Re: Re: M day minus 2 and counting!!!!!!!!

[Guest guest]

Hi Chaitanya,

Best wishes to you on your upcoming surgery. I'm not certain if this will help you but this was my experience. I did not take any pain medication until about 10 at night ( 12 hours after surgery). I had a button that I pushed and it delivered a small controlled amount of morphine IV. I probably pushed it 2 or 3 times that night but that was it. More importantly, make sure you go home with Procardia or Adalat or Nifedipine ( all the same thing) in capsule form with liquid medicine inside it. You may have esophageal spasms and this will definitely help - but you don't want to swallow the capsule just the liquid inside. Cut off the tip with a scissors, squirt it under your tongue or swallow the liquid. This is great medicine for esophageal spasms. Sometimes, I took over the counter Pepsid, the chewable variety for what felt like hearburn. I took 4 (10mg chewable tabs) at one time per day, as my GI said that would be fine. Sometimes it was hard to tell whether I was having a spasm or heartburn so I would take the Procardia and Pepsid at the same time and they worked just great. Other pain you might experience is from the gas that is used. It rose to my left shoulder and took awhile to dissipate.( days) I found those bean bags that you put in the microwave and heat up for 1 or two minutes to be very soothing. A heating pad would work also, you just don't want to burn yourself. I used it behind the L shoulder blade which is where I experienced some discomfort . It takes awhile for the gas to dissipate. I st arted using the heating pad on day 2 at home. The heat should not be placed anywhere near your incisional sites or near where the surgery was done.

I was on a soft diet for several weeks - but for me that included tender fish and chicken as well as mashed potatoes, pudding, smoothies,

oat meal, yogurt and scrambled eggs. I was told to stay away from fresh fruits and vegetables for awhile and no steak for 2 months. You might want to ask about canned peaches, mandarin oranges etc. They may be ok. From your list I thought you might be vegetarian.

Can you eat eggs? .Unless you have become very malnourished as a result of A I'll bet you will enjoy milkshakes and smoothies over something

like Ensure which I found to be less then desirable.

My incisions had steri strips and I kept them dry until they fell off. The doctor said I could take showers but not to let the water thoroughly

soak my incision. I chose to take sponge baths for about the first 5 days. Do not take a bath until your incision is completely healed.

Couldn't lift anything over 5 lbs. for several months.

If your incisions get red, inflammed, ooze purulent discharge, are tender around incision - or you develop a fever ,see your MD.

Before you leave the hospital make sure you know who to call if you should have any problems during the day or at night. If your

attending MD is not available at night then he or she will have a partner who is available. Get their name and number. If you are in a teaching hospital

then a resident or fellow will be available to take call. Fnd out which resident is on call for those first few nights and make sure you get his number.

Frequently, post operatively, your legs will be wrapped in an inflatable cushion that inflates and deflates with air. These are kept on your legs to prevent blood clots and are used post operatively and through that first night. They are unpleasant but not painful and you will most likely be happy to have them come off which is usually the next morning.;

I did not have an NG tube, but some people do. The only discomfort that you should feel is possibly some soreness in your throat and slight soreness where it enters your nose. When I was actively nursing, most people did not complain about it being painful.

Make sure you get up and walk as often as you can. I was walking several hours after returning to the room from surgery. BUT make sure

someone is with you and helping you so that you don't fall. You will also be getting rid of the anesthesia so you may be unsteady on your feet.

Walking helps prevent the complications of surgery and is good for you. Make sure your MD has written an order to walk -which he will do

when he thinks you are ready. The order should be written within hours after you return from surgery. Sometimes the nurses are too busy to

take you for a walk, so whoever is with you can let the nurse know that you are going for a walk and help you.

After all this I am assuming your are having a Heller Myotomy. If you are having an open procedure then most everything that I have told you

will be different.

I was eager to get home on the second day and glad to be in my own bed in a quiet setting.

Just take things gradually and be patient and you will be feeling like a new person almost immediately.. Everyone recuperates differently, depending on age, what shape you are in and how everything goes.

Best of all you will be happy to be able to eat. Eating, which is one of life's pleasures becomes pleasant again. You are going to like

the new you. Weeks down the road when you have advanced to more solid foods, if you drink lots of water, with your meals, eat reasonably sized pieces of food and don't gulp your food down - everything should go quite well.

Keep us posted. We are all wishing you well.

Bobbie

.

[Guest guest]

Happy the information I shared with you helped.

You are going to be fine. Because this is a laparotomy the recovery is incredible. By the

3rd day I was walking on the beach. I would say that is a little too ambitious as I was tired

for the next week after that. But you now have the idea.

Positive attitudes are everything in recovering well.

Looking forward to hearing from you after surgery.

Bobbie

[Guest guest]

Chaitanya,

You will be able to walk with the urinary catheter in and the collecition bag. As well as with the IV pole. Although it is preferable to have it removed, it is unlikely they will do so until the second day. Have the nurse show you how to do this the first time and after that

who ever is with you when you walk can help you.. Generally you can clip the bag onto your bathrobe pocket or hold it and then you can move around with out a problem.

The other thing I didn't mention is that they will have you blow into a little gadget and

raise the balls in the gadget. - its called a spirometer. This expands your lungs and keeps them from getting congested. They don't want you to cough after this surgery as they do for many surgeries.

My good friend stayed with me during surgery and spent the night with me as well

in the hospital. She took notes and I just found them. Only an R.N would do that so well.

She was my angel watching over me, and it allowed my husband to watch over our son.

Anyway, in reading the notes she took, I am reminded of more of the details.

Here they are:

I had a dry sterile dressing over each of the 5 incisions. Underneath the dressing was a clear patch over the steri stips called Tegaderm this came off 2 days after surgery and tne steri strips stayed on. I WAS able to shower the day after surgery but I waited as I told you before. You are able to get steri strips wet but don't soak them. They do fall off on their own. Your sutures should be inside and absorbable Initially had oxygen on ,.very briefly.

I had an IV with D51/2 S and 20meq of Kcl whic is standard. It is basically dextrose,

with normal saline and a little potassium. Standard fare.

Also had a Foley cath in and it was removed the next morning.

They didn't want me to be nauseated so they gave me Zofran.

I was belching and they said this was good as the air is getting thru and decompressing the stomach.

I was back from surgery at 2:15 and walked down the hall at 6:15 pm. Sitting in a

chair at 6:30.

Vital signs were taken every hour after surgery for about 6 hours and then less frequently.

Both Foley Catheter and IV were taken out at 6 am the next morning

Activity: I was told no heavy lifting and no situps. Don't lift more then 5 lbs.

I was reminded that I also had pain in the upper chest as well as the shoulder.

Because the diaphragm is manipulated during surgery that explains some of the pain

(which is called referred pain). Also, the gas is a culprit - which I told you about and

the last bit of pain I had was in the neck from lying in a certain position during the surgery.

All of the pain I have told you about was very tolerable and did not require anything until

late a night and then I pushed the Morphine button. Eventually used heating pad with great relief.

Met with dietician the 2nd day post op.. Stay away from fried foods, stay away from rice and DON't under any circumstances drink carbonated beverages. She went over the

post op esophageal diet which was very helpful.

Once the catheter was out they wanted me to void in 6 hrs. Drank alot of fluids.No problem voiding.

They also gave me a stool softner to take home with me but I didn't need it.

Also went home with pain med and the Nifedipine Capsule that I told you about.

I have a very low blood pressure 90/60 or sometimes 100/70 and I used the

Nifedipine without a problem. You will have to talk to your MD about this and see if

he will agree to give it to you. It depends on your BP.

Those are the details.

Best wishes and a speedy recovery.

Bobbie

[Guest guest]

Chaitanya, I'm pressed for time so this will be brief (well, brief for ME

at least... everything's relative, right?)

> I like the idea of a pain button if it helps. I used to be such a

> Spartan (chewing dog pain kind of thing) but now I realize it is

> totally uneccessary to suffer like that. The present pain meds are

> so much better than they used to be.

I had this after my emergency c-section - works well b/c you don't have to

wait for the nurse to come after you hit the call button (and that can

sometimes be 10-20 minutes!), b/c you can just hit your morphine button

whenever you need it. (it is programmed for no more than X amount every Y

minutes, etc., but you can't tell when it is or isn't dispensing, so

there's a placebo effect as well as the actual drug effect.)

> Have written down Procardia, etc. to discuss with my doctor. This

> kind of info really helps so I am ready to talk to the medical

> professionals I must deal with.

Because Procardia affects blood pressure, your doc may not be comfortable

with it (not that there's anything wrong with it, just that some docs

don't like to give meds for off-label effects.) You can also request

NuLev, Levsin, Levbid, which is an anti-spasmotic medicine. Knowledge is

power!

> I have a hot water bottle and a cold/heat pad to use if/when the

> need arises. Thanks for bringing that up. Have also developed a sign

> language to tell my DH if I am having pain or nauseated.

They also will likely give you a med to dry up your saliva (so you don't

aspirate it while under anesthesia.) It took me over 48 hours to get that

out of my system after my c-section -- even though I was on plenty of IV

fluids, I was SO PARCHED all the time! Make sure your hubby knows to keep

your water/ice glass full at all times -- you don't want to wake up with

cotton mouth and have to wait 20 minutes for the nurse to answer the call

button!

> Will try to be careful not to get steri strips, etc. too damp.

> Thanks for telling me what you did. I can't say enough to everyone

> here how it really helps to hear the details. Keeps me from worrying

> by focussing me on things I can do.

They let me shower the day after my c-section (and goodness did that feel

good!) If you feel like showering (sponge baths just never get me feeling

clean enough... showering has a regenerative effect for me, like I've

washed off the ickiness and watched it flow down the drain), just ask the

nurse if you can shower. (If you're ok with a sponge bath, that's fine

too -- but if you would like to shower, you probably can in some fashion.

For me, I don't feel like I bathed if I didn't wash my hair, too.) They

might tape a bandage over your teeny incisions to keep them dry, or they

may just dry the incisions afterwards and put on new bandages, etc.

> I remember reading someone said that they had those leg massagers

> and no one even plugged them in. Was told I will have some during

> the operation and for a while after.

I believe they will take them off as soon as you're ready to get up and

around. I didn't have them at all with my c-section (and I don't think

they even had them back in the early 80's when I had my appendectomy), but

I was up out of bed about 16 hours after my surgery (probably would have

been sooner, except my surgery was at 6pm, and so it was the middle of the

night when I was awake enough to actually walk on my own, and then I had

to wait until after the 7am shift change, etc.)

> The Anesthesiologist says I will have a catheter. Want that out

> ASAP. My surgeon says he likes his patients up and walking as soon

> as they are able. Helps with recovery.

That's another reason I had to wait so long to get up and walk after my

c-section, too -- had to wait for the nurse to remove the urinary

catheter, and she couldn't do that w/o the doctor's permission, etc. So

you might want to make sure your doc has written orders in your chart for

your cath to be removed after X number of hours, or whenever the patient

expresses an interest in getting up out of bed, etc.

Another thing would be to make sure which doc is going to be on call,

etc., during your hospital stay. After my c-section I had been told by

the operating OB and the nurses that if I did everything they needed me to

do (get up out of bed, pee, eat, walk around, get intestines going again,

etc.) then I could go home on Wed. afternoon (my c-section was at 6pm

Monday night). When the OB on duty that afternoon (not the one who did

the c-section) came through on his rounds, I was in the rocking chair in

my room, nursing my baby. He asked how I was doing, blah blah blah, and

made some notes in my chart, then I asked if I could go home now. He

chuckled and said, " Oh, no, you just had a c-section two days ago, you

can't go home today! " and he left the room.

I looked at hubby and just busted out sobbing... I had to hand the baby to

him b/c I was crying so uncontrollably that I couldn't even hold a 7-pound

baby. (Aren't postnatal hormones wonderful?) I was totally distraught,

telling hubby that I did everything they asked of me and I just wanted to

take my baby home, blah blah blah. Hubby is NOT used to seeing me act

emotional and out of control like this (understatement of the year!) and

he went to get a nurse to see if there was anything that could be done to

get me out that day.

The nurse said to wait until the evening on-call OB (a different doc) came

through on her rounds about 6pm. Sure enough, when that OB came in to see

me, we had the same " how are you doing, blah blah blah " conversation, I

asked if I could go home, she said yes and scribbled discharge orders in

my chart and we were outta there! For having a c-section, I was moving

incredibly fast to get packed up and out the door with my baby... I didn't

want them to change their minds and keep me another day! I felt like a

bank robber.... " Honey, go bring the getaway car around the back and I'll

meet you there with the baby... GO! HURRY!! " LOL

So the moral to the story is just to make sure who is going to be writing

your discharge orders, and when they'll be there to do it, and if there

are any " minimum requirements " that you have to meet (such as walking,

eating, etc.) in order to qualify for discharge. If your doc won't be the

one on rounds when you're expected to be able to be discharged, make sure

he's got it in your chart that you can go home after meeting X

requirements. You'd think it wouldn't be that common, but I had my IV in

for an extra 12 hours longer than I needed to after my appendectomy... the

surgeon had mentioned to me on morning rounds that it would be taken out,

but he didn't write it down and the nurse wouldn't remove it w/o his

orders (even though it was standard procedure to take it out on the second

day!)... they left it in until he came back to the hospital for evening

rounds. So out of two hospital surgeries, I've had two experiences of

docs not properly documenting orders in my chart that resulted in

unnecessary delays for me.

Please know that we'll be thinking of you and praying for you tomorrow!

Whenever you get the chance, please pop online and let us know how you're

doing -- I can't wait to hear your good news!

Debbi in Michigan