in I laughed inside.  I was thinking to myself " Bullshit I didn't just hear that", but I'm sure I heard it.  Next thing I remember was actually waking up and seeing family at the end of my bed.  I think shortly after saying hello I might have went back to sleep I can't remember.

Considering the operation preformed on me I  remember thinking I didn't feel so bad.  I mean I had drain tubes and other misc. IV's in me with a oxygen hose close to my trach, but I wasn't in any great pain. I felt more than anything the pressure of my face swelling which I think looks worse than it might have felt.  It made it hard to sleep, think elephant man's sleeping technique.  I need to thrash around to sleep and this wasn't going to be possible for a good while.

Now like I said prior it was very dang hot, like somewhere around 85 degrees in the room for a few days.  This was to help the blood flow and the healing process as I understood it.  The first day or so I think was a blur. The real fun started when I was being moved to my permanent room for the duration of my stay.

First thing I know I was surrounded by several nurses trying to articulate my situation and organize a mass move with all the support mechanisms that were hooked up to me.  They seemed very unorganized in the effort at first and somewhat dis-concerned with my specific condition.  I'm not sure if they should of been since they were just moving me to the high rise luxury ICU in the sky, but I guess with my state I was expecting more focus (keep in mind at this time I couldn't talk I had to write everything down).  The ride was rather bumpy with a few bangs into a wall on a turn or two.  If only I could have used words during this mass migration.  On nearing the final destination there was even more nurses which were the initial ones to take care of me I was guessing.   I felt good being in the new room as if it was going to be allot cooler in temp and not as fucking hot.  Well I still had a couple of days left of desert heat but with the change I thought otherwise, stupid me.

Here is where things got weird and even though I was under the influence of narcotics I believe I knew what was going on with clear vision rather well (You can keep in mind the narcotics part while reading this if you like).

There was I would say what seemed like 4 or so nurses in the room with a main nurse wearing red who's name I don't remember.  Also with the nurses, who have been obviously trained to take care of ICU patients, there was another person who they told me was " My Sitter".  Now I didn't think much of that at the time except  " A sitter? What is that some kind of super nurse? No wait that doesn't sound very high ranking of a title".  So I just watched this person to see if they did nurse like things.  While the main nurse (the one in red) was organizing what ever else with the other nurses I watched My Sitter organize a rather nice army cot made of 2 chairs and a blanket.  As the Sitter got snuggled into this configuration this sitter decided to crack open a book to read.

This didn't last too long as the nurse in red instructed the sitter that she couldn't sleep or read while watching me.  Here is where I lost my mind.  The nurse just told the sitter person responsible for my well being fresh out of surgery to not sleep or read that they had to watch me through out the whole night. I couldn't believe the nurse had to say that to the person watching me.  I freaked out and was writing like mad to the nurse to call my wife.  I think this nurse was new and was a little unprepared for my reaction and tried kindly to calm me down.  That didn't help the fact I had to ask, write, to call my wife 8 times before the order was carried out.  There was no way in hell I was going to go down what ever road this was leading, my spidey sense was on fire.

Finally I'm guessing around 3 or so in the morning Courtney got there and I preceded to write what was going on.  So along with the sitter ( still there) she was going to stay with me.  I'm thinking it was maybe an hour before I decided to send the wife home to sleep and I would be fine.  The sitter then sat in a chair at the left end of my bed near the wall.  I didn't see many nurses that night that i can remember. Maybe they were checking on me, I just can't remember it.  All I know is I watched the sitter bobbing  apples through out the night and into the early morning.  Granted she would fetch a nurse when I requested it or get me a cold damp rag to help cool me off, but still I felt no confidence.  Needless to say I didn't sleep  well that night.

Morphine remote every 10 minutes , check.

There wasn't much sleep for that week I was in the hospital.  It wasn't so much because of the nurses coming in every few hours to check on me and take vitals.  It was more the fact I could never get comfortable enough.  Those first few days like I said were very hot which helped keep one in a constant state of miserable.  Add to the fact I had to stay on my back no lower than a 30 degree angle.  Those first few days when I did dose off  was a short amount of time always followed with strange dreams or hallucinations.  I would wake myself with my mouth having some kind of reflex biting my inner cheek or tongue.  I don't guess it was enough to cause damage but the fact that was happening kept me from letting myself relax enough to sleep a few times.  I don't remember the dreams that much other than they were strange but I do remember hearing and seeing things.  I would hear car engines, car alarms, what sounded like a crowd at a sporting event, among other various things.  Sometimes I thought there were people in my room when there was no one there.

Trach Tube (seriously there just has to be this perfect hole in my neck right?)

This thing was one big pain in the ass the whole time.  For reasons I can't remember early on in my stay the air way was what I would consider downgraded to a smaller opening.  It felt like I couldn't ever get the amount of air that I wanted even though the monitors stated otherwise.  Doing anything like getting up or moving around exploited this fact even more.  As you can see below there was always a steady oxygen supply but all I could really tell is was just some cold air.  This lasted I think up until the 5th or 6th day as I recall before they removed it, which was followed by being able to breath the way I wanted too.

Dr Cannon removed the trach from my neck one day creating allot of anxiety for me.  I for some reason pictured a perfect hole in my neck not the horizontal slit that was actually there.  So not only the removing of the stitches bothered me but the idea of a wide open perfect circle of a hole in my neck open to the whole outside world.  When Dr.Cannon removed this I saw the bloody bits on the underside intensifying my already " holy hell hurry this up and stop poking at me" mind frame.   I could speak with it in after a few days but it was hard to do so.  When it was removed my neck was covered with gauss and tape.  At the time it unnerved me thinking again of this perfect hole in my neck only covered by some cloth and tape.  When I wanted to talk after it's removal I had to apply pressure to this wound so that the air could effectively activate my voice box for speaking.  I never looked at it during my hospital stay there was just something about that I didn't want to see.  Again my imagination getting the better of me on that one.

Cleaning the thing, which had to be done at least once or twice a day, was not pleasant at all.  Either you had to induce yourself to cough up the gunk in your lungs to get the trach pathway clean or have a small straw like air suction run down it until it made you cough.  I had pretty good control on making myself cough but it wasn't comfortable to do.

Stitch Removal ( Dammit )

So I don't remember which day in my week stay this happened I'm going to guess somewhere half way in.  Dr.Cannon and Dr. Kitamura decided to have some fun and remove all 50 staples and stitches from my face and neck.  Dr. Cannon was working with the staples from my neck near my ear down, while Dr.Kitamura started just under my lip down.  They were I guess going to meet somewhere in the middle and fight over the last staple and stitch.  I asked the nurse for morphine during this and it was allot worse in my mind than it actually was.

Dr.Bailey was nice enough to lend his cold bony hand for me to hold as I prepared for some pain with each snip snip.  I felt a few more than others as I was still pretty numb on that side of my head.   Still my imagination of this being done was more powerful than the reality.  One thing that struck me was Dr. Cannon's eyes and intensity.  Almost like a little kid excited as if his star wars figures were coming to life.  You know wide eyed licking your tongue on your lips and all that.  I was thinking " Man your enjoying this way to much".  So this happened in a short amount of time and I thought that was it.  Next day some more stitches had to be removed.  I maned up for this as Dr.Cannon methodically removed the remained parts that held my face together.  I didn't care at this point weather I had morphine or a hand to hold ( yea yea Dr.Bailey I hear you) lets  just remove the things and get it over with.

The Embarrassing (if you don't like reading about gross things don't read, but since I said that now I'm sure you will have too.)

Ok so here is where the nurses are truly tested.  The things they do and did during my stay I have to say I don't get how they do there job.  I really don't understand the Doctors and the skills they preform but not to be underrated are the nurses.  They have to have the endurance of a whole host of issues and circumstance for which I could never preform.  One of which was on the 4th or 5th night.

Up until this point I don't think Ive been to the bathroom ( other than to urinate which a catheter re insertion was done, more about that later).  At around 2 or 3 in the morning I had to do a number TWO.  It was already hard to navigate with a giant brace on my leg with a fresh wound, much less dealing with the tubes and things connected to me.  It took time to get out of the bed for anything much less this.  I first felt the urge I was deciding what the right action would be.  Should I wait it out and try to get to the bathroom, which at that time would be my first attempt, or do I call a nurse to help get me to that porta-toilet which would take less effort to get too.  This wasn't going to be good I knew that much but when your naked with nothing more than a sheet with string, you may as well just do what you have to do.  Needless to say I was helped to the porta-toilet, the big curtain was drawn, and the room was cleared as if a grenade was being thrown in there.  Needless to say what I did was inhuman even for me who has had much experience.  Now the real problem for me was cleaning up.  At the time it was hard to get back there due to the stiffness in my neck and some parts of my shoulders.  The contortions I needed to preform for this feet I realized wasn't going to happen the way I wish it would.  There was going to be something left for someone else somewhere in this great debacle.  " Ahhhh fuck ", I said to myself pressing the nurse call button to reveal this disaster.

Two people came in, a removal specialist and my nurse for that night.  The specialist was to take away the removal-able bucket that housed the thing.  The nurse and the specialist were discussing something but I guess it hit the specialist hard and he decided to get this bucket out of there fast, and finished there discussion later.  The nurse asked me if I needed a clean up, and I reluctantly said yes.  A large wet towel was introduced with a  few vertical motions to the north and south I  was somewhat clean, but I knew that wasn't everything.  The anxiety was to much for me at that point as I considered that good enough and got my ass back in the bed.  The nurse, like she was putting a band aid on my hand, just went about things like it was nothing.  This is what I don't get about the nurses they were pro's.

Catheter (holy hell for real?)

Having this removed was odd enough but rather quick. Having to have this put back in because I had a liter of pee and couldn't go, that sucked ass.  The way to describe the insertion of this goes something like this.  Imagine driving your car down a curvy road, where on each turn you bang into a tree.  Wait maybe that isn't a good description but I'm not editing it now it's out there to live in the wild.  With each turn of that male area did not feel good, much less at the end when it entered the bladder.  Of course after the reactivation of that mechanism I felt allot better, only to have that short lived by it being removed again.  Again the nurse just did this like no big deal la la la la dee la dee la dee laaaaa.  I don't get it but very grateful for them being the way they were during this.

This isn't really a complete in-depth report of all the emotions, twists and turns of my stay but who want's to know that stuff unless you are going to have a similar procedure done. Then again who wants to know half the crap I just posted.   If you are having this done and want to contact me for any more info please just email me.  More photo's can be found at my Flickr stream.

Wanted to say thanks to those nurses I remember. They should get raises.

Annabelle Maylas
Anne Marie Baker
Jennifer Overstreet
Laura Duggan

Update: Not going to need Radiation treatments so I'm to just heal up and move forward with mass life changes.