Some 36 hours after the operation, I could say that my gut was working, as I had farted twice and had lots of rumbling in my tummy. I was also peeing about every couple of hours. Unfortunately, the abdominal wall block I got from the anesthesiologist before the operation had worn off, so my tummy hurt more and more every time I moved. I even noticed it with the incentive spirometer. The first day, I could bring the thing up to 2000 mL without much problem. By Thursday morning, it hurt to get to 1500.
I still had no appetite for breakfast that morning. Dr. Paddy came in early, before breakfast, and asked how I was doing. I told him about my progress, and he seemed pleased. He talked about advancing my diet,which seemed absurd to me, as I wasn't eating anything. He listened to my abdominal, and seemed very pleased with the rumbling. He was leaving later that morning, and would be gone for a week, but had other doctors covering for him. He talked about getting me home in a few days.
I wanted to leave. Not because I felt ready, but because I was tired of the hospital bed. And the noise. The bed was uncomfortable. I think it made me sweat. Maybe it was the plastic cover on the mattress and pillow. I also hated not being able to move because of those damned inflatable wraps on my calves. I wanted to either be asleep all the time, or have someone there helping me do something else. I was restless and uncomfortable, just trying to lie in bed and do nothing. I couldn't read. I couldn't really sit still and concentrate. But I couldn't sleep all the time, either. It was a little like restless leg syndrome, something I think I've had all my life, but this was my whole body. I would get this irresistible urge to move, but all I could do was tighten my muscles for a few seconds, and then relax them. I couldn't toss and turn, because it hurt my belly too much. I couldn't get out of bed without help. I was sweaty and oily, and felt disgustingly dirty. I wanted it all to end.
Late in the morning, I got to take another walk. The nurse took me around. She said the PCA would take me around again later. Something to look forward to.
I was not on oxygen by then. Someone from respiratory came in to check on me. She looked at the nasal cannula and the connection on the wall.
"Hm," she said. "They have this hooked up, but it's turned off. Your sats are fine. How about we just take this off now?"
I had no argument. Another step toward normal: I was breathing room air.
The PCA came in around lunch time. She checked my vital signs. She put the cuff on my right arm, which is the side the pulse ox was on, so when the cuff inflated, the alarm went off. I hated all those alarms. They were loud and really annoying. Regina ignored them.
After I told her I had no interest in lunch, she suggested a walk. She unhooked the pulse ox, and it screamed at us again, and she just let it scream. The others had always turned the alarms off. Not Regina. She just didn't care. Funny that no one else came to see what was the matter.
I made the walk, and Regina sat me in the chair while she changed the bed. I wasn't very comfortable in the chair. I had decided before the walk not to push the pain med button. That may have been a mistake. I was really ready for the bed when she finished making it. I climbed on, and settled onto the fresh sheet, and pushed the med button as soon as I found it. I think I was asleep in five minutes.
I knew that day that I was getting better. I was strong enough to complain, and too think about all the things I couldn't do, which I hadn't thought of at all the day before. I was progressing as fast as could be hoped. But waiting it out was not fun. I hated life all that day.
After my second walk and afternoon nap, the nurse came in, and asked how I was doing. I don't remember what I said. But she asked a few specific questions.
"How would you rate your pain currently?" About a 2/10, unless I move.
"Have you had a bowel movement, or passed any gas?"
Well, yes, I had passed a little gas. Oh, and, um, I just noticed something. I still feel all this rumbling, but it doesn't feel like gas moving down to the exit. I, um, think I have diarrhea. I had just noticed that.
"You mean now? Have you passed any?"
No. It just feels like liquid trying to escape. Can I get to the toilet?
So, she helped me to the toilet. I sat there, trying to relax. I still couldn't do anything to increase abdominal pressure. Cutting open your belly is a way to learn just how active things like moving your bowels or peeing really are normally. But all that fluid in my gut wanted out, and after a couple of minutes, I had no need to push. It gushed out. It was as bad as during the prep.
I sat, letting it all happen, and waited a few minutes after, in case another bout should appear. Then I had to wipe. I had an IV in one hand, and a pulse ox on a finger of the other. And wiping meant bending one way or the other so I could reach that far down. Pain. Lots of pain. I even thought about asking the nurse to wipe me, but I managed it. Then I pulled the string on the wall, which called the nurse back in to help me back to bed.
So my bowels were moving. Not pleasant. Thin liquid, despite all the narcotics. But it meant my gut was working, or at least moving, if not doing what it should have been doing. After that, I felt empty. Completely drained. I took another nap when I got back to bed.
Then I had another trip to the toilet before my third walk for the day. It was a long, miserable, painful day in which I made every goal I had. Due to that day's events, my diet was advanced for the next day, and there was real talk about when I might go home. It was only just barely worth it.
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