“154/110,” said the admitting nurse. It was the highest blood pressure reading of my life, and tangible evidence that I was more stressed about my rib-removal surgery than I thought I was. I had been anticipating the procedure for months, going from panicked, to confident, and then back to scared again. The blood pressure made it clear that I had not totally conquered my fear.
I was not afraid of the procedure as much as I was of the recovery. The surgeon had gone to great lengths to make sure I was prepared for the agony ahead. “Every breath for the first week will be excruciating,” he had told me in his office. That is a lot of breaths. (at 15 breaths a minute, it’s 151,200 breaths to be exact.)
I worried about how I would get through it. I worried how Lisa was going to get through it. She had been through over a dozen surgeries with me over the last 37 years, from wisdom teeth to hernia repairs to knee surgeries, but I had not been totally incapacitated for any of them. From what the surgeon said I was going to need a lot of help.
The surgeon had performed the procedure over 1000 times before, and I ultimately decided that all of the other patients had somehow gotten through it and that I would too. The thought was comforting, a little. When they wheeled me into the operating room I resorted to joking around with the nurses and residents as they prepared to put me under. “Good night everybody!” I said as they put the mask on my face.
My next memory is of being wheeled into my hospital room. I was hooked up to IV pain medicine, with a button so I could get more whenever I needed it. The doctor had left a catheter inside the wound to drip lidocaine continuously into the area to control the pain. Other than a pain in the muscles in the middle of my back and a terrible sore throat, I wasn’t that uncomfortable. I figured it was because the lidocaine was doing its job.
The pain wasn’t bad through the night. I hit the button a few times out of concern that it might start up, but went through more throat lozenges than I did doses of pain medication. (My uvula had gotten pinched in the surgery, cutting off its blood supply).
I called the nurse a few times in the night to help me get to the bathroom, each time feeling like a wimp and a nuisance. I was a little unsteady on my feet from the meds the first couple of trips and did not want to fall. After a few times to the bathroom with assistance, I was confident enough to go on my own, even disconnecting and reconnecting myself from the oxygen monitor. (No one said anything, so I assumed it was okay…)
I did not sleep all that well because of the throat but felt surprisingly good in the morning. I remember the surgeon had said for me to try and take deep breaths, so I took several, again thinking that the lidocaine was the reason I was not in the excruciating pain I had been told to expect. He had also said I should try to get out of bed, so I grabbed a hold of my IV pole and took a few labs around the floor. The only significant pain I had was when I sneezed while walking. The nurses gave me a few curious looks when I asked if I could walk, but told me that it was okay.
I was fearful that my backside might be hanging out of my gown and asked the nurse if it was okay for me to put my clothes on. He seemed a little leery but said yes then stood nearby as I retrieved my clothes from a bag and put them on. He hooked the bulb of the surgical drain onto my shorts so it wouldn’t dangle.
A little after 9 in the morning the surgical resident and some students came to check on me. With hesitation, he told me that he needed to look at the incision under my arm. “Okay,” I said, raising my arm so he could get a better look. He looked a little puzzled, then looked at my wound.
I told him I was doing well, that it had been over 6 hours since my last pain medication dose, and I asked him when he thought I would go home. (I had been told 2-3 days)
“You can go now, if you want,” he said, “You are doing well.” The nurse came in later to go over discharge instructions. He told me that I was doing really well and that he was surprised that I was not in more pain.
I did not realize how well I was doing until I saw the surgeon for follow up 13 days later. He told me that most patients cannot move their arms at all after the surgery. They hold the arm up against their sides, as even the slightest movement is agonizing. (this explained the resident’s surprise when I raised my arm.)
He told me I could start to drive, then laughed when I told him I had started driving two days after surgery. I then told him that I had only taken a few pain pills and that I had gone back to work three days earlier. Another laugh, with him commenting to Lisa, “This is truly amazing!” He had never seen anyone do anywhere near as well as I had, had never had anyone with so little pain.
At one point in the conversation he started to say, “This is almost miraculous!” but he stopped at the mir- It seemed he did not believe in miracles.
That’s okay. I do.
Bart
PS: As is so often the case, being a patient left me with many lessons. I have a much better understanding of the fear that comes with a major surgery. I will be more sensitive to it in the future.
The surgery resulted in trauma to my phrenic nerve, the one that controls the diaphragm. For the last two weeks I have been living on one lung. I thought I understood shortness of breath before, but realize I didn’t. It was frightening to gasp for air after tying my shoes, to feel like I was suffocating every time I tried to lie down, and to need 30 seconds to recover after walking to the living room.
My lung patients will find me a much better doctor going forward!
(Thankfully, this appears to be getting better)