Saturday, February 4, 2017

Surgery Recovery Tips and Tricks

I have been working on this post bit by bit for months.  I have had several surgeries of various types and have learned some universal recovery tricks as well as some more specific to type of surgery.  Recovering from surgery can be challenging, but there are ways to make it a little easier.

Something many may not realize, is that recovery is as much mental and emotional as it is physical.  Yes, the body has to heal from the trauma (intentional, controlled trauma, but trauma nonetheless), but it takes mental and emotional strength to work through the restrictions and limitations patiently. After recovering from a few prior surgeries, I knew what to expect in general when recovering from surgery.  I have always prepared for surgeries by having things caught up with work and school, having meals prepared, stocking up on groceries, having laundry and cleaning all done right before hand, etc. This allowed me to feel free to just focus on recovery in the first days without worrying about anything else.  However, in addition to this, with the last two surgeries I also chose to spend the final day before surgery celebrating everything I could do--even if it was partially restricted.  I knew I would lose all/most of that ability the next day.  However, the loss would be temporary and I could regain it back.  Thus, after surgery I chose to view that as my baseline and things could only get better from there. Thus, I found myself getting excited over each regained ability.  (I am now several months post op from the hip surgery, still have months to go for full recovery, but I still get excited about things I am being cleared to try again.  Funny how things I used to take for granted suddenly become novelties or privileges to be able to do again.)

Mindset and perspective are huge.  What happens to me is often out of my control.  What I think is my responsibility. I can choose to see the difficulties, or I can choose to find what is going well and take a positive perspective.  I am normally looking for the positive side of every situation.  Example with choices.  These photos were taken without moving anything other than direction the shot is taken.

I can choose to see the crutches.....

....or, look out the window.

It is my choice. I chose to view the crutches as a tool, and enjoy the view out the window. :) 

Pain control.  This is very important.  If once fall behind on pain control, it can be hard to get back on top of it again.  My previous surgeries were really rough in terms of pain after surgery.  I learned to set timers on my phone to remind when a dose of pain medication was due, or wake me in the night when a dose was due.  It seems silly to set a timer to wake from sleep, but with those prior surgeries, if I did not use a timer to wake me and waited until pain woke me, it was too late and it was miserable trying to get pain back under decent control.  With medications, I also recorded time, dose, what medication, etc. every time I took anything. Part of my tracking was done in either notes on my phone or in text messages to myself. With both of the last surgeries I did not need hardly any pain medication, so the tracking was not needed very long.  The benefit of tracking was preventing forgetting when or how much I took, accidentally taking doses too close together, missing a dose, plus also provided a record of how much I actually needed--which is probably only of interest to the scientist part of me.  I think I was on narcotic pain killers for 2-3 weeks after some surgeries, but only hours or  days after the past two.  The past couple of surgeries, I possibly did not actually need narcotic at all, but it took me a little while to realize pain was a non-issue. Also, something many may not realize, but medications rarely eliminate pain.  They just help decrease pain to manageable level.  That was how I realized I did not need the narcotic pain medication with the past couple of surgeries.  After the first few hours or so, there was no pain at all, unless I moved wrong.  Thus, stopped narcotic. I had so much fear of post-op pain going into both of those surgeries because of past surgery recoveries and also severity of pain pre-op, that I was afraid to let pain get out of control.  Thus, was started on narcotic before discharge after surgery, and continued once home until realizing pain was not a concern at all.

General medication tips and tricks from years of chronic pain.  Once needing less narcotic, over the counter medications can be helpful.  I discovered over time that the longer acting medications meant a greater chance of sleeping through the night. Thus, chose to use naproxen over ibuprofen (both of these are non-steroidal anti-inflammatory drugs, or NSAIDs) and the extended release acetaminophen (aka Arthritis Pain Relief Tylenol or something similar) over other forms of acetaminophen.  Also, NSAID and acetaminophen can be alternated, thus as one is wearing off, the other is in full effect. Additionally, NSAID can usually be taken along with the narcotic pain medication.

Ice!  Lots and lots of ice. This is partly to help with swelling, but partly pain control.   I used ice almost all of the time.  I was cycling ice on and off as much as I could. I have always used ice to help with pain management anyway, so after surgery was just increasing frequency. I have multiple types and sizes of ice packs. I potentially have more ice packs than food in my freezer.

This is just a few weeks before the hip surgery. Ice on op side hip; have often had ice on both hips at once, neck and back, etc.  I tie ice packs on--that keeps them in place, but lets me move and get things done. 

Ask for and accept help!  This was one of my biggest challenges as I am incredibly independent.  I learned to ask for help--at least some.  I also had to learn to accept offered help.  I did still change the battery in the ceiling-mounted smoke detector one week post op from hip surgery, but it was because it was late at night and was not sure who to even call at that time of day (and I managed to complete the task without putting weight on op leg at all). With not driving, with crutches, etc. I did have to ask for help for several weeks with rides, help with errands, laundry, cleaning, etc.  I could cook and do simple cleaning tasks on my own pretty early, but vacuuming, mopping, carrying laundry or groceries on stairs were not feasible until off crutches and walking pretty well.

Meals. This is something that can be very helpful to prepare in advance, or often others will offer to help with.  With one surgery, all of the other students in the lab I work in took turns bringing me meals--so incredibly helpful!  That saved me not just meal preparation but from having to go grocery shopping as soon as well. With the hip surgery, I made ahead and froze some things, but had to reserve freezer space for all of my ice packs.  I also had a bunch of snack foods in single servings in baggies that were easy to grab and carry even with crutches. One of my favorites after surgery (or any time really) is homemade granola bars.  I already did a lot of crock pot cooking and this came in very handy.  I can dump ingredients into the crock pot in a few minutes, then it does the work for me. (I have lots of crock pot recipes, too.)  How to move the crock pot to fridge once it is done?  Easy, scoot bar stool over to counter, lean self against counter, transition crock pot to bar stool, push bar stool to fridge (slow with crutches, but works!), transition crock pot to fridge without putting weight on op leg.  Bar stool was an amazing tool for pushing all sorts of things around the kitchen.  Office chair worked great for pushing things around living room.

Rest nest.  I am not sure what else to call it.  Basically think where makes the most sense to spend most of early recovery--bed for me after most surgeries.  Then, I had a power strip by my bed that had cell phone charger cord, ice machine, laptop charger cord, anything else, right at hand within easy reach.  I already had a night light near my bed, and it is definitely helpful when early post op.  I have had enough surgeries and have enough various pain issues that I am pretty well trained to sleep and stay on my back.  However, the first surgery before fully trained to stay on my back was tough.  Pillows helped keep me in position.  Even when trained to stay on my back, pillows were helpful to prop whatever area had surgery--arm, leg, etc.  I had used pillows pre-op to keep legs from going into excessive external rotation and continued to use pillows to prop legs as needed the first weeks post op.

Zero gravity chair!  I love this!  I first heard about it from friends with back pain and since I have back and neck pain, thought it sounded worth trying.  I got one just to see and it was so comfortable and so nice to have another alternative position.  It worked incredibly well after the hip surgery as well and I pretty much just alternated bed to chair the first few weeks.  I discovered a body pillow fits perfectly and makes it super comfy. I also discovered it is very easy to prop up my laptop and work when fully reclined.

Waterproof bandages.  This may not apply to all, but is very important to me. I am a swimmer--just recreational and not competitive, but love being in water and do not hurt as much when submerged in water.  Thus, one of the hardest parts of recoveries for me have been being banned from submerging incisions.  A few surgeries ago I discovered these amazing waterproof bandages that stay on even after being submerged for hours! I asked and was cleared to be in the pool early after the hip surgery as long as I was certain bandages were completely waterproof--and I was certain.  These work better than Tegaderm, which I maybe know from past experience from prior surgeries and injections is not entirely waterproof, neither does it always stay on.

Not sure how many boxes of these I have gone through after surgeries and injections. 

Crutches.....I very strongly disliked them by the time I was done with them.  Crutches create a whole new world of challenges.  With some thinking ahead and problem solving as I went, it was not too bad.  Crutches make it challenging to carry anything.  Not impossible, just challenging.  Bags come in very handy!  Plastic grocery sacks are great for carrying all sorts of things.  Ice packs to and from freezer.  If ice machine, carrying frozen water bottles to and from the ice machine to change out to keep the water ice cold.  I had a small bag that attached to the crutches that I kept cell phone, note paper, pen, medications, hand sanitizer, etc. in.  That way those items were always with me.  With crutches, I did not move very fast.  If the phone rang, not within reach, it just did not get answered as I was not going to get to it in time.  Having it with me, meant not stressing over missed calls.  It also meant if something happened, my phone was with me.  I was on my own early after surgery, thus phone was sort of my back-up in case something happened. Having medications on hand should just make sense.  Note paper/pen was for taking notes during phone calls, tracking medication dose times, etc.

Crutch tips video (Nebraska Medicine) someone told me about after I was already off crutches but wished I had seen before. Also, what they do not show, was with stairs, turning the second crutch sideways and grasping the narrower part of the frame.  I have small hands and simply could not hold both crutches in one hand if using the hand grips on both.  I did not trust myself with crutches on stairs well enough not to hold onto the stair railing with one hand.   This is why I was "stuck" until PT showed me how to hold the second crutch.  Then, I could finally navigate stairs on my own without needing someone to be my second crutch carrier.

Other crutch tips: containers with lids and handles!  Coffee travel cup with lid, meant I could carry it without spilling.  Water bottle with lid.  Microwave safe container with handle and lid--this allowed me to warm up leftovers, put the lid on, carry it to the table on my own.  Water cup with lid and straw--great to have by the bed or wherever I was. It made it easy for carrying. All of the cups, water bottle fit in the crutch bag  as well (not at the same time). I would carry utensils in a baggie.
  
 
Survival tools!

This may seem like a luxury, but they were more of an absolutely necessity as my hands were so sore after the first week or so of crutches.  I got a set of these crutch pads with bag on clearance and they were definitely worth it!

This photo is from ten days post op. Heading to the pool, because isn't that what everyone does 1.5 weeks post op from hip surgery?  I loved being in water--gave my entire body a break and no crutches when in the pool!!!!  Anyway, this photo shows the crutch pads on the hand grips as well as the crutch bag.  I never used the under arm pads as I did not need them and they got in my way.  Not shown in this photo but present nonetheless are the waterproof bandages. The bandages stayed put and the incisions/stitches stayed dry. 

Grabber.  This is optional, I never had one or felt I needed one.  Depending on type of surgery, it can sometimes be difficult to pick things up from the floor. I have had abdominal surgeries and hip surgery and those types of surgery introduced some challenges, but I figured it out.  One of the side benefits to crutches is using them to pull things closer and even pick things up with the end of a crutch. I also have always picked things up from the floor with my toes, so this random talent came in very handy after surgeries when hard, or impossible, to either bend over or squat down to pick things up. 

There are lots of things that require creativity to figure out. That is part of the challenge, but I tend to thrive on challenge as long as not too difficult and as long as it does eventually resolve.  Also, I had modified so much before some of the surgeries, that I had a bit of a head start for after surgery.

Copyright © 2017 by Steph. All rights reserved.

Wednesday, February 1, 2017

7 Months

And, back to the roller coaster of highs and lows.  What a ride.

My left hip is still recovering and rehabbing well after surgery.  I was finally cleared to try running this week! Only in the vortex pool and not in fast current yet, but run nonetheless!  At the same time, I still struggle to stand or sit extended periods of time.  I do great if I keep moving, but quickly run into issues when still.  My right hip has been getting ever more irritable again as the injection continues to lose effect.  I have been grateful that the injection is losing effect more slowly than was the case with the left hip, but it is still hard to have pain levels creeping ever higher, annoying pain keeping me awake at night, ability starting to decrease again. Not sure if being cleared to try running in the pool is actually going to last very long....right hip has a way of taking away new abilities as soon as left hip is cleared to try.  For now, grateful for progress.

Shoulders seem to be competing with each other regarding which one is worse/better.  I can at least write to take notes in class again better.  The shoulders do make sleep challenging and some daily tasks challenging. Interesting how much one takes the entire body and its abilities for granted until something starts to hurt or not work properly.

I had been sent to yet another specialist recently to try to sort out some of the guesses for the ongoing, underlying issues, and to hopefully implement recommendations from some of the other physicians. I very quickly ran into a dead end.  I am still not sure from here.  I am on back-up plans again. At least we had back-up plans this time, though. What is puzzling is how I can have the most normal, healthy blood, but clearly not be either normal or fully healthy.  In other words, more negative blood work, another negative exam, even with lots of affirmative answers to questions.  I asked how much prednisone + maximum dose prescription NSAID + cod liver oil + glucosamine + anti-inflammatory diet + overall healthy, careful lifestyle would have on masking things...and was not really ever given a good answer.  I know prednisone masks things all by itself.  I had a negative exam on left hip when I was pre-op but on high dose prednisone to calm down the first shoulder right after I initially hurt it.  Prednisone will hide the full reality.  That is part of why I got caught by surprise with how bad right hip and left shoulder were when we first started tapering prednisone after surgery last summer.  The prednisone had been masking far more than just the severity of left hip pain.

This may seem random, but please bear with me, there is a point to this.  I have always liked snowflakes.  I was talking with someone recently about the additional meaning of snowflakes to me.  Each snowflake is unique.  Each person is unique.  My body happens to be more of an anomaly.  Snowflakes remind me that this is alright.  This is just how I am, how my body is.  For those who have seen my current Facebook profile photo, it is a paper snowflake I made Christmastime 2015. It is a reminder it is OK to be different, even when it is hard and no one knows how to help me. This also ties into something I shared in a previous post years ago.





Copyright © 2017 by Steph. All rights reserved.