Today has been a very long day. Bill reported for surgery at 5:15 this morning. I was glad he was having the first surgery of the day, no waiting. Everyone that came in to talk with him commented on his blood pressure. He was taken to the holding area about 7:00.
When I checked into the surgical waiting room, I was told that they would update me at about 10:00 & 12:00. At 10:00 they woke me from a deep sleep to give me an update. I’ve always been a believer in no news is good news, so I was a little irritated that all they told me was that surgery started at 8:09 and they were able to go in through the nose. I know they are being helpful but all I could think was “you woke me for this?” Actually, my thoughts on surgery are that if everything is going okay, no need to tell me, if things aren’t going okay, no need to tell me until it’s all resolved one way or the other. There is nothing I can do but wait, I can’t change the outcome of surgery.
It was a little before noon when Dr. McCutcheon came to talk to me. Every time I talk to him, I can’t help thinking what a nice guy he is, and of course a great surgeon also. First he told me that he usually goes in through the right nostril (because they stand on the right side) but that Bill had a lot of scar tissue there (must of had a broken nose at some time) so he went in through the left nostril. He removed a white nodule from the left side of the pituitary right where he had seen something on Bill’s MRI. He said there was also a wedge shaped “something” that curled around the bottom of the gland, I think he meant on the outside, although I’m not sure he specified that part. He said he peeled off the layers of it and it was also sent to pathology. He found nothing on the right side.
The thing with Dr. McC is that he never seems rushed. After talking about the surgery, we talked about J&J and also about his son. Oh, I guess the very first thing he told me was that there was no CSF leak. He said he’d been worried about that with Bill. He said that while a leak is never good, he was afraid that three days on his back would drive Bill crazy. Actually, he said something about every time he’d seen Bill (he talked with us three times last year, pre op and then two post ops, and then talked with us yesterday) he seemed “well, somewhat worked up.” Or did he say agitated? Anyway, he had Bill pegged right. I had also worried about if he had a leak and had to be flat on his back for three days. I thought Dr. McC was pretty observant! We then talked about whether his almost constant agitation was possibly a part of Cushing’s and are hoping that it is.
Bill was put in ICU because of his high blood pressure. I really don’t like the ICU that well. Although I did like the nurse that came on duty right before I left to come back to the hotel. She seemed on the ball and interested in getting his pain level down. I can’t remember what they had been giving him, but it was only somewhat working on his head pain. She also turned on the little machine (have no idea what it’s called) that automatically inflates the leg wraps to help prevent blood clots. I had noticed during the afternoon that I never heard it working so I would ask the nurse how often it should be pumping and she would press a button down there and the other nurse put a new little machine on the tubes. But you know what, they never turned it on!!!! Tonight I asked the new nurse if it was supposed to be working and she looked down and turned it on! All afternoon it had never been turned on.
I think the headache has several contributors. First, he had pit surgery. Second, his cortisol levels have possibly dropped a lot, although they gave him 100 mg of cortef in an IV. Third, I’m not real crazy about how fast they were dropping his blood pressure. I could be wrong, but I think when your body is used to 230/130 for well over a year or more, dropping it down to a normal range in just a few hours, is too fast. I would think that they would drop it for a few days and then drop it a little more. I don’t know, but the afternoon nurses just laughed at me for questioning that. They said his bp was perfect. But I’m not sure his body knows what to do with perfect.
I didn’t see the guy, but Bill said some doctor was in and thought he should maybe see someone in internal meds because of his high bp. I wonder if they realize that it will probably never be under control until the Cushing’s is definitely under control and also his aldosderonism. We’ll just see what happens. But I really want him moved up to the 8th floor.