I wrote previously on tips for recovery from surgery (some overlap of information presented here), and that it is as much mental and emotional as physical and the same applies to preparing for surgery. I do not get too nervous until the day or night before. Even if it is a repeat procedure, I usually still do get a little nervous the day before. I also usually do not sleep at all the night before surgery. I am struggling more with the mental preparation this time. This is not because of surgery--almost looking forward to it at this point with how challenging the hip has become. It is because of being in transition--with lots of things. I prefer things stable during recovery, but this time facing lots of major changes. Working on finding a way to create stability in the midst of the craziness. This is a mental/perspective exercise.
One of my favorite photos.
Post-op aids. This time, I already have crutches, walker, shower seat. I did not have a shower seat last time until over a week post op. But, having had surgery on one arm a few years ago, had learned how to shower only using one arm, so after the hip surgery, stood on good leg, supported myself with one hand on wall of shower, leaving one arm/hand free. It worked, but not ideal, and the shower seat was a welcome aid once I got it. I am most definitely not looking forward to being back on crutches. I recall counting down days until I could be done with crutches last time, and I am closer to being back on them now than when I was counting down getting off then. At least this time, I know how to use crutches already, unlike last time. I found this helpful video by the Nebraska Medical Center, but not until after I had been shown things by PT. Currently, I am choosing to enjoy my final days of "freedom." This time, I will need a hip brace after surgery, thus need to be fitted for the brace. I did not need a brace last time. So, this should be interesting. Curious to see how the process goes, curious to see how I feel about the brace. There were times last time, I thought something to prevent wrong or excessive movement might have been nice, but not having a brace meant being more mindful of how I moved, which in the long run I think was better. So, not sure how this will go. The surgeon told me I'd need the brace ~2 weeks or until I was "sick of it." I thought about asking what happened if I got sick of the brace the first hour, but decided that was probably not a good question to ask. I was told the reason for a brace this time is the EDS--the brace provides extra stability during the early healing stage.
Other supplies. I have a stock pile of waterproof bandages (to allow me to be in the pool early!), my regular "safe" band-aids (I have adhesive sensitivities, these usually work, but last time reacting to these as well by the time I no longer needed to cover incisions), all of my ice packs in the freezer, the water bottles used in the ice machine all in the freezer, jugs of chilled water for the ice machine in the fridge, have the ice machine drained and ready to go (have gotten way more than my money worth out of it as used it post-op several months last time, then for other hip, both shoulders, neck, back, etc. Incredibly helpful for icing at night to save getting up to get ice pack(s) from the freezer, which then more fully wakes me.
Zero gravity chair. I know I mentioned this in the post on recovery. But, I found the chair helpful pre-op both times, plus immediately post-op and it is one of the back-up options for bed depending on how things go with the move. A body pillow fits nicely and makes it really comfortable.
Rehab aids. I have a fair amount of basic items already from being in PT so long and doing exercises at home. I am latex sensitive so have to have latex-free therapy bands. I also have a thick exercise mat, yoga ball, small weights, etc. I knew in advance last time that stationary bike would be part of rehab. For bike, I had to be creative. Initially, I'd only need it a few minutes at a time 2-3 times a day. Not worth trying to get up and down two flights of stairs with crutches to get to the gym, so really needed something at home. Discussed options with PT. What I came up with, and PT OK'd, has worked well for me and my situation with small apartment, small budget. I ended up with folding bike pedals that just sit on the floor. Then, because of trying to avoid too much flexion at the hips, I sit on a tall bar stool (~30") rather than a chair.
My "bike" set-up
Medications. With surgeries, the surgeon prescribes what is needed for after surgery However, I have enough other issues that require medications, that I also make sure that I have refilled any prescription medications, have enough over the counter medications and supplements to last until able to run errands again. Additionally, over the counter pain killers can be used along with narcotic to aid in needing less narcotic, or assisting with managing earlier without narcotic. A caution with over the counter pain medications and narcotic pain killers--if the narcotic contains acetaminophen, it is best not to take any additional acetaminophen. I have managed chronic pain long enough that I know how to stay within the daily maximal dosing for acetaminophen with extra over the counter acetaminophen with acetaminophen-containing narcotic, but this is something that has been discussed with prescribing physicians in the past and they are aware I know the limits for acetaminophen and how to stay within them. I was off narcotic really early with both of the last two surgeries, hoping to be able to be off pretty early again, but will have to see how things go as prior surgeries it took weeks.
Meal preparation in advance. I have done this with every surgery. It looks a little different every surgery. However, with each surgery, I do emphasize protein and lots of vegetables both pre-op and post-op. I did make granola bars again. I also did some crock pot cooking, but less this time. I find I am not hungry the first few days--presumably due to anesthesia effects? Thereafter, feel as if always hungry. Thus, I tend to make sure I have nutrient dense snack options available for the early days. Then, once hungry again, back to normal meals plus snacks as needed. Surgery and recovery are not a time to try to lose weight Ideally, weight should be kept stable a month prior to surgery and at least a month post-op. Even if someone has excess weight, losing weight close to surgery is not a good idea as the body needs to have the resources for healing. After surgery, the body is using so much energy for healing, that even though not moving much, I still was always hungry even though eating well. Another aspect of food/nutrition for post-op is countering effects of anesthesia and/or narcotic pain medication in terms of constipation. Narcotics do not affect me at all, anesthesia does and to the extent that I have yet to figure out a strictly dietary approach and need stool softeners at first. However, plenty of water, fiber (veggies, whole grains, legumes, etc.), probiotics in some cases, etc. can help. I am on probiotics already in anticipation of being put back on antibiotics for surgery.
Finishing projects and getting things to a good stopping place. This applies to work, school, moving, or whatever happens to be going on. I like to have things either completely finished up, or at a stable point. This take pressure off of me to try to get back to tasks right away. This then lets me take the time to rest and focus on recovery initially.
Someone to help after surgery. Help is essential at first. My sister has offered to come be with me for surgery and stay the initial days afterward to help me. She helped after my last hip surgery and I am so grateful she is willing to help again! We (mostly she) figured out systems to help things go more smoothly and help me be independent earlier last time and we have decided practice makes perfect (we hope!), so hoping this time goes even better. This time, I have arranged to have help the entire time after surgery until the move out-of-state. Last time, I was on my own earlier, but with the move, want to make sure I am not trying to do things I should not be doing. (Such as climbing up and changing the battery in the ceiling mounted smoke detector by myself at one week post op last time....)
Comfy, easy clothing. I suspect this varies person to person and by season. I lived in shorter tank top dresses after surgery last summer except for PT, then shorts and t-shirt. I also had supportive, slip-on shoes for early on when getting socks on or shoes tied were challenging. (The brace is sort of throwing me for a loop as not certain of what clothes will work best with it. However, I figured things out last time, so can figure things out again.)
Surgery planning. This is not referring to the details of the procedure itself, but managing medications, other conditions, etc. in context of surgery. Conversations with surgeon and team, anesthesiologist, primary care physician, physical therapist, etc. This is the same surgery, but other hip, same surgeon, same surgery center, etc. So, we all have been through this and know I did well last time. Clarifying some of my unusual (complicating) factors and how is best to address them or work around them during surgery. The recent diagnoses of Ehlers-Danlos Syndrome and Mast Cell Activation Syndrome have ramifications for surgery. These have been discussed and plans are in place. Grateful for a team familiar with these conditions and how to address them! My bigger concern going into this surgery is that I am not on prednisone, as we are pretty sure in hindsight the prednisone is why my past two surgeries/recoveries went really well when none of the prior ones did (suspecting MCAS related). The recommendation/plan is high dose steroid burst prior to surgery. Hoping this works as well as chronic low dose prednisone did the last two surgeries. Choosing not to worry about if it does not--will deal with that as it happens if it does.
Safety issues. "Crutch-proofing" prior to surgery--making sure rugs are picked up to avoid tripping from a crutch catching, making sure plenty of space to maneuver with crutches and even more space for a walker, etc. Any cords out of the way to avoid tripping. Funny thing, is some of the rearranging I did last time never got put back to how it was before. I am not one to do a lot of rearranging or reorganizing. Once I have a system that works, I keep using it--if it is not broken, do not fix it. Surgery necessitated rearranging, but then got used to that system, so did not go back--at least not fully.
Physical preparation: aka "prehab." Last time, PT helped me work on core strength (I was just months post op another abdominal surgery), glute and hip strength, shoulder/arm/upper body strength in preparation for being on crutches and not able to move normally for a while. This helped me go into surgery really strong, which in turn helped with early rehab. So, we are currently still rehabbing first hip, but also again working on making sure I go into surgery as strong as possible. With the uncertainty of timing of when my my bed gets moved or what options after it gets moved, we have worked on how to get to/from the floor early after surgery. This is something I was told last time not to even attempt at first, and took me 2-3 weeks to manage. With PT's direction/assistance, I am surprisingly strong for as many physical limitations as I have. I laughingly consider it as training for surgery. I know others who are training for marathons, or various other races, and I train for surgeries. This is only a temporary shift in perspective. Normally, I am training to survive life. Goal is to get back to thriving again versus just surviving. Life with chronic illness is essentially a marathon--journey, not a race, though.
Back to concept of mental/emotional/physical preparation--each surgery I try to cerebrate what I can still do before surgery, knowing I will lose it after surgery, but can regain that ability again in time and with work. I prefer to do pretty much everything I can the day before surgery for one last time before letting it go. However, with local pools being closed, the timing of travel for surgery, uncertainty of how hotel pool will work for swimming, etc. not sure if that will work this time. So, I considered yesterday my final day just in case nothing else works out. I am still planning to stay as active as I can these final days of relative ability.
It has been overwhelming at times, and I am sure will still be so for a while. However, it has been exciting to see God going before in so many ways. He has been providing help and encouragement along the way. Prayers for the surgery and recovery are greatly appreciated!
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