Surgery & Recovery

I started writing this yesterday prior to my discharge from the hospital, but I didnt have time to finish before leaving. (The trial run of my medications completely knocked me out for a few hours. I was simply not built for pain meds.) Now just over 48 hours out from my surgery (still working from my phone), I am so happy to report that, thus far, my experience has been excellent.

After my last post, I met with my surgeon, anesthesiologist, and some OR nurses (one of whom is a close family friend). My surgeon reiterated what I had come to expect for the surgery, and marked my abdomen with a skin marker. He had me sign a consent for blood transfusion in the unlikely event it would become necessary. Anesthesia checked my mouth for loose teeth (none) and assessed my airway. (If anyone is wondering, I have a large tongue, but I’m a Mallampati II.)

They came in and started the anesthetic cocktail while I waited to get brought to the OR. 5mg Versed in my IV. They wheeled me behind the doors to OR 11, my lucky number. I passed another family friend in the hallway, who had been working on another surgery. It put me at ease to see friendly faces.

In the OR, I scooted onto the table, and they put my arms to my sides, and a rolled up towel behind my shoulders so that my head would lean back for easier airway management and intubation. I had a few minutes to take everything in while the anesthesiologist waited for a note to show up in the system, and I looked around at the lights, the people, and the instruments I had come to be familiar with in the course of my research on the procedure. They were soon ready to start and had me take some deep breaths while they pushed propofol through my IV. Remembering the lovely advice of the nurse on my endoscopy, I thought of my happiest thought.

The next thing I knew, I woke up in recovery around 4 or 5pm, to the best of my very groggy recollection.I was in and out for a while, catching fleeting bits and pieces as my eyes fluttered open and closed. My surgery took roughly an hour and a half. I remember feeling nauseous and dry heaving, and (TMI warning) even vomiting a small amount of bile and blood (this is a post about an operation. You knew what you were getting into.) The recovery nurse gave me a small, kidney-shaped yellow emesis bucket and put an alcohol prep pad under my nose, which seriously worked wonders while she prepared antiemetic medications. (I might use the alcohol pad trick to help patients of my own in the future.) She placed a scopalamine patch behind my left ear, and gave me an alternating mix of Zofran and Reglan– which was first, I can’t remember. Such is the nature of a post-anesthesia wake up.

My dad and stepmom were in the waiting room, and kept things light for me while we spent a couple of hours in the recovery room, and I adjusted to my new, seemingly foreign post-op body.

I have a pretty high pain threshold, but pain-wise, I never went above a 3-4. That was mostly in the very beginning, and with movement. If others are to be believed and the first couple of days are truly the worst (which sounds pretty intuitive), this recovery will be very manageable.

When my room was ready, they moved me over to an air bed and brought me upstairs, through a labyrinthine series of corridors. It’s always felt odd to be moved around on a stretcher. I’m generally the one pushing other people through hospitals in their beds.

My room was amazing. I don’t know whether it’s a good thing or a bad thing, but I have certainly stayed in worse hotels. I ended up in the nicest room in the hospital, one of two designed recently and specifically for bariatric patients. The room was a single- occupancy, easily 20’x20′, and equipped with several chairs for visitors, a recliner, and a small vanity sink. It had faux cherry wood floors, and all the equipment and amenities of a typical hospital room, only… nicer. I’m told the program director was deeply involved in the design, and were she not a respected attending surgeon, she could fall back on interior decorating. The room overlooked the parking garage, which I’ve always thought was an eyesore from the road, but it was almost beautiful when lit up at night. The private bathroom was roughly half the size of the room, and everything was clean and lovely.

I didn’t take a picture before it had that ‘lived-in’ look, but what a hospital room!

Upon arrival to my room, I was met by my evening nurse and CNA, both of whom were very sweet and helpful. They took vitals, performed a skin assessment, looked at my incisions, and gave me my first doses of medication. They gave me an incentive spirometer with instructions to perform 10 times an hour. I had no trouble with it. 

Incentive spirometer. Challenge accepted.

They set me up with a small container of water and plastic medicine cups with the instruction to drink two of them every 15 minutes as tolerated (2 fluid ounces.) 

Shots, shots, shots!

They also suggested that I walk 250 steps (or one trip around the unit) per waking hour in order to reduce risk of blood clots, but I just kept walking rounds. The first trip around, attached to my IV pole, and with a second hospital gown draped over my shoulders like a cape, I did 3 laps. My second trip, I walked 10 laps, and then 11, then 13. I got about 1.6 post-op miles in before bedtime on the night of my surgery. 

Not long after arriving, my mom came up to visit. She walked laps with me, and told me that everyone was asking about how I was doing. I was doing quite well, and couldn’t really complain.

My IV was attached to a patient-administered morphine delivery system, and I was given instructions that I could press the button once every 10 minutes as needed. I kept forgetting about it, which I soon took to mean that the pain couldn’t be that bad, and I really didn’t need the morphine. The most painful thing was getting up, which I insisted upon doing without help. My bed was quite high (I’m very lucky I’m tall) but I would raise the head of my bed as high as it would go, and let my left foot dangle from the side, followed by my right. Pushing off the left side of the bed with my right hand, I found that I could sit, and then slowly stand. Walking was not particularly painful, but changing the position of my abdomen was a bit more challenging. So was coughing. I still made do with all of my activities. I dropped my phone at least 6 times and managed to keep bending to retrieve it.

The first night, I only took in one ounce of water at a time, and I found that it made me quite nauseous at first. By the second day, I was taking in about two ounces every 15 minutes, alternating protein shakes and water.

I could hear that they were having trouble getting my neighbor to walk, so I went over and introduced myself. “I could use a walking buddy,” I told him. “Anyone want to go for a walk with me?” It turned out that he had just had the same procedure with the same surgeon. He was the person ahead of me in the OR. We walked a few laps, and it felt good being able to help, even in my early post-op condition.

During the night and early the next morning, three doctors came to visit me (like a surgical retelling of A Christmas Carol). The first was an overnight resident, the second was the fellow who assisted with my surgery, and finally, my surgeon came to check on me. They were all pleased with my progress and the look of my (super tiny) four incisions. They told me that they would be looking to discharge me around lunch time, provided that I could sufficiently get fluids down. They took me off the pain pump, called my prescriptions in, and the nurses started getting my discharge paperwork ready.

I sat down to a breakfast of protein shakes and water. The trays kept coming far faster than I could complete them (I’m still working on those protein shakes). I threw out the milk and decaf coffee, not wanting to rock the boat with my delicate stomach. I ended up enjoying a simple chicken broth the most. I learned that the key was to take very slow sips, and to meter one ounce out over the course of 30 seconds or so.

They decided to have me try the pain meds they were prescribing for home, and they knocked me out cold. I ended up taking a nap for about 3 or 4 hours.

My vitals were textbook (my O2 level at 100, my resting heart rate around 70, temperature perfect, and bp staying in the range of 116/70, give or take a few points.) I was discharged around 2 pm on Tuesday, and my mom picked me up. The nurses told me that they knew I would do well, and they could see how committed I was to the process. They told me I had probably broken a record with the number of laps I had walked, and thanked me for being their favorite patient. I was incredibly fortunate to have such kind staff looking out for me– the nurses, aides, physicians– everyone was wonderful. I counted myself truly blessed.

On the way home, we stopped at the pharmacy in Target, also picking up some broth. My mom wanted me to wait in the car or to pick it up herself, but I was happy to get back to normal as soon as possible. It felt strange to be up and walking around a major retail store during the holidays when, just 24 hours before, they were cutting through my abdominal wall in 4 places.
I’ve been staying at my mom’s for a couple of nights. It’s been more comfortable having a nurse nearby, and being closer to more people. I’ve been very self-sufficient, though. I’m preparing my own meals (protein shakes and broth), going on walks, and even picking up after myself (bending is not a strong suit right now, but I’m managing somehow.) I took a very welcomed shower this morning (my first since just before surgery on Monday morning), and it felt great to start getting back to normal. Ish.

I’ve mostly been trying to keep up with drinking liquids to prevent dehydration, and responding to the amazing outpouring of love from friends, family, and even strangers. Hundreds of people have taken the time to contact me, and it has been truly humbling.

Thank you all for sharing in my journey. It’s going to be a long road, but I’m going to crush every single mile. And document the amazing road ahead.


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