13 September 2007

On a brighter note

There have actually been a couple of bright spots lately.

My diabetes is actually improving somewhat. I've lost a little weight and my average blood sugar is down somewhat. It's still elevated, but has given me some hope that if I can continue losing weight and following a sensible diet it can be overcome. My initial goal is to lose about 45 pounds (target weight of 220). Once I get there I'll see if I can get to 200, I don't remember the last time I weighed that much, but it's been a long time.

In other good news, we have a new pet, and I'm pretty sure this one can't send me to the hospital. We got a cockatiel from our good friends. Her name is Zoe (it was Zeke until she laid an egg, providing incontrovertible proof of her sex). She's really a lot of fun.

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12 September 2007

Quick Surgery News

I made it through the surgery yesterday (Sept. 11, 2007) and got home today. I don't know yet if it should be counted as a success or not. The goal was to track the discharge tract back to the source and elmininate it, which was done. But another goal was to not have to remove all of the synthetic mesh. We didn't achieve that one.
It turned out that 50% of the synthetic mesh was involved. I haven't discussed in enough detail yet with the surgeon to really understand what that means (or if I did, the Dilaudid kept me from remembering what he said). Portions of the mesh had also become detached. So with both the detachment and the involvement, he removed all of the synthetic mesh. This left a small hole which he sutured together, but we know that won't last.
So the current plan is to try to delay the abdominal wall reconstruction until after the first of the year. I don't have enough leave available to go through that this year. He also took cultures to see if there is an better antibiotic we should be using (I've been on the Invanz since the middle of July). We'll keep the PICC line in and continue IV antibiotics for a couple more weeks.
We had also planned on this being outpatient, but, of course, there were other complications (apparently, I wouldn't have it any other way :)). My blood pressure was very low (hypotension). I think the lowest was around 65/38. Which also meant that I couldn't have pain medication for most of yesterday and last night. Additionally, I bled a lot after getting to my room, so my red blood count was also down (the normal value is around 45 and mine was around 26). So we had to wait until that level stabilized before I could be discharged. It's still no where near normal, but it did stop going down as the bleeding stopped.

I'll have more news after my follow-up visits, but wanted to go ahead and get something out. I want to thank everyone for their prayers and support.

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02 September 2007

Medical diary, continued

I met with the surgeon again this week, for the last appointment before the surgery. The surgery is scheduled for Tuesday, 11-Sep-2007. The surgeon is going to try to follow the tract that the discharge is using to get out of my abdomen (there's still one small opening that it comes from) back to the source. On the way he'll remove any nonviable tissue (that's the debridement part). We expect that it will end up originating at the synthetic mesh. Once he gets there he'll try to remove anything that's involved, including potentially part of the mesh itself. Instead of plain saline for the flush, he's also going to add some antibiotic solution. Right now the surgery is scheduled as outpatient, but it's going to be in the main OR instead of the ambulatory center in case it becomes more involved and I need to be admitted.

This coming week is going to be plenty full of medical visits. I get my PICC line dressing change by the infusion company weekly, which is pretty minor. The infectious disease specialist wants one more follow-up before the surgery. I've got to go in to the hospital to do the pre-op workup (bloodwork, etc). And my family doctor also wants a visit to check on the diabetes.

The new diet has actually been pretty good, and actually makes sense. The goal is to have approximately 45% of calories from protein, 30% from carbohydrates and 25% from fat. In the beginning phases there's a food plan for each day, which includes all meals and snacks. An important part of a diabetic diet is to include healthful snacks between meals to prevent blood sugar spikes and valleys.

Another important part of the lifestyle modification is more physical activity. More on that later...

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