Results

Kay’s follow-up surgery is over, and went reasonably well, though not as well as it might have, in a best case scenario. Kay knew that, if she woke up in the recovery room after the surgery without me already attendant upon her, she would be staying in the hospital. Although it was not the predicted outcome, it did happen. She immediately searched for confirmation of her worst non-death fear – a colostomy – and found that she had not received one. Indeed, no indication had been given that such a measure was even a possibility, much less a likelihood, but it is one of her least dispellable fears. She did find, however, that she had been fitted with another JP drain, and if she looked at the clock, if there was even one available, she found that she had been in the operating room for two hours total, one more than had been planned.

The reason for the extended surgery time was simply the difficulty of the surgery. The abscess wreaked considerable havoc in Kay’s gut, essentially undoing all that had previously been done to un-stick the organs from each other. All was tender, inflamed adhesion, as far as the scope could see, which was not far, as of the reproductive organs only the end of one fallopian tube – whether left or right could not be discerned – was visible. (This tube, for what it’s worth, did have intact fimbria.) Drs. Hilgers and Fitzgibbons also found some remnant of the abscess, though only a teaspoon-sized portion, which they removed, and they “irrigated” – medical-speak for “rinsed” – the area with an antibiotic wash. The JP drain was fitted to allow anything remaining of the abscess to be pulled out, along with blood, irrigating fluids, and whatever other incidental liquids had collected as a result of the surgery.

The primary object of the operation was, I may remind you, the extraction of three pieces of GoreTex bandage. Those bandages had been placed over Kay’s ovaries and uterus to reduce the normal adhesions due to any surgery as much as possible, but had been overwhelmed by the toxicity and ubiquity of the abscess, which left scarring everywhere else. In their efforts to remove these pieces, they had to remove some of the new abscesses, but were hindered in their efforts by the effective blockade created by the jumbled and cohered organs. They hesitated to do much in the way of what they had done last time – separating the organs by removing the scarring – because the inflammation has not yet settled down, and the organs are thus weaker than they would be normally. Of particular concern was the possibility of penetrating the wall of the bowel. Both because this surgery was planned to be less severe, and thus a full bowel prep was not ordered, and because of the weakened nature of the bowel due to the inflammation, which could result in a torn bowel, the surgeons in the end chose to curtail their chase for the third and final piece of GoreTex membrane, leaving it behind.

Kay stayed in the maternity ward, where all of Dr. Hilgers’s patients stay when hospital time is required afterwards (this is either ironic or appropriate, depending on the eventual outcomes of their cases – though the Pope Paul VI Institute and the nurses there were good enough to inquire of us whether we thought the maternity ward was a bad choice for their patients; we told them we were happy to see the babies, if for no other reason than that they were a welcome diversion from the task of healing). The maternity nurses, though a bit shocked to see us – they had hoped Kay would have to endure no more hospital time – were as kind and attentive as ever, apparently giving Dr. Hilgers the news that they felt Kay deserved a gold medal for her behavior, news he promptly passed on to us. Kay was a bit befuddled by this compliment, asking me, “What have I done to deserve a medal? How terrible must the other women be who come through here that I deserve a medal?” I told her it was due to her almost utter lack of complaining, to her patience and mildness when she called the nurses in for help, to her continual sense of humor, to her persistent efforts to comply with their healing instructions (particularly the need to take multiple walks a day). I doubt the other women, mostly delivered mothers recuperating for a day or two, were great termagants, but the nurses’ sense of pity for her rarely precedented stay in their ward, and her perfect behavior throughout, likely elicited the compliment.

On Monday, at one o’clock in the afternoon, Kay and I had our regularly scheduled post-op with Dr. Hilgers, though he had been quite attentive that week already – as is customary he came in to see us every day, skipping only Sunday this time as Kay was clearly in no danger (though he did send his resident in to see her). He had little to say that he had not already said, and his usual joviality was rather suppressed by his discouragement over the results of the June procedure. We had plenty of questions for him, of course, mostly about the future. As the blog format and its readers, however, are polonian in their prejudices, I will attain brevity by saving those – including the questions addressing the mystery of the missing third bit of GoreTex and what happens next – for the next posting.