thompsound blog: speed re-cap #63

Part 4

Surgery-Day + recovery 1

I’ve really been struggling to figure out the best way to describe the experience of having a hernia operated on.

Since you’re kept awake during the 45-minute procedure, but highly doped-up - I would like to present you a bunch of memories from the day in point-form

it’s going to be flashes of things, probably incoherant, and highly confusing - much like the real surgery-day

Woken up by the nurses at 0545

Early surgery-groups have already showered the previous night, and have their surgical-sites shaved by an aggressively bored nurse, starting at 0600.

If you’re in the later groups (like me), then you’re the last to be shaved @ 0700-ish; and are able to shower afterwards.

This will be your last ‘real’ shower for at least a week, so enjoy standing under the water, as you’ll be sponge bathing ‘till the incision has had some time to heal.

No breakfast (nil by mouth since midnight) - so if you’re in one of the later groups, like me, they’re expecting you to be very hungry by the time you’re able to have some dinner = nurses will give you a glass of apple juice around 0800..

Being the second-last surgery for the week, I got the full effect of anticipation, hanging out in a surgical gown, in the lounge, while the doctors finished up their morning chopping, and then took a lunch break...

Rules say that you’re not allowed to leave the floor, or go outside, on the day of your surgery (dinner will be provided to you in your room).

At 1245-ish, when the orderlies collect you, they walk you to the elevator - which takes you to a subterranean surgical area.

You’re asked to lay in what looks like a left-over set from the x-files (very creepy hospital ward), dim lighting, cold and clinical - almost military in feeling...

The surgeries are run to a very tight schedule. EVERYTHING is set up to run as smooth and efficient as possible for the surgeons.

This means that the ‘next’ patient is prepped and waiting, ready-to-go while the surgeon is starting the ‘previous’ patient.

You could conceivably be laying waiting in a cold military ward for 45 mins, get some sleep - it’s oddly relaxing.

When it’s your turn, you’re guided into the surgical suite - those present are: your lead-surgeon, a junior-surgeon who’s assisting, an anaesthesiologist, a lead-nurse, and another floating assistant-nurse.

There’s music playing - I remember it taking at least 6 songs for the surgery to be completed.

Remark on the musical tastes of the team - shocked that my older-male surgeon was a Justin Timberlake fan, it was pop-y, fun, and kept everyone moving. Well, except for me - i had to stay still :)

You are FULLY conscious and lucid throughout the entire procedure

Different doctor to the check-in guy (the one who made the sharpie mark), though I did see that he was operating in a different suite...

There are 4 surgeries happening simultaneously, I’m the 6th for this ‘team’ = ~26/day

It was an ultra-efficient team (anesthesiologist was best needle insert I’ve ever had) - clearly having each team complete 6 surgeries a day makes them good at what they do

IV fluids (due to the longer wait-time) and some kind of pain blocker (checked later, it’s fentanyl)... along with oxygen via nose thingy. All in all it means that you are present and awake, able to continue conversations with the lead-nurse, but don’t feel any pain.

LOTS of “dragging” and “pulling” feelings as they slice and sew.

You’re asked to let the team know ‘if/when’ you can feel a jolt of pain, so they can administer more local numbing fluid...

Then, before you know it, they’ve sewn you up and you’re in a wheel-chair, on your way back to the ward

The whole surgery took about 45 mins (plus an hour or so in the creepy-ward)

Try to get some rest... a later post will explain why that was exceedingly difficult...

Lead surgeon checks-in on their way out for the week (in street clothes)

Then a nurse checks me

A second nurse delivers some Tylenol (~1515)

The other surgeon (junior) checks in (still in her lab-coat)

Then the weekend ‘on-call’ surgeon checks in on me...

Original nurse delivers a dinner just before 1700, sit-up, scarf it down, request a coffee. (sweet sweet cafeine!!! it’s been 20 hrs!)

They allow me to try the “sit up and wait 20 mins” test - passed - I’m allowed to call the nurses back to try the “get up and move around” test

Start to walk around, feel light headed like all blood is draining from my body, sweaty etc. that’s a FAIL!

Told to lay back down

This is not unusual - in fact the whole reason for the ‘test’ is that about half of all the patients will fail the first time

I try again after waiting for 20-ish mins...

Sit up for 20 mins, call it a pass, and get up to pee... Naughty boy! (should have called the nurses!)

Same lightheaded feeling while washing hands = Shuffle back to bed = FAIL #2

At the 1hr mark from my first test, a nurse comes back to check on me.

Naughty man! - you shouldn’t have tried to get up on your own... Since I failed my first ‘test’ - doctors orders are to stay in bed overnight = no getting up, even to pee = you have the bottle - use that!

SLEEP OVERNIGHT (well, sort of... more details later)

Woken at 0545, delivered a Tylenol and told to pee in the bottle

Here’s the thing - I’ve never actually pee’d in a bed-pan/bottle thing before, and have been holding it in, thinking I’d be allowed to get up if I passed the ‘test’

Silly move, I should have been flushing away all my opioids - this is probably the reason that I’ve failed the sit-up test twice - I still have too many drugs in my system.

Pee in the bottle - it feels weird, but is quite a relief.

Nurse comes in at 0600 to get me to sit up for 20 min

Nurse leaves, and I last about 5-10mins before same symptoms (light headed, sweaty, hearing is all tinny and blocked) = FAIL #3

Lay down and call nurse to let them know that I didn’t make it

They make sure I lay back down, deliver some water and ginger ale.

Failed test = Breakfast order taken just before there’s a call for all patients to head down to the dining hall for breakfast = I’ll be dining on my own...

Breakfast is delivered, and I’m allowed to sit up - slight light headed and nausea feelings, but not as bad as I was...

Nurse comes in to remove the bandage covering my incision; so that weekend doc can remove every-other clip.

Since I’m one of the last patients to have my clips removed today - he’s feeling a little speedy and non-gentle... it’s more painful than the actual surgery ;)

Told to lay back down for a half hour, then call the nurse to let me try sitting up again,

Success!!!

I’m allowed to walk around a bit, pee, hang around in the lounges etc

Exercise-time at 1100, it’s like super slow yoga with a bunch of people who move like zombies... quite amusing to observe/take-part-in

Lunch ~1145

Post-surgery massage at around 1230

Masseuse is running late...

It’s basically a big ol’ tummy rub... no pressure, lymphatic stuff, questionable benefit for the additional cost...

Bladder is so full that I have to call it quits, 20 min into the 30min massage.

Pee - lots.

Back to listening to podcasts and sitting in the chairs in the lounge

Transfer some photos to the iPad, post a blog update.

Finally take my first bird-bath in shower room - not allowed to get the incision site wet for a week, so it’s sponge bathe only...

Pain meds (alternating Tylenol/Advil)

Another coffee at around 1620

Finally 💩 at around 1645! Apparently opioids cause severe constipation, and it’s a great relief when you can finally let go, it’s actually a major point of conversation amongst the patients.