Progress …

This will be an update on the recent surgery.  If you don’t care to read about another person’s health stuff, just stop reading here.  I have, however, learned some stuff going through this process.

This is the most major surgery I’ve ever experienced.  Yes, I had two surgeries relating to my right shoulder’s rotator cuff.  And, of course, delivered three babies.  But, that wasn’t surgery – that was joy!

Before the surgery, when friends learned that this back surgery was in my future, many of them shared information about other friends and relatives who had experienced the same.  And, many times, the stories were not pretty.  Even though I really don’t spend time worrying, it did cause some concern.

So, here goes my story.  When I told my physical therapist (Nora) that the surgery was, indeed, in the future, she said, “We have five weeks to get you ready.”  She immediately began giving me isometric exercises to assist with the recovery.  Pre-op PT, I called it.  We didn’t know when, after surgery, that I’d be allowed to return to “traditional” physical therapy.  This pre-op PT was geared specifically for strengthening muscles I would need for post-op recovery.

Having heard the shared information, I confess that I was a bit concerned about the whole process.  I had never had such an intensive insult to my body; but, as I told Gary (my orthopedic surgeon), “I wanted my life back.”  I did not intend to shuffle to the front of my house just to get a drink of water from the kitchen.  Which I was, pretty much, doing at that time.

The day, June 10, came.  I had already had pre-op meetings with Gary and with pre-op people at Rose Medical – the hospital where the deed would be done and recovery started.  So, I admitted myself to the hospital about noon (surgery was scheduled for 2 pm).  All of that pre-op stuff was done by the skilled nursing and doctor staff.  Then, it was off to surgery.

Like all medical facilities, these days, I received a request for evaluation of the staff, etc.  Which I will do in the near future.  Of course, I will really have nothing to say about the staff in the recovery room.  I was waking up and remember nothing about that part.

I was kept in recovery until “a room was found” for me.  When I arrived in my assigned room (161), the recovery process went into fast forward.  Blood pressure.  Blood sugar.  Heart rate and pulse.  (Repeated and repeated.)  Electronics to learn (TV, call button remote, how to order food, etc.).  And, finally, rest.  But, I don’t  remember sleeping.  I just remember being aware of sound.  And, I don’t remember any pain.

Discomfort, yes.  I think that was from the bandage covering the four-inch incision that I’d been promised.  I think it pulled on the skin when I moved.

I met physical therapy and occupational therapy personnel.  “NO BLT,” said the PT.  That was easy to remember.  No Bending.  No Lifting.  No Twisting.  Sometimes, it’s hard to remember BLT.  You want to put on your shoes.  Don’t.  That’s bending.  You want to reach for something on the table/tray.  Don’t.  That’s twisting.  So is turning head and shoulders to see something.  No twisting!

I didn’t know that when, on-line, I ordered these new shoes called Skechers that I was ordering a great assist for the no BLT order.  You just stick your feet into the shoes.  You don’t have to reach for them … or bend down to tie them.

PT and OT put me through the required paces.  About the second or third day out, PT walked with me around the “quad.”  I called it that because it was a walkway around the nurses’ station in the center of all of the patient rooms.  I remember the quad at Western State College, green space with trees, surrounded by classroom buildings and dorms.  So, quad it was.

Both PT and OT “signed off” that I could leave on the third day, but something just didn’t seem right.  I didn’t know what.  I just knew something was wrong.  So, I asked to stay another night, and Dr. G. signed off on that.

I’m glad I did because during the night, about 1am, I woke in a sweat.  Apparently, I had had a fever.  I got up to use the bathroom.  It felt as if someone had “flipped a switch.”  Things were different.  When I explained that to the my doc on the fourth day, he insisted that I explain exactly what that meant.  So, I did – explain.

I could walk better because I was steadier while walking.  My thinking felt different.  I think my speech was more coherent (this is a guess because I didn’t think, until then, that I had any problems with speaking).  Apparently, I had had a fever – but it left.  I have no idea what the various readings of blood pressure, etc., were at that time.  They may also have changed – I just don’t know.

I was released and Daughter #1 drove me to her house.  Grand #2 was with us and would be assisting in the recovery process.  Actually, I felt like a burden because I really couldn’t get my meals or medicine or water, etc.  Someone had to bring them to me.  I spent most of my waking hours in the new lift chair that Daughter #1 had recently purchased.  (But, I didn’t use the lift chair to get out of it – I used my own leg strength.)

“Walk!”  That was an order from my doc.  “Walk as much as you can.   If you walk five minutes one day and two the next, that is okay.”  So, walk, I did.  In the beginning and for about three days, I used a walker that Daughter #1 had purchased for me.  After that, I stopped using it.  I did my walking in the house.  Grand #2 figured out the length of my stride.  She was able to calculate how far I walked each day – back and forth one or more times.  I also walked the stairs – 14 steps.  When I get home, I thought, I’d be able to use my treadmill starting at 5 minutes 1.0 mpg.  I don’t really like to walk outside.  There is no level surface to walk on.  All sidewalks in my neighborhood tilt.  The street is not safe.  And, Dr. G. said the treadmill is okay.  So, it is walk, walk, walk.

My first post-op meeting with Gary was positive.  He said that I was ahead of the curve.  That felt good to me.   When I asked before the surgery about driving, he’d said I could drive as soon as I was off of the pain medicine.  And, the pain medicine would start with Tylenol (which, of course, I’d been taking before the surgery) and move up as needed.   In hospital, I’m sure I received oxycodone.  When I was discharged, I took one pill of oxycodone at bedtime (11 pm or 12 midnight for about three days) and, then, stopped, using only Tylenol.  Which is what I’m still taking,  twice a day.

As for pain.  I don’t and have not had what I would call pain at the incision or surgical place on my spine.  I have had the pulling of the protective covering over the incision.  And, I have had discomfort in the muscles on either side of the incision.  Nora says that may be because those muscles now must be retrained.  They were so much a part of protecting my walking and sitting before surgery that they now have to learn to act more normally. 

During that first post-op meeting with Dr. G., I also asked when I could start physical therapy.  Many weeks was the answer.  “What about continuing the isometrics?” I asked.  I was, then, given this lecture.  He put his hand on his head and pushed against his forehead, indicating resistance.  “This is isometrics,” he said.  Then, he shook his head side-to-side.  “This is not.  This is movement.  No movement!”  When I agreed to be involved in only isometrics, not movement, that was acceptable.

I’ve learned so much from Nora about this recovery business.  How to avoid bending.  Lifting.  And, twisting.  I’m very sure that patients in the recovery stage do not know any more than I did about BLT.  Nora taught me the difference.  I showed her various things I was doing.  She either approved or disapproved of these movements so I would be meeting the challenges of BLT. 

I don’t hesitate to thoroughly discuss issues with my docs.  And, so, it is my plan to provide Gary with a list of things I’ve learned from Nora about this BLT recovery business and suggest that it might be a very good idea for him to  recommend this type of post-op PT before getting into the more aggressive work – with the hope of not damaging the surgeon’s work.  I can only imagine the damage we may be doing if we don’t really understand what the BLT requirements mean.  I know that I was making mistakes while trying to follow the directions in these first few weeks.

I am concerned that I may be expecting too much too fast.  And, this may be the pollyanna outlook that may breed something that brings my apparent satisfactory recovery to a crashing halt.  Sister Clara says that I’ve got to stop thinking like that and put the best construction on this recovery process.  “Accept what is happening,” she says.  “Just keep moving forward.”  I’ll make every attempt to take her advice to heart and do just that.  Nora continues to remind me to have patience – not an easy thing for me.

Here, I really want to tell you all how thankful I am for your good thoughts, prayers, and whatever brought me through this process to this point.  Thank you so much!

Be Safe and Be Well
The Cranky Crone
Thoughtful comments are appreciated.