BigMac's day 2 Post Op

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CD and BigMac

CD and BigMac

Member Since 2009
Yesterday's Post Op Report
Surgery Condo


Another day. BigMac was pretty animated today... actually I'd say agitated and unhappy. He was much stronger in trying to get up and off the table to get the heck out of there. When I visit they bring him to me in an exam room. I wondered if the extra handling was not helping him but they said he is much better when he is with me. He flails around in his cage and when he finally calms down a little he lies in the litter pan. :sad: He is so unhappy.

At my second visit tonight they told me that they had to completely remove the J-tube that he partially pulled out yesterday. I don't know why they told me yesterday that they couldn't take it out and now have changed their minds. I asked the tech if this increases his chance of infection since the J-tube was into the intestine. She said he'd be fine and they were monitoring him a lot.

Tonight when I went in, they asked me to come to his cage instead of dragging him out. That was FINE with me because I do worry about too much handling and all the pain he must be in. I asked earlier today if he needed an increase in pain meds because to me he seemed to be in pain. So tonight I noticed they had given him extra sedation and he was a bit loopy. But still not resting easy. I asked again about more pain meds. The night shift doctor was on rounds and they did discuss increasing his hydromorphine. He is also on buprenorphine and was given acepromazine to sedate him because of his agitation. He was calm after I got there and they said it was the best they'd seen him all day. (boo hoo.... :cry: ) My poor baby. I sat on the floor for about an hour until my bones started to ache. I hated to leave him but at least he was calm; yet not asleep.

I know they want him to come home as soon as possible because he isn't resting well in the hospital. There is a small chance they will release him to me tomorrow if the drain from his stomach slows down.

Here are some photos of my two visits today.

Dontlikeithere.jpg


Takemehome.jpg


Imserious.jpg


Loopy.jpg


Inthelitterbox.jpg
 
Carolyn I'm really concerned about pulling out the Jtube - I would try and talk to the surgeon on this. Maverick needed emergency surgery when he pulled his stomach PEG tube out at day 10. They had to do an internal lavage/wash after they opened him up also. I'll email the FAF mods to see if they know and also do a google search for how a jtube is placed. He looks wonderful in the pictures. Are they feeding him?
 
oh, our poor little buddy! sorry to hear that he's agitated and unsettled. on the bright side, he looks very alert and aware in your pictures.

hope he can come home soon - i'm sure you'll both be happier! you're a good mom to sit on the floor so you can be with him. :YMHUG:
 
(((((CD)))) Big Mac is looking good! I hope he can come home tomorrow. Thanks for the update. Continuing to send healing energy to Big Mac and you.
Liz, Anne, Zener and Tillie
 
sending him lots more recovery vines may he be able to come home soon after being a vet tech for 16yrs I know cats as a rule recover better at home ((((((Carolyn))))))
 
Hi Carolyn,

That poor little guy! I hope they do let him come home for the weekend in a way but in another way I wonder if it's safe since you won't have the monitors they do and what if he pulls another tube? That will be soon for all he's been through. I also am wondering if they are giving him enough pain medication for him to be so awake. He has to hurt like anything. He had such extensive surgery. I know you would give him more attention though and he would be happier and rest more. I would have a serious talk about the pain meds with the dr. if I were you. I know some dr.s have a habit of undermedicating cats.

What are they doing about feeding him if they took the tube out? That is also something to talk to the doctor who operated about.

He really looks good though. I've been thinking of you both all day off and on.

Melanie

Edit: The reason I had asked about the table is because like you, I was surprised they were moving him that much so soon. When Racci was operated on, I went back to the cage and sat on the floor to visit also rather than them moving her.
 
Karrie and Maverick said:
Carolyn I'm really concerned about pulling out the Jtube - I would try and talk to the surgeon on this. Maverick needed emergency surgery when he pulled his stomach PEG tube out at day 10. They had to do an internal lavage/wash after they opened him up also. I'll email the FAF mods to see if they know and also do a google search. He looks wonderful in the pictures. Are they feeding him?
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I know. I was very concerned because they made a big point of saying that the tube HAD to stay due to infection risk. And the very next day they take it out. :? The surgeon took it out at 4 pm today. I asked the tech if they had to go in and stitch the openings or what. She didn't give me a clear answer and tried to reassure me that it was ok. I'm not sure if she was on duty when the tube was removed so she may not have known. But they know I'm wondering and I told them I needed to talk to the surgeon about it because I was confused.

The only thing I can think of is that perhaps it is like when you get a serious cut... there is a time limit to when you can get stitches and if you wait too long the areas start to heal on it's own and the two edges cannot be sewn together. But if it is early enough the two edges will close. Maybe it is early enough that there will not be a stoma created and the cut opening will close together. I am only guessing. After BigMac's surgery they told me specifically that the J-tube had to stay for 14 days to create the stoma, whether the tube was still being used for feeding or not. See why I was a little freaked out?

I believe they are giving him nutrition through the IV as well as today through the E-tube.
 
aw...it just tugs the heart knowing how bad he wants to be home with you :sad:

I think Sienne was so spot on yesterday when she said as humans we'd be curled up in a ball after such an ordeal,
while your lil hero is just looking for a way to bolt!

Sending all the strength we can gather his way, Carolyn...and MAY HE COME HOME WITH YOU TOMORROW!!!

Hang in there, tuff burger-dude...and hope the KTSS Krew isn't kicking up too much of a ruckus while they're visiting!!
(although the Tortie Girls claim Binks tried to ditch them and leave them last night at the clinic,
and I'm pretty sure shy lil Annie wouldn't have minded spending the night with BigMac ;-) )
I warned her she's got a WHOLE lot of competition for his affections! :lol:

Rest well and heal well tonight, Buddy!

39.gif
 
He has the most beautiful haunting eyes. It must be so difficult for you to resist doing exactly as those eyes are telling you and picking him up and racing out the door. Sending more healing vines for BigMac and some relaxation vines as well. He is a very lucky boy that he has you overseeing his treatment, I feel bad for the kitties whose beans think the vets know it all and don't know when to intervene.

I know you don't like it there BigMac but if you relax a little you will heal better and get to go home with your bean all the sooner so try to relax ok and I'm sending you some special vines of my own, they're laced with cat nip - Vyktor
 
((((Carolyn & BigMac)))) I've been thinking about you both all day. Thank you for sharing the photos. I'm also concerned about how he pulled out the etube and how he is getting nutrition. I really hope the pain meds are keeping him comfortable. Yeah - cats are amazing. Most people wouldn't be able to move after surgery like that, but BigMac is ready to go.

I honestly think cats get better care at home than in the hospital, especially after what I went through with Sid. When Sid was in the local ER for 5 days, they let me visit him in his cage and that was much better. The specialist always brought him to me in an exam room which meant they had to disconnect all of his tubes and carry him around plus exposing Sid to who know what from other animals in the exam room - I just didn't like that at all.

BigMac looks alert in the photos and that is good. Poor baby doesn't understand what is going on. I will be glad when you can bring him home.
 
(((((Big Mac and Carolyn)))))

I'm sorry to hear that he is so uncomfortable :sad: I hope he starts to feel better soon.

I remember that my dad had some chest tubes after his surgery and they were stitched specially when the tube was inserted during surgery, so when the tube was removed it would close up and stich itself. I don't know if this is the same with kitties? Maybe?

Sending healing thoughts to you and Big Mac!

Tanya and Elie
 
MelanieAndRacci said:
Hi Carolyn,

That poor little guy! I hope they do let him come home for the weekend in a way but in another way I wonder if it's safe since you won't have the monitors they do and what if he pulls another tube? That will be soon for all he's been through. I also am wondering if they are giving him enough pain medication for him to be so awake. He has to hurt like anything. He had such extensive surgery. I know you would give him more attention though and he would be happier and rest more. I would have a serious talk about the pain meds with the dr. if I were you. I know some dr.s have a habit of undermedicating cats.

What are they doing about feeding him if they took the tube out? That is also something to talk to the doctor who operated about.

He really looks good though. I've been thinking of you both all day off and on.

Melanie
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I KNOW! I am thinking the same thing. I want him home to rest but also worried about all the tubes and monitoring. Plus his surgery was a big whoppin' deal. Not minor by a long shot. The surgeons were almost giddy when they discussed it with me immediately following the operation. I know they worked long and hard but it was kind of like they enjoyed the challenge. Seeing the X-rays and images on the lead surgeon's iPhone makes me think they are using his case as a teaching case or something. Maybe they always do that but it seemed unusual to me.

Yes, the pain medication. Every time I go in I ask about it. And each time they gave him more. Tonight I did hear they planned to increase the dose. Plus they added the sedative... which didn't seem to make him sleep... he just acted goofy and his third eyelid was slightly up. That was different from earlier today. It killed me to have to leave him while he wasn't sleeping. The whole hour I sat on the floor he only closed his eyes if I stroked his brow and kind of gently pushed his eyes closed. When I lifted my fingers his eyes would pop open again. That was so sad.

His cage is labeled with all sorts of warnings ... one of which made me laugh a little ... "Will RUN." No kidding! That explains why they had to make him all druggy. I'd rather it was with the pain meds first. Of course I want him to stay safe and not be over dosed. But I don't think they need worry about getting him hooked. It's not like he's going to hang around street corners buying crack. :shock:
 
thebigfuzz said:
(((((Big Mac and Carolyn)))))

I'm sorry to hear that he is so uncomfortable :sad: I hope he starts to feel better soon.

I remember that my dad had some chest tubes after his surgery and they were stitched specially when the tube was inserted during surgery, so when the tube was removed it would close up and stich itself. I don't know if this is the same with kitties? Maybe?

Sending healing thoughts to you and Big Mac!

Tanya and Elie
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Oh, that makes sense! Thank you so much for sharing that. Maybe I can sleep now. I have been almost as agitated as BigMac. Wow.... just a few words can really make a difference!
Hugs to YOU, Tanya!
 
I think you need to talk with the surgeon that placed the jtube. I've been doing some reading and its not one you just pull.

"Occasionally, more serious complications can occur such as infection at the exit site; potentially, complete tube dislodgement could result in peritonitis in the case of a gastrostomy or jejunostomy tube."

http://jfm.sagepub.com/content/11/11/925.full

I'm still waiting for replies from the FAF moderators. I'll keep looking.
 
Hmmm maybe its a combo tube:

Jejunostomy tubes are generally placed surgically and therefore beyond the scope of this presentation. J-though-G or PEG-J tubes, although still requiring anesthesia, can be placed endoscopically and have the benefits of allowing for gastric content management (such as suctioning) and post-gastric feeding, especially helpful in cases of pancreatitis. Should post-gastric feeding no longer be necessary, but the patient continues to need enteral nutritional support, the J-tube can be pulled while the PEG tube remains in place for gastric feeding. Variable methods exist for the endoscopically-placed tubes. Despite being non-invasive, more expertise is required compared to the placement of the PEG tube only. The primary complication of the PEG-J tube is retrograde migration of the J-tube and diarrhea from alimentary liquid diets.
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http://veterinarycalendar.dvm360.com/avhc/article/articleDetail.jsp?id=581792&sk=&date=&pageID=2
 
It's so true that a person could never dream of moving around like he is after surgery like that. Cats are so brave and heal so quickly in comparison.

We're sending more healing wishes and hoping BigMac can go home soon. Racci said he's her hero and she thinks she's in love, as she batted her eyelashes.

Melanie & Racci
 
Karrie and Maverick said:
I think you need to talk with the surgeon that placed the jtube. I've been doing some reading and its not one you just pull.

"Occasionally, more serious complications can occur such as infection at the exit site; potentially, complete tube dislodgement could result in peritonitis in the case of a gastrostomy or jejunostomy tube."

http://jfm.sagepub.com/content/11/11/925.full
Click to expand...
Exactly. I mean that is what they basically said yesterday... and again last night. So what happened today where they changed their tune? And it was the surgeon who made the call to remove it.

I have the charts from the surgery and post op as far as this morning. I wish I had waited to get them tonight so I'd have more info on what happened after I left this morning. The hospital is very good about giving me all the paper work so I'll get the updates tomorrow morning. I didn't think about it tonight since I already had most of the reports.

I just now re-read the surgical report. The J-tube was called by it's usual name and doesn't appear to be a combo PEG J-tube. "Jejunostomy tube was placed with a purse string and sewn to the wall in a circumferential pattern." Then the report discusses the sentinal Jackson Pratt negative pressure drainage tube... then... "Both tubes were secured externally with purse strings and chinese finger traps." Funny language. :roll:

Melanie, hee hee! BigMac would blush if he could. :-D
 
Maverick's PEG tube was secured with the chinese finger stitching also. I'm sorry to alarm you if it turns out to be okay. I just remember what I went through with Maverick. He had his PEG tube placed and the surgeon botched the endoscopic placement and tore his stomach so they had to open him up chest to groin, wash him out etc. Then ten days later he pulled the tube out and needed a second major surgery. It was an emergency. But I know nothing about Jtubes except what I've read tonight. And on FAF they mention it for very rare cases where you need to bypass the stomach. It was often done for pancreatitis cats early on.
 
(((((Carolyn)))))
It is all so complex and therefore we beans are prone to worry about everything. I hope that you will be able to relax a bit tonight and trust that BigMac will get some rest, too. It would be great if he could come home with you tomorrow. We will be thinking very positively and hoping that he will. We all want the best course of action possible for BigMac, and you have to have faith that the doctors are doing the right thing. They have too much invested in his case to send him home if he isn't medically ready. I'm glad that you got them to give more meds for his pain.

BigMac, you listen to your mamabean and try not to rutsch around too much. We want you to heal, buddy! Nice and easy: that's your motto for tomorrow. OK?

Many :YMHUG: :YMHUG: :YMHUG: s

Ella & Rusty
 
((((((CAROLYN)))))) He is such a good boy, he looks so alert, you'd never know he is so sedated!
He sounds very determined to get home soon, and I so hope he does...Having you there is comfort, you are his home.
Hope they fix everything & he will heal quickly-cats do... Come on Big Mac relax so you can come home soon.
Saying Prayers for him several times a day, it is always on my mind, & you are both in my heart..
Love you both Kiddos, rest, rejuvenate, tomorrow will be a better day-Hugs & Love from us!
Healing snowflakes & green vines to our dearest Boy!
 
Thank you Ella. You are right. The surgeons did invest a lot of time and energy into this surgery. The lead surgeon (yes, I googled him :roll: ) is well qualified and has had some awards. So his peers seem to respect him. My vet said our city is lucky to have him here. I'm not truly worried... just confused as to why they made a point of telling me one thing and then doing another. I am pretty sure they weighed their options this afternoon and did what was best for BigMac.

They really hoped to use the J-tube for the initial few days so they could completely bypass the stomach. Most of the surgery was not on the stomach but there was some. The plan was to use the E-tube when he came home. The J was to be used only at the hospital... from what I recall of the original post op discussion. There was a lot of things said and I was just so happy that BigMac survived that I didn't retain everything as well as I wished. :?

Thank you Liz & Anne, and Jordan. I hope he can come home tomorrow too. He can rest in a quieter bed and no snoring or whining doggies to keep him awake like there were today.

Lisa you have seen it first hand and I know you are right about kitties healing better at home.

Julie; my knee caps really want BigMac home so I don't have to sit on that hard floor anymore. I might have to bring a pillow next time or wear kneepads. LOL!

Hillary; nice to see you again. Yeah, it hurts to see our little buddies like this. Give Maui a big hug for me.

Melanie; I also was surprised that they brought him to me so soon. I would have rather they let him stay where he was. At least from now on I will request that they NOT bring him to me. If it is too busy in the back, I will understand and wait until it is safe and appropriate for me to go to him.

Celi; I hope we both can rest easy very soon. (And watch out, I still may have to smack you... just 'cuz it sounds like fun. :lol: )

Serryn; awww, thank you. I love his eyes too. Not that I had anything to do with that... but he has the sweetest look when he stares at me with that cone of shame. It is weird when he tries to head butt me and the cone gets in the way. I managed to get centered enough on the cone so he could at least bump his nose on my head.

Lydia; I know you have great understanding and empathy about kitties and hospital stays. I wish we didn't need to have to know it from experience but here we are... My thoughts are also with Sid and hope he recovers from his UTI very soon.

Melanie; Sometimes I think BigMac is brave and other times I just wish he'd be like most of us humans and stay in bed when we don't feel well. But I do admire his strong will to fight and come home.

And Tanya, thank you again for your comments about your dads experience. Whether that is going on in this case or not... it made me feel better. :-D

Hi Roni, I do appreciate (and need) all the prayers and healing thoughts for my Big Hamburger boy. I was so used to him being an easy cat with no sicknesses or injuries... even his diabetes was easy to treat. So this is a new experience for both of us. He clearly is a tough guy and determined to get out of jail soon.
 
Oh Carolyn, this brings back so many memories. I had my cat many years ago, in a big University hospital for 4 days, and I actually slept there in the waiting room, and I made them let me see her every 2 hours. Maybe if they won't let you take him home, you can ask if you can stay there with him, since he will definitely feel much better with you there. I understand if you have other obligations or other beans at home that need you, but I just thought that I would at least give another option in case he can't come home.

I will be sending lots and lots and lots of healing vines and a ton of prayers and white light for BigMac and for you too! :YMHUG: :YMHUG:
 
Daphne#5 said:
Oh Carolyn, this brings back so many memories. I had my cat many years ago, in a big University hospital for 4 days, and I actually slept there in the waiting room, and I made them let me see her every 2 hours. Maybe if they won't let you take him home, you can ask if you can stay there with him, since he will definitely feel much better with you there. I understand if you have other obligations or other beans at home that need you, but I just thought that I would at least give another option in case he can't come home.

I will be sending lots and lots and lots of healing vines and a ton of prayers and white light for BigMac and for you too! :YMHUG: :YMHUG:
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OMG how sweet of you to do that for your kitty! I actually think they were surprised that I stayed there through his surgery day and into his post op recovery evening. I didn't think being there for 13 hours was a big deal. It was important to know BigMac was doing ok before I'd leave.

I'm guessing they wouldn't kick me out if I wanted to stay overnight but I also think they don't encourage it because all they have in the waiting room are wooden benches built into the wall. Good for easy cleaning but the chair rail behind the benches makes them exceptionally uncomfortable for leaning back. I wonder what evil minds thought up that configuration! Hahaha! The room they gave me to wait in while the surgery was happening at least had a leather love seat. I was comfy there.

My DH would understand if I wanted to stay but he might look at me a little funny. I wish I could consider it but unfortunately I'm also juggling the fact that my daughter is about to deliver a baby any day now. I have to be ready to go get my two other granddaughters when she calls. She is recently divorced so there isn't much of a back-up plan. I'm it. She and I both hope she holds on until next week. She understands about my immediate concern for BigMac.

When it rains it pours. sigh...
 
Rest Carolyn! BigMac will need you all rested for when he comes home..... I know easier said than done....I live it every day with Rocket....

He looks amazing considering what he has been thru

Hugs to you both!
 
(((Carolyn))))

I'm glad he's doing better overall...he looked great! I'm glad you've gotten to spend as mich time with him as you have. Try to get some rest because when you do get him home...you'll need to be tested.
 
Marjorie and Gracie said:
(((Carolyn))))

I'm glad he's doing better overall...he looked great! I'm glad you've gotten to spend as mich time with him as you have. Try to get some rest because when you do get him home...you'll need to be tested.
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I'm sure I'll need to be tested... tested to see if I've lost my marbles. :lol: :lol: :lol:
 
Hi CD - I wish I could help with nay of this, but it is so out of my league. I can only offer prayers and positive thoughts that things go well, that BigMac heals well, that he can rest and sleep. I will be keeping you both in my thoughts.
 
I'm sending strength to you and healing to BigMac, CD. I so hope he can go home with you soon. Thanks for posting the pics for us to see him. :YMHUG:
 
CD, he looks amazing in the pictures, and I do hope he can come home soon. Sending healing vines and prayers for your baby and you, too. Hugs
 
Awww .. I'm sorry BigMac is so uncomfortable .. and I'm sorry you are getting conflicting information .. nothing worse after a serious surgery like this then to be confused as far as aftercare goes ... I really hope he is calming down for them and then gets to come home to his momma ..
 
Thinking of you both this morning....and hoping that you can get some answers...
it all sounds so confusing about the tubes...and the info you have been getting is so conflicting.
i hate when that happens....
nailbite_smile
What IS going ON????

Mac...you need to settle down and trust that your Mama will get you home as SOON as it is okay and safe for you to leave there. She misses YOU too sweet boy.....(wish you could get some ear plugs for him too along with all those darn tubes....the noises there must be soooo annoying to him!!!) :sad:
Hugs and love to you both (((((((((BigMac & Carolyn)))))))))
 
Maybe you can ask them if they will let you "camp out" overnight in one of the exam rooms with BigMac? You can bring your sleeping bag and he can stay with you in a small, enclosed room. That way he can have you there and he won't wander off in to the rest of the hospital.
 
:YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG: :YMHUG:
I'm no help on the technical aspects. Sending white light and healing vines that Big Mac calms down and gets some rest. You too, for that matter. I think camping out in an exam room might be good for both o you. There are some awesome inflatable mattresses out there now! ;-)
 
(((Carolyn))) & ((((Big Mac))))
Sending you lots of hugs and healing vines & snowflakes. Big Mac is so strong! I am praying that you can bring him home today. I'm sure he'll be happier and heal faster at home. You have a lot on your plate, so take care of yourself too.
 
Hi Carolyn Do Lou and I are thinking of you and Big Mac today sending lots more snowflakes and healing vines for his recovery :YMHUG: :YMHUG: :YMHUG:
 
Counting the minutes until we here he is home with YOU!

http://blog.garethjmsaunders.co.uk/wp-content/20061116_spotclock01.jpg

When Latte had the ARF, I was at the door before the vet opened and spent all open business hours in a room w/ her. I entered the clinic each day with a bag of various foods, blankets, my phone, computer, and eventually a sleeping pad :lol: I think I caught the vets and techs off guard. They had no idea how to say no to me. :mrgreen:

The things we do....and they ARE worth it for your furry friends. cat_pet_icon
 
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