Saturday, July 11, 2009

Drugs and Physical Therapy. Day 3

Ok, they said the second day would be the worst, but so far the third day is the worst for me.  Yesterday was my second day, and I believe I was still coming down from the big time drugs from the surgery.  In the morning, the Physical Therapist got me standing up with the walker, walking around the bed, and sitting up in a chair to eat my breakfast.  Later that day, the PT came back and got me up, walking (more like scooting.  You move your good leg forward and kind of scoot or drag the operated leg behind it) and out into the hallway!  I remember during my last PAO, on my first day of PT, I stood up for barely one second before loosing all strength and falling face first into the wall in front of me, before I burst into uncontrollable sobs and was moved back to bed.  So this was a far cry from the first time.  

I have been in a cpm machine, that gently moves your operated leg from 0 degrees to 40-60 degrees.  I stay in it for 4 hours at a time.  I also do ankle pumps every hour on the hour, and a set of ten each of quad contractions and glut contractions once every few hours.  I also have a breathing machine that I use every hour to re-expand my lungs, I guess from putting my system to sleep during surgery.  I am still unsure of all the meds I am taking.  There are  a lot!  First off, are the pain meds, which will probably be the most important to you if you are in this situation.  I started off on a dilaudid(morphine substitute) shot every 2 hours.  This stuff does not sit well with me, so they gave it in conjunction with an anti nausea medicine.  Unfortunately, it doesn't matter, you will probably get nauseous and vomit quite a few times during the first couple days.  During the second day, I was on a liquid diet, and threw every bit of it up.  The dilaudid seems to be the drug of choice for this kind of recovery in the first couple days.  During my last PAO, I was put on a dilaudid drip that I could press every 12 minutes.    As  I said, this stuff really does not sit well with me, so I was very happy when late yesterday, I was moved up to taking Percocet orally, every 3 hours.  This seemed to help control my pain much better.  In conjunction with the immediate release pain killers ( dilaudid and percocet), are the timed release oxycontin that is taken orally every 12 hours.  This helps to control your base pain over a longer period of time, and is supported more by the immediate release drugs.  I did not have oxycontin during my first PAO, and I notice a huge difference.  At Kaiser, during my first PAO, after I was taken off the dilaudid drip, I was only allowed 5 mg. of Percocet every 4 hours.  This finds you in excruciating pain every 2 1/2 hours or so, and the staff treated me like a drug addict for asking for more.  You should not be experiencing that!!!!  Your pain should be controlled, especially in the hospital!  This is an extremely painful procedure and recovery, that will take longer to recover from if you are crying in discomfort the whole time.

Anyway, the other meds they give you are pretty basic.  An iron pill twice a day (for your blood), 2 senna pills ( to counteract constipation that will most definitely afflict you), sometimes a Tylenol ( which is extra weird right now, because the FDA has put a restriction on the amount of acetaminophen that one can take in a day, in conjunction with oxycodone, because it messes with your liver.  This has screwed up my Percocet system I was on, because it has acetaminophen, and apparently I've had too much of it.  Now my meds are all screwed up again).  Other meds include Lovenox ( a blood thinner that is given as an injection in the stomach ( you will also have to do this on your own for 14 days,  after you leave the hospital). Ambien at night for a sleep aid.  Hmmm, there are a couple others I can't remember right now.

Ok, Dr. Santore just came in to check on me!  He says I am doing well, although I am having some pain issues.  He is doing everything he can to control it now, including giving me ativan to calm me down and keep me from crying ( which has been coming and going frequently today). He said I had probably flushed all the tricks they use in the surgery room to keep you numb and pain free.  Now it is just a matter of working out a few kinks.

 I got my cathater removed this  morning, as well as my blood drain thing.  There is a tube that drains blood from the surgery site; not really sure what it is called.  Being cathater free is kind of nice, but I now have to get up to pee, which is a whole ordeal with many people involved.  I have a bedside commode, as well as a real bathroom very close, and I have used them both today.   I have to tell my cathater experience at Kaiser, simply because it was so ridiculous, and paints a picture of the incompetency of the nurses and staff at Kaiser. 

 First off, my surgery was  a lot longer for my LPAO because I had an arthroscopy at the same time.  I didn't get out of surgery until around 3 pm, and then I had to wait about 4 hours to get a bed.  I was in the recovery room, puking and miserable for hours, until they stuck me in one room briefly, where I continued to be sick.  Finally, they took me to my 'real' room, which was a section in a shared, teeny tiny room, barely big enough to house me, my IV and a nurse hovering over me, breathing on my forehead because the room was so small.  I was extremely ill and in tons of pain.  At 6am, the following morning, my catheter came out.  This was the dumbest thing ever.  First off, when you have an epidural, it puts all of your organs and spinal fluid to rest, so all the stuff sitting inside you just takes a deep nap.  It takes a while, a couple days, for this effect to wear off.  When the catheter came out, I was unable to control my bladder because it was still sleeping from all the meds.  This kept me from peeing for almost 12 hours.  The nurses didn't believe that I really couldn't go on my own, and would just hand me a bedpan and leave.  After PAO, you cannot lift your hips on your own to maneuver a bedpan under them.  You need assistance!  For EVERYTHING!  And besides, there is nothing coming out on its own this early after surgery anyway.  Finally, my stomach and bladder got so full that you could see it under all the swelling from surgery, and I was starting to get dizzy and sweaty and green.  The nurse finally agreed to put another catheter in, after me and my mom begged her to, for a couple hours before she gave in.  It took not, one, not two, but THREE failed cathaters and nurses, including the Charge Nurse to put one catheter on little old me.  All three  of them crammed around my little bed, pulled the curtain around them, and hovered and poked and prodded around my vagina like they were discovering a strange alien land.  It took three nurses, a flashlight, a manual, and what seemed like weeks of mortification to get another cathater in.  Once in, I pressed on my belly/ bladder and emptied an entire bag's worth of urine into that thing.  They had to empty it immediately.  Ahhh!  The stupidity was astounding at Kaiser.

OK, now I am starting to get mean.  My pain level is high, and the only thing that has kicked in is the Ativan, which is making it really hard to do anything at all.  I feel slightly stupid.

Third day blues! :(

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