Keeping Track of Papa...

Tuesday, January 26th, I took Papa to Lexington to have one of the squamous cell cancers removed. The one they chose to do first was on the top of his head. Dr. Davey was able to get it all in the first removal. Thank heavens. We were at the doctor by 1:15 for a 1:30 appointment. We were on our way home by 3:30pm. 

This surgery us called Mohs and is a microscopic surgery where thin layers are removed, immediately studied in the lab to determine if there are cancer cells in the margins, then another layer removed as needed. The wait time for the lab is about 45 minutes for each layer they do. I went prepared to stay for hours and did not have to stay that long. 

They had a lovely little waiting room for Mohs patients with very comfortable chairs. Papa was able to recline and stretch out his back while we waited for the lab results. 

Once they knew they got everything on the first removal, they took Papa back and stitched him up.  Then they called me back to hear the instructions for caring for the wound. They dressed the wound. I sure wish I had taken a picture of that dressing over the wound. The nurse stretched gauze over the incision. Then she placed 4 or 5 hard rolls of gauze like a dentist uses when working in your mouth on top of the initial layer of gauze. Next she had these lovely, stretchy bandage strips. She would remove the backing and then stretch the bandage strip out and place it on his head. The result was it caused pressure on the incision. She put at least 5 of these bandages on the wound. It was pressing down very tight. Papa takes Warfarin and they wanted to be sure he didn't start to bleed at all. Papa was feeling great because of all the numbing done to the incision and then again to stitch it up. No pain...yet.

Wednesday morning I had lesson leader training for the Homemaker lesson I was to teach. Before I left my home, I had a call from Papa that we were in real trouble with his head. After careful questioning, it really was that the numbing agents wore off about midnight and he was hurting. 

After the training was over I hurried to Papa's apartment with a basket of supplies for caring for his head. The nurse told us we could leave the dressing on until Thursday before beginning the cleaning process. It definitely had to stay on for 24 hours before removal. However, Claude and were headed to Michigan on Thursday afternoon and I wanted to be sure Papa could do this himself. If he could not, I would not be going to Michigan. 

We also had to get his INR test done at Dr. Weckman's on Wednesday. This checks the thickness of his blood.  I scooped Papa up and took him to lunch at Dairy Queen. He loves their chicken tenders dipped in gravy. He got some pretty interesting looks with that lovely bandage still on his head. It looked like a white square patch keeping a horn that was trying to grow out of his head covered up. 

After lunch we went to Dr. Weckman's office and the INR reading was 1.2.  It is supposed to be between 2 and 3. The lower the number, the thicker the blood. This was not a good reading. Dr. Weckman said to increase in dosage of Warfarin and come back in a week. The nursing staff at the Dr. Weckman's office all know us by now. They were all concerned about Papa's head. After all, this was not done in their office and they couldn't figure out what it was. Papa simply told them I hit him. Nice, really, really nice!!

We next went to the nursing home. These people are so like family to Papa. He has known them all the 10 years he has lived in Kentucky. They tenderly cared for Mom six years. They marvel that Papa is still coming each Wednesday, DVD in hand, to share music with the residents. They were very concerned about what happened to Papa. They all call him Papa or Mr. Lawrence. Again, he told them I hit him. Nice, really, really nice!!

When we got back to Papa's apartment from the nursing home, it was 24 hours since the surgery.  Time for the first cleaning of the wound by us. 

I carefully showed Papa the instruction sheet and went over the parts about cleaning. Then I showed him the liquid I prepared, the cotton pads to use and I proceeded to remove his bandage and clean his head. Then I showed him how to keep it covered in Vaseline so the skin would not dry out in the healing process. Simple enough. 

We opted to not clean again until Thursday morning when I would come back to be sure he had plenty of groceries and could clean the wound himself.

Thursday morning I got his additional groceries, made sure his meds were full, and watched him clean his wound and cover it in Vaseline. He did great. I would be able to travel. I told him I would call every morning and evening to remind him to clean that wound.

We left for Michigan Thursday afternoon and returned Sunday evening. 

I was at Papa's Monday morning to see how things went. The wound had a little white spot at one end of the incision. But other than that I thought it looked good for a week after surgery.

Tuesday, February 2nd, I took Papa back to Dr. Davey's at 2pm to have the stitches removed. I should really get the nurses name that works with him. She is just great with him. She remembered his story from the day of the surgery and got to listen to it again when she reminded him of it. The stitches were removed. Dr. Davey said it was healing really, really well. Papa is to clean it twice a day still until it quits oozing or any blood is on the pad he cleans it with. That sounds like there is a lot but really there is only a touch. There are stitches inside his head that will dissolve on their own. They will take a lot longer. We are to go back in August for the next check and they will go over his head, neck and arms again to look for any other occurrences of the cancer. 

The really great news is Dr. Davey decided the place on his cheek does not have to have surgery. They will check it again when we go back in August. Yippee!!  Little blessings!!

Yesterday, Wednesday, February 3rd, I took Papa back to Dr. Weckman's for his next INR. It was at 1.9 this time. Much better. We keep the dosage the same and come back in a month.

Caring for Papa is not easy. It isn't as hard as others have in caring for family. But it is a constant strain. I am grateful this surgery was done and healed well before my sisters come next week. They will care for him for the next two weeks while I get a much needed break with my hubby. At least this is not something they will have to take care of and his Warfarin concern is also not an issue for them.