Road to recovery begins...

Good morning, all. Kristin has had a rough couple of days, but we may be turning the corner.

Kristin woke up Tuesday morning in the ICU in pain, but she was alert, talkative and hungry (she ate a really good meal). She had been on diluadid for her pain, along with a cocktail of various other drugs in attempt to relax her muscles and control the usual post-op nausea.

For those of you who don't know or who have never had the "pleasure", diluadid is pretty strong stuff. As I understand it, dilaudid is a Class-A narcotic whose base ingredient is hydromorphone, which is also used for morphine. I can tell you from personal experience that its effects are quickly felt and very strong. I was given it while in the ER following a car accident. I immediately felt very warm, calm and had little or no pain in spite of s very serious injury to my hand. However, when I came out of surgery and asked for it again I was refused (they gave me something else) on the grounds that it is too strong.

The difference with Kristin is that the location of her surgery is very sensitive. There are a lot of nerve/nerve endings in that area, plus the muscles in her neck were literally cut and then put back together in order to accommodate the need to gain access to her skull. Moreover, Kristin has been on so much pain medication for so long that she has developed some resistance to the different narcotics used to treat severe pain. Accordingly, dilaudid - being as strong as it is - is a good option.

When Kristin got to the ICU the diluadid was being administered via "patient controlled analgesia" ("PCA"). Kristin was required to push a small button when she wanted the medication. The dose would be administered from the PCA machine into Kristin's IV. After that the PCA machine would lock her out from using it for between 6 and 8 minutes.

The trick was that only Kristin could push the button. If she fell asleep (which she did understandably often) she wouldn't get any of the drug, and would eventually wake up in considerable discomfort. This happened frequently enough that the doctors eventually decided to up Kristin's dose by nearly half (a nurse later told me that I would need to be "peeled off the floor" if I was receiving that much of the medication). The side-effect was that Kristin became essentially sedated (she couldn't stay awake for more than a few seconds and barely spoke) and her breathing was shallow, which led to her being put on oxygen through a "nasal cannula" (i.e., little tubes in her nostrils).

Between this added airflow, the effects of the intubation tube she had in her throat during surgery, and the surgical anesthesia wearing off, Kristin's throat became inflamed. She didn't eat, talk, or drink very much for about 24 hours, into the afternoon yesterday. She was also still very uncomfortable due to the considerable pain in her head and neck.

On top of all of this, it was important for Kristin to start moving around and out of her bed. The nurses moved her from her bed in ICU to a chair, a process that caused a great deal of pain. In addition, she was visited by occupational and physical therapists who put her through some mild exercise. She was understandably less than thrilled about this, but she pushed through and did it. Maintaining her physical capacities and keeping her blood flowing is an important step in Kristin's recovery.

Kristin was transferred from ICU to a regular room early yesterday afternoon. Her doctors were concerned about the state of sedation she was in, so they decided to take her off the PCA and cease all narcotics except for smaller dilaudid doses administered by the nurses every 2-3 hours. The initial few hours of this were incredibly difficult for Kristin as her body adjusted. She couldn't get comfortable in bed and was in as much pain as I have seen her in since she was in the recovery room after surgery.

The good news is that Kristin appears to have adjusted. She's still uncomfortable of course, but this morning she has been far more alert, oriented and talkative. Her throat is less sore and she's able to move herself around the bed without help. She even managed a smile when I made a joke earlier. This is a major step - not because my jokes are funny, mind you - but because she's back to interacting with people after more than a day of withdrawing from almost any such activity.

In addition, the doctors removed her bandage at about 6:00 a.m. this morning and I got my first look at the incision. It runs from the mid-point of the back of her head to the base of the back of her neck. Its about 1/2 inch wide (maybe a tad more in spots)when you include the staples that are holding it together for the time being.

The incision itself is very thin and looks good to my untrained eye. Its swollen of course, but not too bad. It has some redness, but again nothing that you wouldn't expect from such an intrusive procedure. Most importantly there does not appear to be any seepage from the incision whatsoever.

Thanks for your patience in awaiting this update. I have been with Kristin nearly all day and night since she arrived here, so it had been hard to find the time and energy to sit down and write a good post that would get you all the information that I know Kristin wants you to have. Many of you have checked-in on Kristin several times. That sort of love and support for her is incredibly meaningful to her recovery. Please keep it coming. :)

Mike