Recovery & Post-op

June 10, 2011

I think I got out of surgery about 7:30 – probably lasted about 2.5 hrs. – not quite sure though. I did wake up to a relatively quiet recovery room. The two nurses left were chatting about iced espresso in Italy I think, when I came to. I joined the conversation. Guess they didn’t want any outside participants in their conversation because I soon got rolled down to my room in the older part of the building. I think that was around 8 or 8:30. The older rooms are smaller, and the cot for Scott took up about half the free space. He didn’t have much room to get around, that poor man.

Clear liquid diet for now. No catheter. IV until it is finished. IV antibiotics for 3 doses, every 6 or 8 hours. IV or oral pain meds. Vital signs every hour for 4 hours, then every 4 hours. 12 hour shift for this nurse – shift is just beginning. This hospital is very focused on pain management – one of the initiatives. Sometimes I wonder if it doesn’t take precedence over old fashioned nursing or maybe standard nursing care. The nurse is pleasant and seems competent. The quiet music go inside music continues on the television channel of choice until near midnight I think. We actually got to sleep around 12:30.

What’s different in nursing?

Alcohol gel for handwashing, no soap and water. I guess I’m glad that’s the case. The hand sink with the soap was in a corner with the paper towel dispenser on the wall. Just below the towel dispenser is the towel rack for patient hand towels and wash cloths. What if that nurse had washed his hands at the sink, used a paper towel and his wet hand dripped on the towel and wash cloth I’d be using? Not such a good plan.

I had a drain attached to a suction device by a very long tube. Oops – I see that tube touching the floor. Ick…

I have an incentive spirometer given to me in recovery. Neither of the nurses on the unit asked me if I’d been doing my breathing exercises or asked me to do them for them. No mention of coughing and deep breathing. Surely those would be key activities in preventing post-op complications. Way back when, when I was a nurse, every time I visited my patients, and they were awake, I’d have them show me what they could do with their breathing exercises. No one assessed my breath sounds by listening to my chest with a stethoscope until just before I left. Mhmmm. 

No mention about moving in bed. Guess that’s why we have to have compression devices on our legs.

No checking of my dressing on my chest. I had a tight compression wrap going around my chest. Maybe no one ever springs a leak? Maybe the old timey basics are not taught anymore? Or maybe I just don't remember them carrying these activities out?

Night shift nurse to patient ratio on this urology floor – 1:5. I used to have 8-12 patients, depending on the unit. Guess that’s why there is such a nursing shortage. No nursing assistants or LPNs that I could tell.  

I didn’t say much about being a nurse – just acted like an educated patient for the most part. Though I did tell the night nurse when I was asking him some specific questions. I used to work on a urology unit when I was in Virginia at MCV right after I finished nursing school.

My progress

IV Dilaudid for pain. Didn’t think I’d do so well with pills in my stomach and no food. I stayed well medicated until about 2 AM. I woke up nearly every time the nurse came in even though he was very quiet. I am just not a sound sleeper. Soon after his 2 AM visit I felt sweaty, nauseous, and like I was either going to vomit or faint. Was it hypoglycemia from all that sugar in the liquids I’d been drinking? Was it a reaction to the anesthesia? Not sure. Called the nurse back in. Interesting – he had just done my vital signs, but other than asking a question or two then going in search for my requested protein, no further assessment that I recall. I now progressed to a full liquid diet with an Ensure. I was grateful for that. Within 30 minutes or so, I was drifting in and out of sleep, I was feeling better. I woke up again around 4 without much success in falling back asleep except maybe a nap near 6 AM. Good news – I get a regular diet for breakfast.  

A hospitality person brings around an extensive menu with multiple choices on it. Nice amenity. Wonder how much that costs. I ordered a breakfast sandwich, fruit, a bran muffin (pain medicine is constipating you know), not sure if anything else. Scott, dear man, went down the street to get me a Starbucks latte. It had been over 24 hours by this time since my last caffeine!

By this time I had been out of bed to the bathroom with the nurse’s help once, with Scott’s help at least once, and on my own at least once. It meant taking the compression devices off of my legs, managing the tubings, washing hands, getting back in bed, rewrapping my legs, and Scott turning the machine back on. Bad bed head going on! 

Shift Change

This nurse is a bit more – terse? How’s my pain? Well, not bad right now but I’m planning ahead for getting dressed. And I need to make sure I can tolerate the pills or that what is ordered will work for me. Well, on the scale of 1 to 10 what is it? (You can’t have any if it’s not a 3.) A two – it’s not a sharp pain, but pressure. Ok. Nurse leaves and goes about her business. By the time I have eaten breakfast, and she returns about 9, I am miraculously at a 3. I get a pill. When will Dr. I be in? Oh, he’s not usually early. Sometimes around 1. Ok.  

Dr. I pops in about 10, checks to see if I’m having much drainage, how I’m doing, shows me an arm exercise/movement I can do. Tells me the surgery went well. They weren’t able to do single stage reconstruction. Brings me my beloved picture of Cystosarcoma Phyllodes. That’s one ugly sucker. I tell him I have a plan for a piece of art using that photo. He chuckles. He said the nurse would change my dressing, give me a camisole to wear, give me my discharge instructions, and I can go home when I am ready. Yippee. I get up and put pajamas on so I can go for a walk in the hall to test my ambulatory abilities. Nurse is waiting for final orders. I have to sign some paper. The Walk – it was a short one because you can’t go far. Back to my room and wait for the nurse. She needs to change my dressing yet. Nurse comes in and yes, she listens to my lungs and checks my bowel sounds because she needs to do that yet. Changes my dressing and gives us a few instructions. Honey, I am gonna get dressed! 

Discharge

I get dressed and we wait for our final papers. Seems like we walked out to the nursing station to see if we needed anything before leaving. We finish up. It used to be you had to be wheeled out in a wheelchair – no more. I’m up, I’m walking, I guess I can walk to the car. We gather our stuff and skidaddle. Home by 11:30!