Keep Your Eye on the Real Prize

By , SparkPeople Blogger
Expectations are powerful things. They can turn relatively easy challenges into incomprehensible failures or transform the most difficult situations into interesting and rewarding opportunities. What you get out of your own efforts depends almost entirely on what you expect to achieve in any given situation.

The foundation for getting the most out of yourself and your own efforts in any situation is continually choosing and adjusting your expectations so that your strategies and actions match up well with what you can realistically achieve in that situation. Otherwise, you'll end up spinning your wheels trying to achieve the impossible, or settling for a lot less than you could accomplish, or never bothering to find out what really matters to you.

My recent experience with some medical problems and a pretty long hospital stay might provide a good, concrete example of this principle in action. If not, this blog will at least give you the opportunity to introduce yourself to my Inner Pig, who will likely be appearing here in future blogs.

When I went into the hospital a couple of weeks ago for open heart surgery to replace a defective heart valve, I expected that, aside from coping with my phobia of needles and my extreme reluctance to be seen in a Size 6 hospital gown, the most difficult part of this experience for me would be finding the patience to give myself time to recover gradually, and avoid the desire to do too much, too soon. I knew I was in pretty good shape physically and mentally, and I expected that the surgery would go smoothly and I’d be back home pretty quickly, fighting the urge to test out my new heart valve on a nice hard bike ride before my incisions had even healed.

And in fact that’s exactly how things went—for the first week. I was out of the Intensive Care Unit on the first day, out of the step-down unit in two more days, and ready and eager to give back my hospital gown and go home on day 6. That’s not to say that everything was a piece of cake-- there were a few challenges that were a little harder than I imagined they would be. Like breathing. And moving. And finding a position to sleep in that didn't make me hurt everywhere.

Don’t believe anyone who tells you that waking up with a breathing tube still in your throat is “no big deal.” If possible, make sure no family or friends see you until this has been removed--this will only scare them and make you feel worse. And don’t imagine for even a minute that you’re such a nice person that you would never seriously consider strangling that sadistic respiratory therapist who comes around every two hours, all night long to wake you up and make you breathe into that stupid little tube for 10 minutes. By Day 2 you’ll be looking for places you can stash the body where it won’t be found until you’re safely back at home, and by day 4 it will just be a question of whether you get discharged before you snap and do the deed. Just keep in mind that none of this makes you a bad person, as long as you don’t actually act on these fantasies.

Other than these and a few other challenges (did I mention that you have a very grumpy roommate for most of your stay?), week one went well enough, and I arrived back home sure that the worst was over. But after my first day at home things started going downhill quickly.

First, my right leg started swelling up fast, and I began having these incredibly intense and painful burning sensations running down my thigh every time I moved. Then I woke up in the middle of the night with my chest and my back aching very badly, and not from the incisions or sore muscles. So, it was back to the hospital for me, by ambulance.

After a long and somewhat terrifying night of being shuffled back and forth between basement rooms filled with large, noisy MRI, CT, X-Ray , echocardiograph, and nuclear perfusion machines, it was finally determined that no one really knew what had gone wrong. There was no sign of blood clots in my legs or lungs, or deep vein thrombosis; but there was some crackling in my lungs, so maybe I was coming down with pneumonia. There was a small hematoma (basically, a bruise) in my upper thigh near where one of the incisions had been for my surgery, but it didn’t look significant enough to explain all the swelling in that leg, much less the extreme nerve pain. And the cardiac enzyme that’s often used to tell when chest pain is coming from a heart attack instead of some other kind of problem was elevated, but that apparently doesn’t mean much so soon after major heart surgery. The doctor said "I wouldn't call this a heart attack, exactly, but I can't say it wasn't, either." In either case, the chest and back pain was gone by now. And the groin incision might have irritated a leg nerve and caused some swelling—or not. There was no fever or other sign of infection. But the swelling and nerve pain was definitely still there, so the decision was to admit me back into the hospital for observation, and see if anything became more clear the next day.

Unfortunately, it didn’t. The docs kept me in the hospital for three more days, until everyone was pretty sure my condition was stable, but we never did figure out what exactly had happened, why my leg was still swollen and painful, or where things should go from here. I came home again last Monday. At this point, I still can’t stand or walk without a lot of pain. Sitting in a chair or lying in bed doesn’t bother me, and I can ride a bike for short distances at very moderate speeds without trouble. I’m up to about 4 miles per day at this point, with more to come, and I’ll be back at work full-time on Monday as originally planned.

The fluid retention in my leg does seem to be going down slowly. I’m still about 8 pounds heavier than I was before surgery, but that’s down from 34 pounds at the high point (that was a shocker when I saw the nurse write that number down in my chart, lol), and it’s all located in my right leg, as far as I can tell, which looks more like a tree trunk than a leg right now. The pain hasn’t changed significantly, and no one is making predictions about if or when it will. The hope is that it’s just a simple paresthesia that will clear up on its own soon, and not a permanent nerve injury, but it’s just too early to tell.

The good news is that I seem to be handling this pretty well emotionally, so far at least.

I’m not happy about the prospect of being in pain for potentially quite a bit longer than I expected, or having to live with an "exercise lite" approach for quite a while, but it doesn’t feel like the end of the world either. There are some things I can do right now, for both exercise and pleasure, as long as I don’t get caught in the trap of putting everything on hold until my leg problem gets sorted out. And if the leg problem doesn’t heal on its own, there are some things the doctors can try. There’s no reason for me to make assumptions about how that’s going to turn out at this point, and especially not to spin out a bunch of worst-case scenarios, so I’m doing my best not to do any of that.

All in all, I think I’m doing a pretty good job of keeping my eye on the real prize, which is doing the best I can with what I’ve got to work with each day, one day and one choice at a time. That's where real satisfaction comes from, and it doesn’t really matter whether what I can actually do is more or less than what I expected.

Does it?

The one concern I haven’t quite come to terms with is how to describe my post-surgery self. I used to be about 85% Irish and 15% mutt. Now I’m 85% Irish, 14% mutt, and 1% pig. My new heart valve was provided by some pig who gave his all so I could live, and I certainly feel like it’s important to acknowledge his contribution in some way. I stopped eating pigs a while ago, so I’m thinking that maybe I should give my new heart valve an appropriate name, but I’m having trouble coming up with one I like. My Piggily just doesn’t do it, you know?

Do you have any suggestions?