Friday, April 4, 2014

Surgery Report: My External Iliac Artery Repair

I am looking forward to this blog returning to a triathlon focus, but as a journal of the ups and downs of being an athlete in the sport, this surgery is a part of my story. If you'd rather avoid this detour, tune back in sometime in May. But I am sharing this in the hopes it will help someone else, just as Kelly Williamson's report helped me.

What a whirlwind the last few days have been. I showed up at Carilion Roanoke Memorial Hospital 6 am sharp on Tuesday and things immediately got underway for 7:30 surgery. As I was being prepped, I met with my vascular surgeon, Dr. Jesse T. Davidson, III (pictured above) and anesthesiologist Dr. David Thompson and also got a surprise visit from tri-pal Karen who is a third year med student working in the hospital. She walked in as we were discussing cycling and she said, "I figured!" It was here that I learned that my initial pressure testing done in late February showed my leg pressure dropped by half after running and took 20 minutes to recover. No wonder I had problems.

As I rolled down the hall Dr. Thompson gave me the first sedative that he referred to as a "glass of wine," to which I said something about "is this like a pub crawl?" and that's pretty much all I remember.

I woke up in recovery feeling nauseous and loopy but not in any real pain. I learned then that Dr. Davidson had patched 7" of scarred and narrowed artery and separated the inguinal ligament where it was pinching the artery. My husband asked Dr. Davidson about the chances of this problem recurring and he reportedly replied "not in that leg" which is very reassuring!

Then I was taken to a room in the Vascular Progressive Care Unit. Here is the requisite hospital bed shot. I had three bandages - one around my thigh, one diagonal lower abs, and one mid-ab. 


They put a cuff on my good leg that inflated on a regular basis to keep blood flow going and reduce the risk of blood clots for the first 24 hours I would be stuck in the bed. It was my knock-off NormaTec recovery boot. 

Then the fine dining began. I was on a liquid diet for nausea and it was just as well. I had little appetite.

Tuesday night was rough. I did not sleep much, but was in some state of morphine-induced twilight zone of random thoughts and images parading through my brain. My bloated stomach hurt and I could not get comfortable. By Wednesday that pain had subsided, replaced by a headache that was remedied by a cup of coffee. Caffeine withdrawal, I suppose!

By now I was feeling downright proud of my booming ankle pulses (x marks the spot!). My ankle had its 15 minutes of fame.  I was told that palpable ankle pulses were pretty unusual since they don't get too many healthy people through the unit. The staff and nurses uniformly sang the praises of Dr. Davidson. I have discovered over the last few months, from my friends in the medical community, that his reputation, skill, and expertise are extremely highly regarded. People rave about him, and I feel very fortunate that a series of events and people led me directly to him.

Wednesday morning a fellow named Brian showed up to take me for a walk. It turns out he had moved from the very town in Pennsylvania where I was born and his son is a cyclist who works for Cannondale. Small world! Obviously my ability to chit-chat had not been impaired. Once I got moving I felt OK and walked at a good clip, prompting the nurses to tease him about his ability to keep up.

Karen came by a few times to check on me, as did another tri-pal, Casey who works in IT for the hospital! Very cool! 

Karen and I at CRMH (above) and at PPD Beach2Battleship (below). I prefer the photo below!

The hubs came back Wednesday night with the kids. I have no pics because the kids were pretty weirded out by it all and I was busy offering reassurances and trying to keep it light. I took them for a walk around the floor and tried to show them all the cool stuff. Suffice it to say, medical careers are likely not in their futures.

Equipment Coach Bryan came by (arteries counting as "equipment") and helped by filling out the Discharge Planning board to be sure everyone knew I would be ready to leave Thursday.

Wednesday night went a lot better. I tried to go morphine-free but caved in, got a "hit" sometime in the night, and subsequently slept relatively well between interruptions. 

Thursday morning I got disconnected from the ECG leads (or whatever they are called) and the IV (of which I had two, one smaller, done pre-op and one larger, put in when I was asleep) which meant I could finally put normal clothes back on.

 So it was a triathlon shirt, of course - 2013 Nationals!

We also took the dressings off of my incisions. I was a little taken aback by what I saw, but I would adjust.

By now I was roaming the floors solo, as I was told that it was good to move around. At one point the phlebotomist was trying to find me to draw blood and couldn't locate me. I think that's a pretty good sign it's time to go home.

Before I went home I had some great conversations with the nursing staff about running and triathlon and I saw the gleam in the eyes of Natasha, Emily, and Karen! I see some good athletic goals in their futures! In all seriousness, the staff in the Vascular PCU was fantastic.

I arrived home at 3 pm on Thursday, just 57 hours after this all began. And if you are interested, here is the picture of my five incisions, 50 staples, and bloated belly. I think the four on my leg were from where the vein was harvested and the one across my abs was to access the external iliac artery which is tucked in behind the intestines. I put on a bikini suit bottom so it is a "G" rated photo. I will probably not be wearing this bikini bottom again. No biggie, I'm all about function over form!

Note I had Dr. Davidson's pre-surgical "autograph" on there, lol. Next Wednesday the staples come out.

Last night went pretty well. I woke up a few times but generally slept through the night. I took one of the pain meds overnight and woke up feeling nauseous and rough. I think I need to avoid those meds if at all possible.

This morning (Friday) I'm just laying low and trying to kick this round of nausea - hydrate, sleep, move around, repeat.

Thank you for the support and well-wishes along the way.