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My median sternotomy and thymectomy: Part IV – Hospital, cont.

I’m not going to try to do a day-by-day run-down of the rest of my time in the hospital, just some of my overall impressions and thoughts. I stayed in the hospital for 5 days total. Every day was better than the last, but every day sucked.

Respiratory: Respiratory therapists starting coming in to check on me regularly almost immediately. I was tasked with blowing into my little spirometer every hour I was awake to slowly get my lung capacity back up. Deep breaths followed by coughs. The coughs hurt. This is the part of a sternotomy that everyone seems to be aware of – hugging a pillow tight to your chest while coughing. That pillow, man . . . it is a necessity. So, the coughing. It hurt. Anything that moved that part of my body hurt and I could feel my bone slightly grinding if I didn’t have the pillow tight enough. Plus, all of my chest muscles hurt. It almost felt like they had been ripped apart. Huh, imagine that.

Getting up: I got out of bed on the morning after surgery. The nurse removed my catheter and my only requirement was to get to the bathroom and try to pee. It was hard at first. Standing up straight was difficult. I had a nurse on one side and a family member on the other to make sure I didn’t fall. After the first day, I just needed someone next to me as a precaution, but at first their support was extremely important. The first walk, as I reached the bathroom, I felt the need to cough. I managed to squeak out, “I need to cough. This is going to hurt bad, right?” to the nurse before coughing. And then screamed. I actually screamed. I’ve never felt pain like that. I was embarrassed that I screamed, but I just wasn’t expecting the pain. It is hard to describe; the best way I can explain it is like being stabbed from the inside every time I coughed. Once I knew what to expect, it was better, I guess. It still hurt like a bitch – for a long time, long after I came home – but I didn’t get caught off guard again.

Sitting up and walking: After I got out of bed for the first time, I was encouraged to sit up and walk around more and more. I had a spare wheelchair in my room and would use it as makeshift walker. Eventually, I started going on walks down the hallway and at some point, my mom started pushing the wheelchair for emergencies as I walked beside it. [I should mention – my husband got sick while I was in the hospital. I had to kick him out when he said he felt like throwing up and my mom stepped in for her turn as caretaker for a couple of days.] I didn’t really like sitting in a chair. It was very difficult to get back out of the chair I had in my room, so I mostly just used the side of my bed. By the fourth day, I could move back and forth to the bathroom without any support or extra precautions. I found the best way to get out of bed was to move the top part forward as much as possible. I then could be sitting straight up and slowly work my legs off of the side. This was a surprise to me – I didn’t really have the ability to rotate my upper body, so just swinging my legs off the side normally wasn’t an option. It took some work to figure it out. That was a bit shocking for me; something that I did every day without a second thought was now a carefully orchestrated process.

Eating: My appetite didn’t return to normal until the third or fourth day, but I started eating some on the second. I nibbled mostly. The toradol I needed for my stomach made my mouth extremely dry and I remember laughing hysterically [ouch!] with my mom as it took me nearly five minutes and half a glass of water to chew and swallow a bite of biscuit. There were no restrictions on what I ate.

Drains: The small drains came out on day two. The big chest drain came out on day three. That chest drain was awkward – I had to load the bubbly thing up into my wheelchair when I wanted to walk around. I hated the feeling of it moving around inside my body. I had already learned from the internet that removing the big drain wasn’t exactly painful, but was very uncomfortable. I held my mom’s hand and the surgeon just pretty much pulled it out in one swoop. It felt like most of my inside was going to come with it, but it didn’t of course. Once it was over, I had no pain or problem with any of my drain sites.

Bathing: I couldn’t take a bath until my last day in the hospital, so it was sponge bath city for me. I’m sure some of the elderly patients on the ward needed help from a nurse for this, but I was mobile enough to make due with just family and my private areas covered. I didn’t feel yucky, but my hair was a mess. I needed a headband from the gift shop to be presentable. I suggest bringing a hat.

TMI, bathroom time (you may want to skip this): I had great difficult wiping myself after using the bathroom. My range of motion was severely limited and I couldn’t rotate my body at all. I had to ask for help from the nurses every single time. You can imagine how embarrassing and degrading this was. Eventually, on the very last day (don’t know why no one else thought to show me earlier), a nurse showed me how to increase my range of motion by leaning forward and slightly squatting. It was very helpful. Not 100%, as I’m fat and that got in the way, but helpful.

My median sternotomy and thymectomy: Part III – Hospital, Day One

loadBinaryCAERMIFEThe first day was the hardest, as you might assume. It only took an hour or so to figure out that morphine was not the best drug for my pain – the relief was immediate, of course, but it wore off fast and hard. When I had my c-section I had a pump, but not this time. I was dependent on the nurses getting me the medicine asap when they had so many other people to look after. They switched me to pills fairly quickly. Slower to take effect, but long-lasting with a more gentle wearing off period.

Pain medication makes me queasy. Very queasy. Always has. Every time I called a nurse for my pain medication, I asked for toradol too. After a few oh-my-god-please-hurry emergency buzzes, they started to bring it automatically. Vomiting was just not going to happen.

Surprise #1: I was offered a meal immediately. I didn’t eat it. First, I was fighting to keep my stomach quiet from the pain medication. Second, I didn’t have an appetite at all. I didn’t expect to be allowed to eat that day at all (I don’t think anyone told me that, I just assumed), so this bit of normalcy was encouraging, even if it was unwanted.

My physical condition: I had three small bulb drains and one large chest drain attached to a bubbly thing on the ground (no, I’m not going to look up what it is called). The small drains sometimes got in the way when I moved around in bed, but weren’t uncomfortable. They had to occasionally be emptied. The large tube coming out of my chest was a different issue. It wasn’t exactly uncomfortable either, but I could feel it move around inside my chest. If a nurse moved it or what it was attached to, I ended up with a very odd sensation. I did not appreciate it.

Aside from the drains, I still had a catheter (it was removed the next morning) and the compression devices on my legs. My incision was bandaged (I didn’t see it at all the first day) and I was wrapped up in a big compression bra that held everything together. It was only after I went home and removed this compression device that I realized how much it helped. Boobs are heavy and they pulled at the incision. So did my arms.

One unexpected problem – my back muscles were a mess. I have scoliosis, so the muscles in my back and upper body are often held in a delicate balance of tension that keeps me from great pain. When I’m overweight, my muscles are strained and uncomfortable. Well, apparently ripping open my chest didn’t help. Because of the problem with my back, I felt like I was surrounded in a big circle of pain. I couldn’t get a lot of relief – the medication didn’t help the back pain as much. I don’t think I was able to explain the extent of my pain to the nurses, because they never took it very seriously. Eventually, I managed to secure a heating pad and got a little relief. This extra pain made a couple of hours absolutely unbearable though.

Surprise #2: I found out later that afternoon that I was allowed to get up and walk around. Again, I didn’t expect this. And I didn’t get up either. I felt like I could barely move; I certainly wasn’t trying to get up yet.

I had to keep my upper body elevated – the flatter I got, the more intense the pain was. This caused me to slowly slip down in the bed. Typically, you would just scoot yourself back up and not think twice about it, but I couldn’t quite move that way yet. I wasn’t allowed to use my arms to do anything, so pushing myself up that way wasn’t an option. My abdominal muscles were angry. Very angry. And I wasn’t able to isolate them to help me do anything either. The eventual solution was to have the nurses help pull me back up in bed. This was helpful, but meant that they had to lay me as flat as I could go [ouch, pain] and then quickly pull the sheet back up with me on it [ouch, pain].

I was a mess. I was in pain. I was confused about what was going to happen next and nervous about the recovery period. My chest was still orange from the surgery. Overall, it was a rough day. I didn’t cry, but I did come close to breaking down a few times.