Surgery II (5 months post-op Surgery I)

*20 week (5 month) surgery anniversary*

Here we are...exactly 5 months (140 days) post surgery I, going under the knife for surgery II.

[Today, I am 3 days post-op from surgery II and feel well enough to start posting again.  It took me 12 days after the first surgery to feel well enough to get back to my blog. ]

 Here is a recap of my surgery II day:

6:15 am- Alarm

I took care of some last minute personal affairs and wrote goodbye messages in cards to my parents and also in my journal.  When you have a surgery that you have to go under general anesthesia, there is a very real danger that you may not wake up, from the anesthesia alone, no matter how simple or severe the surgery you are having.  Add the severity of my surgery and there are an infinite number of ways that my surgery could have gone wrong.  Luckily, I am still here, so we know that it went well, but I still had to leave some final messages, just in case.

6:45 am- Shower with antiseptic soap

7:45 am- Arrived at the Hospital 

When I got to the hospital, I had to take care of some paperwork, and then I got taken to a pre-op room.  There, I changed into the surgery gown, answered a lot of questions from nurses and doctors, got a complete physical by the house physician, gave a urine sample, got my foot and leg shaved, and had the IV put in.  For my last surgery, they were able to put the IV in my hand, and I remember it being the most painful of my pre-op experiences.  This time, she couldn't find the vein in my hand, so she tried to put it in my left arm.  She stuck the entire IV in, and didn't hit the vein.  She bandaged that site up and then found luck in placing it in my left wrist.  Neither attempt hurt as much as placing the IV in my hand for the first surgery.  When the IV was secure, I was rolled to the pre-surgery staging area.

In this area, nurses and doctors asked me the same questions I had already been asked before.  It is amazing how repetitive the paperwork is, but I can only imagine how many mistakes have been made that it has to be that repetitive.  The anesthesiologist talked with me and talked me through the nerve block and anesthesia process.  As my doctor instructed me to do, I was deeply questioning him about the procedure and making it clear that it didn't work the last time and that it HAD to work this time.  While I was talking to the anesthesiologist, my doctor came to visit me.  He warned the anesthesiologist that I am probably the most intelligent and thorough patient he has ever had, so be prepared to answer my questions! I was laughing really hard.  I know that I have the distinct advantage, that I am in this field, and I actually understand everything that has to be done to me and why, but do patients really not do their own research about their conditions?  Being informed is the best way to prepare yourself when you have to go through life-altering surgeries like this.

My surgeon thought he was off the hook after signing my right leg (they come and put their initials on your surgery leg to confirm that they operate on the right side), but of course I had a few questions to ask him before he left...further validating what he already said about me.

Question 1: When is the earliest I can travel?  Up to a 2 hr flight is possible at 2 weeks, but it would be better if I travel no earlier than 4 weeks.  I asked him this because I am actively on the job market, and if I have to fly to a university for a final interview, I want to be able to tell them when I can go.

Question 2: When can I start PT?  When the bone sets, some time between 4 and 6 weeks.  I hope to convince him at my 2 week appointment that I will be ready to start at 4 weeks.  I am only 7 weeks away from moving where I currently live, so the earlier I can start PT, the closer I can get to being able to drive again, and walk upright (with some assistance) so that hopefully by the time I move I will be able to live independently in my new city.

10:30 am- TIME OUT

My surgeon left, and then it was time for the "time out" with the anesthesiologist.  I said bye to my mom and then moments later I was out.  The next thing I remember is being in the recovery room.

12:30 pm- Recovery Room

Same as last time, I was asked to wiggle my toes.  I could do it, but just barely.  I felt a numbness down the entire lower part of my right leg...which meant...THE NERVE BLOCK WORKED!!!  Instead of immediately writhing in pain, like after my first surgery, I was looking around taking the room in, asking for my mom, and I felt hungry!  My pain level was so low, that the worse pain I felt was my hunger pains! I was so happy in that moment...it was absolutely amazing the difference from my first recovery room experience.  My mom was only allowed to feed me ice chips while I was in the recovery room.  I wasn't allowed to eat or drink anything since midnight the night before, so it did feel good to have something in my mouth, even though it was just ice chips.

3:00 pm- Patient Room

After a few hours in the recovery room, they wheeled me to a private patient room.  As soon as I got there, I was ready to get up out of my bed and use my crutches to go to the restroom.  [With the first surgery, the nurse had to threaten me with placing a catheter if I didn't go before 11 pm the first day.  I didn't end up going until just before that, but I did avoid having to get the catheter.]  I told my nurse that I was ready to go, and she said that I wouldn't be allowed to without PT coming and confirming that I knew how to use the crutches.  I explained to her that I had the same surgery 5 months ago, and that I am very skilled with crutches, walkers, canes, wheelchairs, you name it!  She wouldn't have it.  She actually wanted me to use the restroom in a bed pan.  I told her that I wouldn't do it, and that I would wait until PT came.  She called PT and said that they couldn't come for at least another hour.  I held my ground.  Finally she said that I could get out of my bed and use a bedside toilet, which at least looks like a regular toilet.  The bedside toilet was only about 5 steps closer to my bed than the actual toilet, so I still can't understand all the fuss she created over me not getting out of my bed.

With my first restroom trip out of the way, I was back to being hungry.  I discovered that the nurses have turkey sandwiches on the floor that they can give to patients whenever, considering dinner was still several hours away.  Somehow, I never figured out the turkey sandwich secret with the first surgery.  I devoured the sandwich and then I felt like I had a lot of energy back.  I realized that the main reason I felt light headed at that point was because I was so hungry.

5 pm- Feeling pretty normal

By 5 pm, I felt well enough to be smiling for pictures and texting my friends, things that were absolutely impossible after the first surgery.  My pain level was around a 6.  It took over a week to get my pain level that low after the first surgery.  I ate dinner and waited for the PT.  I was able to feed myself!  The pain of the first surgery was so great, that I couldn't even focus long enough to use the fork to pick up my food and put it in my mouth, it was hard enough just to get myself to chew.  My mom fed me most of my meals in the hospital with the first surgery.

6 pm- PT Visit

Finally, the PT and his two interns came to visit me.  The therapist remembered me from my last surgery.  We skipped all of the normal introductory instructions and got right down to business, getting out of my bed!  It wasn't until I had crutched a few steps that I realized that the IV placement in my wrist was not going to work.  With the severe angle that you have to bend your wrists to use the crutches, I was painfully bleeding through my IV line.  I was only able to crutch to the door of my patient room and turn around.  They did let me go to the bathroom while I was up.  The therapist went and told the nurses that I needed my IV moved.  My session was over for the day since my IV line prohibited me from doing more.

7 pm- IV line moved

They had a lot of difficulty before the surgery finding an IV location, having to try two before they successfully put it in.  Now I was facing yet another puncture in my arm.  They used an IV line for a child this time and were able to put it in my right forearm.  This really complicated things because my IV pole was on the left side of my bed, which meant that the remaining time I spent in the hospital, I had all of the cords laying across my lap.

First Night

I was nauseas and itching- both side effects of the narcotics.  They gave me drugs for both of those.  I tried to keep pressing my pain drip on a schedule.  I was allowed to press it every 8 mins, but that is really difficult when trying to sleep.  I also had vitals and drug checks every 1-2 hrs, so not much sleep that night.  I went to the restroom about every 2 hours, which was much less than the 16 times that I had to go with my first surgery.  That was obviously a result of them having the IV fluids on high since I wasn't going, and from all the water and gatorade I was chugging to try to make myself go.  Around 4 am, I asked for another turkey sandwich.  Since I didn't have the pain to distract me from my hunger, it was time for some more food.

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Reflection

What a difference the nerve block makes.  Day 1 was closer to Day 7/8 of my first surgery.