Surgery Day + 2

Going home From the hospital and getting a  reprieve from the governor for  your prison sentence are about equal in importance .  Dr. Kai says I can go home tomorrow. The usual hospital stay is one to four nights so two nights does not sound so bad, kind of like a cheap cruise package - three days and two nights - only not so cheap. The modern hospital wrist band includes a bar code which is scanned with the administration of each pill, shot, treatment, blood draw, meal delivery, and therapy. There is a definite cha-Ching sound with each wave of the scanner wand.

Dr Kai passed the HIPAA test yesterday. Or was it day before yesterday? Anyway, as Dear Husband and Belle Fille ( that's the lovely French term for step daughter) waited to speak to someone as the surgery was over, they witnessed an older doctor stick his head out the door of the surgical sanctum and deliver a cryptic "your loved one has survived" message broadcast to the anxious family and everyone else in the area. As the family jumped up and rushed forward he was already receding back behind the safety of the "surgery personnel only" door. So it was with something more akin to suspense than anticipation that they awaited Dr. Kai's appearance. When he did appear, a bit wan and with bloodshot eyes, he invited them into the surgical area and patiently and privately revealed the details of the operation. He reassured them everything went well and told them they could join me in my room momentarily. That's how it is supposed to go!

By Day 2 I was ready to eat grilled cheese and tomato soup, my version of comfort food. I could visit the bathroom on my own. Love that! I was alert, awake, pretty comfortable due to the miracle of pharmacology. Why didn't my nerve block work? "Sometimes they don't." No matter, I was doing well, albeit slightly breathless. The respiratory people kept telling me to breathe more deeply. Did my arm hurt? Not really. It burned a bit, the bandage from collar bone to inner elbow was kind of scary, but pain? No more than the miserable eleven months previous and I didn't have the benefit of drugs, staff and hospital flowers to dull the discomfort then.

I was still wearing hospital gowns, had not the energy nor desire to delve into my tote bag of carefully chosen, chic pjs. The gripper bottomed hospital socks were better than my color coordinated socks, especially since I was not wearing anything they coordinated with. A hairbrush and a toothbrush seemed to be all the grooming tools I needed. Why did I bring all that stuff? The only toy I needed was the TV remote control. A second slightly restless night.

Time traveling

The astute blog reader might notice that my dates are a bit off. My only explanation is that, along with the upper parts of my humerus, they also removed some brain cells. I simply could not tackle intellectual pursuits for the couple weeks after my surgery. A light novel I had downloaded to my ipad went unread. Magazines lay unopened. Don't even think about a crossword puzzle! If you are not bored to death by now and if you keep reading, you will see that there was a lot going on and my Little dipper was full. Opening a new blog page was out of the question.

So in order to keep continuity I am labeling my posts as "Surgery Day + " and hope to fill in all the missing details pretty quickly now that I am feeling better. Stand by.......

End of Day 1

By the time I was moved to my room it was 6:00 PM. I was alert but weak and not hungry, even though I was offered all sorts of food, snacks and even grilled cheese sandwiches. I was thirsty and water sounded perfect. A dry erase board across from the foot of the bed was crucial to my knowing who was who. There was a veritable parade of doctors, nurses, therapists, technicians, service people,  food service workers and volunteers. Everyone introduced themselves. Every procedure was explained, every drug was identified. Everyone asked about my pain level and offered pain relief if needed. As abhorrent as a catheter is it was a blessing to not have to get out of bed to tinkle. After family visits I was able to sleep intermittently all night. Day 1 went pretty smoothly.

Day of surgery!

Coordinating who is where at what time for surgery has to be as complicated as planning the invasion of Europe in WWII. Of course the hospital gives you a time to show up for all that pre op stuff but does your family really need to be sitting in the "family waiting area" for hours before, during and after? One thing my hospital does is to assign you a secret code (number) that displays on an electronic board in the waiting area  along with the brief detail of where you are: pre-op, surgery, recovery or patient room. You can also use that number to request info by phone if you, the friend or relative, are not at the hospital. Great idea!

But I was given the number as I checked in and the race was on! I was  whisked into pre-op and asked to disrobe and put on the dreaded hospital gown. I grabbed my cell phone to call the triage system of notification. No signal in the depth of the surgery wing with all its electronics.

Now positioned on the Stryker bed with a friendly nurse putting an ID on one wrist and an IV in the other, I was trying to log my iPad mini in to the hospital network to send family emails. Yes, I agree, yes, I accept, oops here is my surgeon. We quickly agree which shoulder is being operated. Did you know a representative from the company that makes your prosthetic knee, hip or shoulder is present in the operating theater? They are not present to assist in the surgery. That would be illegal, remember the Law And Order episode? But they are in place to consult about the devices and offer suggestions if things don't snap together like Lincoln Logs. As Dr. Kai walked away the anesthesiologist, Dr. Magnifico, rolled up with his portable ultrasound machine. As I frantically typed my patient ID number into the email and zipped it off to all children, Dr. Magnifico explained I would receive both a nerve block and general anesthetic. The nerve block lasts 24 to 36 hours and numbs the shoulder during the immediate possibly painful post op period. The ultra sound helps him position the drug in just the right spot for greatest effectiveness. As the nurse slipped my ipad from my hands I slipped away.

My eyes fluttered open briefly and I had been magically transported to the surgery room. It was cold and brilliantly illuminated and white. Off to one side Dr. Kai and the prosthetic rep were rattling pieces of metal rod, presumably my new arm parts, and nurses moved in slow motion around my bed.

That's the last I remember until I managed to squeak out "HURTS" to a recovery room nurse bending over me. Briefly incredulous, she asked me if I could feel her touch my fingers. I certainly could! I heard someone say the nerve block did not work and someone else said dilaudid and I was instantly pain free and drifting back to sleep.

In spite of the failure of the nerve block, from that moment on the pain was not severe and managed very well with ordinary pain meds administered as often as I requested. It seems to me that the hospitals are very concerned with your pain level and mean to keep you as comfortable as possible.  In spite of the failure of the nerve block I was kept quite comfortable...if you don't count how uncomfortable hospital beds are.

Don't get your knickers in a twist!

Packing for the hospital stay is a challenge. Wear something easy to get out of. Bring something easy to get in to. Wear slip on shoes or shoes with Velcro closures. A big loose button front soft shirt will let you slide your operated arm into the sleeve without too much contortion. But what about the bottom half? Loose stretchy pull-on shorts, loose enough that you can pull them up with one free hand, is a good idea. Those popular "pajama" bottoms that are seen everywhere now are great.

Remember house dresses of the 1950s? Loose fitting and buttoned all the way down the front. Where is a vintage store when you need one?

No one has mentioned unmentionables. What does the zaftig, modest female patient do? The morning after surgery the doctor is going to walk in to the hospital room, smile reassuringly, and want to check out his handiwork. Will you be wearing your Maidenform under your hospital gown? Probably not. I'm still working on this problem. If "bloomers" suggest something loose and large below that is a good idea.. What I don't need right now are Spanx!

What I do need is Anna, the lady's maid from Downton Abby!

What kind of a joint is this?

I forgot to tell you about the TOTAL SHOULDER JOINT REPLACEMENT PATIENT AND FAMILY EDUCATION PROGRAM offered by my hospital. This is really an addition to the long standing HIP And KNEE program which is much more popular. It is run by the Rehabilitation Services Department, presented by an RN and a physical therapist with a power point program. Lots of fluff but also lots of good information. Of the 25+ participants I was the only shoulder patient... made me feel a little anxious. Many of the patients were repeats so even they had good advice to share. We could ask all kinds of personalized questions.

A big deal is made about scrubbing down with Hibiclens the night before surgery and again the morning of. This is to prevent infection, of course. I was diligent Monday night before surgery, practically scrubbed my skin raw! Then, as I stepped out of the shower and grabbed my four day old bacteria-ridden towel to dry off, I realized a vital step had been omitted. USE A FRESHLY LAUNDERED TOWEL if you don't live in a hotel with fresh towels daily!

The blog is back!

Wow is not enough. I've been busy. But I am going to catch up on all the fun I have been having the past twenty or so days. If it is too much detail, forgive me. There is nothing more fun than reliving your medical experiences once they are behind you.