S-4

I spent a good part of yesterday with Della, reading aloud to her from Reader's Digest bad jokes and several "unsolved mysteries" from a Life Magazine special issue. For the most part Della was still feeling very uncomfortable - her abdomen felt like stone, and she was very tired. Five doctors associated with Dr. Lee's team came to see her around 5 PM. They assured her that she would feel better "tomorrow" (Friday). She was able to sit up for a few minutes and was able with help to use the bathroom. And she was allowed to swallow 1 fluid ounce of water every hour until she was told by the doctors last night to stop. Apparently that is complicating the problem with the abdomen. She has a room with a lovely view - getting to Montefiore and parking there is considerably easier than going across the street to Presby. The gift shops and small cafeteria are more to my liking than the ones at Presby. All in all, a small bit of progress. She is very happy to be out of Trauma ICU. So am I. One of Della's close friends told me that if I keeping reading bad jokes I will drive her out of the hospital.

Today I may get to see her for only an hour or so. Diocesan Convention begins this evening, and I have to interview a possible replacement for our secretary this morning at 10. Back to the grind. I expect to get back home this evening around 11 - then up at 5:30 AM and off to Sewickley at 6:00 to register for Convention which begins at 8:00. It will continue until 3 or thereabouts, then to the church for the 5:30 Saturday Eucharist, and then home.  I'll see Della again after the 9:30 service on Sunday. She wants me to tell all of those who have kept her in their prayers and written notes that she loves you. You mean a great deal to her.

S-3

Della spent her second day in the Trauma ICU recuperating from her first. She was alert when she wasn't dozing (the anti-pain medication and the nerve blocks were working well yesterday). She sleep during much of the nine hours I was there, though we did work together on the USA Today Crossword puzzle which we were able to complete in little less than an hour. Archbishop Duncan came by at around 3. He and Della engaged in a relatively lively conversation about archbishops, bishops, and popes before His Grace gave her his archiepiscopal blessing and left for a meeting with other important folk. Fr. Paul Sutcliffe also stopped by. Just before 6 PM, the nurses got Della out of bed and into a chair - she was supposed to remain there for an hour at least.

When I left, she had still not seen her surgeon. What we did find out from a nurse's speculations (and this may be wishful thinking), is that the spleen was probably not removed, and that only the distal section of the pancreas was taken out. This is fairly sophisticated surgery even for laparoscopic procedures. Type "distal pancreas" in Google and you'll learn what I mean. http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web%20pages/pancreas%20resection/distal%20pancreatectomy.html

The nurse said the size of the incisions on Della's abdomen suggests there was no removal of the spleen, and that she had "heard" that Dr. Lee removed only the distal portion of the pancreas. Several of Lee's team have come to check on Della's pain, but volunteered no further information even when we asked them. When I left last night, Della was resting comfortably.

This morning, UPMC Presby called and notified me that Della was being moved to Montefiore (part of the UPMC complex) - the buildings are connected by a beautiful bridge. So when I leave here in a few minutes, I will head to Montefiore. I hope I don't have the hassle I had yesterday in finding a parking place.

UPDATE ON THE UPDATE: Della just called. She did see Dr. Lee last night. He told her they did not remove the spleen and that he had taken out the distal section of the pancreas. They are now waiting to see whether the pancreas will resume functioning in several days. As for whether the cells were malignant, the lab tests won't be complete until Tuesday or Wednesday. Della's room in 1067 N UPMC Montefiore.

S-Day 2

The surgery ended at approximately 2:30 PM. Della went to the recovery room for about an hour or so and at 3:25, I was informed that she had been moved to the Surgical ICU. Paul Sutcliffe, a priest and friend, had stopped by about an hour before, so he and I went to the ICU. Della was still floating in and out of consciousness, but she recognized Paul and said some words to him. After he left (around 4 PM), Della began to experience a great deal of discomfort, nausea, and pain in the area of her abdomen. The nausea was particularly distressing since there was nothing in her stomach. Several of the ICU nurses set her up with one of the pain medication pumps, gave her anti-nausea medication, and propped her back up with something which enabled her to lie slightly on her side. The discomfort eased, Della was able to relax a little. Around 5:20, she dozed off and slept. I left the hospital shortly after 6. I will be there this morning around 10.

At this point, neither Della nor I have any idea what was done during the surgery or what we should be planning for. Della may be in ICU for several days - after that, we don't know. Dr. Lee did not meet with me after the surgery, nor was I contacted by any of his team. I hope I can find out more. In the meantime, I hope Della got some rest last night. She cannot have have any nourishment, except that provided by the IV. Last night she pleaded for some moisture for her lips and tongue, and one nurse resisted while another immediately went for some cold water and a swab, which she used to daub Della's mouth.

Yesterday morning, I attended the Catholic Mass at the Montefiore Chapel. The Scripture readings were consoling, and it meant a great deal just to be able to pray for Della while she was undergoing the surgery. Lunch at the Presbyterian Cafeteria, a Tuscan salad, was adequate, but nothing worth blogging about. Bob Lytle, Sr., the deacon at my church, stopped by for several hours, but had to leave before the surgery was completed.

Yesterday, in the PreOp area, several Hasidic Jewish men, clothed in black hats, suits and overcoats, with heavy beards and the dreadlocks, were gathered around someone, praying. Later that morning, I saw them in the Montefiore lobby, seated at a table and saying their noonday prayers.

S-Day

Around 4 this morning I drove Della to UPMC Presby for her surgery. From our entrance into the hospital to her being taken to the OR, everything was done with clinical precision and efficiency. The surgical center has planned for every contingency: from lockers for families to parking vouchers to directions to various shops and eating places in the hospital complex to the ritual which surrounds the patient from the time she enters the pre-op area until the completion of her time in the recovery area. We entered pre-op at around 5:45 - a nurse came to take Della's medical history and ask her questions about medications taken or not taken in the past week. (This routine with the same questions was repreated by the nurse anesthetist, the physician anesthetists, and the nurse who came in to prepare Della's IV.) After the initial interrogation, Della changed into her hospital garb, packed her belongings in the bag she brought with her (this was promptly whisked away and put in a locker to accompany her to the ICU after surgery), put on her hospital socks and hair net. We had some time for talking with one another. At 6:15, began a steady stream of medical personnel: nurses and anesthetists to install a catheter for a nerve block. They gave a long detailed explanation to Della of what they would be using to "put her under". and asked me to leave for a "few minutes". The young resident anesthetist assured me that I would be able to see her before they took her to the OR to "say your goodbyes" - about as unfelicitous a use of words Della and I could have heard given the circumstances. He's young - someday he'll learn. I should mention that the senior anesthetist actually came to me while I was waiting and asked me how I was doing. I told him I was ok - I wasn't so sure about Della. But when I finally did get to spend about five minutes with her, she said she was feeling "relaxed but a little anxious" too. When they first took her blood pressure, it was a bit high. By the time they took her to the OR it had dropped back to her usual healthy level.

So now I wait. It's 10:30 AM, and I am typing this at the Family Lounge computer. No word yet. On the big scoreboard next to her number are the words: Still In Surgery.

A word about breakfast at the UPMC cafeteria. There was a time 17 years ago during my CPE (Clinical Pastoral Education) at Children's when eating at the Children's or Preby cafeterias was a treat. The quality has declined substantially. This morning I had the "special" - the eggs were fresh is about all I can say about it.

In the meantime, I have been reading a chapter in the book I use for my Sunday morning education class, and sitting at the computer.

Love you, honey.