August 3rd, 2022
It was the morning I had been anticipating for weeks. Anticipating with anxiety, frustration, a desire to just get it over with, and finally the day had arrived.
The night before I had carefully showered and washed myself with antibacterial soap and dried afterwards with a freshly washed towel. I hadn't used any deodorant, perfumes, lotions, etc. I hadn't eaten since dinner or drunk anything other than just a swallow to take my pills. I slept on freshly washed sheets. I took another shower with the antibacterial soap that morning and dried myself with another freshly washed towel.
Steven and I left around 6am to arrive at the UC Health hospital in Highlands Ranch by 7am to check in for surgery which was scheduled for 9am. We made it in good time and had no trouble checking in. It wasn't long before they took Steven and me back to the pre-op area where they had me wipe myself down with antibacterial cloths, gargle mouthwash, and change into a hospital gown and bright yellow socks. They asked a ton of questions, took blood, applied stickers here and there and ran tests. They inserted an iv line in my arm just above my wrist. One by one people dropped in to introduce themselves, tell me what role they would have in my surgery, and have me sign consent forms. Eventually I kissed Steven goodbye, they put something in my iv, and the next thing I remember was trying to wake up after surgery was over.
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| In the pre-op room, the surgeon drew on my neck where he expected the incision to be. |
The doctor told me the surgery went well. He had cleaned out my tracheoesophageal groove, removing most of the lymph nodes on the left side of my neck. Test results later showed that at least 12 of 52 lymph nodes removed were "involved by metastatic thyroid carcinoma". Everything else at that point looked good - besides the fact that I resembled Frankenstein's cyborg with the scar and the drain coming out behind my ear! The drain filled with fluid that would need to be emptied and measured on occasion. Immediately after the surgery, it was a light red.
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| Post surgery, with my scar and my drain |
(If you want to see a photo taken during surgery with my neck open and the chunk of stuff they took out, feel free to click here! I didn't want to post it here and potentially impose on those who would rather not subject themselves to such graphic images.)
After some time in the recovery room, they wheeled me to a private room where I would reside for the remainder of my time in the hospital. The incision site wasn't unduly painful, and while I was tired and groggy from the anesthesia, I was feeling pretty good.
8/4/2022
Sometime early in the morning, the discharge from my drain turned from thin reddish yellow to a thick, milky white, the sign of a chyle leak.
Google says:
"What is a chyle leak? Chyle is milky-looking fluid made in your small intestine during the digestion of fat. Chyle is carried around the body by lymphatic vessels, just like blood is carried around the body by blood vessels. The lymphatic system carries fluid, fats, protein and cells that fight infection. A leak can occur in the lymphatic system after surgery. This is called a chyle leak." (source)
"Chyle leak formation is an uncommon but serious sequela of head and neck surgery when the thoracic duct is inadvertently injured, particularly with the resection of malignancy low in the neck. The thoracic duct is the primary structure that returns lymph and chyle from the entire left and right lower half of the body." (source) |
| My drain full of chyle |
To combat the effects of the leak I was put on a low fat diet (<10 g fat/day) and they gave me shots of medicine in my belly that hurt! I didn't get to go home that day. As I feasted on fruit, salad, sorbet, non-fat yogurt, and whatever other very low fat foods I could scrounge from the hospital cafeteria, they watched my drain and measured the output, hoping that it would decrease to a point where I would be able to return home.
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An egg-whites only omelet, along with my nonfat yogurt and fruit cup.
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8/5/2022
On Friday, I read the ebook I had downloaded to my Kindle. I paced the halls. I got a shower and convinced one of the nurses to put my hair in Dutch braids, which helped to keep it out of the bacitracin on the incision and from getting tangled in the drain tube. Luckily they were able to switch from stomach shots to putting the medicine in my IV, so that wasn't so bad, I just had to take my pet Pat the Patient Pal (my IV stand) with me when I took my laps around the floor of the hospital. I was told that they would monitor the leak over the weekend and depending on how it was doing, make a decision on Monday as far as when I would go home or if I would need another surgery to stop the leak.
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| Pat the Patient Pal |
That night, Steven and the boys came down to the hospital to see me. They brought me some books and my crocheting stuff, and Josh set up Netflix on my tablet so I had more to do.
8/6/2022
Saturday was Josh's birthday. Rather than having standard cake and presents, Josh had asked to go to the Renaissance Festival for his birthday, so Steven and the boys stopped briefly to say hi on their way to and from the festival in Larkspur, CO. They brought me a really cool set of earrings as a souvenir - one of the earrings actually hangs around the back side of the ear and has dangly bits from the front and the bottom!
I had other visitors on Saturday as well. Brother and Sister Moats are John's mission leaders here in the Denver Service Mission. They actually live only 5 minutes away from the hospital where I was so they stopped by for a little while on Saturday and brought me flowers. (Steven and the boys had visited with them briefly Friday evening after their visit with me, and told them where I was.)
While not entertaining visitors, I crocheted a small giraffe and started working on a lion. I avoided the hospital bed like the plague. In spite of the bland low-fat diet I was still eating, the white milky stuff continued to fill my drain, but it was a little less on Saturday than it had been on Friday.
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| Here are the flowers the Moats brought me along with my giraffe and the beginnings of the lion. |
8/7/2022
On Sunday I caught up on some seminary training meetings I had missed (I was grateful that the zoom meetings had been recorded!). I listened to a couple "Follow Him" podcasts. I finished crocheting the lion. Brother Moats and his grandson brought me the sacrament. I walked the halls. And I had my full drain emptied, again, and again, every 1-2 hours. The leak wasn't drying up.
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| Peter enjoyed drawing on my communication board when he visited. |
Steven sent me a video of a torrential thunder storm they got that evening. There was a river in front of the house and the patio flooded. I looked out my hospital window where there were clouds in the sky, but no sign of rain, and I wished so much that I could be at home.
That night they doubled the rate of the medicine drip in the IV to see if that would slow down the chyle leak over night. If it made a difference, it wasn't much.
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| The bed of doom. I tried to use it only at night. |
8/8/2022
Monday morning around 7am, the nurse came in and told me not to eat or drink anything until further notice. Steven came to work from my hospital room so he could be there to bring me home or for support for whatever they decided to do that day. Doctor Campana came in around 9am. He told me I had lost a liter of fluid the day before and he strongly recommended I have another surgery to stop the leak. An hour or so later I was being wheeled back down to the pre-op room where I had a strange sense of deja vu as I again wiped myself down with antibacterial cloths and gargled mouthwash and answered questions and signed consent forms. Once again I said goodbye to Steven, something was inserted in my IV and I lost consciousness as they wheeled me on the bed down the hall towards the operating room.
I awoke later, still feeling drowsy and feeling more discomfort in the neck area than I had before. The contents of the drain had returned to the thin red fluid that had been there immediately following the original surgery. I was instructed to continue the low-fat diet for the time being.
I gave the giraffe and lion I had made to one of the nurses who had two small children at home who would enjoy them.
8/9/2022
Tuesday morning, the drain still showed no sign of any milky chyle, so they let me go home! First they showed me how to empty and measure the fluid in my drain (as though I hadn't observed them doing it several times a day for the preceding week, but I supposed they had to be sure I understood.) I had to stop at the pharmacy to get some pain killer and a medicine to smear on my incision (apparently the bacitracin was irritating it somehow?) But by 11am, I was finally home again! The painkiller I was on (oxycodone) makes me drowsy so I did take a nap, but I enjoyed showering and chatting with Hannah and being able to sleep in my own bed without being woken up every few hours so a nurse could take my vitals!
8/10/2022
The drain is still slowly dripping a reddish fluid, and I'm supposed to measure it and text the amount to the surgeon every morning. This morning's exchange:
Hi Dr Campana, I was told to text you the measurements from my drain. There were 19ml at 5:30 last night and another 12ml at 7:30 this morning. It is still a thin reddish color.
Great. Keep the reports coming. Stick to boring low fat diet.
I'm grateful for all the friends and family who texted or called to check in with me during my hospital stay. I am grateful for all the nurses who were so friendly and helpful, especially when I was frustrated or bored. I'm grateful for the people from nutrition services who answered my calls for meals with helpful suggestions about what I could order that would add more variety and flavor to my meals. While I wasn't thrilled with having to spend almost an entire week in the hospital, they definitely did their best to make my stay as enjoyable as possible.
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