I'm Post Op

Mar 22, 2009

Well, my surgery took place with Dr. Cribbins last Tuesday, March 17. I got to the hospital at the crack of dawn (6:00 AM) to register, etc., and was wheeled back for surgery at 7:30. The surgery went smoothly, and I was in my room with my parents around noon. I was hooked up to all sorts of machines at this point. I had a Foley catheter, an NG tube, a JP drain, two On-Q pumps (which supposedly help with post-op pain by dripping small amounts of anesthesia into the incision sites), oxygen, an IV, blood pressure cuff, embolism stockings, and massaging booties to prevent PEs. I was quite a site. And still pretty goggy until the anesthesia wore off. I was on fluids and morphine at this point and wasn't feeling too horrible. Ah, narcotics.

That first night in the hospital was pretty miserable. I wasn't comfortable and I couldn't sleep. I was horribly itchy and anxious. I was given Benadryl and Valium, which helped for a while, but I was up again a few hours later. Thank goodness that my mom was there with me and we had a wonderful night nurse, Ruby. Ruby worked up a plan and called my surgeon in the middle of the night. We switched my pain meds from morphine to Dilloted, and I was able to get a little sleep in.

Things started off well enough on Wednesday. My heart rate was high (~140) and I was starting to run a little bit of temperature (it would roam from 98 to 100), so they were worried about the possibility of infection. I got the Foley taken out, which was wonderful, and managed to get Dr. Cribbins to let me go for a CT to check for leaks so I could possibly start on some ice chips. The thirst was absolutely killing me at this point, and the little swabs they gave me were not cutting it. The CT showed that I had two large hematomas--one the size of a softball and one the size of a baseball. Apparently, I had been responding really well to the Lovanox (sp?) that they gave me to prevent blood clots. My blood had thinned and there was some seepage from the staple line that was collecting into the hematomas. The suspection was that this was also causing my high heart rate, which got as high as 149, and the slight temperature. So, they stopped the Lovanox, and I began to get regular visits from the lab techs, who always chose such convenient times to visit. I mean, who doesn't want to get blood taken at 3:30 in the morning every day?

In the mean time, they removed my NG tube since no leaks had shown up on the CT, but I was still kept NPO because of the worry of internal bleeding and possibly having to go back in and look around. We waited for a few hours and my labs continued to drop. I got up to go to the bathroom, and it was the scariest sight. I had lost all the pigment in my face. No pink anywhere, not even on my lips. I truly looked like a ghost. That night they started blood transfusions. I received a total of five--two Wednesday night, one Thursday morning, one Thursday evening, and one Friday morning. I immediately began feeling better on these, though the labs took a little longer to respond. Apparently it's harder to come back from too much Lovanox than from too much coumadin.

Thursday was a lesson in remembering to request my pain meds every four hours. Otherwise the pain came back quickly and took longer to get back under control. Not so fun. I didn't do much walking on Thursday simply because I still felt awful and they were still pushing so much blood and fluids and antibiotics into me. But I was finally allowed some ice chips, so things were looking up.

By Friday my heart rate was back down and my labs were showing steady improvement. I was cleared for clear liquids and spent a lot of time walking the floor. I was feeling so much better. Dr. Cribbins removed the On-Q pumps and respiratory took me off oxygen, so I was finally only hooked up to an IV and the clot-buster booties. It was looking like I'd get to go home Saturday or Sunday.

During the night on Friday, my IV infiltrated. Not a fun experience. I got a new one in my right hand, and my poor left hand was all swollen and puffy. Then the lab tech decides that the only place she'll be able to get blood is from my left wrist (never mind that they had had no trouble drawing blood from my arms until this point or after). I think it was the most painful blood draw of my life.

Thankfully I was discharged on Saturday and was home around noon. I took it easy yesterday, but I have definitely hit the "What the Hell Have I Done to Myself?" stage. I knew it was coming, but that didn't make it any less unnerving when it happened. I'm guessing being off my Paxil for the four nights I was in the hospital didn't exactly help. Hopefully being back on the meds will let my anxiety level stabilize a little. Otherwise I'm feeling pretty good. Sipping away on liquids. I'll go back to see Dr. Cribbins on Wednesday to get my JP drain removed and to weigh in for the first time since surgery. For this first week of clear liquids I am simply focusing on getting in as much fluid as possible. The protein's just going to have to wait until I go to full liquids since I cannot tolerate the Isopure or Nectar. Luckily I have a few protein powders that I do like and several more samples to try so I'll be able to reach my protein goals starting next Thursday.

On the protein note, the nutritionist at the hospital concurred with me that at almost 6'0", 60 grams of protein is probably a pretty low goal, even though it's the top of their recommended range for women. She suggested aiming for 70 grams, though I think that will be the low end of my personal goal range of 70-90 grams/day.

Well, the hospital stay was quite an adventure. I am happy to be home, and I'm feeling pretty good today. I know I'll feel better and more confidant about my decision as the days go on, so I'm just trying to stay at peace with that.

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