Stepping Out

By Wednesday, 8 days after the operation, I was ready to expand my horizons. I started going for walks. It was Liz's influence. She more or less challenged me to get out of the house. She took me for a walk, all the way to the end of the block. I was wearing my scrubs and holding my splint pillow over my tummy, but I was walking outside, even outside the yard. It was both a major expansion of my horizons and a reminder that I was a convalescent. I made it to the stop sign and back, but it was work. When I got back, I settled onto the couch. My plan was not to move more than necessary for as long as I could manage it. I was pretty wiped out.

I was, at that point, still taking the Percocet exactly on schedule. I did make it to the end of the six hours each time, but I didn't go more than ten minutes past. Walking around the house was becoming routine, but I hadn't left the yard on my own, and without Liz's encouragement, I may not have for a few more days. Once again, I found myself caught in this place, between thinking I was really making progress and the limitations on what I could do, or was willing even to try, because of the pain when I made any real effort. I knew I could manage walking to the bathroom and back. I knew I could stand taking a shower. It was weird to recognize that those felt like real accomplishments. How much of our lives is based on illusion and perception?

I had received a few emails from colleagues at work. Most were just expressing hopes for my rapid recovery and return, but one of my colleagues, Cyndie, who was covering one of my classes, sent me an email asking about a few questions on the exam I had shared with her. She was polite and professional, but the message on the questions she asked about was, What the Hell are you thinking? Well, on the two most obvious problem questions, I explained that I had edited the question, but forgot, somehow, to update the key. That's what the problem was. I think that may have been the truth, as I don't usually use the test bank key to make the keys for my exams. I just read the test, and type in the answers before I scan the forms. But once in a while I screw it all up, and put the wrong answer in the key. Fortunately, most of the time when that happens, everyone misses the question, and I notice the error when I check it. I do check questions that most of the class miss. That got me wondering again when I might get back to work.

And then I remembered my walk. If I could barely get to the end of the block and back, I couldn't stay on my feet to proctor an exam, much less give a ninety minute lecture, and teach a lab or two or three in the same day. I was still dreaming of getting back to work after a couple of weeks, but here I was, over a week out from the operation, and just walking half a block. Maybe Dr. Paddy was right. Maybe recovery from major surgery would take a bit of time. And I would just have to learn to deal with that.

The best I could do was keep taking a few steps more every time I went out.

A New Normal

I woke up Tuesday, and got up to the bathroom. I didn't go straight back to the couch. I wandered into the kitchen, and stood looking at the stove for a few minutes, wondering if I could make my own breakfast. Before the operation, I would get up nearly every morning and make some eggs, veggie bacon, and usually coffee for Liz and me. I just wondered if I was ready to start again. I decided I wasn't.

I went back to the couch, and started reading. I was waiting for Liz and Sharon to get up. And waiting for time for my next Percocet. I timed everything I did around when the pain meds were due. I could take longer walks, or even shower or something, in the first hour or two after I took the pill. I avoided any unnecessary motion in the last hour before the next pill. But I was just starting to wonder if I could stretch that, or challenge that approach. Maybe I could shower right before the next pill was due.

I didn't shower on Tuesday. As it turned out, I didn't shower Wednesday, either.

I guess the biggest variation from the dull routine was that I took a nap on our bed on Tuesday. I could get comfortable if I arranged the pillows right, but I couldn't lay on either side. I wasn't a good nap. I wasn't ready to sleep in our bed yet. When I woke from a bit of dozing, which was the best I managed, I went back to the couch. I settled in there for the rest of the day. And the night. And most of the next day, too.

I think Wednesday, I took a walk outside. I walked down to the end of the driveway. I was getting more ambitious as I sat on the couch, reading, but ambition quickly melted in the face of motion. A walk to the end of the hall and back still felt like an accomplishment, though I did manage to spend more time on my feet. I could stand at the window, for example, and watch birds and squirrels. That was something. And eventually, I figured, I would get back to regular showers, and maybe wear something besides scrubs and t-shirts. Someday. But not yet.

Learning About Schedules

Monday morning, I felt pretty good. Liz made me a couple of fried eggs with veggie bacon for breakfast, and Sharon made me a bowl of oatmeal. That was a good start to the day.

I took a shower. I didn't take the splint pillow into the shower with me, so it was rather a long time standing up without support. I washed my hair, face, arms, and various other parts, avoiding the abdomen. After I rinsed off, I turned off the water, and grabbed my towel. I carefully dabbed the water off around the staples. I was pretty tired by the time I was done and dressed again, but I had a feeling of accomplishment.

Meaning to carry on doing things that mattered, I called the doctor's office to schedule my staple removal. I asked for an appointment in a week, meaning 21 April, thirteen days after the operation. Usually, staples are left in for a week to ten days, but the doctor, on discharge, had suggested I go in that Monday. The office, however, said there were no appointments that day. The earliest I could get in was 28 April. Three weeks after the operation, with staples still in.

"But that would mean I would have the staples in for three weeks," I explained. "Do you think the doctor would want that?"

There was a pause. Not along pause, but noticeable. I don't know how much medical education the person answering the phone had, but I hoped enough to know my question wasn't absurd.

"Well, sir, I can't schedule you for any earlier, as there are no appointments available. You can call next Monday morning to see if there are any cancellations, or if the doctor wants to work you in," she said.

"Okay," I replied, slowly, stretching the word out to show that it meant something else. Like, if that's the best you can do, I'll have to make my own arrangements. I know people, people who know how to remove staples. Maybe I'll just take my business elsewhere.

It is true; I know people who can remove staples. But I wasn't going to call them. I knew Dr. Paddy was on vacation, so I decided I would wait, and call the next Monday morning. And when I called, I would make a fuss until I got in that day, because I wasn't waiting three weeks. That's what I was thinking. I doubt that came across in the way I pronounced, Okay.

I had kind of expected that Dr. Paddy's office would anticipate a patient needing an appointment to get staples out after surgery. I mean, that's what Dr. Paddy does. He cuts people open, takes out what needs removed, and staples them shut. Then, after a week or two, he has the staples taken out. So, you schedule an operation, and you pencil in a time for removing the staples. But I guess not.

The rest of the day was about like the day before. I sat on the couch reading, I ate what someone brought me for lunch, which was leftovers, I took a nap in the afternoon, and I read some more. Until about 5 pm, when I asked Liz if she wanted to watch TV. I doubt that that marks a point of progress in my recovery. Maybe it did, because I hadn't wanted to watch TV Saturday or Sunday. Maybe turning on a show was too much commitment before Monday, but that evening, I was ready. I could manage a whole episode of Star Trek. Then we watched Haven. Then X-Files. And finally, Poirot. Yes, about four hours of TV. But around 9 pm, I took another Percocet, and said I wanted to sleep. I was at my limit for TV endurance. Until the next evening.

Resting, drinking lots of water, walking some, eating healthy food, and not too much, and resting. That was my life that day. The other stuff was all extra, and helped to pass the time. And now, I need some more rest.

Defining Progress

I was glad to be home. I spent the first two days just sitting on the couch, reading, and eating when meals were brought. I didn't even turn the TV on. I took my pain pills  on schedule, and I kept my splint pillow on my tummy almost all the time, including when sitting and reading. It was much better than being in the hospital, because I wasn't constantly being disturbed by nurses or noises from the hall, but otherwise it wasn't much different. More comfortable, calmer, quieter, more consistent, but still the same. Lie still and convalesce. How could I know if I was actually getting better?

I called my mom when I got home. She had tried to call me in the hospital, but I didn't talk on the phone at all in the hospital, not even to Liz. I had texted a few times, but that was all. Liz had called Mom once or twice to report on my progress. But Mom had tried to call me, and I hadn't answered. Mom rarely calls. I think she has social phobia worse than I do, which really is saying something. So I called her, first thing, after I got home. I told her I was doing well, and everything was under control. Because I was doing well, and everything was under control. But at that point, there was still enough pain to keep me mostly focused no enduring. It hurt too much to let boredom set it.

By Monday, things were changing a little. I finished The Handmaid's Tale, and had to start another book. I picked up one Liz suggested. She had put it on the coffee table in front of me. So there I was, thinking about something besides enduring the pain or taking care of bodily functions. Not a truly momentous occasion, but still, a sign of progress. Someday, it seemed, I would be thinking about normal things again. It was nice to know.

A Day at Home

I was awake when Liz got home from Pleasure with Payne, the fundraiser for Columbus Dance Theatre. I heard some of her stories. She was talking to her mother, Sharon, in the dining room. I was still lying on the couch, but I had recently taken another Percocet. The show did go on, but Catherine Payne had some troubles. She misremembered the way she had practiced some of the songs, and played variations on them, even getting the wrong song once. That made it a challenge for the dancers, who had to adapt. It may have been the influence of the pain Ms. Payne was in. I hear she skipped her pain meds, in an attempt to keep her head clear. She may also have been suffering from a concussion. I'm guessing there may be some follow-up to that accident.

I don't think Liz came to talk to me. She thought I was asleep, and I was trying to be. I did sleep on the couch, but I had to get up every couple of hours, all through the night, to pee. I had a lot of extra fluid on me. I weighed myself soon after I got home. Despite having no food Tuesday, a couple of sips of broth on Wednesday, and a frozen lemonade on Thursday, before eating most of the hospital meals Friday, I had gained five pounds since leaving for the hospital Tuesday morning.

I noted that I did not have a bowel movement Saturday. My last one was Friday, early morning. The med I had been given to help my gut move had been stopped after Thursday morning, but I was still on the pain meds. Between not eating, and taking narcotics, it seemed I had slowed my gut mobility. Or stopped it. I ate Friday and Saturday. Saturday, I even had solid food. But eh servings were small.

I was awake between 2 and 3 am, so I took my next Percocet as scheduled. I noticed that walking to the bathroom when it was near time for the next pill hurt more than right after the med. I tried to challenge myself to hold out on the pain medicine, see if I could stand to be without it for a while. I made it 10 minutes. Yeah, I'm a wimp. I hate pain.

So the first day home, I sat on the couch and read, I ate when meals were brought, I slept after every pill, and I walked to the bathroom a lot more often than seemed reasonable. It wasn't much different from being in the hospital, except it was completely different, and I was ecstatically happy to be home. But at that point, it was hard to visualize full recovery. The most ambitious thing I did was walk past the bathroom, all the way to the bedroom, just to take a look at it. That took its toll. What if I never got better than that, and had to walk with a pillow pressed against my tummy for the rest of my life? That would make it hard to gesture during lectures.

Change of Venue

Saturday morning, I woke early. I lay there, waiting. But I wasn't expecting anything soon. I wish I could have slept in, because I knew I wouldn't get to leave until around mid day, but I guess the excitement got to me.

My breakfast was still full liquids. Blended oatmeal and stuff. I skipped the yogurt again.

My vital signs were fine, but my BP was creeping up a little. I had been restarted on my ACE inhibitor on Friday, I think. The nurse came in and talked about my discharge, but she said there were no orders for it yet. She said she didn't know when the doctor would be coming. So I waited.

I got up to the chair for a few minutes a couple of times. I didn't need the bathroom. I noticed that, but didn't think anything of it.

Liz came just before noon, and the doctor still hadn't come by. It was getting hard to be patient. Liz tried to help by reading to me some more.

Just about noon, the doctor came. He was from Dr. Paddy's group. He checked me over a little, listening to my tummy and looking at the incisions. He said he thought I was ready to go. He told me to call for an appointment to have my staples removed a week from Monday, and said I shouldn't lift more than 10 pounds. Then he left to look over the orders from Dr. Singh, written the day before.

I had to wait a bit more, because Dr. Lindsey had to read over the discharge orders, and sign off on them, and then the nurse had to look them over and prepare my discharge instructions.

Finally, around 1 the nurse came in with a few pages of instructions. We discussed my diet, because the instructions say to stay on the diet you had at discharge, which was still full liquids. The nurse suggested I advance to a regular diet as tolerated. She told me to use a pillow to splint my tummy, and to try to keep increasing my activity. She told me what to expect, and when to call the doctor. It all seemed simple and straightforward. I was going home.

Liz had brought some clothes. She brought my bathrobe, some scrub pants, a t-shirt, and a pair of slippers. The scrub pants, normally quite loose on my, just barely fit around my belly. The t-shirt was okay, but also seemed a little snug. I was happy about the slippers. Bending all the way over to tie shoes would have hurt.

The nurse took me down in a wheel chair, and we waited at the curb while Liz got the car. Getting into the car took some effort, and hurt, but I settled in. Liz had the seat reclined, which meant I had to lean back. I couldn't really lean sideways and then lift my feet, as I did getting in and out of bed. But once I was settled, it was comfortable.

Liz drove home as carefully as she could. I did feel some bumps. We got home about an hour before my next Percocet was due. I began to worry about that, even before I got into the house.

Climbing out of the car was easier than getting in. I could use my arms to pull better. I walked slowly into the house. Sharon was all smiles as I shuffled through the kitchen. Nala barked once in greeting, and wagged her tail.

Liz had put blankets and pillows on the couch, set up so I would be at the end that let me see the TV. I settled on the couch, covered myself with a blanket, and pressed a pillow to my tummy. Compared to the hospital bed, this was heaven.

By then, though, I had to pee. I found, after I got home, that I had to pee about every two hours, even through the night for the first couple of days. That first trip down the hall to the bathroom reminded me that I was still in the early stage of recovery from the operation. I set the pillow down, and lowered myself carefully to sit on the toilet, then picked up the pillow and pressed it too my tummy again. Peeing had become entirely passive; I would think about relaxing and letting it go, but didn't try to increase abdominal pressure. It was working fairly well, but it did take a little time.

When I got back to the couch, I was tired, and ready to try to nap.

Liz went to the pharmacy to get my pain meds. She got back half an hour before the pill was due. I was glad. I was beginning to feel the pain return.

After I took the Percocet, I picked up my book. I found it easy to read, then. I read two hundred pages before the end of that day. I pretty much read for the rest of the day, stopping briefly to eat a meal brought to me on the couch. Liz had to go the Pleasure with Payne that evening. Sharon stayed home with me. I just read, except for those regular trips to the bathroom.

It was good to be home, but I was still weak, slow, and absolutely dependent on the Percocet. I was worried about eating too much or the wrong food. I didn't try any salad. I ate cooked veggies and pasta. Real food, with real flavor, and it went down fine. It was very good to be home.

Anticipation

Friday morning, I woke feeling better than I expected, as I had to get up to the bathroom twice during the night, and for an hour in the middle of the night I found the bed unbearably uncomfortable. I even got up, just to stand beside the bed for a few minutes. But the pain med button got me through the wee small hours well enough. And I knew change was coming.

Fairly early that morning, I was visited by Dr. Paddy's fellow, Dr. Singh. He was a pleasant young doctor, enthusiastic about life, it seemed, and very energetic. He made me want to get up and, well, not dance exactly, as I knew that wasn't advisable in my condition, but maybe walk a little faster than I had been.

He asked me about how things were going. I told him about my successes at various elimination processes, and my three walks the day before.

"Good," he said. "Excellent. We should think about getting you home tomorrow. Or maybe even late today if there is any reason to."

Wow.

I was still on a clear liquid diet, because my first BM was after the doctors' visits on Thursday, but Dr. Singh wrote the orders to advance my diet to full liquids, and then, assuming I tolerated those, to a regular diet. He also ordered the stopping of IV pain meds, and other IV meds, switching everything to po (by mouth). If I could eat real food and get by on pain pills, I could leave the hospital.

My breakfast was brought right after Dr. Singh left, so it was still clear liquids. I ate most of it. Then, just after I finished, another breakfast tray was brought, this time full liquids. I really wasn't that hungry, having eaten most of the clear liquid breakfast, but I ate the blended oatmeal, just to prove I could.

Soon after that, the nurse for the day came in, and told me about the change in pain meds. I was being switched to Percocet. This was Taylor, the same nurse I had on Thursday. That mattered, I think, in events later in the day.

I had been given Percocet once before, a long time ago. It was after I had my wisdom teeth removed, I think. This is how I remember that. I was living in Indian Springs, Nevada, which is an hour away from Las Vegas, and I started having pain on the drive home, as the anesthesia wore off. I took a Percocet. A few minutes later, I got dizzy, and then nauseous. I was so sick, I couldn't stand it. I blamed the Percocet, so I never took another.

And now I was going to be taking Percocet for my post-op pain. I almost spoke up, but I decided it might be wise to try a pill, and see how I did. An hour or so later, when Taylor brought me my first Percocet, I took it.

After fifteen or twenty minutes, I was getting a little drowsy, and I was certainly feeling no pain. I did not, however, feel any nausea. So for thirty years, I had been blaming my episode of nausea after my oral surgery on Percocet when it was probably caused by the withdrawal of the anesthesia. After all, on this occasion, I also had nausea some hours after withdrawal from anesthesia, which it never occurred to me to blame on the pain meds. Good thing, too, because I needed those pain meds. They got me through three days of misery. Percocet, it turns out, is my friend.

So for the most part, I was just biding time, and doing what I could to prove I was ready to leave the hospital. I felt so much better that day than I had even the day before, it was hard to remember how miserable I had been on Tuesday and Wednesday. Maybe we need to invent a dissociative drug that will let the nurses and other hospital professionals lead patients through the first few days of post-op recovery without conscious awareness on the part of the patients. It would make recovery much less miserable if we didn't have to actually experience it.

At lunch, I ate almost all of the my full-liquid food tray. Hospital food sucks, but one can choke it down if the incentive is right. Getting the hell out of there was enough for me. No reflection on the nurses and PCA's, who were wonderful, and helped me get through all that misery, but I was longing for the comfort of the couch at home by then.

After lunch, I made a trip to the bathroom. The IV had been disconnected. I was not getting IV fluids anymore. I noticed the tape around the IV was a bit loose, and I pressed it all back down in place as well as I could, but when I got up, I pressed my hands over the sorest spots on my tummy. Than meant I turned my hand up sideways. And the whole IV fell off, onto the floor.

The PCA noticed, and picked it up. He placed it on the bedside cart. I made it to the bathroom, completed my elimination processes, and went back to bed. The PCA said he would tell the nurse about the IV.

Taylor came in a few minutes later, and looked at my hand.

"Well, we knew it wouldn't last forever," she said, philosophically. She just sort of looked at my hand for a minute or two, thinking. "Maybe I can get the doctor to write an order letting us leave it out, since you're leaving soon anyway."

I don't know if another nurse, one who hadn't gone through the struggle to get that IV in place the day before, would have taken that route. I was a little afraid she would try to place another new IV. But we were both hoping I wouldn't need one. I was not on IV fluids, and had no IV meds, so the IV was only there in case of unexpected changes. In an emergency, and new IV could be put in. Only, let's not have an emergency.

Friday afternoon, feeling like I had been given license to behave like a patient about to be released, I started getting myself up to the chair, and going to the bathroom to pee on my own. I didn't have any problems with it, and I didn't get caught by the nurse or PCA. I spent half an hour or so in the chair. I tried to read my book at one point, but I still found I was concentrating on my abdominal wall, and couldn't focus on the words. But I was ready to go home.

I had expected a regular food tray for dinner, but I got full liquids. Potato soup, which turned out to be very tasty, along with chocolate pudding and some sherbet. I didn't drink the carton of milk.

I noticed Friday afternoon that my tummy wasn't rumbling like it had been the previous day or two. I had a BM that morning, but now my tummy seemed rather quiet. My kidneys were still working, though my fluid intake was all oral now. I can say I felt, not normal, but at least human again.

One nice thing about the switch to oral meds was that the pulse ox was removed from the right index finger. The skin on that finger was all swollen and wrinkled, like it had been in the bathtub for much too long. Three days. My left had was still a bit swollen from the IV problem the day before. So neither of my hands looked or felt at all normal. But I could tell they were going to recover.

Liz stopped by briefly on Friday. She was dealing with Dress Rehearsal for Pleasure with Payne, a fundraising dance recital by Columbus Dance Theatre, for which she had provided the costumes. And there was a lot to deal with. One of the company dancers got hurt the day before, so she had to outfit his replacement, who was a good six inches taller, at least. And Ms. Payne, the cabaret singer providing the music, fell of the edge of the stage, hitting her head and braking an ankle, perhaps changing the whole meaning, and spelling, of the title of the show. But show biz is show biz, and the show would go on. So Liz got there a little later than planned, and stayed long enough to hear my progress report. She immediately began planning for my transport home. Then she read me a chapter of Shadows as I settled in for the evening.

I told Liz to plan to come around mid day on Saturday, as I didn't expect things to happen too quickly in the morning. I welcomed the drowsiness of the Percocet, and dreamed of relaxing on the couch with a flannel quilt and the remote for NetFlix, and other heavenly visions. I was going to survive the hospital ordeal.