Saturday, November 30, 2013

Healing, Part Two (In 55 Easy Steps)

On October 31st I had a fistula repair performed. In the bad news category, it was my third attempted fistula repair. In the good news category, it turned out to be a new fistula, which means the two repairs on my original fistula worked. In the bad news category, this means I have a new fistula. In the further bad news category, the fistula drainage didn't stop enough to allow proper healing to the repair site, so on November 22nd I had another temporary stoma (my fourth) installed. In the good news category, the surgery went very well and there were no adhesions involved, so the surgeon is extremely hopeful about the outcome.


Refer to #31 and see how many you can identify.

Life is full of poop. Sometimes it's more, sometimes it's less, but the fact is that all of us have to deal with a certain level of both metaphorical and literal poop. And the sooner we learn to do that without whining or running away or collapsing, the better off we are.

I apologize in advance for any unpleasant imagery this post puts in your head. On the other hand, hey, you're here under your own volition! Gross or not, this is my reality. And if your sense of humour is slightly twisted, it is kind of funny...  Afterwards. So, for those of you silly bored reckless brave enough to continue, I offer you:


How to Change a Stoma Appliance in 55 Easy Steps

  1. Wake up repeatedly during the night and check the base of the stoma bag to make sure it is still securely fastened to your skin.
  2. Finally fall asleep soundly around 4:30.
  3. Awake with a start at 7:05 to find that yes, you have sprung a leak.
  4. Cuss.
  5. Get out of bed. As you are still only 10 days post-op and cannot sit up normally, this involves rolling onto your right side, causing more leakage, and pushing yourself up to a sitting position.
  6. Bite your lip and sigh. Pledge that you will not cuss your way through this entire procedure.
  7. Stand up. Check bedding and execute small happy dance at the knowledge that you caught the leak before it soaked through all the bedding & the waterproof pad you now sleep on, which means you do not have to strip the bed at this immediate moment.
  8. Realize that your little happy dance caused the stoma to become active. ("Become active" is a euphemism for "spew poop".)
  9. Cuss as you grab a pile of compresses to cover the leak. Grab robe.
  10. Run (well, okay, shuffle-jog) to the bathroom.
  11. Empty the clean laundry out of the washing machine. Take off your pajamas, one-handed (remember the other is holding bandages to the leak), and throw them straight into the washing machine.
  12. Sit on toilet. Empty stoma bag into toilet. Ask yourself again why you ate so many green onions at supper the day before??!? Gingerly peel the wax base of the stoma appliance off your skin and stitches/steri-strips.
  13. Cover stoma with toilet paper to prevent further leakage incidents. Throw everything in the garbage can. Make mental note that garbage must be emptied ASAP.
  14. Hop in shower.
  15. Begin washing.
  16. Begin relaxing in the warm water.
  17. Watch in amazement as your stoma becomes active (see #8 above) and does a very admirable imitation of a sprinkler head. Specifically, the impact rotor type.
  18. Cuss.
  19. Wash shower walls and tub.
  20. Finish showering.
  21. Dry off.
  22. Grab toilet paper to cover stoma 2 seconds too late.
  23. Grumble and moan, remembering previous pledge not to cuss through the entire exercise.
  24. Clean up. Place bathmat in washing machine.
  25. Throw on robe.
  26. Debate where to put on new appliance. In bathroom? Feel too weak to stand for another possible 20 minutes and rule out lying on cold floor. In your bedroom? Not ideal, as DH is still sleeping and you'd rather not wake him up for a variety of reasons, including embarrassment/frustration about the leak.
  27. Peek out bathroom door, spy that Little Toot is up and her bed is free. Score!
  28. Shuffle to bedroom, holding TP on stoma and robe (more or less) secure with one hand. Gather up as many supplies as can in the other. Shuffle to Little Toot's bedroom and dump supplies.
  29. Repeat.
  30. Repeat.
  31. Lay out supplies on bed: two towels covering bed, compresses, adhesive-remover wipes, stoma appliance base, appliance paste, stoma powder, medical scissors, half-moon plasters, stoma appliance bag, small medical waste bag, and hairdryer all within reach.
  32. Feel around blindly under Little Toot's bed for the extension cord you know is there. Wonder what else is under there. Make mental note to have Little Toot clean out from under her bed ASAP.
  33. Find power strip, plug in hairdryer.
  34. Lie down.
  35. Using medical scissors, cut a 30-mm hole in the wax stoma appliance base and place base under your bum to warm up and become more pliable. Wonder who first used this technique.
  36. Wipe stoma area down using adhesive-remover wipes. Wonder why they are made so thin. Discard used wipes.
  37. Slowly dry stitches/steri-strips and stoma area with hairdryer on low setting. Wonder how many of your friends and acquaintances are going to blow-dry their abdomens today.
  38. Grab compresses to mop up small squirt. Re-blow-dry area. Proactively place pile of compresses on top of stoma.
  39. Congratulate self for not cussing over squirt incident. Make mental note to add squirted-upon robe to the load in the washing machine.
  40. Grope around and find stoma powder; sprinkle a liberal layer around base of stoma; wipe off excess. Discard used compresses.
  41. Pray fervently for no more activity from the $%#@! stoma.
  42. Retrieve appliance base. Apply stoma paste around edge of hold in the middle.
  43. Begin to peel off the base backing so base can be placed on skin; realize that you have applied the paste to the wrong side of the hole.
  44. Cuss.
  45. Clean off base as best you can. Apply paste to the proper side. Discard used compresses. Apply base to skin, fitting base hole snuggly around stoma. Wonder who spends their time designing stoma appliances.
  46. Find stoma appliance bag; snap securely to base and press ring to make sure the seal is tight.
  47. Place hand over stoma/bag/base to continue keeping the area warm and ensure flexible and strong adhesion.
  48. Check clock. Note time is 8:18. Relax back on pillows, glad to have the process mostly done. Still time to eat and brush teeth before the home care nurse arrives at 9:00.
  49. Decide that maybe the 10 minutes of lying quietly and heating the stoma appliance with your hand could be used for some prayer and reflection.
  50. Hear the doorbell ring and Bubba bark at 8:20. Listen frantically as Boo answers the door; stink, the nurse is here 40 minutes early!
  51. Cuss. But only a little.
  52. Spend 10 minutes with the nurse, who inspects the change job closely. Try not to breathe in her face (see #48).
  53. Express gratitude as the nurse helps apply the half-moon plaster, which you had forgotten about. Wonder how many people had to deal with improper base placement over stitches before they were invented.
  54. Bid adieu to the nurse, get up, get dressed, clean up supplies. Empty garbage in bathroom. Toss robe in laundry and start load. Cook & eat breakfast. Deliberate upon an appropriate penance for the all the cussing. Con Resident Domestic Goddess (aka Mom) into changing and laundering sheets after DH gets up.
  55. Begin obsessively checking for leaks every hour on the hour....
The hard work of healing is not for the faint of heart. Or for those lacking a Junior High level sense of humour.

"becoming active"
Your turn: what physical or metaphorical steps do you need to take to slog through the poop in your life at the moment?

Thursday, November 28, 2013

Tiny Feisty

This is Baby.


To be more precise, this is Baby holding her Daddy's finger. Baby was born in October with a heart condition which required open heart surgery within the first 5 hours of her life. Since then she has been through a myriad of smaller treatments, a collapsed lung, and too many ups and downs to be counted. Very recently a clip installed in her heart during the initial surgery broke, requiring an emergency surgery. Baby's parents were told she wouldn't survive. With much prayer and hope they sent her off to the surgery, whispering to her, "Prove them wrong."

She did. She proved them amazingly, beautifully, phenomenally, feistily wrong.

The latest update is that she is doing better than anyone expected; she may be able to go home at the turn of the year or soon after.

Baby's father is a baseball fan; in a moment of sleep-deprived silliness at the hospital, Baby's Momma grabbed his ball cap, punched it inside out, and slapped it on his head as a Rally Cap. A picture on Facebook was all it took to start a landslide of "Rally Cap for Baby" photos being sent in, with assurances of prayer and support from all over the globe.

All Saints Maastricht Uni Group (& Bubba) Rally for Baby

Baby's Daddy has been printing the pictures out, hanging them by her bassinet in the NICU. The nurses are blown away by the amount of support Baby is receiving; the surgeon and the anaesthesiologist are dumbfounded at Baby's strength through all of this. Baby's Momma and Daddy keep praying, keep hoping, keep loving. What can I say? They believe in prayer; they believe in hope; they believe in love.

I know Baby's Grandma; she's a pretty feisty lady. I know Baby's Daddy (he once interned for me while I was preggers -- every 20-year-old guy's dream job!) and he's a pretty feisty guy. I "know" Baby's sister and Momma through Facebook; they look to me to be the very picture of feisty gorgeousness. And Baby is proving herself every day to be more feisty than the rest of us put together.

So Baby, as dubious an honour as it may be, I pronounce you a Tiny Feisty Broad. Your Momma says you were a kicker in the womb. Keep kicking, Baby; keep kicking!

"Nothing is impossible. The word itself says, 'I'm possible.'"
(A favourite quote of Baby's family, from Audrey Hepburn.)

Your turn: if you would like to support Baby in prayer, send me a picture
of you & your Rally Cap.
I promise I'll get it to Baby's family.