So, after about 4 hours at Maine Med, 3 hours at Mass General, and about 4 hours on the road, we got home a bit after 9pm last night. It was a long and pretty overwhelming day for everyone.

We had to wait for the surgeon at Mass General to get out of surgery before he could see her yesterday afternoon. Rachel’s head surgeon wasn’t at the hospital yesterday; I’m not sure what we were interrupting all day for him, but he was so great about talking to all the doctors at Maine Med and texting me and consulting with his fellow and nurse practitioner at his clinic. They took a sample of the fluid that’s draining and sent it to the lab to see if it’s cerebrospinal fluid (CSF), which is what the Maine Med neurosurgeon kept insisting he thought it was. We should get those results today. The surgeon fellow and the NP said that her incision hasn’t opened completely; there’s still a thin layer of skin there so it’s technically still a closed wound. It doesn’t appear infected at all; Maine Med ran bloodwork to check for other signs of infection and everything came back fine. (If it does end up infected, it would mean having another surgery to clean out the infection and then being put on antibiotics for 6 weeks – that’s why this is such a concern.) The NP and fellow confirmed what I had suspected was the issue: the radiation to that area has damaged the skin to the extent that it’s not healing as fast as the sutures dissolved. The top and bottom of the incision – where she didn’t have radiation – is still fine. They didn’t really want to put more sutures in because they thought it would still be draining and would also damage her skin more. Instead they put on a vacuum dressing, also known as a negative pressure dressing. The dressing is connected to a drainage tube and then to a vacuum pump to suction out the drainage to help the wound heal better. Applying continued vacuum helps increase blood flow to the area and draws out the excess fluid, promoting better healing. These are often used for chronic wounds that won’t heal (such as for diabetics) and in severe burns. She’ll have to wear this for 7 days and hopefully the draining will have stopped by then.

After they got the dressing on Rachel, they talked to the head surgeon and he was concerned that in the unlikely event that it actually is CSF that’s leaking, having the vacuum dressing suctioning out more of it would be bad and wanted them to put a few sutures in addition to the dressing; however, they’d already used the only dressing they had on hand so they couldn’t take it off to put sutures in because they didn’t have another to put back on. The fellow tried calling the lab to get the results but they said it wouldn’t be ready until today because only the day shift works on that type of test and there was no way to get the results last night. Rachel didn’t get any headaches after putting the vacuum pump on there, though; I would think that if it was CSF she would have, since that’s one of the main symptoms.

Her dressing looks very similar to this one, though the pump is different and larger:

Did I mention that my car wouldn’t start yesterday morning? A huge thank you to my big brother Mike who drove us to the ER and sat around waiting for 4 hours and another huge thank you to Alyssa, Nick, and Caitlyn for leaving work early and especially to Nick for driving us to and from Boston last night. ❤ And another thank you to TJ for agreeing to come over this morning to take a look at my car to see if it just needs a new battery or if it has a larger issue going on.