When I got out of surgery, on a Monday almost three weeks ago, I had four drains in. The bulbs were all safety-pinned together to the front of my sling so I didn’t sit on them or get them caught on anything, and the bloody-looking, rubbery cables draped between the bulbs and the holes in my body. Their uphill/downhill placement isn’t so important, thank god, because they work via vacuum. After unstoppering and emptying the drain, one squeezes the air out before stoppering it again, leaving a flattish disc, like a red blood cell. The negative pressure keeps the drainage going in the right direction, until the bulb fills up, and the sides pop back out, making it look more like a sated tick. Struggling up from the couch, I would sneak my right arm under my left for support, getting tangled up in red, rubbery bulbs and tubes. It’s like wearing your viscera on the outside.
Outside is a terrible place for viscera.
My first post-op visit was Thursday of the same week. One of the drains was low enough that they took it out right then. One down. Three to go.
The next week there was some interdepartmental jostling about who would get me for the post op visit, since I refused to get through one appointment, then turn around and wait in another office, and have to get in and out of the sling again (a complicated and exhausting prospect). I ended up going to plastics, and orthopedics sent over a member of their team to see how the healing was progressing. Both teams were delighted with the incision. I posed a concern to both teams that my arm was healing hunched forward, in a tendency very much reminiscent of the one that extruded the cadaveric scapula. While that ended up being a good thing for the reconstruction, I didn’t want it to now result in my being a hunchback. Not after all that work. Both teams assured me that it could be fixed later with PT, and that I shouldn’t do anything to stress or tear the muscles in the first six weeks. It was actually going to be *healing* for the next year, so don’t stress out about what it does in the first few weeks.
I also had some concerns about the drain coming from under the armpit. It was leaking a little bit at the insertion point, and there was no way to bandage it. Well it was a slow leak, and we were still getting a volume over 30 ml daily, so I was just going to have to put up with it for now. They would see me again in a week.
They took out one of the other drains instead. Two down, Two to go.
Like a slow, grisly striptease.
I spent the next few days trying to manage the leaking drain. It wasn’t much, volume-wise. Some gauze tucked in the armpit kept it from bloodying my clothes. But the moisture wicked down the tube, wetting my underarm in a way I could not prevent with any number of dry washclothes. By Monday, I had a diaper rash so bad on the under side of my arm and left side of my breast, that there were open sores. And the drain hurt. Carefully rotating the flesh of the arm up revealed that the tube had pushed itself out about an inch, the suture dragging irritated skin tightly behind it. The sutures were actually cutting their way through.
I contemplated the mess while Mark was logging that day’s drainage. It was only 15 ml, well below the 30 the doctor said he would take it out at. There was no pushing it back *in*. That was a guaranteed infection. At the least we needed to cut the sutures, but that still didn’t solve the problem of the rash.
So I said to Mark, “Get the scissors. This drain has to come out right now.”
And my beloved partner, who has patiently drained numerous drains, injected numerous injections, and bandaged numerous bands, said, “Ok.”
After snipping the sutures I gave him the option of pulling the drain or applying the direct pressure. “I ought to pull, don’t you think?” he said. We did it that way, but I’m pretty sure I could have done it. I was highly motivated. He pulled about eight inches of tubing.
Three down. One to go.
I called the office to let them know the next day. They had a lot of questions, but seemed satisfied finally to wait to see it until my already scheduled appointment later in the week. I could call them for antibiotics if there was any sign of infection in the meantime. There wasn’t. The rash started healing almost immediately.
Which brings us to today. My dear neighbor Renee drove me in, not for the first time, because Mark was working and Mom was home for Sarah (it takes a village, right?). They took out all the many, many staples, even fishing the suture remnants out of my armpit for me. AND pulled the last drain. That hole is the only part of me that is bandaged right now, and the surgeon says I can take that off in a couple days and take a bath this Saturday.
That was all pretty great, but I was still concerned with the conformation of the shoulder. It had pulled forward even more extremely, and, yes, I had plenty of time to fix it with PT, but considering how much damage those muscles had inflicted on the previous scapula ( and I’m not entirely sure the pressure from those same muscles didn’t cause the leak and extrusion of the underarm tubing) maybe we shouldn’t underestimate what was going on there.
I don’t want to accidentally extrude my new scapula.
So I got permission to sleep with the sling off, letting the arm rest at my side rather than being held forward, and he prescribed a muscle relaxant which I could take before bed.
I’ve never taken a muscle relaxant. ADVENTURE.
So that’s where we are. There’s a pronounced and glorious dearth of tubes, staples, and adhesives, and going forward is all about healing and straightening and getting stronger.
Except for the next round of chemo, but that’s not… Aw. Dammit.
One thing at a time.
No more surgery! Yay!