The Day of Surgery

Now that I’m back on the blog, I might as well head back to the day y’all last heard from me….the day I had surgery. In case you’ve forgotten what was going on, you can read this post as a refresher. I went in for a left sacroiliac joint arthrodesis (fusion). Basically, I had three titanium rods hammered into me to connect the lower part of my spine to my hip because the joint wasn’t stable and kept causing me a lot of pain. 

Surgery

Pre-Op

I had to be at the hospital at 6am on the morning of my surgery. My mom had just arrived the day before, so she and Dave were with me on the drive downtown. Once we arrived, Dave came with me into the hospital and my mom went back to the house to take care of the dogs (she brought her two – Abby and Mischa – down from Canada with her, and of course we have Katie). We had to wait a bit to register, but the registration process itself was a breeze because I had done the pre-registration questionnaires over the phone the week before. Then we were lead up to the surgical waiting room, where Dave was given a pager and a special number he could use to identify me on a screen in the waiting room that would tell him where I was in the process of things. 

We had to sit in the waiting room together for a little bit, and that was torturous. Of course I was kind of nervous about the surgery to start with, but they also had fresh coffee brewing for the friends and families of the patients. Do you know how hard it is for a caffeine addict to ignore the aroma of fresh brewed coffee at 6:30am when you can’t have any!? Let’s just say that it was horrible for me. Thankfully it wasn’t long before me took me back to the pre-op prep area. Dave was actually allowed to accompany me, which was nice. I got to give a urine sample, rub myself down with disinfectant wipes, put on a gown, have my temperature and blood pressure taken….all that kind of stuff. During this time I also got the first glimpse of my friend Colleen, who was working as the pre-op pharmacist. It’s so nice to have a friendly face around (other than out family) when you’re heading into surgery. While the nurses were bustling about the neurosurgical resident came by with a med student in tow to mark the leg they were supposed to be operating on with a sharpie. Then my neurosurgeon, Dr. Rodgers, came by before heading into the OR to make sure I didn’t have any last minute questions. Finally….my anesthesiologist came by. As a pharmacist, my primary concerns were all drug-related, so he was the poor guy who got peppered with a million questions and concerns from me. As soon as I started talking it became very apparent that I wasn’t some Joe-schmoe patient, so it didn’t take long for the anesthesiologist to figure out I was a pharmacist and start talking to me like a real person and not some kind of imbecile (which is how I feel when health care providers start talking to me like they do to every other normal patient….not that I blame them, I talk to patients in the exact same way). So once the anesthesiologist and I got talking on the same level, I quickly got the assurances I needed. Then it was time for me to get on the gurney. Colleen stopped by for a quick “see you later” and I said goodbye to Dave, and the anesthesiologist wheeled me away. 

It was really weird to be in the OR as a patient, at least for me. I haven’t been in an OR as a patient since the age of 5 when I had a tonsillectomy. Laying on the gurney in the OR this time around, I envied my 5 year-old self. At that age all you’re told is that you’re going to go to sleep for a bit, and when you wake up you might be in a bit of pain. Kids are blissfully unaware of all the risks involved with surgery. On top of that, now I’ve actually been in the OR and worked in a hospital. I know exactly what happens once a patient is under anesthesia. Don’t worry, I won’t tell you, because you don’t want to know. Not many people would go in for surgery if they realized the indignities patients suffer when they’re none-the-wiser! But as I was saying, it was weird to be in the OR. The sights, the smell, even the sounds are so familiar to me. So that, in a way, was comforting. But then I looked around (or at least, looked around as best I could while on a gurney) and I didn’t recognize anyone. Well, I recognized Dr. Rodgers, so that was good, and the resident and student who had come to see me just a bit before, but there are so many other people. Nurses. Other physicians? It’s bustling, and they were all preparing for me. I know what it’s like to be on the inside of that kind of group, that works together so often that you get into a rhythm with each other. Everyone know their jobs, their places, and can predict what the others will want or need from you in advance. Even in the most serious of situations, everyone works together in a way that resembles an amazing synchronized choreographed dance. I’m more used to being part of that dance, rather than the patient in the middle, which is really like being the outsider looking in. 

Thankfully, my nurse in the OR was nothing short of fantastic. She was chatty in exactly the right way. While she was working she kept me talking and thinking about other things so that I didn’t spend too much time looking around and getting worried about what was to come. Before I knew it the anesthesiologist was placing my IV, and soon enough it was go time. I vaguely remember being asked if I was ready, and I think I replied something along the lines of “I’m as ready as I’m ever going to be.” Then I remember the anesthesiologist telling me that I would be out in 5 seconds, and sure enough I could only count to six. 

Post-Op

I had entered the OR at 7:30am, and presumably was put under within 15 to 20 minutes. Around 9am Dave was paged and told that they were finishing up with me in the OR, and around 9:30am Dr. Rodgers came out to tell Dave that everything went well. Of course the next thing I remember is waking up in the PACU. “Waking up” really isn’t the best term….anesthesia does a number on you and I kept coming in and out of consciousness. The PACU was by far the very worst part of the whole experience. First of all, they operated on my side / back, which meant that they had me almost face-down in the OR, but they flipped me back over on the gurney to the PACU. As a result, my weight was resting on the area that had just been cut into and was all swollen and painful. NOT FUN. In my groggy state I kept trying to flip over to my stomach, but the gurney was upright in a sitting position, which made that really difficult. To make matters worse, my oxygen levels kept dropping below 90% (they’re normally supposed to be almost to 100%), so I kept needing a nasal cannula for oxygen and I kept getting all tangled up in the tubing. I’m pretty sure my low oxygen levels were due to all the pain killers they were giving me (it’s a fairly common side effect), but the pain killers at that point were only being partially effective. So Dave ended up getting another page letting him know that they were keeping me in the PACU longer trying to get my pain under control. The only good moment in the PACU was when Colleen came to visit me. Dave wasn’t allowed to see me yet, so having a familiar face there was fantastic. Plus, she got me hooked up with some crackers as I woke up a bit more, and I needed them because I was starving!

When I finally was ready to be transferred to the level 2 PACU, where I could see Dave, the physical therapists showed up. They ended up following me there then immediately wheeling me off to the orthopedic unit where they have equipment set up to help teach me how to use my crutches, especially for going up and down stairs. The wheelchair ride was not fun because once again I had all my weight on the surgical incision. To make matters even worse, we had to go across the main level to get to a different wing of the hospital and it’s tiled….which means it’s kind of bumpy ride. I guess you probably wouldn’t notice the little bumps much if you were feeling fine and dandy, but when each little bump feels like someone is punching you in your hour-old surgical incision….let’s just say it’s not very pleasant. Despite the nasty ride, the physical therapist and his student minion were great to work with and they had me hopping up and down stairs in no time, even though I was still a bit groggy from the anesthesia. I even made it part way back to the elevators by myself on the crutches! 

When we got back to the level 2 PACU I was given my discharge orders. Whoop whoop! Dave gave my mom a call to let her know to come pick us up. While I was in surgery she had drive back to our house (about 45 minutes away), showered, taken the three dogs for a little walk, gone and grabbed me some sweatpants that wouldn’t put any pressure on my surgical site, and was just in the process of picking up some crutches for me when she got the call from Dave. Honestly I don’t really know how much longer we had to wait because I was still groggy and falling in and out of a really lousy pain-filled sleep. Dave ran out to the car to grab the sweatpants and crutches, brought them back to me. As I changed out of the hospital gown Dave got the crutches sized up to match the ones I had been using with the physical therapists. Then I got to take another in a wheelchair through the tiled lobby (ugh) and into the car to go home….where I promptly fell into another round of pain-filled sleep. Despite the fact that most people stay overnight in the hospital after this surgery, Dr. Rodgers wanted to get me discharged ASAP because we were battling with the insurance to cover the procedure and he didn’t want me to have to pay for anything I didn’t really need. He felt I was safe to go home, so I did. My surgery started just before 8am, and I was in the car just after 1pm. Crazy, right?

Once we got home, I managed to use my new skills on the crutches to go upstairs and get into bed. Once settled, I promptly asked Dave to go get me some sushi from the Kroger down the road. Concerned that I would be nauseous and might vomit from the anesthesia and/or the pain killers, he refused. I appreciate his concern, but I wasn’t nauseous at all, I had a huge craving for the sushi, and I figured that after having three titanium rods hammered into me that morning I should be able to eat whatever I wanted. (He did finally relent and get me sushi for lunch the next day. Hallelujah!).  

Recovery

I was going to talk about the rest of my recovery in a separate post since this post is already long enough, but it’s pretty short so I figure I’ll just tack it in here.

I had a pretty extensive regimen of pain killers and muscle relaxers, and drugs to combat their side effects, for two weeks. I was on crutches for three weeks. Throughout my entire recover phase I felt like everything was pushed ahead of schedule by just a few days. I felt like I needed 17 or 18 days of pain killers / muscle relaxers rather than 14 days, and I also felt like I needed another 3 or 4 days on the crutches. That said, I think getting off the crutches was going to be really difficult no matter when I got off them. After resting your leg for so long your muscles just deteriorate and you’re insanely weak. Even by the time I got to physical therapy at week 7 (and had been walking / limping on my left leg for 3 weeks) my left leg was considerably smaller than my right leg because of the muscle atrophy. 

I don’t know what I would have done without my mom for those 6 weeks. She stayed with me so Dave could keep going to work and not have to worry about me. I was in bed for most of the first three weeks while I was on crutches because a) going up and down the stairs was a huge pain and b) it was the most comfortable place for me to sit. She brought up my meals, gave me projects (aka cutting out quilt pieces for her), and bought me an adult coloring books and colored pencils (an idea I originally heard about from Chelsea at The New Wifestyle as a way to help manage anxiety….for the record it’s also a great way to combat boredom and forget about the pain when you’ve recovering from surgery). I also appreciated having two extra dogs to snuggle with in bed, even if they didn’t get along all the time. 

Mischa, one of my three canine recovery buddies.
Mischa, one of my three canine recovery buddies.
One of my few trips downstairs to enjoy the spring weather on the lanai with Mischa and Abby.
One of my few trips downstairs to enjoy the spring weather on the lanai with Mischa and Abby.

So after all of this….the surgery, the pain, the crutches, the limping around, the 6 weeks of physical therapy….life is better than ever. I am almost completely pain free. There’s the minor pain here or there, but nothing major, nothing I can’t handle, and nothing that’s limiting anything I want to do. It’s insanely liberating. It’s scary to think how close I came to giving up on believing that a pain-free life was even possible. The journey to get to this point took way too long, and I had to go through even more pain to get out of the pain, but the end result is so worth it.

Until later, Ashlen