Tuesday, March 29, 2011

Working Back Through the Intervening Days

So what happened after coming out of surgery and leaving hospital on day 7? Well quite a lot really.
I vaguely remember this insistent voice in recovery saying "what's your pain now dear?". The scale is 1 (no pain) to 10 (unbearable pain, worst you've ever felt). I remember answering "7" every time. It sounded like a good number in my semi-conscious state. The unexpected result was that I arrived on the ward from recovery with 40mg of morphine on board and quite quickly accumulated another 4mg. Life was pretty painless at that stage!!
I also had various tubes and lines in place. A venous line into the back of my left hand, put there by Charles when he anaesthetised me and now being used for the Patient Controlled Analgesia (PCA). This is a marvellous device that delivers 2mg of morphine every time you press the button, limited to 1 press every 5 minutes and 95mg total over some time period which I never worked out.
I also had an arterial line in my left wrist, which soon came out leaving a big bruise; a drain from the wound on my back and an in-dwelling catheter in my bladder to remove the need to get up to go to the loo; and finally a further "spare" venous line in the crook of my left elbow.
The wound was dressed with a waterproof dressing which was in turn covered with a heavy "cushioned" dressing of something like rubber or neoprene. I never suffered the slightest pain from the suture line, however all tapes and adhesives give me some degree of inflammatory reaction so that was an issue from time to time.
Bruising after removal of the arterial line from my wrist

The first 24 hours focused on keeping pain relief up and helping me learn to turn with assistance from the nurses. I was allowed no water or food whatsoever until bowel sounds returned just the occasional wipe around my mouth and gums with a dampened swab. Once small bowel sounds returned I was allowed crushed ice to suck. What we were all waiting for was a full-blown fart! A sign that my gut was again working. Apparently surgery on the spine can cause your gut to go into a sulk. Taking food or drink in that situation leads to nausea, vomiting and other dire consequences so crushed ice it was. Finally about 50 hours after my last food I finally produced the requisite fart and was allowed to begin a light diet.
About 30 hours after I returned from surgery I was encouraged to hoik myself out of bed and into a vertical position. This involved edging towards the edge of the bed in lateral recumbency and then pushing up with my arms as I swung my feet to the ground. That happened all in one motion and got me to a sitting position with the minimum of twisting and very little pain. From there it was simply a case of using a small walking frame and what remained of my wasted thigh muscles to rise like Lazarus to my feet. The first thing I noticed was that my left side, that had been so painful pre-op, was now completely pain free.
That ws a huge milestone getting to my feet again and taking a few small steps.

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