Thursday, October 18, 2012

Surgical Saga

I am just too drugged to write up the junk that happened with insurance, so I will save that for later.  It was absurd.

For now, I am bored between bouts of narcolepsy.  Plus I want to document my recovery.  This is both for friends, family, and interested readers, and as sort of a service to those looking at having surgery for femoro-acetabular impingement (FAI), and especially those looking at having it with the surgeon I saw - Dr. G. Peter Maiers in Indianapolis.

I did a lot of Googling for stories of recovery from this surgery, and for stories of Dr. Maiers and felt very lucky to find a blog by a young woman distance runner with a lot of experience with Dr. Maiers who happened to have my exact surgery (for FAI with a psoas release).  You might remember I was totally terrified of this surgery.  I had frequent freak-outs about the anesthesia (I have been under general anesthesia several times, but not since I've been a mom and it really REALLY freaked me out.  Thank you to my friend K, an anesthesiologist, for putting my mind at ease in so many ways!).  And, of course, freak outs about recovery - and just how much I ever would recover.

Anyhoo, we headed up to Indianapolis on Tuesday still not knowing whether I was having surgery.  About 5 minutes from the surgical center, Dr. Maier's Physician's Assistant (she is an angel) called to say my surgery had been approved by the insurance company.  So The Beast and I rejoiced, and then I of course said, "sooooo now I'm going to freak out about the surgery part for a little while.  We've been through this and the surgery is the best idea, right?"  (Yes.  I couldn't go through the rest of my life periodically limping and having shooting pains in my leg, and beating my leg after sitting for an hour - even if I have every side effect of the surgery...would it really be worse?)

We arrived at the surgical center and picked up the cuff for my new best friend, The Iceman. This is basically a fancy ice pack.  It keeps me on ice for several hours at a time.  We then registered and waited for a nurse to come get me checked in and started on an IV.

Once I was in my gown, started on my IV of fluid, and approved as not needing to be shaved by a nurse before surgery (something I was so not looking forward to and kind of hoped they would do once I was unconscious), A-Train and The Beast came back to hang out.

A-Train was so adorable.  He has lately been checking on people when they're hurt - he gently pats them and says "kay?  kay?"  (roughly translated:  "are you okay?") and he insists on giving kisses to ouchies - especially if he caused them.

He  had a little toy fighter jet, and he kept flying it around my room and then he would land it upside down.

A, animated:"Uh oh!  Bawa!  Uh oh!"  ("Bawa" is his word for airplane - I have no idea where it came from.)
Me: "Oh did the airplane crash?  Is it hurt?
A, concerned:  "Yeah.  Uh oh.  Bawa."
Me:  "Can you make it better?"
A, turning the airplane over, stroking it, and speaking in a quiet voice:  "kay?  kay?"

Lather. Rinse.  Repeat.  And repeat.  Again and again.  It was so sweet!

Then Dr. Maiers came in and marked my right leg/hip (it says "GPM YES") and asked if I had any additional questions.  He was pretty thorough at my previous appointment with him, so my only question was "you've done a lot of these, right?"  His answer:  "we just did a count, actually, and it was about 240 last year.  So about 20 a month."  (It's worth noting that there are only two surgeons in the state of Indiana who do this procedure, and a handful nationwide.  People are traveling to see these various surgeons.  So it's not like there is a Hoosier epidemic of FAI.)

As Dr. Maiers left, he shook my hand and also The Beast's.  A-Train took note and started shaking The Beast's hand over and over.  SO CUTE.

In the video, he says "Pee-poh!  Dis!"  (roughly translated to "people did/do this.")  I'm surprised it wasn't "guy!  dis!" because usually men are "guy" and women are "mom-o."  Yeah, my kid calls every woman "Mom."

A little while later, my anesthesiologist came in.  We talked briefly about my kidneys and I mentioned I was nursing A-Train.  He immediately responded, "not a problem at all.  We used to tell moms to double-pump, but there is absolutely no research to say that's necessary."   Basically, he answered my question just the way I'd hoped! The staff was generally really great, and I was impressed with how well the surgical center is run - and also with the beauty of the outside of it.  The fall foliage right outside was gorgeous, and The Beast was able to take A-Train for walks in the woods (Bean, during all this, was at a friend's - thanks to a different friend K for that offer!!).

So they wheeled me to the OR and had be walk in (colllllld in there!) and lay down on the traction table.  They explained that I would get drugs in my IV that might burn, then I'd be out.  They'd place a breathing tube and then they'd position me with my foot in the boot of the traction table.

I don't even remember them giving me the drug.  I just remember being told, "you're awake.  Surgery is done!"  And groggily looking around for The Beast and asking "does my husband know I'm awake?"

I came out of surgery 30 minutes earlier than anticipated, so The Beast was not at the surgical center (I think they went and looked for him in the waiting room). But because he was with our 2-year-old and I couldn't really move or talk, it was decided we would wait until we were talking about me going home before my family came back.  Which was the right decision, of course...but I was so lonely.  I felt desperate to see The Beast - like somehow seeing his reaction to seeing me would verify that I was ok.

It also turned out that no one called The Beast to let him know I was awake - he just happened to see a nurse and she asked if he was waiting for someone.  That was over an hour after I was out of surgery! 

Anyhow, after I asked if my husband knew I was awake, the next thing I remember was seeing the nurse get a syringe ready (most likely of morphine) and quickly saying "can I breastfeed on that?"  She said the anesthesiologist noted I was breastfeeding and approved everything.

I was sitting up in bed, and felt like I was sliding down it.  The nurse said I sort of was, but when she went to out me at a different angle it hurt way too much.  Finally, she helped me bend my bad leg so my foot was flat on the bed, which (surprisingly) felt better in every way. 

After a whole bunch of drugs (morphine, Percocet, and Dilaudid are what I remember), the nurses started talking about me going home.  They called my husband back and gave him my discharge instructions, and included a video of my surgery!  I assume this is video from the scope end, and nothing external - if there is no cutting of my skin and not a lot of blood, I think I might watch it!

Anyhow, they then told The Beast to go get the car and they'd get me dressed and ready to go.  They sat me up and I immediately got nauseous.  A nurse gave me an anti-nausea pill to dissolve under my tongue and sat me in a wheelchair with a barf bag for the short trip to the bathroom.  I told her I was suddenly really, extremely tired and couldn't keep my eyes open.  "It's probably the Dilaudid," she told me.

She helped me get seated on the toilet and told me she'd be outside the door and to let her know when I was done.  As I was peeing (apparently they gave me a LOT of fluids in that IV), I laid my head down on my hands, which were on the bars I had used to help lower me onto the toilet. 

I'm not sure how long I was asleep before the nurse said, "you ok in there?"  And I woke up with a start and slurred, "Iwuz'sleep."  She said she'd thought so!

She helped me stand up and get my pants back on, and then I said I was going to throw up.  "Go ahead and sit down," she said.  So I sat back down on the toilet.  "Ha! I meant in the wheelchair, so you're not sitting on the toilet with your pants on!"  She helped me turn around and sit in the wheelchair, all while keeping a trash can in front of me.

About two hours after I'd come out of surgery, I was being loaded into the car.  Bean was at his friend's, so I had lots of room in the back seat next to A-Train.  And I was HUNGRY.  I hadn't eaten in over 24 hours, except for some graham crackers they gave me in recovery.

What I remember of the ride home was waking up with food in my mouth.  Repeatedly.  And then some instances of desperately needing water right this instant.  I had cotton mouth for 24 hours, plus my throat was a little swollen from the breathing tube.  I constantly felt like food was getting stuck in my throat.

I missed Bean all night. I was relieved to hear he had a great time at his friend's and went to bed there no problem, but missed his sweet face and his current "helpful hero" phase. He has been looking forward to "taking over" for me and doing things like bringing me my crutches and catching A-Train when he runs off.  Bean has been pretty darn sweet over the past day or so.  He wants to play Zelda all the time (well, he wants me to play while he acts it out next to me!), which is a blast and something I can do to hang out with him while I can't move much.  He can turn on the game console, the tv, bring me my iPod Touch (I'm using a walkthrough), and he even helped me get cereal and milk and a bowl and spoon out at the table this morning so I could fix my breakfast without bugging The Beast yet again.

Possibly more from the psoas release than from the rest, I have a lot of weakness picking up my leg right now.  So I am glad I kept up my upper body strength to some degree when I stopped doing much exercising - I am literally picking up that leg to get it on the bed, into pants, etc!  Getting dressed is like target practice right now - I drop my pants on the floor and then carry my leg and aim it into the pant leg!

In terms of pain, it's not as bad as I expected so far.  It actually feels better to put the foot down and bear the tiniest bit of weight when I'm getting around, rather than picking up that foot/leg and only bearing weight in my good side. Dangling the foot/leg on my bad side HURTS.  It just puts way too much pressure on my hip.

I am relieved to report that my "private area" (as the surgeon referred to it in our consult) does not appear to feel numb.  So far, I have numbness in the skin of that thigh, but I don't notice it until I rub it, and then it just feels strange.  It's likely I will get all or most of the feeling back - and I've said before that I would prefer a little numbness to the zinging and throbbing I had before.  So, otherwise, some pain and pressure, and so far fairly localized to the joint, which is more than I could say before as I got zinged all over my upper leg and even around into my back.  I backed off a little too much on pain meds last night and got more achiness in my back and a little stinging in my incisions (which are small, and there are three of them).

In general, so far so good.  I have physical therapy late this afternoon.  I'm kind of scared.  I hear it's pretty brutal because they want us weight bearing pretty quickly (my surgeon's PA and all the nurses keep saying "yes!  bear weight as much as you can!").  I'm all for taking the physical stuff slowly, because I want to get off the narcotic painkillers ASAP.

The narcolepsy sucks.  I'm definitely complaining more about that than the pain!

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