Monday, April 25, 2016

T+13 Days

After landing in San Francisco, everything was pretty normal. I was going out, walking around, eating/drinking as usual until the evening of Tuesday 4/19/16. 

My friends took me to a Poke Bowl shop where I ordered Spicy Tuna as my protein and later realized there was Octopus mixed in by accident. As I was eating my Poke bowl, there were several pieces of white meat and I didn't think anything of it ---- until I saw suction cups! I then realized I ate something I shouldn't have. I've never eaten Octopus before because I know I'm allergic to shellfish and squid, hence I had no idea what those few white pieces of meat were at first. 

Note on my shellfish allergy: If I accidentally eat shrimp mixed in with food I typically get itching and I sometimes have difficulty swallowing. I have never gone into anaphylactic shock or needed to visit the ER due to my shellfish allergy. I have never officially been diagnosed with a shellfish allergy by a Doctor. 

I began to feel itching on my arms and went to sleep. I woke up feeling very tight around my neck and upon further inspection my neck was quite swollen. I took some Benadryl in the morning and again in the afternoon. There was minimal relief so I felt it was best to visit the ER. I was admitted into the hospital on the afternoon of Wednesday 4/20/16. 
Admitted to Mills-Peninsula on 4/20/16

My neck was noticeably swollen on 4/20/16

There was a lot which transpired because the Doctor's at Mills-Peninsula have never heard of SLAD-R surgery and were being extra cautious. They didn't know if my swelling was truly an allergic reaction or a complication after surgery. They even contemplated air lifting me back to UCLA which in my opinion was overkill. However in retrospect I appreciate the Doctors at Mills-Peninsula aired on the side of caution. 

I was on IV from 4/20 thru 4/23. I was allowed to have a liquid diet on the morning of 4/23 and slowly progressed to a regular diet in the evening and eventually discharged on 4/24. 

Discharged from the hospital! 
**Note I've added more details at the bottom of this posting (for those who are interested) in regards to the events which happened at the hospital. The above is a brief summary but overall it was a VERY frustrating experience! But again, the doctors did the best they could with what the knew and I'm thankful for that.**

I got back to the house on the evening of 4/24 and took a nice long hot shower. The steri strips which were already beginning to curl, easily peeled off after my shower. I noticed a big bump on my neck and was a little worried --- but as time progressed it started to go away. My neck was probably squeezed tight from the steri strips and needed time to "relax." 

This morning on 4/25, the bump around the incision spot is barely noticeable and looks pretty normal. The incision site looks very good. If you notice in the photos I have two lines on my neck. The green arrow shows a neck line which was present BEFORE surgery. The red line shows the incision site. The green line is more prominent because there is still some post surgery swelling (or post allergic reaction swelling haha). But other than that I'm happy with how my neck looks. I bought some mederma + mederma PM to begin using within a few days. 

Red arrow = Incision from surgery
Green arrow = Neck line I already had before surgery 
My voice is the same and still a whisper. It's stronger in the morning and weakens as the day progresses. If I talk a lot I do get light headed. 

My diet is normal except I will stay away from ALL seafood whether cooked or raw as a precaution!!!

**Additional events from my frustrating hospital ordeal**

  • Wednesday 4/20/16
    • Admitted into the ER at Mills Peninsula Hospital 
    • They ran an MRI and noticed a small amount of fluid near the right side of the incision.
    • I was given Benadryl and an anti-inflammatory steroid via IV.
    • Mills Peninsula was able to get ahold of the resident doctor on-call at UCLA; The resident doctor recommended I be on antibiotics and stay in the hospital overnight. They will attempt to get a hold of Dr. Berke tomorrow.
    • I am transferred to the ICU step-down floor so I have heart monitors and an IV hooked up to me.
  • Thursday 4/21/16
    • My neck was still swollen but not as bad as the prior day and the tenderness around the glands has gone down. 
    • 9am: The Dr. at Mills Peninsula feels it's a bad reaction to the Octopus. 
    • 11am: The ENT at Mills Peninsula examined me and feels it's a bad reaction to the Octopus and is fine releasing me. 
    • 2pm: Now the Dr. at Mills Peninsula notified me they will keep me for 5 days. I will be on an IV only diet --- so no food or drink. They contemplated air lifting me back to UCLA but decided to leave me at Mills Peninsula based on information provided by Dr. Berke. 
    • 3pm: To get further clarification, my mother called UCLA and spoke to Dr. Berke. He said there "could be" a salivary leakage point causing an accumulation of liquid which "could be" causing an infection. Dr. Berke is concerned that if I continue to eat and drink food, particles could get stuck in the leakage point and want me to be on IV for 5 days for the "possible" leakage point to heal. This is from the SURGICAL point of view. UCLA is making the assumption above based on my symptoms from a post surgery point of view and not factoring in the Octopus. 
    • 5pm: A case manager came to my room and informed me they are attempting to transfer me to UCSF or Stanford so I can be provided with a "higher level of care." It turns out the team at Mills Peninsula is not comfortable treating or diagnosing me as they are not familiar with SLAD-R 
    • 6pm: Frustration sets in. I am not sure why they want to transfer me to a different hospital because: 
      • #1: I have never had a fever even prior to being admitted into the hospital 
      • #2: My blood pressure has consistently been below 120/80
      • #3: There were no visible signs of infection (leakage etc..) other than the swelling which did go down with the Bendaryl 
      • #4: No swallowing issues 
    • Physically I feel perfectly fine. 
  • Friday 4/22/16
    • 9am: 
      • The Dr. came to examine me and now is concerned because my neck was slightly red. I explained my skin is very sensitive and she just examined my neck which turned red after.
      • The Dr. is now concerned about Celulitis and wants to drain the fluid around the incision site 
    • 10am: 
      • UCSF does not want to touch my incision because "it's so minimal" and it's normal post surgery fluid -- The Mills Peninsula Dr. said UCSF would have just discharged me but they will not follow that recommendation. 
      • Stanford said they have 60 people lined up in the ER and are unable to take me 
      • So the Dr. at Mills Peninsula will ask the radiology department to drain the fluid 
    • 11am: 
      • Medications being taken: 
        • Prednisone
        • Protonics 
        • Ampicillin 
        • Vancomycin 
    • 1pm: 
      • The ENT came to visit me and said they will attempt to extract the tiny pocket of fluid 
      • Best case scenario - It's just dried blood and post surgery fluid. 
      • Worse case scenario - It's pus and will better determine what antibiotics to use 
      • However the ENT thinks it's just dried blood and I had an allergic reaction to the Octopus 
    • 2pm: 
      • Now the draining of the incision is cancelled. The radiologists aren't comfortable removing the fluid because it's a little deep
      • They will continue to observe me in the hospital 
  • Saturday 4/23/16
    • 8am: ENT came to visit and said I look really good and wants me to start eating a liquid diet and evaluate if it causes anymore swelling. If there's no swelling, I will be discharged by Sunday at the latest. They just want to make sure there's no salivary leak/incision. 
    • 11am: Doctor wants to observe me overnight again and discharge me tomorrow 
    • 5pm: I'm given the green light for solid foods! YAY! 
    • 8pm: I'm moved from the ICU step-down floor to a regular room. The heart monitors are finally taken off and the IV is only reattached when I need my medication! 
  • Sunday 4/24/16
    • 9am: I am notified I need a few more dosages of vancomycin and I will be released about 7pm tonight
    • 7pm: #freedom 

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