Mikenh and Surgery

BRHMichigan said:

Not for the weak

My hospital food & care was amazing.  I did not want to leave until 100% ready.  Glad you are getting the same!  

Not sure what type of ostomy you are dealing with, but I found Coloplast to be far superior to Hollister.  Interestingly, much of my pain was around and under my stoma. A burning pain.  Oxycodone made me feel mentally out of it and didn't help the pain.  I used Norco at home and still use it on occasion to help me sleep.  My incision never hurt much.  Lots of staples!!  But not really sore.  Also I was given choice of belly or thigh for heparin shots.  No pain when administered to thigh.  

I hope to be back at the gym next week.  Need to get my legs back in shape and improve endurance before going back to work on the 13th.

Mike you are a great inspiration.  And, Jim, I love the poker game analogy!  I feel the same.  Quality of life is so important.

Best wishes to all from Beth

A trading friend sent me an article on hospitals do the billing with Medicare and insurance companies and it appears that it's often a price per procedure as opposed to per stay night in the past. Given this, if they can get you out earlier, then it helps their profits. The problem is the incentive to discharge early. So Medicare penalized hospitals for readmits. I think that we all have an idea as to when we should go home. For me, it was my anxiety over pain. Once I had a sufficient explanation and sufficient confidence that I'd be fine, I was ready to go.

I think that a readmit is a tough thing because the situation has to be bad enough that you'd travel, and get out of your planned routine to be in the hospital, likely in a lot of pain.

Trubrit said:

I would say...

No, don't drive. Even with an automatic, your foot has to be on and off the gas pedal, and that all ties in with your tummy. 

Just my opinion, and nothing near medical advice. 

Tru

Son drove and that was a good idea. I felt rather drained in the pharmacy (took forever to get my package of shots). I left the Oxy prescription with them asking if they could hold it. I'll decide next week whether or not I want the stuff. Had a nice home-cooked dinner (chicken porridge - chicken balls with super-boiled rice, soy sauce, ginger and garlic pieces - might be a staple with me with or without the chicken). VNA called and is coming over. Took a few Benefiber packets. My stoma is to watery - I think that I need to take the Imodium as well. I don't think that I need to drive for a while. I do need to sleep and I do need to transcribe all of the stuff from hospital discharge into my phone. I just realized how dependent I am on iCloud Notes and Reminders for getting all my stuff done.

I overdid it today. Yesterday I walked 1/2 mile. No problems. Today I've walked close to a mile but I tried using a powerwalking approach to alleviate the dull ache. It did alleviate the dull ache but I had blood in my urine afterwards. So no more powerwalking. BTW, powerwalking is a technique - I wasn're really going any faster than before. I'll go back to my regular walking, dial it back down to no more than 1/2 mile a day and then work up from there.

I'lll be getting lab results tomorrow.  Nearly forgot that they do pathology and so forth.  Im not too worried since everything else has gone well except hamburgers on the day of surgery.  That wasnt too bright..  There was no mention of home care follow up by anyone yet. Then again, I dont think I need it. I keep being told how great Im doing blah blah but Im sure they do that with everyone. 

im trying to eat 3 meals although Im not really hungry and haven't pooped yet.  Im getting close though with rumbling and gas.  My wife and kids spent the night here last night which was nice for a change.  The room is big enough to hold 20 people.  Im on my 3rd pair of hospital walk around socks. They call them slippers but they are socks.  These are the same type they had me wear for the ultrasound.  I notice they have a lot of signs about preventing falls.  These socks have rubber treads, like a car tire so there must be a connection.  They dont wear out but do get dirty after walking a while.  .

Waiting on dinner to show up. Had salmon for lunch which wasnt too bad although it was a tad dry.  Trying pot roast now along with cheese cake which just arrived.  It tastes quite good.  Not what youd expect for hospital food. 

The pain killer they have me on is an opiode yet I dont feel loopy or anything like that. But since it is that means this is going to hurt like hell when it wears off.  That comes tomorrow too. Oh well, this is what I signed up for.

Friday

One of the things that overshadowed my hospital stay was my roommate who had some kind of infection. He had a lot of doctors in his room including a few people from the infectious disease department and he had been on a bunch of different antibiotics. They apparently figured out what he had (might have been more than one thing) and that morning, the doctors and nurses treating him were wearing gowns. There was a notice on the door of the room about contact precautions added. I also overheard them asking him to take precautions because of the possibility of passing something on to me. I had been careful from Wednesday using the public toilet instead of the shared one in the room when it was easy to do. My roommate had immune system issues which is why he caught this thing. A normal immune system shouldn't catch this and should be able to deal with it if it did. I just didn't need to be sick while recovering. I felt like I was in pretty good shape and ready to leave anyways.

I had a very good sleep last night as they didn't do vitals every few hours on us and they didn't need to come and change his medications. The pain thing was still an issue and I took some Tylenol. Additional rest cleared it up. Also peeing helped. I'm pretty sure that it's a bladder pressure issue.

6:20 AM Doctors' Rounds: they looked at the wounds and I described the pain situation and he said that it's probably a muscular thing and that it was a good sign. I indicated that maybe I was doing too much. I did squats, tree pose, warrior pose and a bunch of other stretches and range of motion exercises yesterday. He wants to dial back the Imodium to one or two and make it algorithmic instead of fixed. He wants me to keep up with the fiber packets as well.

I asked about removing the staples and that could be done at the post-op appointment. I also asked about driving and he said anytime, as long as not on medication.

I really wanted to take a shower but I was afraid to use the bathroom so I did I washed up with a towel as best I could. I also changed underwear and pads. I saw the mucous that leaked out and it didn't smell or anything. Just black-colored. Some had got on the bed protector too.

8:00 AM Ordered scrambled egg and whole wheat toast. I did not want to eat much before the long ride home so that I wouldn't have to change the bag along the way.

8:53 AM The IV Nurse took out one of th elines and redressed the other one. I had an Imodium, Tylenol, Ibuprofin and fiber packet. The Nurse went to assemble a team for discharge. I kept my ride informed via email. One note: flat pushups, fist pushups and dips are good exercises for working the arms and shoulders for getting out of bed when you can't use your abs.

9:30 AM Got out clothes for trip home and packed up.

11:00 AM An intern came in and removed the tubular loop that held the stoma outside the body. The intern had to push the bag back onto the body attachment and asked me to brace myself. I just tightened my abs and there were no problems.

11:15 AM Stoma   change education. It's in another note (the description) but it took quite some time because my stoma was so active. The nurse was very patient. I think that I will do this first thing in the morning in the future so that I won't have to deal with stuff coming out while I'm changing the bag.

Discharge stuff was next. A list of documentation and directions and a form to sign. Then injecting myself with Lovenox. I got an ETA from my ride and the nurse called for a wheelchair and brought me to the valet area where I was picked up.

The trip home was uneventful. Zero pain on the ride home.

My son drove me to the pharmacy to pick up the first box of injections. I left the Oxy prescription with them but didn't get it filled. I'll decide on the Oxy next week.

I was weak and revenous and asked my wife for toast but she gave me a large bowl of chicken balls, rice porridge and soy sauce instead. Very good stuff.

I contacted the Visiting Nurse service and set up an appointment for a visit.

11:00 PM Had three packets of Benefiber and emptied the bag and the consistency was thick. It's more comfortable changing the bag at home where then enviroment is controlled.

Total walking for the day was about 1/2 mile.

BRHMichigan said:

You're doing so well

Great transition to home!  I must say, I was on a post-op floor in the hospital where everyone had a private room.  I askked about it, and they said the surgeons all required it for their patients.  Was heaven.  You were ar a more sought after hospital, so maybe they have to double up?  

I cannot believe how wonderfully active you are.  I see my surgeon today for second followup.  Can't wait to get the ok to go back to the gym.  My incision is finally healed.

The general standard of care is determined mainly by the insurance companies. I had the option for going for a private room for $375/night extra and I considered it but the benefits of the private room would mostly be lost on me (gourmet food, hotel-style room, furniture for guests to sleep over and other amenities). I couldn't really eat much of anything for a few days. The hospital was very crowded. I think that the administrators were trying to get me out early as they had more patients to bring in.

I think that you'll love the gym. Remember, start out slowly. I actually do this myself when I start out from a break on a particular exercise as it is very easy to injure yourself using barbells, dumbbells and weight machines. My postop is only 8 days away and I look forward to getting the staples out, and driving. I could likely drive right now but there's no need to try.

Thanks, Cindy & Mike.  I mentioned in another post that I visited my surgeon today.  Although my incision is healed, no swimmimg for 3 months!  Walking and stationery bike only.  He fears hernia could result from too strenuous of activities.  I am so disappointed.  Can't use resistance equipment either.  Welp, I am certainly learning patience.

I can feel daily improvement but it’s slow. Walked 1.5 miles today and that’s the most since surgery. My rear end gets sore sitting for a while. Maybe related to all of the cutting down there. Good excuse to go for a walk. We get freez temps soon so I need five pounds of clothes to go out.

Mike, I think a mile and a half is amazing!  I pushed myself to do a lot of activity today and feel much better for it.  Need to spend our days LIVING.  I go back to work Monday and am really looking forward to concentrating on work rather than cancer!

Mikenh said:

Fir bag change took me an

First bag change took me an hour. One screwup cost me a wafer and redo. I’m going to have to get much better at this.

Changing the wafer is my greatest challenge and dread.  I am tempted to just coordinate and pay for a home health care nurse to do it for me, but that is escapism and silly.  I can do this - not well, but I can do this.

I finally had some minor leakage and a small area of my skin became irritated.  Obviously, I need to change more often and do a better job of it.

I can identify with your concern over wasting a wafer.  Insurance will only pay for 20 per month and the turn around time for resupply is slow and out of my control.  I do not like that situation, so I have located local outlets where I can pay out of pocket for additional supplies.

If I could have one do-over, it would be to have the WOC nurse conduct another tutorial AND have me do it all while she observed and critiqued my performance.

Jim