This post turned out to be more details about my surgeries than I thought I would give ;) Be warned, its detailed and probably boring, but helping me to get my facts straight!
We originally thought that the infection had occurred because my open and non-healing incision had a bit of exposed mesh from a previous umbilical hernia repair. Apparently, the mesh used is safe until exposed and can cause serious infection. We went into surgery anticipating the removal of a piece of mesh. But oh how things changed!
They removed the mesh without a problem, but having seen first hand the amount of infection and that it was all over my internal organs, my doctor expressed the gravity of my situation. I am pretty sure I blocked that out or I wasn't informed because I still thought I was going home soon! There were pockets of fluid all over my insides that had become infected. He saw an area around my duodenal stump that looked unhealthy and like a possible leak. He tried to replicate the leak with no success. He was very disappointed, but also reporting how much of the infection they removed...manually. They went in with CT results in hand and removed, scrubbed and flushed my abdomen over and again to remove all the infection. He said every organ was washed and scrubbed. Infection. Was. Everywhere. They closed me up feeling like the infection was hopefully resolved, but still questioning a leak. They were not convinced the mesh caused my issues at all.
I am not sure if I don't remember Surgery #2 or if having 4, I just have them all confused. Surgery #2 took place because via CT there were still a few pockets of fluid that could potentially become abscessed if they weren't already. In that surgery, they found a small leak in my colon. They felt that it was always there, but so small at the time of the first surgery that it was difficult to isolate. They also still did not like the look of the duodenal bulb and discovered a bile duct had been cut.
My new surgeon was very respectful of the previous surgeon and at least attributed the colon possibly to clamps used during surgery. I believe that to be true, as my surgery wasn't any where close to my colon. The other issues....the biggest issues we dealt with...I have a hard time believing it to be relating to clamping. The bile duct was really still in question as they hadn't isolated which duct it was and if it was a smaller periphery or if it was the Common Bile Duct. The Duodenal bulb was so unhealthy that he couldn't stitch it and still could not replicate a leak. Bottom line, I was sick and there were still a lot of questions. They repaired all they could, still not confident in total repair.
Surgery #3 occurred when it did because of an excellent nurse. It would have eventually been discovered, but she caught it early. At one time, I had 4 drains across my abdomen. I joked and called them my basket of eggs when I had to stand up and move. I had to stay light-hearted as I looked like a cactus and felt like a pin cushion to the 100th degree! All the drains were draining well except one that looked infected. They really had their eye on that one. I returned from a procedure and stood to walk with my nurses help. When I sat down, something leaked out of the holes of the three healthy drains that were across my lower abdomen. My nurse grabbed a gauze and excused herself to speak with the charge nurse. At that moment, my surgeon walked in and said, "We have to go back in." It was stool and it was freely moving about my abdominal cavity. At this point, I remember feeling desperate. We HAD to find the leak! I was also so tired and in so much pain. The thought of them opening up my incision for the FOURTH time (including my original surgery) just made me hurt even more. It was a successful surgery. They never found the leak, but knew it had to be coming from the duodenal stump. They used a special powder that acted as a cast or super glue that would seal whatever microscopic leak there was until it could heal itself. They also scrubbed, scrubbed and scrubbed the area where the bad drain was located and replaced that drain with a sharp eye on that area to ensure the infection was gone.
In between those surgeries were many CT's, a Hidascan, so many blood tests, other tests, at least 8 pints of blood, wound care. Oh the wound care girls. They were so nice, but caused more pain than I could stand. I had to be pre-medicated when they were on their way and screaming could be heard during the dressing change. I had to have a family member with me each time to hold my hand because it was brutal. Pain meds didn't touch the pain. Monday, Wednesday, Fridays were their days to visit and certainly not a part of the good things I want to remember. BUT....those girls on the wound care team were so good, encouraged me so much and I felt so confident in their skills and my healing wound every time they came for a dressing change. Sadly, after every surgery, we had to start all over again. They do deserve mention because they were the girls I loved to hate, but I loved them so much for all they were doing to help me heal.
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