“post-op”. . .

by mulberryshoots

DSC_4871My multiple fracture ankle surgery took place on Wednesday with a knee nerve block anesthesia as well as being knocked out. The surgeon noted afterwards to G. that instead of two incisions, only one was needed; and while two plates were inserted, the two pins he thought might be needed were not. So it sounded like the surgery went well with less impact than might have been anticipated.

What I have learned since the surgery is that the fallout from having the procedure itself are all the side effects and potential complications one experiences: a sore throat from intubation; fluid in the lungs from the anesthesia which can develop into pneumonia; avoidance of post-operative infection (two rounds of IV antiobiotics,) avoidance of clots forming into aneurysms or causing a stroke, to mention the major ones. Just this little list describes the potentially dangerous shoals that recovery navigates back to health. Not to mention over-administration of strong narcotic drugs as painkillers that create nausea, anxiety and grogginess. In the middle of the night when I noticed that my blood pressure was dropping below 100, it was hard to sleep even though the nurses made little notice of it.

My constitution is highly insensitive to pain, it seems (I have a high pain threshhold) but also quickly reacts to any kind of medication. When I am prescribed two tablets, four times a day; a HALF tablet each time takes the edge off the pain. Thus, over some periods of four hours overnight in the hospital, I was given SIX TIMES the amount of dosage I had adjusted to at home. When I mentioned this later to the anesthesiologists who dropped by, they said that the proper dosage would have been to correlate my pain score to the dosage. Instead, the nurse gave me the maximum each time (and for me over the maximum dosage) that they could have. Don’t people sometimes O.D. on narcotic painkillers?  I also had had no food for over twenty four hours and the painkillers were taken on an empty stomach. I was glad to be discharged in the afternoon that day and avoided staying another night unable to sleep when they wake you up every hour to take your vital signs.

Once home on the next day, the private nursing group sent over a nurse to intake my information, show me how to self-inject the blood thinner and also helped me to understand how to clear the fluid out of my lungs. Later in the afternoon, a physical therapist, who had been doing PT since 1978 visited and watched me maneuver around using my wheelchair and observing how I got onto the couch and into bed at night. He gave me some arm strengthening exercises so that when I graduate to using a walker and arm crutches, my arms will be a little stronger. I knew we would get along when the first question he asked me was about the pianos in the house.

G. noticed that a pair of cardinals has been singing everyday and flutters around the house. I’m buoyed up by that–and our little singing canary is doing fine also. On another note, I just started reading a book that I’m enjoying a lot. It’s called “Love and War”  jointly written by Mary Matalin and James Carville. It describes the twenty years of their marriage and leaving Washington for Louisiana five years ago. On the day Carville arrived and they drove to a local grocery store, he received a phone call that his very good friend, Tim Russert, had died. It was a deep blow as the families were close, Luke Russert was described as being like the son they didn’t have along with the two daughters they did have. The Mary and James excerpts in the book are almost seamless, a literary writing and editing feat given that the content of their writing was so diverse emanating from their ideological differences. I am reminded of an engraving on a gold ring I have that says, “amor vincit omnia” or, “love conquers all.” Fascinating reading. Also witty, warm, sincere and candid. The best kind of writing to have on hand while one is dealing with inconvenience and pain.

It has also occurred to me that I survived the surgery, as nightmare an experience as the post-operative night in the hospital was; and that I will keep on living. My daughters are coming for a visit tonight and will stay a day or two. We will have homestyle Chinese cooking and snack while we watch movies together. One of them will be “Bed of Roses” with Christian Slater and Mary Stuart Masterson because one of my orthopedic residents who helped put my leg back together again in the ER originally looks a lot like Christian Slater.

So that’s it for now. It’s always what you don’t know about that surprises you in the end: sort of like childbirth. And come to think of it, had they told me about all of the side-effects, it wouldn’t have helped either to know ahead of time that I would have these post-op contingencies to deal with. The human carelessness of giving me so much Oxycodone on an empty stomach was avoidable though. Maybe I’ll be in a better mood the next post I write. Hope so.