When I got the phone call that Sam’s surgery could be done August 1st there was really no discussion. Dave and I both just assumed that 1) she would have it done and 2) I would go with her. Honestly, I was actually much more concerned about her surgery and recovery than I was Dave’s. After all, his mapping had gone so smoothly and although I knew this wasn’t the same, I wasn’t worried. And luckily Dave’s sister was more than happy to accompany him for his procedure.
Kris picked Dave up in plenty of time for his 10:30 check in at the hospital. It sounds like it was the standard – check in, sit and wait, get taken back, sit and wait, prep, sit and wait. Dave’s procedure didn’t start until 1:00 so I’m still not sure why he had to be there SO far ahead of time. Dave’s doctor talked to Kris afterwards and let her know that they were able to see the radioactive areas so the Sirsperes appeared to have traveled exactly where they were supposed to. Unfortunately the star closure device that had worked so well to close off Dave’s femoral artery the first time around didn’t take this time, so they had to apply a lot of pressure which meant that he was likely to be sore. The plan was to keep an eye on him for 3-4 hours and then he could head home.
When Kris went back to see him, she said he mostly slept and when he was awake he was extremely uncomfortable. In fact, even in his sleep he was wincing. At 6:30, the nurse took him for a walk around the floor. When Dave was asked his pain level, he told them he was at a 5 on the pain scale and that was WITH pain medicine. I am amazed that the nurses thought that was an acceptable level of pain. I think they are much more experienced in dealing with cardiac cath patients rather than interventional radiology patients. (When Dave and I went in for his mapping, we got glazed looks from the person who checked him in and the nurse who was in charge of getting his vitals and starting his IV when they asked him what he was there for that day.)
Kris called me because she was concerned that he was going to be discharged before he was able to get another round of pain meds. She was also looking at the time and realizing it would be a tight squeeze for them to get home and for me to run out and get his prescriptions filled before he was due to take them. So I called my brother and had him stop by the hospital and get the prescriptions and bring them to me. In the meantime, I called the pharmacy to make sure they had everything in stock. They had 32 percocet and Dave needed 30 so we were good! I was a little paranoid about being put on some sort of watch list after filling 3 narcotics prescriptions for 2 different people in one afternoon.
When I got back from Safeway, Dave and Kris were back. Kris was putting in a call to the doctor about Dave’s pain level. He was very uncomfortable on the drive home and the Dilaudid seemed to be having no effect. Dave was upstairs and I think the best description of his actions was like those of a woman in late labor. He would lay down for a minute and then sit up. He was leaning against furniture and then sitting down. There was no position in which he was comfortable. Kris and I muscled a leather and wooden reclining chair upstairs thinking that might help. But it didn’t. He was rating his pain level at a 7 or 8. In the meantime, the doctor on call called back. Dave had been prescribed the same size Dilaudid tablets as Sam but only half the dosage. So I asked if Dave could alternate Dilaudid and Percocet every two hours instead of taking one Dilaudid every four hours. The doctor said the Dilaudid is actually stronger so to take one pill every two hours and if that didn’t work that Dave would need to go back to the hospital for IV meds.
Kris and I decided that we would give him his next dose, when it was time, and if it didn’t help then he would have to go back to the hospital. Then we heard Dave upstairs throwing up. There was discussion about calling an ambulance but I pushed for the car thinking that Dave would be miserable on a gurney and an ambulance arriving would scare the crap out of the kids. So Kris loaded Dave back up into her car and took him back to the hospital. I called the doctor, and he said they should go straight to the ER. When they got there, the doctor had not called, so the ER didn’t know what to do with Dave. Fortunately for him, Kris took complete charge of the situation and got him what he needed. He was admitted into the hospital and got to his room in the wee hours of the morning. Although it sounds like it took much longer than was bearable, Dave felt relief once he was able to get pain medication through his port.
When we consulted about this procedure the side effects that were most mentioned were nausea and fatigue or as they call them “flu like symptoms”. The importance of being hydrated was stressed. Pain was not something that was highlighted as something of which to be aware although Kris said they did talk about it yesterday before he went back. I am glad that Dave decided to treat the whole liver at once. Because if he had anywhere near this reaction to treating half of his liver, it would have been a hard sell to get him to do a second round.
As of now, there are no orders to send him home tonight. We have been assured that they will give him oral meds and make sure they are effective before they release him. In the meantime, he is actually getting some sleep and eating and drinking which is very positive news.