Wednesday, June 27, 2012

2 weeks Post Op

Wow. I totally meant to do a weekly update after surgery in case this helps anyone out there... but... I was on an airplane! Yes, I booked my return flight home exactly 7 days after the surgery. They said it was a 5-7 day hospital stay and I was hoping to make that and didn't want to miss a flight if I booked too early. Then after my first night post-op... I was worried I wouldn't even make my 7 day flight. I did. Things got better so I will break down the first week by days and then summarize the last week I've had at home.

June 14 - Post Op Day 1
I was still on an epidural, catheter, IV and hemovac drain. I was still pretty numb from the night before and doing fairly well. I could still feel it hurting fairly good every couple hours and would get a dose of dilaudid to help with the break through pain. I was in the CPM machine which was bending my hip to 25 degrees (they were supposed to start at 30 but it hurt too much). It did feel good to move it though. P/T came and had me sit up on the bed. I was pretty excited that it felt better than I thought but I was still pretty exhausted. I could feel the muscles in my thigh spasm-ing and I was also pretty itchy. They gave me Vistaril - which was supposed to help with the itching and relaxing the muscles. I also had issues with my IV. The first line they put in... hurt so bad every time they put anything new in it. Also, I had an emergency line put in the night before when I was crashing. Well today they came in and put another line in. They wanted one good main line and then another emergency line.

(IV #4 - the one that finally worked) Untitled (Hip CPM machine - side view) imagejpeg_2_3, Uploaded from the Photobucket Android App (Incision & Drain gauze/tubing) Uploaded from the Photobucket Android App
June 15 Post Op Day 2
Still on the epi, cath, IV and drain. This day was very similar. P/T came and had me stand up next to the bed with the use of a walker. I was unsure how that would go since I was still hooked up to the epidural and had only partial feeling in my legs. It went ok but I got pretty dizzy and it took it out of me. Turns out that my blood levels were very low - on the verge of transfusion. The nurses said as long as I was alert and hadn't passed out that they wouldn't probably transfuse but that was a reason I was so weak and dizzy. I also had no appetite. I didn't quite expect this. I had figured that after not eating before surgery and the excitement of the first night - understandable. But even on day 1 I didn't really feel like eating. Well Day 2... I still couldn't finish anything and this wasn't helping my blood levels but I was trying. Before bed I took my first does of long acting oral pain meds.

 June 16 Post Op Day 3
Everything came out. I was finally able to see the incision without the bandages. The epidural was removed and the IV line removed but not taken off. The drain bag was also removed and about 8 hours later, the catheter. I couldn't believe how long the drain wires were that came out of me (eek) and my scar was super long but looked pretty good! Dr. Mayo uses internal dissolving stitches and a glue to seal the incision. I had to get my first shot of blood thinners (Fragmen). I will have to inject myself for 21 days after I leave the hospital. I also took my first short acting pain meds. I was feeling pretty good most of the day - thought I HAD THIS. I was able to get up, take a few steps and go to the bathroom with a walker and a bit of assistance. I even walked 50 ft out in the hall - I thought I was ROCKIN IT.

(3 days) Uploaded from the Photobucket Android App (Hip CPM) Uploaded from the Photobucket Android App
 Well about 3am... I didn't "have it" anymore. The epidural was continuing to wear off and I was an in an increasing amount of pain. The nurse came in and came me another dose of dilaudid which helped initially but not for long.

June 17 Post Op Day 4
My surgeon's nurse came in to check in on me and I was still in an significant amount of pain. She adjusted the dose of my short acting oral pain meds and sometime in the middle of the day I FINALLY started to NOT HURT. It was a long day and I was exhausted but eager to continue with recovery. P/T offered to let me start using my crutches and I was nervous and anxious but tried it anyway. I knew I could walk with the walker but only had my crutches to go home with. I felt a little shaky - sometimes a lot... and dizzy but I was sitting upright for longer periods at a time and was able to was able to walk the same 50 ft with my crutches. Blood levels were still low and I still had a very limited appetite.

June 18 Post Op Day 5
Steps! We tried walking steps in P/T. I was able to do 1, up & down! It seems so simple and even as the therapist was raving about how well I was doing - it felt small even though my hip and body ached and I knew that it was really was a good accomplishment. Even if I still got dizzy and needed a wheelchair to get back to my room (I walked all the way down and around the hall to get to the stair). Blood pressure still lower but good and stable. Blood levels still low. Appetite still MIA. Drs and Nurses were happy with my progress and were suggesting that I might be ready for discharge the next day. They were a little concerned with my toileting habits. I was up and using it independently just fine but I hadn't had a BM yet. (Great to talk about, I know... TMI but they get super worked up about it). I am not a very "regular" person so to add anesthesia, narcotics and low activity level... I wasn't worried.

June 19 Post Op Day 6
I walked up/down a flight of steps with my crutches and P/T said I was doing AMAZING and they weren't worried at all about how I would do when I got out. I just needed to take it slow and mind my restrictions (no weight bearing, well only 40 lbs, no straight leg lifts and no abductions for 8 weeks). Miralax, stool softeners, Milk of Magnesia... still nothing. In order to calm everyone down and make sure that I would make my plane ride home the next day I finally gave in... yuck. a suppository. It worked and everything was fine and everyone happy. Dr. Mayo said that I could have probably been released that day but since I was flying out in the morning - they kept me just to make sure and to make my med schedule line up the best way for the flight.

(6 days) Uploaded from the Photobucket Android App Uploaded from the Photobucket Android App
June 20 Post Op Day 7 - Flying home on AK Air 3.5 hour plane ride!!!!
I flew with my husband and kids. We had seats C, D, E  & F. I had tried to get a first class ticket or bulkhead but it didn't work. I debated quite a bit about taking the aisle seat so that I would have the aisle to stretch my op leg out into the aisle for relief but I was so scared about someone hitting it. So I ended up taking the window seat (op leg next to window) but I had my littlest son sit next to me, my husband in the aisle by me and my 8 year old in the aisle across from her dad. I took 3 little travel pillows. I angled myself into the corner of the row with two pillows behind me and extended my leg/hip out under the middle seat next to me. I was "V'd" into the window seat basically and I had the room because I was sitting next to a 4 year old who was sleeping on my lap. I was able to easily flex my foot to pump blood and bend/straighten my leg throughout the flight so overall I felt WAY better just sitting than I anticipated which was HUGE. So my advice...
request a wheelchair - do not walk and don't wait until you are there to decide you need it, make sure you have quite a bit extra time - that last thing you want is to be rushed or stressed when in pain,
get a seat with extra legroom if you can (buy an extra seat if you can afford it, travel with someone who will let you encroach on their room and keep you operated side protected from others and carts),
have your meds with you - take them as close to boarding as possible to maximize the effects as you settle into the flight and make sure the flight attendants know you just had surgery - mine were very helpful and brought me ice and helped hold the bathroom door.

Post Op - Week 2
I didn't realize how "unfriendly" my house was going to be until I got home. We definitely need the toilet eat riser, grab bars and the hospital bed with a trapeze. I also needed to set up a little "recovery area" with a table for drinks, phones, remotes, etc... It took a day or so but I am now in a bit of a groove with it. I am sleeping in my bed. My sweet husband carries my pillows and CPM machine from my bed to the hospital bed every morning. He also moves my water, pills & ice. I have coffee and breakfast. I get up and walk around the living room and go to the bathroom every hour or so. I have gone down our stairs and sat in a reclining camp chair several days for a couple hours. I have also started walking outside in the yard - taking laps around the house to get used to more walking on uneven ground.

My days go up/down, physically and emotionally. 6 more weeks of this. Wow. But I am here. Today I think we will try an outing. I will see how I do going to a store and operating an electronic cart for an hour or so... Wish me luck!

(14 days post op) Uploaded from the Photobucket Android App

Thursday, June 14, 2012

Post-OP Summary

The surgery went well from what I hear. They were able to cut and rotate the acetabulum to a correct position. My labrum was not only torn but almost completed detached. He sutured it back but labral repairs aren't extremely successful. He also shaved down the bone on my femoral neck. The surgery took from 8-2:30 and I was in recovery for about 3 hours. Mostly waiting for my room to be ready. I was doing pretty well in recovery, I thought. however...

My epidural doesn't completely cover the surgical incision. I can feel the top two inches and it hurts. So the anesthesiologist came in to "play" with it. She wanted to up the dose on it to see if that numbed up farther or if they just weren't going to be able to control it with the epidural. She gave me a dose of whatever it was with lidocaine. It felt better after about 10 minutes so she decided to give me another dose. About 10 minutes after that - so 20 minutes in I got really nauseous and started dry heaving a bit which hurt so they gave me vial of something for the nausea & some benedryl to control the reaction I was having. Well a couple minutes after that I felt super bad. I felt numb almost up to my chest and told my mom something was wrong.

I suddenly felt like I couldn't talk or breathe. Matt hit the call button and went outside to find someone. I looked at my mom again and started to panic - I couldn't breathe so she left the room too. A nurse rushed in and hit the thing to take my vitals. My oxygen sat level was in the 80s. My blood pressure was 58/54 and my heart rate was over 200. Mom grabbed the kids (who were in the room watching TV) and took them out to "go for a walk." The nurse hit the rapid response/code button and within seconds there were like 20 people in the room. They were lowering the bed, wheeling in a crash cart, hooking me up to oxygen, and telling me to squeeze their hands. I started to black out. I couldn't really see and was super hot. The nurse was shaking my hand and yelling "stay with me, Rebekah, look at me." I remember thinking OMG I am going to pass out and NOT wake back up. I honestly thought I was dying.

I was strapped to an EKG and given a dose of something else in a new IV- they started another one on the other arm. I faded in and out of consciousness and the details are fuzzy but I remember Matt finally coming over and replacing the nurse who was holding my hand. I couldn't help it or stop it... the tears started flowing. I was so overwhelmed. Apparently my diaphragm was paralyzed. It was horrible. The anesthesiologist had to give me several other drugs and monitor my blood pressure every 3 minutes for 30 minutes before it started staying in the 90s over 60s. It has pretty much stabilized today but my blood counts are low too so.... lots of slow movements and dizziness here. I was able to sit at the edge of the bed for about 2 minutes before getting dizzy and needing to lay down again so I didn't pass out. Soooo... exciting huh?

 This was AFTER my daughter passed out when they were clearing my drain bag. Yup she is like her dad and faints at the sight of blood. She hit her head and they had to file an incident report. I am feeling okay right now and seem to be staying on top of my pain with a syringe of dilaudid every 8 hours or so, I guess I should be pretty grateful for that but please let the rest of this recovery be NOTHING like the first 24 hours!!

Tuesday, June 12, 2012

calm before the storm.

My surgery is in less than 12 hours now. I finished all my pre-op appointments, spent some time in a hot tub and am sitting in a hotel room. I am anxious, don't get me wrong, but right now... I feel fairly calm. I was a hot mess of nerves this afternoon and I know I have been snapping at mom, the Mr. and the kiddos - I hate that, but can't shake the 'on-edge' feeling. Right now I don't even know to actually write out how I am feeling. Partially - I am terrified. I have spent the better part of year wanting this fixed, the last six months talking myself into it... and now here I am. Dr. Mayo walked in smiling - I felt comfortable right away. He even joked about me turning and running and trust me, I wanted to. I still do. I told him that he really shouldn't let me have an out. I also got to meet a fellow hip chick, Tessa. It was fairly comforting to meet her even with some of the "out of the norm" stuff she had with her PAO. So officially... tomorrow I will be having a periacetabular osteotomy, labral repair/debridement, and a femoral neck resurfacing... Yikes. Alright... off to wipe myself down with weird antiseptic wipes and not get to use lotion, deodorant or make-up. I will be sticky, smelly and barefaced. Otherwise... though, I feel fairly calm.