Saturday, August 23, 2014
Inquirer Daily News

No Pain, No Gain

I'm not a complainer, but last night after my surgery, I was in a lot of pain. Around 2 a.m, I started having terrible muscle spasms in my right thigh, where my femur was cut out. Even though I was getting intravenous morphine through a pump, the pain was a 7 on a scale of 1 to 10.

No Pain, No Gain

Rachel with her surgeon John Dormans after the big operation
Rachel with her surgeon John Dormans after the big operation Kurt Kovach

 I’m not a complainer, but last night after my surgery, I was in a lot of pain. Around 2 a.m, I started having terrible muscle spasms in my right thigh, where my femur was cut out. Even though I was getting intravenous morphine through a pump, the pain was a 7 on a scale of 1 to 10. I can push a little button on the pump if I need extra morphine. I was pushing that button a lot last night. Eventually, they started giving me Valium every six hours on top of the morphine.

Now it’s about 2 p.m. and the pain is down to a 2. That’s not too bad. (The worst pain I ever had in my life was in my knee before the doctors figured out that Ewing’s sarcoma was causing it. On a scale of 10, that pain was a 20!)

You can probably guess that I’m not in the mood to write for the blog, so this post is based on what I told my dad, Kurt, and the Inquirer reporter, Marie McCullough. They did the actual writing.

Yesterday was a really long, hard day. I had to get to CHOP at 6:00 in the morning.  I was comfy in my bed in the hotel (we stayed in a really nice hotel) and didn’t want to get up at 5:00 a.m.  I was really scared and just wanted to go home.  In the pre-op area, Dr. Kraemer, the anesthesiologist, came to see me and explained how the anesthesia would work. I told him I didn’t want him to put the mask on my face because I get really claustrophobic and start to hyperventilate. I asked if he could give me the anesthesia through the port in my shoulder since it was already open.  He said OK.  He saw that I was nervous and asked me what was wrong.  I told him I was afraid I wouldn’t wake up. It’s not that I didn’t trust the doctors or thought I would actually die, but this is my first major surgery and I couldn’t stop thinking that something might go wrong. He smiled and told me that I would wake up a few hours after my surgery was over, and not before.  I also asked him to give me what I call my “giggle juice” -- a mix of Benedril and Tylenol – through my port instead of by mouth because it tastes so bad. How bad? Like barf. He said OK to that, too.

I remember my parents kissing me on my head and then getting rolled off to the operating room.  I don’t remember much after that.  When I woke up, Dr. Kraemer asked me how long it felt like I was asleep.  I told him about ten minutes.  He told me my surgery was about eight hours long!

I was soooo groggy and thirsty after I woke up. The nurses gave me some ice chips to crunch on.  That helped a little, but I wanted a giant glass of water. But then I started having nausea from all the drugs in me.  I vomited twice. When my stomach calmed down, the nurse gave me a cherry ice pop. Mmmmm. It tasted so good.

My parents came into the recovery room and I was really happy to see them. I got a lot of kisses on my head.  They said the surgeon, Dr. Dormans, told them he replaced the top two-thirds of my right femur with a cobalt-chrome prosthesis that weighs about five pounds. He said I didn’t have any problems during the operation and there were no surprises.  He came to check up on me last night, but I can’t remember much about it.

This morning some of my friends from Mother Theresa Regional School came to visit. It was nice to see them, but I was too tired to enjoy it. I just wanted to take a nap.

That’s what I’m going to do right now.


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About this blog
Rachel Kovach, 12, is a seventh-grader at Mother Theresa Regional School in Atlantic Highlands, N.J. She lives in Highlands, N.J., near the Sandy Hook national seashore, with her parents, Mari and Kurt Kovach.

Since first grade, Rachel has been swimming with the Monmouth Barracudas, a year-round competitive United States Swimming Club program. She hopes to continue competitive swimming after her cancer treatment; if not, she envisions coaching someday or maybe a career in medicine. Figure skating and jazz dancing have been big parts of her life. One of the things she hates about being in the hospital is missing her dog Cocoa and her many friends.

Rachel's doctors

These are the key physicians overseeing Rachel’s care at Children’s Hospital of Philadelphia:

Naomi BalamuthNaomi Balamuth, pediatric oncologist, specializes in treating pediatric sarcomas, a subset of solid tumors.

 

 

Richard B. WomerRichard B. Womer, pediatric oncologist, led studies of the latest chemotherapy treatment protocol for Ewing’s sarcoma.

 

 

John P. DormansJohn P. Dormans, M.D., chief of orthopaedic surgery, is an international expert in the surgical treatment of musculoskeletal tumors.

 

Timeline of Rachel Kovach’s Treatment

Dec. 3, 2010: Pain in Rachel's right knee is initially diagnosed as tendinitis.

Jan. 20: An MRI reveals a tumor in right leg.

Jan 24: Rachel sees John Dormans, chief of orthopedic surgery at Children's Hospital of Philadelphia.

Jan. 27: A biopsy confirms Ewing's sarcoma.

February to mid-April: Regimens of chemotherapy alternate every other week. The three-drug regimen is given over two days; the two-drug regimen is given over five days.

May 3: Surgery replaces most of the right femur with a prosthesis.

May 5: A Children's Hospital team will help Rachel get out of bed.

May 10 to September: Alternating regimens of chemotherapy are to resume.

Around May 10: Physical therapy will begin in the hospital and continue for at least several months after Rachel goes home.

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