Naomi – The Worst Day Yet
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Two days after the surgery to replace her prosthetic hip, Naomi suffered through the most painful and difficult day recovering from any of her surgeries. After having remained in bed continuously for two days, since the surgery, the physios and Naomi both wanted her to get out of bed to move around a little. Due to the almost complete blocking of sensation due to the epidural, the physio wanted to take Naomi off the drug, so that she would have some sensation in her legs when she stood up. Unfortunately, it seems it was too soon to cut this pain relief, and as a result, transferring from the bed to a chair and back was equal to the most painful thing Naomi had ever felt. Even sitting in the chair was so painful, Naomi could only manage it for 40 minutes, in agony the whole time.
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After a brief sit out of bed (top), Naomi transfers back to her bed, assisted by a frame and two nurses, the pain clearly visible on her face.
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Moving around and exerting herself partially opened up the approximately 33cm (13in) wound, requiring additional bandaging.
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Even after returning to bed and being given high doses of oral painkillers, the pain was too severe for Naomi to tolerate. Mercifully, the nurses resumed the powerful epidural drug that completely blocked all pain from the lower back down. The change in Naomi’s disposition was like night and day, within a mere 10 minutes of the reinstatement of the epidural. Seen here at the lower left is the patch and bandage on Naomi’s back where the epidural enters her spine, to deliver the drugs. The bloody bandage at upper right covers the surgery wound.
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The following day, the epidural had to come out permanently, or risk infection. Fortunately a good alternative was available. Naomi was given a PCA (patient controlled analgesia), an IV painkiller that Naomi can control herself with a button whenever the pain becomes too severe. There is a limit of one dosage every five minutes. Naomi was using it to its limit, but was gaining significantly better pain control than the previous day – though not quite enough for comfort.
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Due to her immobility and the swelling in her right leg, Naomi is required to wear a “TED” stocking, to help prevent the occurrence of a deep vein thrombosis, or DVT.
Fortunately, and to our great relief, Naomi’s condition today (day 4) is much improved on the days described above. With an extra day’s healing, a doubling of the dosage given via the PCA and a short but very productive physiotherapy session today, Naomi’s pain is at a much more manageable level and she is actually able to enjoy some measure of comfort. I plan to visit Naomi earlier in the day tomorrow to hopefully photograph her doing a physiotherapy session.
Naomi After Surgery
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I’m absolutely exhausted after a very long and stressful day, so I won’t say too much now. Only that Naomi’s surgery this morning, to replace her prosthetic hip, seemed to go well, and she is in good spirits and without pain, but still groggy from the anesthetic when I saw her. I am taking photos to document Naomi’s recovery from this surgery as part of a special project that Naomi and I want to work on together. I won’t say more now, but stay tuned for more information. Now I need to crawl into bed…
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Naomi’s Portacath is Flushed by Nurse
During her home recovery from her recent hospital stay, Naomi had daily visits from the Hospital in the Home nurses. During these visits, the nurses would observe Naomi’s vital statistics, such as blood pressure, and change the bag of antibiotic fluid that was being automatically being delivered into Naomi 24/7 by the pump to which she was attached.
In these following photos, which were taken three weeks ago, the nurse also flushed Naomi’s Portacath. This is a small valve implanted in Naomi’s chest, below the skin, with a pipe leading directly into an artery near her heart. This was implanted to allow the nurses easy access to her bloodstream while she was participating in a drug trial. Every month a bag of the trial drug would be given to Naomi through the port, and would allow for blood samples to be easily taken. Part of the care for the port included flushing it monthly with saline solution to keep it clear of blockages.
Since Naomi has been in hospital fighting the infection, she has come off the trial. The port remains, however, while Naomi and her specialist decide what the best new treatment for her will be. Part of the Hospital in the Home nurses’ duties then, was to flush the port when needed.
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Naomi has since completed her IV antibiotics course, and is now free of the pump and doesn’t need the inconvenient daily nurse visits. This has been a great relief for both of us! As of today, Naomi is doing well, but is starting to suffer from the effects of the deteriorating prosthetic knee joints which will both need to be replaced early in the new year.
Naomi’s Arthritic Feet – Photo Study
As part of my ongoing photo project covering Naomi’s Life With Arthritis, I plan not only to photograph the happenings of Naomi’s daily life, but also document the effects that the disease has had on her body. Today’s photos are the first of these documentary photos, and show Naomi’s feet.
Although the arthritis effects every joint in Naomi’s body to some degree, her ankles are by far the most painful and crippling. It is due to the physical damage already done to the joints and the bone that Naomi suffers most of her pain, and is currently forced to use crutches.
As the following photos document, Naomi’s feet, and in particular, her ankles, are quite swollen. The swelling as you see it here is typical, but on some days can be far worse than this. Also note the angle of the ankle joint, especially as seen from behind. This rolling in of the ankles is due to the damage, and makes standing and walking difficult, and forces Naomi to stand with an uncomfortable posture.
It’s not all doom and gloom, however. Today we saw Naomi’s specialist, and he’s trying to get his hands on a special injection that will hopefully be able to provide a buffer for the damaged ankle joints and if it works as expected, provide significant relief for the pain for up to six months. We’ll keep you up to date.
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Naomi Walks From Chair to Bedroom
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For this series of photos I experimented with a couple of ways of presenting a sequence. The first image is the traditional way of showing a series, and shows everything clearly, but is unimaginative. For the alternative I tried overlaying most of the images on an auto-aligned panorama of all of the photos. This looks pretty cool, but due to the path that Naomi took, later photos obscure the earlier ones, so you don’t see her getting out of the chair.
I have presented both versions here for demonstration and documentation purposes. I want to experiment more with sequences in the future.
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