2 posts tagged “surgery”

Well, obviously I couldn't do the diary thing, but here's the story.  Some bits may be inappropriate for the weak of stomach...

I did a short (two card) reading the morning of surgery to ask how things were going to go.  I used the Druid Oracle, which uses animals instead of what most people know as the major and minor arcana.  Representing the surgery and it's outcome was the Hind, signifying elegance and grace.  The message was that the surgery would go well.  For the recovery, however, was the Wolf, signifying challenge and the need for strength in the face of adversity.  Both cards were hauntingly accurate.

Pre-surgery was easy.  I went in, didn't really have to do any paperwork because I'd done it in advance, and they set me up with a pre-op prep room.  The nurses were very kind and patient, didn't have a problem finding veins for the IVs or anything, and Rob was with me.  One of the nurses was even joking about the street value of my post-op pain med prescriptions.  They all made me feel very at ease.  My surgeon and anesthesiologist both came to see me in advance and met my partner and seemed very comfortable and at ease with the whole thing -- like it was just a walk in the park.  They took all kinds of precautions, like writing 'Yes' on me in purple marker where the operation should be taking place, everyone that saw me asking me what operation I was there to have, etc.

I don't remember waking up in recovery, though I know I must have for them to release me to my room.  They had done an incision on my abdomen, slightly below and to the left of my belly button that was about 5" wide and horizontal, and one in my back, about 6", vertical and extending up from my belt line.  There were also four puncture-type holes in my back in a rectangle around the vertical incision, presumably for stabilization while I was on the table.  There were no external stitches, only steri-strips to hold things closed and minimize scarring. 
    For the first day or so after surgery, I slept almost continually. I was nauseous when I woke up, and couldn't pass gas like they wanted me to for anything.  The nurses were impressed that I wasn't using my Patient Controlled Analgesic (or PCA -- the morphine button they give you that's on a timer), but it was really only because I was so out of it that I kept forgetting it was there.  Once I figured out that all I had to do was press a button to kill the pain I was all over it.  I locked myself out more than once.  They only let me keep it for a couple of days before switching me to IV-administered stuff since I still couldn't take pills.
    It took a day to be able to handle fluids, and three days to pass gas.  My surgeon seemed unconcerned, but he was the only one.  I must have seen a dozen other residents and doctors while I was there, and I got a little tired of answering the same questions over and over again, but I know they were all doing their jobs and learning.  I was, from all reckoning, a good patient except for not using the stupid incentive spirometer.  I developed a mild case of atelectasis as a result, causing them to wheel me down to X-ray at what felt like 1:00am.  Everyone reminded me from then on to use the spirometer however,  and with some antibiotics, I recovered from it quickly. 
    The in-house physical therapy people were very nice and got me walking in no time, and made sure I would be able to handle the stairs when I got home.  They set me up with a walker, which I despised, but couldn't live without for the first few days.  Once I was up and walking, it didn't take long for my tummy to work things out and for the plumbing to start up again.  I remember rolling onto my side one morning and giggling like a third-grader, happy as could be that I'd farted.  They started me up on solid food that day, but my appetite hadn't really returned. I gained an all-new appreciation for jello, because it was the only thing I could tolerate smelling/eating for the first two days.  That and eggs -- eggs were fine too for reasons I can't explain.
    After only four days post-op, I was walking with assistance and going to the bathroom on my own, so they said I could go home if I wanted.  I did so on Saturday.  We picked up my prescriptions on the way home, and I settled in to my trusty recliner with the remote and a blanket and put the projector to work. (Gotta love home theater.)  After only two days though, I was miserable.  My body didn't like Oxycontin one bit.
    I had to stop taking the pain meds completely.  I still had Vicodin from pre-surgery, but I didn't want to take any kind of narcotic, so I had to stop everything cold turkey.  I went into withdrawal.  Fever, cold sweats, wild changes in body temperature (from freezing to burning up), mood swings, crying fits, shakes... all of these were the norm for a week after I left the hospital.  I should mention here that I was having most of those symptoms while still on the Oxycontin, so going cold-turkey wasn't much different -- even though they recommend against doing it.  It took what felt like an eternity to get that stuff out of my system.  Once it was though, I felt human again and I wasn't in much pain at all.  In fact, the pain that remained after stopping all pain meds was still less intense than any of my pre-surgery back pain, so it was already worth it.
    I'm now three weeks post-op and other than the incision sites itching occasionally, and not being able to sit still for long periods without reclining or walking, I feel fine.  I plan to return to work next week after only three weeks out.  I feel pretty good, take Vicodin only when I need it, and I only need it when I do something I probably shouldn't be doing yet anyway.  Wearing pants are a pain in the stomach, but other than that I have no real restrictions.  I can tie my own shoes, walk, dress myself, shower, sit down and get up without much pain, and climb stairs without a problem. 
   
    If you're in a position to consider this kind of procedure, here's some of the things I learned: 
    I'm glad I did this when I was younger (35).  I had good nurses, doctors, and physical therapists, but I think the fact that I did it when I was still young meant a faster recovery.  I wish I'd done it earlier; 15 years of episodic back pain could have been avoided. 
    I'm also glad I waited.  I know that sounds like a contradiction, but this surgery has changed a LOT since I started researching it just five years ago.  Originally, nearly 70% of patients having this procedure needed to have it done again on adjacent vertebrae within ten years.  I'm assured now that that number is significantly lower. 
    I'm also glad I waited because I found a great surgeon.  He was a pain in the ass to get to see, and some of his office staff needs a swift kick, but you don't pick a surgeon because of his secretary, do you?  The ones that are hard to see are usually hard to see for a reason.  Be patient, do your homework on them, and choose based on the three R's:  Reputation, Repetition and Recommendation.  Reputation -- has he/she written any scholarly papers on this procedure?  Are they mentioned in any medical journals?  Repetition -- how many times has he/she done this?  It's more than okay to ask.  Recommendation -- talk to the people in the waiting room.  Are they happy with him/her?
    I'm glad I got off the pain meds early.  I don't even want to THINK of how long those nasty withdrawal symptoms would have been had I taken the full course of the prescription.  It's true that even minor pain can impede the healing process, so I'm not advocating skipping the trip to the pharmacy post-op, but if you can work with your surgeon to get a pain med that doesn't make you feel like a junkie, do it.  Oxycontin/oxycodone is pure evil.

So, it seems like the time for it. 

My aunt in Ohio is going under the knife to get a heart catheter put in so she can be treated for pulmonary hypertention today most likely.  PH is a rare disorder in which the blood pressure in the artery going to the lungs is abnormally high.  Since gas exchange is pressure-differential dependent, the increase in blood pressure means less oxygen makes it in, and less carbon dioxide makes it out.  In short, it's slow, progressive suffocation.  Send her some positive thoughts and prayers if you can.

I'm also talking to my spine docs about getting this pesky L5/S1 disc replaced.   I'm opting for this surgery for a number of reasons, but chiefly because it's not fusion and its recovery time is a fraction of other surgeries.  Hopefully, it will give me back my life.  15 years is a long time to be in pain.  Wish me luck.