Friday 31 January 2014

PART XVI: Post-surgery Foley catheter, prostatectomy side effects

Recovery from cancer surgery is going well. The sutures are beginning to heal.
The catheter is getting easier to manage, switching from the night bag to the day time bag that straps on his leg. It is mentally and physically tiring for a healthy caregiver. Even an experienced hospice volunteer, like myself. Catheters are not part of our mandate!

Side effects of a catheter: urinary urgency. It feels as if you have to urinate, despite having a catheter in place. The first night there was 1.5L in the bag! It's important that urine flows freely.

The surgeon prescribed Tolterodine. [Effects of tolterodine, trospium chloride, and oxybutynin]
PubMed infoAntimuscainic agent
Some of the commonly used drugs are oxybutinin, tolterodine, trospium and propiverine. They all have side effects, the most common being a dry mouth, as well as constipation. 

Constipation is a side effect of the hydromorphine, too. This is a pain killer, as he has 8 belly
Foley catheter, daytime (left) and nighttime (right) bags.
Bottle to flush the bags: 33% vinegar/water.
incisions that need to heal.
I brought in bran muffins, fruit, and went to the druggist for a stool softener. It has all helped.

Foley catheter care is vital to preventing complications such as infection.

It's tricky finding good websites for information, without ads! Here is one.
Uploaded on 7 Dec 2011
Kimberlee Reed, RN Clinical Coordinator explains proper care and maintenance for your Foley Catheter.

Of course, remember that with a prostatectomy, it is normal to have some blood and blood clots in the Foley bag. Remember to wash your hands, wash the body with soap and water, use antibiotic ointment. With a prostatectomy, you must read the literature during the 7 - 10 days you have a catheter. I've put a fresh supply of rags and cloths in the bathroom. I keep forgetting if I have closed the port at the end of each bag, or not!
The ports are a site of possible infection. You need antiseptic wipes, to wipe each port at the time you switch them. This is a juggling act. Trust me! The video uses a manikin, which isn't the same as a moving spouse!

I have a spray bottle of antibacterial soap, as well, and clean up around the area, the floor, and the toilet each time. A bucket in the bath tub collects the dirty cloths.


Book Review: Love Me Slender

It intrigued me, especially the PR line:
"The book is practical, helpful and (pardon the pun) easy to digest." 

Written by two highly qualified UCLA Professors, Thomas Bradbury and Benjamin Karney, they draw upon their observations of hundreds of couples to explain why conversations about weight and diet can be so challenging––and how all couples can team up in their pursuit of better health.

Doesn't this make sense? My hubby lost 30 lbs. several years ago. It struck me that it would important to support him as much as I could, even while I was gaining weight after I retired! I've lost 10 lbs. this month. Some days I had to stand back and refocus. I would find myself feeling envious that he managed the self control required to do so, while I was dealing with my own eating issues. 

Many partners enable one another for reasons that revolve around many psycho-social issues: social/emotional and self-centred ego-based reasons. Of course, interpersonal issues are very deep and complex, and it makes sense for couple to be retrained to speak honestly and treat one another with dignity and respect. When one experiences great success, the other is called upon to dig deep and laud this success. But it is difficult. This is the same for weight loss as much as career success, for example. The bottom line around weight loss, we know, can be simplified to: eat properly and exercise more. 
The ideas in this book help with this premise and will assist a couple in getting control.
The conversations are not surprising: 

What does my eating pizza have to do with your diet?!”
“Why are you worried about going to the gym? I think you look fantastic!”
“You’re going to eat that?! Didn’t you say you were trying to lose weight?”

This book, to be published in February, the relationship month, will be a wonderful addition to any couple's library. Heaven knows, we can all use more information and digest it.

Love Me Slender Offers a New Perspective on Health – and Shows How Relationships Enable Healthier Habits:

▪     New Years’ Resolutions are often a distant memory by the time April rolls around.  How can partners recognize and mobilize the strengths in their relationship to help make these healthy resolutions stick?
▪     Studies show that couples gain weight as they settle into their relationship, and again after their children are born.  But why are some couples able to counteract this effect?
▪     What do partners misunderstand the most when it comes to one another’s health and weight? What are the best approaches to initiating a more productive –– and more compassionate –– dialog?  

Love Me Slender Introduces Surprising New Research on Health and Relationships:

 ▪     Good Health Is Relational”:  How the behaviours that are most central to determining our weight and fitness are inextricably linked to closeness and communication in our intimate relationships.
▪     The Halo Effect”:  How both partners benefit even if only one partner resolves to become healthier.
▪     Reward Substitution”:  How intimate partners are uniquely positioned to shift each other’s attention toward long-term goals for health, making it easier to resist unhealthy temptations in the moment.
▪     Invisible Support”:  How partners can encourage one another in subtle but potent ways, going ‘below the radar’ to avoid the criticism and defensiveness that overt support can elicit.
▪     The Boomerang Effect”:  How reassuring and praising our partners can backfire, and why a combination of acceptance and pointed encouragement gives us the support we need to change.

“Love Me Slender: How Smart Couples Team Up to Lose Weight, Exercise More, and Stay Healthy Together.” 

By Thomas Bradbury, PhD, and Benjamin Karney, PhD.  
Publisher: Simon and Schuster/Touchstone / Hardcover Original 9” x 6” 
 Publication Date 4 February 2014 / Language: English
 $25.99 List Price / 320 pages / ISBN 9781451674514

January weather: rain, snow, sleet,

TOTAL : 62 cm!

Jan. 29  snowfall - 30 cm between the big ice storm, and now! There is 54 cm on the ground.
had to shovel snow.

JAN snow  
4-Jan       7  
6-Jan      ice rain
7-Jan    5 snow
9-Jan    7  
18-Jan    8  
19-Jan    5  
27-Jan    30  

January - out like a lion?
Wind warnings, indeed

Jan. 23
More snow.
Jan. 22
Cold weather predictions
jet stream hauls down the cold

Jan. 21 - What a cold morning!
Jan. 20
Jan. 19 - Blowing snow, windy, about 5 cm
Wind chills of minus 30 to 35 tonight and tomorrow morning. An Arctic airmass has settled over Southern Ontario. The combination of cold temperatures and moderate northwesterly winds is expected to produce wind chill values minus 30 or colder. Areas east of a line from Port Carling through Haliburton and Kaladar to Brockville - Leeds and Grenville wind chill values could reach minus 35 or colder.

Jan. 18 - 6cm

Jan. 16th - checked the metre stick, and after last week's melt, we've gone down to about 24cm snow base.
Jan. 9 - 12cm, on top of about 31 cm of a snow base.

Jan. 12

Jan. 10 

A band of freezing rain associated with a warm front will move into the regions from the south tonight. The latest indication is the freezing rain will begin late this evening and end overnight. Depending on the speed of the warm air moving northward the regions may receive 2 to 6 hours of freezing rain. The estimate for ice accumulation on surfaces is 2 to 5 millimetres. Motorists and pedestrians are advised to exercise caution especially on untreated surfaces. Local power outages are possible due to the ice accumulation.

Jan. 6  big melt

What a mess. The Maritimes have had 35,000 without power, this month, from their ice storm, and then dump of snow (30cm?). Toronto has blowing snow, following a melt. We, in SE Ontario, have rain, and 5+ C. temperatures. The eaves are dripping with melting snow. Buses cancelled for school kids.

Happy cats are outside hunting for mice.

Thursday 30 January 2014

PART XV: Pain assessment post surgery

I have written much about keeping on top of pain. In my husband's case, with 8 incisions from his robotic surgery, his neck and tail bone are more sore than the incisions!

I took photos to be able to tell if they became infected.

That said, you have to be relaxed and comfortable, in order to heal. He's been walking about a bit. I've been writing down when he takes his pills, since it is easy to forget. Also, he has to take bowel softeners. He didn't eat anything all day, the say of his surgery. He had fluids that night. Yesterday and today, he's been having normal foods, with some extra fibre-rich foods. Protein is needing for tissue repair. He had a good night, the cats were happy to sleep beside him and keep him warm.

Here are some assessment tools to help the patient and caregiver.

Page 1/2

Page 2/2

My pain diary 2

My pain diary 1

journal personnel FR v. 1
journal personnel V.2 FR

PART XIV: Home from the hospital

White board with his info.

Surgery went well, the surgeon phoned me in the 15 minutes between his two six-hour surgeries on the day. My task was to bring hubby home.
Impending snow storm
I was terribly relieved to have a good night's sleep the night after his surgery.
I could have stayed in the city, or with my kids. It was better to be in my own bed, and get some rest.
I recall the stories of the new moms in hospital, when the nursing staff try to bring the babies to the moms, to begin the bonding process.
They began to imagine that one mom wasn't bonding, except that she had had child #6, and knew she should get some needed rest before going home!
This is an important part of being a caregiver. I find that many client's families feel the need to keep 24-hour watch of their loved ones in hospital. This is when they call in community home support volunteers to support the family. It is best to visit, have a good visit, and go home to have a break. It is better to get your rest when you can.

He's up!
It was a long hour and a half drive, but the snow storm didn't materialise into much. Thankfully.

What do we need?

  • To get the prescriptions filled
  • Get in high fibre foods: bran, roughage, as the pain killers tend to constipate one!
  • Get in antiseptic wipes, to clean the catheter equipment
  • I cleaned the bathroom
  • He's been taking walks
  • Gathered a garbage can, and a heavy book, to hold the catheter bag at night.

This is our life for the next week or two.
There is a day catheter bag, straps to the leg,
and the night bag, which holds far more urine.
Watching for infection, washing hands at every moment, ensuring he is well-medicated, pain-free, and walking, to keep his circulation going.

He was in bed early. Slept like a log.
He didn't need a pain pill (1 every 4 hours) in the middle of the night, which was something I worried about.
It wasn't until the morning that I suggested one. We both woke at 5:30 a.m., I got up and got going! He read for awhile.

Hooray for bendy straws!
I laud all caregivers.
Buster, the cat, was keeping him warm!

1. Dominion Tankard 2014: Ontario men's curling at Smiths Falls

The snazzy tankard!
The Dominion Tankard 2014 is being held in nearby Smiths Falls. Due to our circumstances, I cannot attend, even though I donated a curling broom, signed by the Ford World 2013 Championship skips. (I'd won it for a photo of Dorah watching curling play on TV!)
cat's play

Ontario Curling has a huge number of teams, with many famous names in the sport.

Scott Howard, son of Glenn Howard; Mark Homan, brother of Ottawa's Rachel Homan, off to the Olympics.

The photos aren't great. I'd forgotten my real camera, and took photos with my videocam. I was on my way to pick up my husband from the hospital and was looking for a brief break.

There were lots of local schools kids (about 450), who were able to attend as a group.

Pink Shirt Day

The pink shirts, worn for the morning draw, will be available for silent auction on Wednesday. They are part of the pink anti-bullying campaign, in support of the national
Gotta love them!
They are for sale!

These shirts will be put up for auction beginning Wednesday afternoon (minimum bid $40). As teams are eliminated the bidding for their shirts will stop, with shirts going to the highest bidder. The bidding for the final 2 teams' shirts will close after the fifth end break in Sunday afternoon's final.
Pink Shirt Day is a nation-wide anti-bullying campaign to bring awareness of the growing issue of bullying in schools. School children have been encouraged to wear pink at the same in support of the campaign. Proceeds of the auction will go to the Kids Help Phone line charity, as will the $5 admission for the school children.

Teams and Skips; schedule here

On the middle rink,
Team #3 Mark Homan, Rachel Homan's brother.

It's being covered by TVCogeco
(which we don't get!)

Lots of sponsors and raffles!

The famous Skip Glenn Howard
conferring with Middaugh!

2. Dominion Tankard 2014, morning practice videos

I won't have time to attend the match. Instead, I visited the morning draw in Smiths Falls.
I have never attended a curling game! I stayed about 15 minutes, then headed into the city, Ottawa Hospital.
The pink shirts, for the fundraiser, were fun to see!

Dominion Tankard Curling Practice I from Jennifer Jilks on Vimeo.
On a cold day, what better than to go inside a cold arena! Team Howard busily, um, discussing...
Dominion Tankard Curling Practice II from Jennifer Jilks on Vimeo.

3. The Dominion Tankard 2014: luncheon, volunteers

Smiths Falls Curling Club
Cheese please!
I visited the volunteers who were setting up for the luncheon. It was a lovely spirit of preparation.

Curling is big in Smiths Falls. The main events happen at the arena, but the luncheon was at the curling club.
After dropping hubby off at the hospital, I decided to go and see my broom. They weren't set up for the auction yet.
They were set up for the lunch. There are many great volunteers about, making the place look terrific. There were paddles, created
soup bowls good to go