Monday, October 22, 2007

Post Op Shop

On the Other Side
My surgery was at about 10:30 AM on Friday (19 Oct), and I woke up after about 1pm. It was a little weird getting my sensations back bit by bit, and I didn't relish the lack of control. However, in a few hours I had all my major senses and not much feeling below the waist.

They kept me in the post op recovery room for 27 hours, because of lack of bed space in the hospital. Everybody wants their recovery on the weekends, maybe. But the nurses in the recovery room were very nice and helpful - pulling me through some confusing times. I was fortunate, in that I had little or no post operative pain. When the PT got me up for walking, I had some pain but was able to take a couple steps with a walker.

I was struck by how many tubes and wires were attached to my body, to either monitor body functions or deliver some important substance to my body. I had a saline IV in my hand, an antibiotic IV (wrist?), a PCA epidural in my back, sedative drip in my jugular vein (neck), 3 EKG electrodes on my left lower rib cage, a catheter up my schlong, oxygen tubes up my nose (photo), a bag to collect fluids from my surgical incision, and two pressure cuffs on my lower legs to encourage circulation (minimize chance of clots). Maybe I've forgotten something? The only thing left now is the cuffs, which pleasantly squeeze at intermittent times with a 'puff' sound. These cuffs actually brought the first sensations to my lower legs - making my toes tingle, then feet, then ankles, calves etc. Removing most of these things was often painful - as they were taped to my fairly hairy body. Rip!!

The cocktail of chemicals and pharmaceuticals in my body was also impressive. I had/have blood thinners, clot busters, pain killers, anti-inflammatories, antibiotics, stool softeners, vitamins... I've probably omitted something. The PCA epidural is a machine that delivers pain blockers to space between vertebra in my lumbar region. So, sensation from pain receptors at or below the level of the epidural were minimized. PCA refers to 'patient controlled anaesthesia'; I had a device with a button that I could press to deliver a pulse of meds to the epidural. While in post op, the machine delivered meds at a slow rate, so any pressing I did just upped the dosage temporarily. When I moved to my room, the auto drip was off, so I had to pump to get the drip. At that time, however, they also started giving me Vicodan and eventually weaned me from the pump altogether. I now take Vicodan every 4-6 hours (when I ask) and think I've cut it to one pill instead of 2. However, PT may push my dosage up again.

Room with a View
They moved me to a room at 4pm yesterday. I shared it for one night with an amazing 66 y.o. guy that had two THR (one a revision of a BHR), and was in such great shape he was ambulatory after 3 days. The room is on a remodeled floor (8th), and very spacious. I count eight window panes over looking the East River. Both beds face the river; I have a great view of the lights at night and the sunrise in the morning (below). Some aspects of the layout and equipment are not optimal, but these things could be worked out with little effort. Every morning with breakfast, they bring you a flower that you can stick in a little vase - gives you a sense of how many days you've been in the clink. Rooms are provided with free wireless internet of dubious quality, and you have to pay $8 a day to use the TV. After my roomie left this morning, I've had the room to myself - so I could really enjoy TV at normal volume levels.

I was switched from liquid to solid foods Saturday evening. Speaking of food - the quality is OK (and quantity), but the service is erratic. I remember writing down preferences before surgery (low lactose) - but apparently these have been forgotten. We are given menus with choices to circle. Unfortunately, some mental midgets on the serving staff are unable to remember to give me what I asked for, despite having highlighted my selections and attached it to the meal tray.

Physically Challenged
Today was day three - and my first full day in the hospital room. In the morning PT session, I had some light-headedness, so I didn't walk any. I felt embarrassed and frustrated - and also worried. I think my Vicodan wore off, as the pain was prominent. Or it may have been related to the fact that I didn't sleep well after they removed the catheter on Saturday evening. The sensation was annoying, and I couldn't figure out if things were moving or staying. The threat of replacing the catheter if I couldn't void put a lot of pressure on me to go before midnight. It was like learning how to pee again, but with lots of irritation. And my best friend is a plastic bottle between my legs that I fill up religiously. Maybe this has been the toughest thing to deal with so far, but I'm happy to report that my plumbing is nearly normal at present time. :-)

After an hour's nap and lunch (with more omissions), I felt stronger. When the afternoon PT person came, I rather easily sat up on the bed, stood with the walker, and made it halfway across the room and back. I think the timing of my pain pill around lunch also helped. Later on, after my wife and mother arrived - I sat up on my own, and with some help got to sit up on an elevated chair so that I could watch some TV from that position. Well, that was my hope. But with both gals yakking and fussing, I didn't see much. That's an easy price to pay when someone that is willing to bring you a decent cappuccino and donuts.

They also have taken my bandage off, and I've seen my incision with the help of my digital camera. It's pretty ugly, and seems to be covered with some sort of papery material. I don't quite see stitches or staples, so I'm not sure what keeps it close.

The care here at HSS has been excellent for the most part. I'm a little disappointed with myself that I can't make more physical progress. It will come, but I wish I didn't have to push myself so much to get over the pain or be so reliant on pain meds. My MD told me to try sitting to motivate me to get up more. I think it helps. I really want to be up and about on my own. And with bowel issues coming in the next day or so - I have added motivation. If I have the time or energy, I'll give an update in the next few days.

Well, the lame ALCS game is nearly over, and like the Indians, I'm out of gas.

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