Discharge 6 days?! Still coughing profusely after complete esophegectomy/pull up...

This hospitalization seems to be going at warp speed.  The doctors at this medical center are saying that my husband will be discharged on Monday, just six days after he had his surgery.  He is doing so well but is coughing and coughing, with huge mucus balls coming up. The put him on a mucus mist and albuterol.  Can they discharge him with this cough? They keep saying that it is normal 4 days post surgery.  Is it?Just some background, my 63 year old husband, healthy normal weight, avid bike rider, athletic, never smoked or drank, diagnosed T-3 adenocarcinoma in March, had 28 days of radiation 6 weeks of chemo and last week Tuesday had the 10 hour surgery to remove his entire esophagus and part of the stomach, and pullup and attach the remainder of the stomach. He spent 2 days in ICU. Coming out of surgery he had an epidural with morphine pump,  2 chest tubes, a gastro tube, a J-tube, catheter, arterial line all of which were removed on the third and fourth day after surgery.  He had a fever of from 101 to 100 all while in the ICU.  He was moved to the telemetry floor on the 4th day and they started the Legevity in his feeding tube, trained me how to flush infuse meds and the feedings, taught me how to give the injections of the blood thinner in his stomach, introduced clear liquids.  Now on the 5th day they introduced milkshakes, and tomatoe soup.  He has been moving his bowels on this 4th and 5th day and eating without consequence. He is walking around and oxygen levels are at 90, but he coughs and coughs.  Temperature at 99.  They say that he will be discharged on Monday, which will be less than a week from the surgery.   I am wondering if this coughing is normal and will continue or is surgery based.  He had a cough prior to surgery of course, but this is much more productive. My head is in a whirl with all this.  Thank you for any insight.

It took me ovcer 7 weeks to get out and I was only 32 at the time - 3 weeks of that were in intensive care on dialysis as my body shut down (I also had pneumonia).  I had the cough for at least a year afterwards.

It is not easy but you can get your life back, though portion sizes will always be a bit smaller.

Aoife

My husband was about your husbands age when he had his surgery - he was in a lot longer but that was due to some complications.  The cough as I think a lot will chime in on is a new normal, he will experience many of these through the recovery stage.  Jim is 3 years post surgery and still has bouts of coughing, mainly a night which will cause him to vomit.  He will  learn to control how he eats and sleeps which will help with the cough.  The cough could also be related to some nerve ending damage from the radiation, my husband had a paralyised vocal cord for almost a year, which allowed some fluid in and would start him coughing. 

Just remember the recovery process is slow - one step forward, two steps back.  Make sure you have some help and support to get you both through it. 

Please feel free to ask any questions - I know I had about 100 a day during Jim's recovery and everyone on this sight was fantastic.

I had my surgery 9/11/09 ( I was also 63). I went in on a Friday and came home the following Friday. I had the same surgery...about 2/3 of my esophagus was removed and had stomach pullup. What I  have to this day is a cough.  A year after, I had my surgeon do a endoscopy to see if he could find the reason for the cough. He said it is caused by reflux.  This September will be 3 years and I still cough....especially when eating. I am at my wits end because the doctors cannot get rid of this cough....btw, I was T1 and did not need chemo or radiation.

My husband had no complications related to the surgery and was in 12 days. He had not even had his first swallow test by day 6. His surgeon was a stickler about no fluids till he passed a swallow test to make sure there were no leaks. He also never needed dilation post-surgically (survived almost 6 years past esophagectomy as a Stage IVb at diagnosis). I often think he did so well post surgically for scarring and narrowing in the esophagus because it healed so fully before he started using it again. Pat could not handle much dairy in his post esophagectomy years, but yogurt was okay. He could not tolerate the lactose anymore. 90 is still kind of low for an oxygen reading and that much coughing does not sound normal to me...but I'm not a doctor. Have your surgeons done this procedure much?

 

I was in the hospital for tweleve days in 2008. I had the same kind of surgery and I coughed and vomited a lot. It took weeks for it to get better. It just takes time. I hope that he gets feeling better real soon.

Pipernickel

I had MIS surgery in 2010.  I do remember coughing up loads of stuff, seems like I use boxes and boxes of tissues.  I was in the hospital for 12 days, longer than expected but I failed by swallow test due to paralized vocal codes.  That went away in about two days.

I was told that the coughing was due to reflux.  I have to be sure I do not bend over too much.  I did cough a lot at home at first but have learned not to eat too late, sleep at an angle, and for some reason I can eat a peeled apple about 30 to 45 minutes before I go to bed.  I did move from a wedge to sleep on to a genie mattress which helps me to not roll over at night.

It is a slow process but doable.  I wish you both the very best.

Well he has been diagnosed with pneumonia. It just had to be with the enormous volumes of fluid he was bringing up. Of course he was still sent home with 101.9 degrees and a nebulizer which I fought for . This is the be resident intern time of rotation so I am using my gut reativity to insure our oxidatec needs are sufficient Man this is scary and so difficult to rein in a physically healthyguy....I.e.the AC went out and I practically had to strangle him as he attempted to help gerrymander the garage door open, "NOoooooo you are going to rip out you esophagus !!!!! We will make this. Path results next week. Arghh.

As a fellow man I can relate to his need to help. 

You will make this, hang in there!

They really need to be careful of straining. Pat had his bowel herniate into his chest cavity about a year and a half after his Ivor-Lewis. I still think it was related to using our beast of a snowblower in the side yard when a car slid off the icy driveway into the yard. He just had to help and it almost killed him years sooner than the EC recurrences.