Monday, February 01, 2010
I made any number of mistakes heading into surgery, but I also did a few things right, if I do say so myself. I want you to know what I know now. That way, if you go into it, or you know someone who is, you can be better prepared.
I chose this song not only for its lyric (which is in the title of this blog, as always), but also because it's positive, major chords. But it made me cry a little this morning. What can I say? I'm still overly emotional and I suspect I will continue to be so until my routine is restored. And that will be at least a few weeks from now, and more likely it will be a few months.
But back to prep. There are a lot of things that you can do that will make life easier, not only for you but for your caregiver(s). Every little bit helps. I'm going to not only list my suggestions but also tell you why I'm suggesting something. Of course you're free to reject everything. You won't hurt my feelings.
Also, to recap, for those who may not have been following along, I had a tummy tuck, a breast lift and an umbilical hernia was repaired. All of these things happened 17 days ago. You may be getting one or two of these procedures, or something similar. Hence you may need to modify my suggestions to suit your own particular situation. Oh, and my apologies in advance if any of this is too icky, or it seems like TMI.
SIX MONTHS BEFORE SURGERY
* Make your appointment for surgery - I *highly* recommend getting the surgery done in the Wintertime. This is because you'll have to wear a surgical binder, and, even in 30 degree weather, you can find yourself sweating into it. Sweat's got salt in it, and your open wounds are being covered by the binder. Yeah. Ouch. Imagine the sweat when it's in the 80s. Another reason is, the binder must be worn about 2 months or so. Hence mine will come off in mid- to late-March. Just in time for lighter clothes, and the 5K running season will begin in April.
* Line up your caregiver(s) - more than one, if you can get that. Generally, your primary caregiver will be your spouse or significant other, or a parent. Ask them if it's okay, as it might not be, or they might have their own issues. And be sensitive to their needs. If your mother is 95, no matter how much she loves you and wants to do it, she's not a good choice for a primary caregiver. But she could be all right for a secondary caregiver. The secondary is to give the primary a break, perhaps allow the primary to go back to work, or get in some "me time", or just take you to the doctor on occasion. Your primary will thank you a thousand times over if you can do this for them.
* Start strength training, if you haven't already started - work EVERYTHING. Your abs are going to be out of commission for a while, so it's better if they are as fit as possible before surgery. That way, when you are able to go back to working them, they might still have some fitness. Plus well-worked abs might require less surgical intervention. Work your arms because for the first few days after surgery, that's how you're going to get in and out of bed. Work your legs because they will also assist you for getting in and out of bed. Work your chest because, if you have breast work done, you also won't be able work the chest area for a while. Hence give yourself some extra fitness there as you'll be idle for a while.
A WEEK BEFORE SURGERY
* Get your hair cut - you won't be up for it for a while, so do something nice for yourself.
* Stock up on the following medical supplies - tape, bandages (you can get some from the hospital; I got 2 weeks' worth. Problem is, I need 4 weeks' worth, possibly more), big band-aids, Bacitracin or the like, baby powder (you'll want to sprinkle this on the inside of the binder every time you put it back on), Zantac (the way you sit and lie may very well give you reflux; you can also get it from your pain meds. Ask your doctor if it's okay to take it), Maalox (same idea as Zantac, but it's not as long-lasting. Go with whatever your doctor recommends), Colace (general anesthesia and narcotic pain meds can give you wicked constipation. Again clear this with your doctor), Fleet Enema ('nough said), Monistat1 (if you need to be cathetered, you can find yourself with a urinary tract infection. Get the one-day deal even though it costs more, so that you can minimize any suffering you may encounter), Cortaid (this is anti-itch cream; healing skin can become very itchy, and scratching will reopen everything), Hydrogen peroxide (for wound care), Q-tips and/or cotton balls (to apply the hydrogen peroxide to your wounds), Extra Strength Tylenol (it's better than Aspirin or Advil because it won't make you bleed. But ask your doctor first), Mederma (this is a cream for scar care. Start applying it as soon as wounds have healed in order to minimize the appearance of scars), saline nasal spray (sneezing and nose blowing will hurt for the first few days, so avoid that by blowing a little gently but frequently. Make sure your doctor says it's okay to use this; it might not be if you have high blood pressure), multivitamins (clear these with your doctor; you'll need them at least for the first week or so as you won't be eating much, so this will give you a fighting chance to get in some nutrition) and, finally, sunscreen (any scars will have to be either covered or sunscreened for at least a good year after surgery).
* Pick up any prescriptions you've been given
* Make sure you have the following other supplies on hand - about a half a dozen pairs of panties that are one size too big (these are granny panties; be as comfortable as possible), slipper socks (you'll get them from the hospital, too; this is in case you need extras so you can wash a pair), slippers with treads, two pairs of sweat pants that are one size too big, about four tops that are maybe a size or two too big (these should be minimal fuss as you will end up sleeping in them half the time), at least one zippered sweatshirt or soft (non-itchy) cardigan (you'll get cold, then too hot, and back again, so make it easier on yourself and avoid having to raise your arms to take off this sweater or sweatshirt), extra pillows (the less you have to lean back, the happier you'll be. It'll be easier on your abs and it will minimize the risk of reflux), blankets (my parents brought over an electric blanket and it was heaven), soft cover books or crossword puzzles or magazines (you won't be able to lift -- or rest on your abs -- a heavy hardcover book), jigsaw puzzles if you like them, playing cards, and any other easy entertainment. Movies are fine, but stay away from anything that's too stressful or funny, as stress and laughing both involve your abdominal muscles. Get yourself a binder alternative, such as a girdle-type item or a stretchy camisole. Make sure these items are too big for you. Also purchase a leave-in hair conditioner spray and, if you can find it, dry shampoo. Get yourself soft-cup front-hook bras if you are having breast work done. Get a pad of paper and a bunch of good pens (you will need to record your medications and anything out of the ordinary that you're feeling. The last thing you or your caregiver needs is to be hunting around for a pad of paper or a working pen).
* Stock up on the following foods and related items - bendy straws (you'll need them to drink while you're lying down), individual yogurts if you like them (there were times when that was all I could/would eat), soups, potatoes, tea bags, flavor sticks for water (you'll need to drink a lot of water), prune juice (for obvious reasons), oatmeal (the reason for all of the soft food is, a lot of heavy chewing will also involve your abs. You'll be fine after a few days to a week, but in the beginning you'll want to avoid all that chewing), and any other plain foods you like (yes, PLAIN. Narcotic pain medications, and the anesthesia, can make you nauseous, even days later, so head that off at the pass and avoid spices).
ONE DAY BEFORE SURGERY
* Do the laundry
* Change the sheets on your bed
* Make up a separate bed for yourself, elsewhere, if you don't normally sleep alone. If your partner tosses and turns it will not be pleasant for you during the first week or so
* Put a clean towel down on where you're going to sleep
* Set up a table next to your bed, with a tissue box, a pad and paper (so that you can record which medications you're taking, and any other information that will help your doctor and caregiver), napkins, bendy straws, magazines and anything else you might need on hand
* Go out to eat (you won't be able to for a while, so treat yourself nicely)
* Fill the car(s)'s gas tank(s)
* Pay any bills and balance the checkbook, if those are your regular tasks
* Board your pets, at least for a couple of days (you might want them nearby, but if they get on and off the bed, it'll hurt. You won't be able to let them in and out, walk them or change litter, and if they get underfoot and you trip, it will REALLY hurt. So seriously consider at least a few days of pet-free living)
* You may also want to consider, if you have very small children, having them sleep over elsewhere, at least for the first night or two (teenagers and tweens can obviously fend for themselves, but preschoolers may not understand why you are moving slowly or taking forever in the bathroom, or why you can't pick them up. Plus you will mainly be sleeping for the first few days, and your primary caregiver will be occupied caring for YOU. So make it easier on your primary caregiver and make it so that s/he doesn't also have to care for the kids)
* Color your hair if you do this at home (you won't want to have the hair color rinse off in the shower over your wounds until they've completely healed)
* Remove any nail polish from both fingernails and toenails (you aren't allowed to wear any makeup to surgery, and there are things that doctors can tell by checking your fingernails, such as whether you've become cyanotic. Make life easier for your doctor and take off the polish
* Clip your fingernails and toenails (it'll be too hard to bend over and clip your toenails for a while. As for your fingernails, for the first few days after surgery, you may be absently touching your face or body a lot; it would be best if that didn't mean you were constantly, inadvertently, scratching yourself)
* Take a shower and wash your hair, shampooing twice (you won't be able to shower for a while after surgery). Oh and shave your bikini area. ALL of it. Trust me on this one; the doctor's gotta put tape somewhere. 'Nough said.
* Pack your overnight bag for the hospital and take the following items - a pair of larger panties, a large top, a large pair of sweatpants, two pairs of socks, a laundry bag, a case for your glasses (if you wear eyeglasses), your prescriptions in their original bottles (including anything you take regularly that isn't surgically-related, such as thyroid medication), a soft cup bra (only if you aren't having breast work done. If you are, they'll give you a bra to wear) and your cardigan or zip-front sweatshirt. Also bring basic toiletries: powder, deodorant, hair brush, tooth brush, tooth paste. You may get some of these things at the hospital but it's nice to have your own things.
* Take down from high shelves anything you might need. Reaching up is going to be tough for a while.
FIRST WEEK AFTER SURGERY
* Get up and walk whenever you can. You will have very little stamina but every moment up and about will help you. Try not to let your caregiver wait on you hand and foot, no matter how tempting that might be. It's better for everyone if you become as self-sufficient as possible, as soon as possible
* Drink a ton of water. Think you've had enough? Drink more. You need to flush out the anesthesia and do anything you can to prevent or at least ameliorate constipation.
* Try to stay out of stressful situations. Just because you've got a ton of family togetherness does not mean it's time to have some sort of major talk.
* Be as good and considerate a patient as you can be. You're in pain, yes, but it's not your caregiver's fault.
* Do whatever you can independently. This will not only be better for healing but it will also improve your mood. No laundry or heavy lifting of course, but you should be the only one getting yourself in and out of bed.
* Make sure to take your medications with food or milk, EVERY SINGLE TIME.
* Visit your doctor at least once. Bring your pad of paper with your medication information on it; the doctor may want a copy. Mention anything that seems of interest or at all related to the surgery. Are you feeling hot more often than you should? Is anything lopsided? Is there swelling? There will be bruising, but what if it doesn't seem to be going away? Do your wounds seem to be healing? Do they smell? Are any stitches pulling? Are the medications managing your pain well? Can you sleep at night?
TWO WEEKS AFTER SURGERY
* You'll be more independent, which is great! This should help your mood
* Start off slow with walking. No more than maybe 15 minutes at a time, and not uphill
* Do some short-distance driving. Select a time when there shouldn't be too much traffic, so as to minimize stress. Of course make sure you are not on any sort of narcotic painkiller when you drive. Tylenol is fine
* You should be able to do things like go food shopping. Take it slow and don't lift anything too heavy; leave that for your caregiver. If you can get your groceries delivered, seriously consider that. This is another reason to get the surgery done in the Winter -- since it will take longer than usual for you to put your food away, it's better for food safety if it's not super-hot in your kitchen while the food is on the counter.
* You might be seeing your doctor. Again, mention anything of interest. If you've ended up with a hematoma or seroma, ask to have the fluid aspirated out as that will help you feel better
ONE MONTH AFTER SURGERY
* With your doctor's okay, start light strength training
* Wounds should be all healed by now. If you've gotten a hematoma or seroma, it should be close to being all resolved by now
* You should be able to work if you haven't gone back already, so long as you don't engage in heavy lifting
TWO MONTHS AFTER SURGERY
* With your doctor's okay, you should be able to take off the binder for good
* You should be able to engage in heavier strength training, and you may very well be back to your pre-surgery levels by now
There's probably more about the later times, but I haven't lived them yet so I can't comment.
I do hope this helps people. I don't want any of you making my mistakes and feeling more pain and discomfort than you have to.
Friday, January 29, 2010
If some of this is icky or seems to be TMI, my apologies, but it's all relevant. The first song is my happy place song for the week. It's what I forced into my head whenever I was feeling particularly awful. It isn't that I like the song that much. It's just that it was pleasant and slow tempo and a point of focus.
1/17 RETURN HOME
I barely remember this day, I was so out of it. And I was more alert than I'd been in the hospital! My parents arrived maybe an hour after we got me home from the hospital, and the Jespah rules were posted: #1. No making me laugh. #2. No touching or sitting on the bed. #3. There is no #3. :)
For my father, who is the Consummate Jokester, Rule #1 must've been torture.
1/18 QUIET TIMES
I mainly sat around, worked on a jigsaw puzzle and slept. My parents were excellent; they cooked, they entertained and they also kept Mr. Jespah company. I ate whatever I could handle, which wasn't much.
1/19 THE ATTACK OF THE KILLER POOP
When I left the hospital, I was told that, if I didn't move my bowels by the end of the day on Tuesday (the 19th), that I'd have to return to the hospital.
Well, nature did call that morning. And called. And called. But it was tough to answer, seeing as I still had very little use of my abs for the purposes of, well, not to get too graphic, but for pushing.
It hurt. I strained. It hurt even more. Add to this the fact that I was not drinking enough water, and that the drugs I was taking could (and did) cause constipation, and it was a recipe for disaster.
Here's where it was truly vital that my parents were there. My father and my husband drove to CVS to get me some help. My mother stayed and talked to me, just to keep me calm and focused. And, frankly, I needed to not be alone. I was scared of passing out from the pain. My mother talked to me about the family, about this one and that one. It doesn't matter what she said -- she just kept me cool and I was able to keep my head together.
My father and my husband returned. Not only did they have an item manufactured by Fleet Labs (see: www.fleetlabs.com/fleet_enema
_products.php?panel=0 ), but they had saved big bucks with a coupon I had given them earlier. The whole shebang had cost them a big sixty cents.
By this time I was not truly able to appreciate the major league bargain. I just needed relief.
Now, if there was ever even the slightest thought that my husband did not mean the old "in sickness and in health" vow, that doubt, that thought, was immediately dispelled as he helped me. I will not go into details, of course, but I do want to thank him, and my parents, for their roles in it all, for helping me. It was extremely distressing. I cannot imagine what would have happened if I had been living alone. 'Nough said.
1/20 TOO MUCH TOO SOON
The previous day's activities completely wore me out. I had been getting better, but I was wiped. It was a quiet day, and I desperately needed that.
1/21 THE FIRST DOCTOR VISIT AND FOOD SHOPPING
It was time to get the stitches taken out and the drains removed.
Gawd. Thank God my mother was with me.
The removal of surgical drains is its own exquisite pain (with maybe a quarter of a minute of after-effect burning as well). It should be used at Gitmo. It is simply awful. And, I had had no idea where the drains were attached, because they were pinned to the front of my binder and up by my chest so that I wouldn't accidentally sit or lay on them. I had not followed them to their origination points. There are just some things you don't want to know.
They were actually attached to the front of the bikini area. I know you're all cringing, and I'm sorry. Fortunately it was very fast. But, my God. I never want to have THAT happen again.
Stitching was removed from around my breasts and then I was patched up there again with tiny bandages. The tape at my hips was left on for the moment.
And so I was done for the day. The doctor said it would be fine to go to Target and get me some clothes. And, in particular, I could get something like Spanx to use as a replacement for the binder, so that it could be washed.
Afterwards, we went food shopping. I had my own cart so that I could lean on it. We bought a bunch of produce and then I went to the fish counter while my folks bought some deli stuff. I saw my friend, for the first time in months. He's known me at 346 pounds, of course, but I don't think he's seen me look quite so hellish. I held onto his arm to hold myself up. It was good to see a friendly face.
Target was not crowded and my parents left me to my own devices. I kept looking for front-hook soft-cup bras. They apparently did not exist at that particular Target. And soft-cup back-hook bras only existed if you got nursing bras. Weird. I bought two nursing bras anyway, along with a stretchy camisole to hold me in and a harder stretch long-line panty thing to hold the bottom. Plus a size Large shirt so I'd have another thing to wear over the binder. And then I went to the swimsuit area and picked up something in the Juniors department (I haven't shopped in that department since I was maybe 19 or so) to remind me of why I'm doing this in the first place. We were there for maybe an hour but I was worn out.
My plans for the next day were a shower and then we'd have brunch out and see off my parents. Everyone agreed I'd come a long way. I went up and down the stairs seven times, three of them in the evening, in order to get all prepared for the following morning. Mr. Jespah and I stayed up late (well, late for me) and watched the entire Haiti special. Oh, and TOM arrived (this is important).
The above song is what ran through my head for much of the 23rd.
1/23 THE PERFECT STORM
I got up at maybe 5 AM and could not sleep any more, so I turned on the iPod and listened to music for a while, for the first time since the day before the surgery. I whispered to sing along to the songs. TOM was heavier than it had been the prior day. 6 AM came and it was time for Oxycontin. Keep in mind that this is a narcotic. I took it and the other early morning medications I'd been taking, and then sat down to do the crossword puzzles. By seven or so, everyone was out of the upstairs bathroom. I walked up the stairs and thought, hmm, it feels like the stitches are pulling over my right breast. I commented on that to Mr. Jespah. He asked if we needed to call Dr. Silverman. I said, well, I don't know. Let me shower first.
I stripped down and noticed that my right breast was significantly larger than my left. It had a crease in it from where it had pushed up against a soft-cup bra I had worn to sleep. It hurt a little to the touch. But I was hellbent on having a shower. I knew we'd have to call the doctor, but I figured it could wait. I told Mr. Jespah to stay nearby.
I took about 2/3 of the shower when I began to feel lightheaded. The shower was not that hot, but it wasn't a cold one, either. I had conditioner in my hair but had otherwise rinsed everything. But I could not hold myself up. I grasped the grab bar (so glad we had it installed when we had the tub interior redone a few years ago). I called for Mr. Jespah or perhaps he heard me -- that part is foggy. Call the doctor! Well, it's a Saturday. He came in and turned off the water and called the answering service. I was nauseous and dizzy, and sat on the side of the tub with a towel over me. I then felt slightly better and rinsed the conditioner out of my hair. That may seem vain or silly but I realized I'd be going to a doctor or a hospital soon; might as well prevent yet one more problem for myself. I finished and sat back down. I was a mess. At eight, he gave me an Oxycodone, which is for breakthrough pain and not taken on a regular basis. It's another narcotic.
I was nauseous, dizzy and cold, then hot, particularly over my right breast. I told Mr. Jespah to call an ambulance or perhaps he suggested it. Again, foggy. We got me dressed as quickly as possibly (it was in the 30s). The EMTs arrived, Arthur and Mark. They had a portable stretcher with them but we didn't use it. I held Arthur's hand as we walked down the steps. Mr. Jespah and I sat in the back of the ambulance with Arthur. Sitting was easier than lying down. Mark drove.
St. Elizabeth's is very close so it did not take long. I was brought into the Emergency Room via wheelchair and Dr. O'Neill, the doctor on call, took a look at me. He thought I had had a vasovagal episode (see: en.wikipedia.org/wiki/Vasovag
Then we went over the reasons I might've been feeling faint:
* no water except minimal amount to swallow pills
* narcotics without food
* recent surgery
* the breast thing (I'll get to that in a moment)
* warm shower raising my body's temperature
* heavy TOM meant that I was even more dehydrated and had lost more sugar
Yep. It all made perfect sense. The perfect storm of conditions to cause fainting. I had not felt faint any other day because on those other days:
* I'd had my Oxycontin and then eaten not too long afterwards
* I wasn't climbing the stairs in the morning
* I was drinking tea or cocoa in the morning
* no shower until that day
* no heavy TOM until that day
Now, as for the breast thing. Dr. O'Neill felt it was possibly a hematoma. See: en.wikipedia.org/wiki/Hematom
a . He said this is not uncommon. It was possibly a blood clot in the breast as a result from the surgery. We asked, and he confirmed: THIS CANNOT LEAD TO A STROKE.
Allow me to repeat myself.
THIS CANNOT LEAD TO A STROKE.
But it's uncomfortable, and lopsided. The swelling was slated to go down, in days or weeks. In the meantime he said I could pad the other side to even things out.
Dr. Silverman's associate, Dr. Lee, came in for a look, and brought along an intern, Jake. They took a look and agreed that it was either a hematoma or a seroma. See: en.wikipedia.org/wiki/Seroma . They confirmed that it could go away in a few days or weeks, but an interview would be fine. In the meantime, I already had a followup scheduled with Dr. Silverman for Thursday, and was told to keep that appointment.
The Nurse Kathy came in and drew blood, just to make sure that I didn't have a seriously elevated white cell count, which would be a sign of infection. My vitals had already been taken. My pressure was good, and my temperature was normal. The signs did not point toward an infection but of course this was due diligence. I also found myself with a little acid reflux, most likely due to how I was sitting/laying.
The bloodwork came back and I was cleared to go at about eleven or so. Since everything is on hospital time, this meant I didn't actually leave St. E's until around noon or so. Dr. Lee and Jake did return, and we pointed out to them that it looked like the swelling was going down a bit. That is apparently possible.
I got home (I walked out of the hospital, no wheelchair!) and had some very plain food. My parents left and Mr. Jespah and I got upstairs, where I was napped and read with an ice pack on my right breast. Someone should invent an ice pack insert for a bra. That would come in handy.
1/24 REFLUX AND WALKING
I don't normally get acid reflux, but my body decided, hey, this is something that's gonna happen. Again. Ai yi yi.
Maalox is an extraordinary invention.
Mr. Jespah and I also decided it was about time I started doing a little cardio again. We decided to start up as if I were again 346 pounds and starting from nothing. We walked around the block, a trip of no more than a quarter of a mile and probably a lot less. This normally takes me about five minutes. It took fifteen, and that was all I could possibly do. But it was a start, and it felt good to do it.
1/25 DOCTOR VISIT
Mr. Jespah left for work and I spent some time online. I have to show job search activities but they can be done online. I had finished, was actually, finally, recording my food on Spark, and otherwise winding down. The phone rang, and it was Dr. Silverman. Come on in.
I took a cab. It was a good thing I went to see the doctor, as he grabbed a needle and aspirated out about 15 cc of, er, stuff. It's still unclear whether it's actually a hematoma or a seroma, but that kind of doesn't matter. This did help some of the swelling go down but he told me that it might swell up a little bit more before it goes down in earnest. In the meantime, ice became a constant companion.
The doctor also told me that the reflux is partly due to body positioning and partly due to the narcotics. Another delightful side effect.
1/26 THE END OF THE CELEBREX
I finished up the first of the drugs and was glad to see them go, as the reflux was even worse. But I was able to be awake and alert even more. I got some rest in the afternoon and we walked again. Instead of one block taking fifteen minutes, it took twelve. Progress!
1/27 THE END OF THE OXYCONTIN
With no more Oxycontin, Extra Strength Tylenol became more important to me. I still had Oxycodone left but decided I only wanted it for nights.
1/28 INTERVIEW AND DOCTOR VISIT
In a sure mark of insanity, I agreed to a job interview at 10 AM, and a doctor visit at 4 PM. But both, surprisingly enough, turned out to be good ideas.
The interview went well, not only for the two-hour conversation I had with the three principals but also because I was wearing something a lot nicer than sweats and sneakers, and did not lose stamina. It felt good and vital to do something so normal. I crossed my legs and thought, that's normal, that's good. I do not know yet how I did. Details to follow if the results are positive.
When I got home, my intention was to change, eat and rest. But there was a phone message: could I come in earlier? Sure. So the plans were altered to change clothes and eat but don't rest.
The doctor took out more fluid. This time, 50 cc! 50 cc = 0.05 Liters, AKA about 2/10 of an ounce. That may not seem like a lot, but the projection was maybe an inch. Yep. Ow. It was a huge relief to get that out of there. There was still a possibility of more fluid, or of fluid in the other breast. But for the time, things felt infinitely better.
He also told me that my navel, which is still kind of, er, damp, will be so for another 2 weeks or so. Just keep cleaning and changing band aids. He removed one last stitch that must have been missed the last time, and took off all of the tape. I was left with the band aid over my navel and two surgical pads on the underside of each breast (those are just a little sore and red but otherwise okay). Once all of that heals, I'm done with all of that, and all I'll have to do is wear the binder or its equivalent (the stretchy camisole and stretchy shorts I was wearing proved to be decent substitutes).
I will be wearing the surgical binder or an equivalent until mid-March, but can (and will!) walk before then. Strength training will wait until late February or so. I had originally planned on returning to my gym on Monday, February 1st, but that will end up happening later as I'd like to have my navel completely healed before then, and probably will wait to have my next doctor visit (February 18th) accomplished by then. We'll see (the doctor had said that I'd probably only be able to tolerate about 10 or 15 minutes at the gym to start, anyway).
I'd like to blog about other things but at some point I will be blogging about what I've learned from this experience. That will be Part 3 and may or may not be next week's topic. Plus I'd like to cover my return to fitness, which will take considerably longer. Those things are for another day. Thank you all for your kind attention and good wishes. It means a great deal to me.
Wednesday, January 20, 2010
There are going to be at least three of these, perhaps four or even five as I sort out and process everything that is continuing to happen to me. But I want you to know -- while it is fresh in my mind. You need to know this, and I need to tell you. I NEED to tell you.
Some things are going to be alarming. Some will be gross. It is very personal. But I want to -- I insist -- on laying it out for you. This naked, shivering truth.
I had the following three procedures done on the 15th: breast lift, umbilical hernia repair and tummy tuck. Of course most people don't have all three done at once or even at all. I've been thinking for quite a while about whether if, knowing what I know now, I would have done all or most of these things, and whether I would have done them all at once. Today, my conclusion is that I'd still do it. Same way. But there have been many times I've thought of doing things differently in the past few days. Anyway, here's my tale.
I went in for a consultation about six months ago. I was interested in breast reduction, actually, and didn't even know I had a hernia. The doctor took one look at me and said, if we reduce you, you'll end up looking like a teenaged boy. Not that there's anything wrong with that, but that's not how I wanted to go. Hence I decided to go for the lift. The bottom line, even though, of all three procedures it's probably the one most informed by vanity, the lift is something I want because I've had sagging breasts for twenty freakin' years. I looked middle aged when I was still young. Now that I'm middle aged, I'd like to look young. Or at least younger. Hey, humor me. :)
So I said yes to all three.
Before going to the hospital, I did the following: I packed an overnight bag. VERY IMPORTANT: I included a top and sweat pants that were too big for me. I was a Medium before I walked into the hospital. The top was an old 2X and the sweats were XL. Also, we arranged for my parents to come up on Sunday. This would assure that they'd be around to take over for my husband so that he could return to work, plus he does not drive so they would be able to help with emergencies. And to keep him company and spot him. It's too much work for one person.
We also cooked some bean soup in advance and bought some easy foods like deli sliced turkey and little individual Greek yogurts. I cut up tons of produce for future salads. We were set.
Our expectation was that I would not even stay overnight. Ha! How wrong we were.
Oh yes, one more thing. Because I am looking for work, I arranged for a job interview (an in-person; I had already talked on the phone to the Hiring Manager) for today. Insane.
We arrived early (we walked to the hospital; it's that close). The doctor was there and I changed into the lovely attire they give you. And then the next thing the doctor did was, he grabbed a purple magic marker and marked me up. Lines on my breasts. On my belly. Around my navel. Under the breasts. To the sides of my hips. Purple everywhere.
Then I met the anesthesiologist and signed more consent forms.
I'd like to right now acknowledge all of the amazing people who cared for me: Dr. Richard Silverman (my surgeon); Dr. Derek Keller (anesthesiologist); Tom (surgical nurse); Kaye (ICU nurse); Katie (overnight nurse, both nights); Leanne (day shift, first day, first shift); Jackie (day shift, first day, second shift); Courtney (fill-in nurse, both days) and Kelli (day shift, second day). See all those days? Oh yeah. My plan to be outta there without an overnight stay was, shall we say, overly optimistic.
Back to our story. I signed the forms and they wheeled me in, or at least I assume that's what happened, as things get foggy. Shots in the arm, in the IV line. Lights out. I learned later that Dr. S. did me from the top down. And, for the breast surgery, I was up on my elbows a lot, so they hurt later.
I woke up in ICU. Mr. Jespah was there; so was Dr. S and Kaye. Dr. S told me he'd removed six pounds of flesh. The entire apron of skin around my belly was gone. He had stitched down my abs. I was wearing a soft truss and a kind of surgical support bra. Inside the bra were the ends of two drains, attached and hanging down on the right side. Everything was taped up snugger than a Christmas package.
Kaye kept talking to me. She was unbelievable. She did whatever was needed. Mr. J would come in and out (I don't think he was allowed to constantly stay in the area). Kaye, of course, had to stay. I could hear machines and the other ICU nurse, Carol, talking to the patient in the next, I dunno, area. They aren't really rooms. More like booths, I suppose.
Then Kaye tried to get me to sit up. We were all still of the opinion that I might head home that night (it was getting late, 8 PM?).
If you were wondering about today's blog song and why I chose it, here's why. The song, if you cannot get to Youtube, is The Beatles' "Twist and Shout".
Because that's exactly what I did.
I have never felt such agony. You don't know what your abs do until they hurt like THAT.
Kaye and I tried to move me. I screamed. Ixnay on THAT. I then apologized. She said I didn't have to. I said, I just don't want to alarm the person in the next room. And it's true. I never knew their name or even if they were male or female. But I hope I didn't scare Carol's (the other ICU nurse) patient. Things are scary enough.
The decision was immediately made for me to stay overnight. Kaye called Marco to wheel me to seventh floor West in the Seton wing. St. Elizabeth's Hospital is a Catholic hospital, so the wards are named for various prominent Catholics. Seton is of course Elizabeth Seton, the first American Catholic Saint. I asked Marco if he was an immigrant from Italy. No, Costa Rica. He got me in, safe and sound and wished me well.
DAY AFTER SURGERY
This is where I met Katie, a pretty, young woman, probably in her twenties. It was maybe midnight on the 16th. I did a lot of sleeping, of course, as is to be expected. The first alarming thing was being unable to urinate. Not a happy thing. Not at all.
If you are reading this and you can urinate on your own, I know this sounds silly but, flush an extra time and think of people who cannot. Because, let me tell you, when you can't, it is just awful. Not just the feeling of fullness. It's also the feeling of utter helplessness. Yes, Katie had the unenviable task of having to catheter me.
Leanne took over in the morning. Leanne is the kind of person who calls everyone honey and love and dear. We went through all sorts of pain medications. Oxycontin (yes, that's what Rush Limbaugh is addicted to). Celebrex. Percocet. Over and over. No real relief. I was never truly pain free. They asked me to rate my pain on a scale of one to ten, with ten being agony. Trying to move in ICU was a damned 11, I swear. But during the day, even doped up, I was at a six or so.
The urination thing was still at issue. Leanne brought in Jackie. They talked. Then they brought over the Resident on call, who introduced himself and shook my hand with a grip of iron. That would have been fine if I'd been interviewing him. But lying there in a hospital bed, that just hurt like the Dickens. Yes, you use your abs to shake hands. Jackie insisted that I get cathetered again, and they stop this nonsense.
She eventually won out and came up close to me and whispered. "It's because I'm a b----." That made me smile. But no laughing. Because, you guessed it, you use your abs to laugh.
Jackie took over for a while, and was in and out with Courtney. Courtney was another lovely young woman. Jackie and Leanne were both a bit older, maybe my age. I think they were all Massachusetts natives. Mr. J was around by then (yes, for the second cathetering, too, a sight that must have been a wonder to behold). The doctor had been in, too, and his verdict was, I had to pass two tests: urinating and walking (hopefully not at the same time!). If I could not do both, I'd have to stay.
Mr. J left again (he needed to clean house and set up the downstairs couch for me, plus he needed to email my interviewer and tell them I wouldn't be able to make it). I again attempted urination. Sitting there for an hour was just not a fun time at all. But I was otherwise more alert, eating meals and talking with the staff. The phone rang a few times. I talked to my parents and my brother. Eventually Mr. J returned and I again made the attempt (this was on a commode chair so that I wouldn't have to walk much). With the water running in the bathroom, and with a lot of straining and prayer, suddenly there were happy sounds.
Mr. J wanted to gently high five me but, of course, you use your abs to high five.
There was a football game on, and so Mr. J turned it on without the sound. Even though I no longer had a roommate (when I'd first arrived, there'd been a Filipino woman with some sort of lung function issue, and diabetes -- I kept hearing Katie talking to her about her sugar numbers -- but she was gone by then.), the door was open and we didn't want to disturb the other patients. Dinner was served. Good Lord, coconut cream pie. The first pie I'd had in two years. Weird.
Naturally I did not count calories or log a damned thing. I drank scads of water, and the first thing I had after surgery was a small can of diet ginger ale that Katie gave me. Wow. The best stuff I'd ever tasted. I figure my calories were pretty much in line with what I've been eating, since there were no snacks. It doesn't matter.
I finally sent Mr. J home late that night. He needed the sleep desperately; I'd seen him dozing off in the chair.
SUNDAY MORNING COMING DOWN
The next day, my arms were really starting to hurt me. This was because, since I could finally eliminate on my own, I was getting up every few hours to do just that. This involved using one of those things over the bed -- I forget what they're called. But they look sort of like one of an Olympic male gymnast's rings. I'd pull myself up, swing over as well as I could, and then flop onto the commode, do whatever, and then the return trip was harder as the ring was not in a good position. Back and forth, forth and back, over and over again. Since I could not push hard (those pesky abs again!), I could not eliminate much. Hence all of the trips. But, every time I did it, things got better, or I got faster.
Kelli came in, and we decided to do some walking. We took a tour of the floor and then she got me to the Interfaith Chapel (next door to my room), where I read the bible a bit. Joseph and his brothers. I know the story but it reminded me of dreams and their meanings. And my gosh, Jacob's family was quite a blended family. But the Brady Bunch they were not.
I had accomplished my goals. I could urinate and I could walk. It was time to go.
Mr. J of course came for me. The guy who needed to wheel me out seemed to be going fast; that was scary to me. It's odd what you're afraid of, but that terrified me.
We got into the cab. The World's Most Wonderful Cab Driver helped me in. I didn't know the man, of course, and held his hand like a long-lost friend. The ride was short, cost maybe three dollars. Mr. J gave him a ten. Here, keep it all.
Going up about a dozen steps to our home was easier and faster than I'd feared. The open sleeper couch looked amazing. My parents were enroute. I was exhausted and fell into bed and awaited the next part of the adventure.
If this ending seems rushed; it is. I cannot sit still for too long. More to come in a few days. Thank you for reading.
Friday, January 15, 2010
Surgery is today. I have been thinking of it for months, and the day is finally here. It's set for 12:30 and we've got to be at the hospital at 10:30. I'm certain I'll be nutty so this is a shot at coherence.
My dreams have been dominated by visions of losses of control. Not necessarily specifically medically-related, but there is a fear of putting myself into others' hands. I have always been this way. Yes, I am a Control Freak. Know thyself, right?
I put some stock in dreams, even odd and obscure ones, perhaps more than I should, but I do, and it has been that way since I was a scared seven-year-old who thought she wouldn't fit in.
One recent dream was of opening up a mess kit, you know the kind with nesting utensils, and somehow the flat knife was mechanized and spun. Tried as I might, I could not stop it, and I was becoming more and more afraid that it would cut and harm me. Finally, somehow, I took my eyes off the terrifying spinning knife and cast them on the floor; it was the old, ratty, linty carpet from when we lived in Mineola over fifteen years ago. I somehow flipped the wheeling knife over and buried it in the carpet. It stopped, the mechanism jamming due to the presence of the lint. So it was a happy ending I suppose, but it took damned long for the solution to present itself and, in the meantime, fear held my throat and my heart in its grip.
I know that my surgeon is good. I know that the hospital is good. But there is a nagging fear that somehow this will be the exception, and oxygen will fail to go to my brain and I'll become a vegetable. Or that I'll die on the table.
I cannot help these fears, no matter how much I tamp them down with other activities and concerns and thoughts, beliefs and feelings. And, in the meantime, I also am in the position of managing others' feelings. Sometimes it's all too much.
Guitars and major chords tend to soothe me, so I thought of Sugar Ray immediately. And then when I really listened to "Someday", I got it.
I hope that this is not the end, but stranger things have happened and I am mentally prepared even if my dreams are trying to tell me otherwise. So before I go, and before whatever is going to happen, happens, I want to thank you. Because you really have always been there for me. I could not have gotten here without you.
Perhaps I am sentimental, and overly dramatic. Feelings are sloppy and indulgent and don't always make much sense. But I hope that what I feel for all of you has shone through, even amidst the muddiness of my own fears and phobias and idiosyncrasies.
You have always been there for me. If I have said anything at all, at any time, let that be what is front and center, and remembered.
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