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Update II - Mrs pNut and some problems
16 Answers
Despite my last post stating that things are looking up for my OH following a gall-bladder removal I have to report that things have not gone as smoothly as we had hoped.
Basic facts are that she is still in hospital (7 weeks), she still has a drian on the original operation wound, she still has a bile dust drain and in fact last week the radiographer 'installed' a new drain - for her liver.
She is only eating enough to keep a pigeon alive (in my opinon) which I believe is due to the fact that she is unable to keep any solids down. During her stay she has lost in the region of 20lb. She has to have an anti-nausea drug just before each mealtime.
The doctors seem to be upbeat about it but I am beginning to lose my faith in them and feel that they are simply trying each avenue with no real idea of the outcome.
Mrs pNut is also getting a little deflated, institutionalised, fed up of hospital food and generally down. They keep promising she will have the drains blocked off and then she will be sent home to return in a few weeks (I assume for further tests!!) but that has happened at least 3 times and she is still there.
I have asked (with my wife too) to see the surgeon who is responsible and am awaiting an appointment from his secretary.
Sorry to be so negative but this is really pi$$ing me off and so far I have covered 1000 miles going to & from hospital (well very few 'other' journeys)
Basic facts are that she is still in hospital (7 weeks), she still has a drian on the original operation wound, she still has a bile dust drain and in fact last week the radiographer 'installed' a new drain - for her liver.
She is only eating enough to keep a pigeon alive (in my opinon) which I believe is due to the fact that she is unable to keep any solids down. During her stay she has lost in the region of 20lb. She has to have an anti-nausea drug just before each mealtime.
The doctors seem to be upbeat about it but I am beginning to lose my faith in them and feel that they are simply trying each avenue with no real idea of the outcome.
Mrs pNut is also getting a little deflated, institutionalised, fed up of hospital food and generally down. They keep promising she will have the drains blocked off and then she will be sent home to return in a few weeks (I assume for further tests!!) but that has happened at least 3 times and she is still there.
I have asked (with my wife too) to see the surgeon who is responsible and am awaiting an appointment from his secretary.
Sorry to be so negative but this is really pi$$ing me off and so far I have covered 1000 miles going to & from hospital (well very few 'other' journeys)
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///Sqad
puter thanks for the diagram and also your full and expert description.
My guess is that the constriction is at the the junction of the pancreas and duodenum and the bottom line seems to be....the cause and nature of the constriction.
This will take a bit of sorting out, so don't get depressed if her recovery is a little slow.
Again...excellent description and drawing.........keep is informed.
05:19 Fri 12th Aug 2011Report////
This was my opinion a month ago and it remains the same.."What is the nature of the "constriction?"..........ask your surgeon. This is a big deal and may be difficult to sort out, so you will have to be patient.
Keep us informed.
puter thanks for the diagram and also your full and expert description.
My guess is that the constriction is at the the junction of the pancreas and duodenum and the bottom line seems to be....the cause and nature of the constriction.
This will take a bit of sorting out, so don't get depressed if her recovery is a little slow.
Again...excellent description and drawing.........keep is informed.
05:19 Fri 12th Aug 2011Report////
This was my opinion a month ago and it remains the same.."What is the nature of the "constriction?"..........ask your surgeon. This is a big deal and may be difficult to sort out, so you will have to be patient.
Keep us informed.
puternut, I am going to give you this advice frankly and as though it was my own wife that was in this predicament.
1) Don't go stamping into the Consultants room with all guns blazing, as he will feel just as exasperated as you about the condition of your wife. You may think that they are overpaid arrogant, unfeeling distant an unapproachable individuals, but this is far from the truth.
2) Ask him straight out " Is there any chance that this stricture is malignant (cancerous) ? Unlikely but a possibility to which you may ave to prepare yourself.
3) if as is most probable, the answer is that it is not, then you must be prepared for a long wait for this to heal or possibly another exploratory operation.
I have put my cards on the table, so please keep us informed.
1) Don't go stamping into the Consultants room with all guns blazing, as he will feel just as exasperated as you about the condition of your wife. You may think that they are overpaid arrogant, unfeeling distant an unapproachable individuals, but this is far from the truth.
2) Ask him straight out " Is there any chance that this stricture is malignant (cancerous) ? Unlikely but a possibility to which you may ave to prepare yourself.
3) if as is most probable, the answer is that it is not, then you must be prepared for a long wait for this to heal or possibly another exploratory operation.
I have put my cards on the table, so please keep us informed.
Good news - had a call from surgeons secretary and said that he is away in London for a couple of days but his Senior Registrar is quite happy to see me, in his absence, this afternoon. If I preferred I could wait until Friday when he's back but will see registar.
I am writing myself little notes to bring up the subjects I would like to discuss with him.
And Sqad - I think the situation on Monday got the bettter of me and I was a little overwrought. Whilst I did say I felt like stamping my feet, I do realise the important job these guys do and I will treat him with respect and just seek his views on the subject, possible causes and his expert prognosis.
So will report back later
I am writing myself little notes to bring up the subjects I would like to discuss with him.
And Sqad - I think the situation on Monday got the bettter of me and I was a little overwrought. Whilst I did say I felt like stamping my feet, I do realise the important job these guys do and I will treat him with respect and just seek his views on the subject, possible causes and his expert prognosis.
So will report back later
Greetings all
I had a great meeting with Mrs pNuts registrar this pm who is a really nice guy. We spent about 30 mins talking over what has happened since day 1 of her hospitalisation and he went through all their decisions and why certain procedures were done and whst effect they had. I had no cause whatsoever to feel that he was blinding me with science other than his usage of the medical terms he used occasionally for the equipment / procedures they did (or didnt) use / do.
Okay the main problem appears that following the initial sugery on day one Mrs Nut complained of pains in the stomach area. X-rays showed that she was indeed seeping bile into the body cavity - not a good thing in anybodys book. To counteract this the initial bile drain (T-Tube) was inserted to prevent further complications from this.
There was also a possibilty of other things giving her the pain - i.e. internal bruising following keyhole surgery (apparently quite a common side effect - low pain threhold - anasthetic wearing off.
The narrowing of the duct (apparently close to the head of the pancreas) was the next problem to be overcome.The surgical team together with the radiology team hatched the plan of using a thin wire and balloon / stent to try to expand the duct. First attempt was a success, second attempt appears to have made it better but still not 100%.
So the state of play is now that radiology have done their best and all drains are in place, working as they should with output having been monitored and all is going to plan!!!
The nausea I mentioned abov was no more than a reaction ( and a known side-efect) of the antibiotics they were using - and had to use. Since coming off them this has greatly reduced.
So what now ....... drains will stay in pace for another 7 weeks to allow all to settle down. Then a revisit to do the 'CP' part of an 'ERCP' to determine if the narrowing is holding up when if all goes well then drains removed. If not - and this is the scary part - and it looks bad then she is of to London 'Kings' for major surgery to get the narrowing dealt with by - as rowanwitch puts it a 'Hep Bil' centre (Thats hepato-biliary which I had to look up <LOL>). But that is worse case scenario and major surgery and will not happen ,fingers and toes crossed.
At the end he did have excellent news in that as there is now a 7 week wait and providing a final liver function test (result Thursday) comes back satisfactorily Mrs Nut will be sent home Friday (YIPPPPPPEEEEE) with drains clamped off, shortened and strapped to her body so that if needs be they can be reattached and the situation really re-thought quickly - but that is not going to happen. Is it. No.
In conclusion - and I am going to make this the final paragraph (but one) in this vast post - Thank you one and all for your concern and wishes. It has helped me to know there are people out there who care for someone you don't know and have never met.
In final conclusion I did ask registrar to answer a worry voiced by Sqad. During one of the first radiology procedures they apparently took a sample from the restriction and had it tested for cancer and it came back negative. They did expect this result as the problem had been so long-standing and the feeling was that cancerous tissue would grow at a much faster rate. It was good to have it confirmed though.
So I bid you all a farewell and goodnight!!
I had a great meeting with Mrs pNuts registrar this pm who is a really nice guy. We spent about 30 mins talking over what has happened since day 1 of her hospitalisation and he went through all their decisions and why certain procedures were done and whst effect they had. I had no cause whatsoever to feel that he was blinding me with science other than his usage of the medical terms he used occasionally for the equipment / procedures they did (or didnt) use / do.
Okay the main problem appears that following the initial sugery on day one Mrs Nut complained of pains in the stomach area. X-rays showed that she was indeed seeping bile into the body cavity - not a good thing in anybodys book. To counteract this the initial bile drain (T-Tube) was inserted to prevent further complications from this.
There was also a possibilty of other things giving her the pain - i.e. internal bruising following keyhole surgery (apparently quite a common side effect - low pain threhold - anasthetic wearing off.
The narrowing of the duct (apparently close to the head of the pancreas) was the next problem to be overcome.The surgical team together with the radiology team hatched the plan of using a thin wire and balloon / stent to try to expand the duct. First attempt was a success, second attempt appears to have made it better but still not 100%.
So the state of play is now that radiology have done their best and all drains are in place, working as they should with output having been monitored and all is going to plan!!!
The nausea I mentioned abov was no more than a reaction ( and a known side-efect) of the antibiotics they were using - and had to use. Since coming off them this has greatly reduced.
So what now ....... drains will stay in pace for another 7 weeks to allow all to settle down. Then a revisit to do the 'CP' part of an 'ERCP' to determine if the narrowing is holding up when if all goes well then drains removed. If not - and this is the scary part - and it looks bad then she is of to London 'Kings' for major surgery to get the narrowing dealt with by - as rowanwitch puts it a 'Hep Bil' centre (Thats hepato-biliary which I had to look up <LOL>). But that is worse case scenario and major surgery and will not happen ,fingers and toes crossed.
At the end he did have excellent news in that as there is now a 7 week wait and providing a final liver function test (result Thursday) comes back satisfactorily Mrs Nut will be sent home Friday (YIPPPPPPEEEEE) with drains clamped off, shortened and strapped to her body so that if needs be they can be reattached and the situation really re-thought quickly - but that is not going to happen. Is it. No.
In conclusion - and I am going to make this the final paragraph (but one) in this vast post - Thank you one and all for your concern and wishes. It has helped me to know there are people out there who care for someone you don't know and have never met.
In final conclusion I did ask registrar to answer a worry voiced by Sqad. During one of the first radiology procedures they apparently took a sample from the restriction and had it tested for cancer and it came back negative. They did expect this result as the problem had been so long-standing and the feeling was that cancerous tissue would grow at a much faster rate. It was good to have it confirmed though.
So I bid you all a farewell and goodnight!!
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