Recovery Day 2 -- Fail Whale

After a good night's sleep last night, I continued the Sleeping Beauty trend through most of the morning, confounding many of the various medical team visitors that came by in the morning intending to work with/on me and finding some sort of hibernating, mumbling creature in my bed.

My lucky epidural/Valium/nubain combination certainly did treat me well through the night and this morning, but when I finally woke up midday I had two problems. One was that my shoulder muscles, having been kept in the same position for two days and nights straight (because of IV lines and injury), were stiff and very sore. The second was that Phlebotomy had not been deterred and was waiting for me to wake up. Seriously? Are they playing some sort of sick darts game with me? Didn't I just give them blood samples yesterday? I was unable to feign sleep well enough to discourage them, so they stuck me again and again and again until they they finally found a vein that could give them what they wanted.

By now all the evil forces amassed against me had noticed that I'd awakened and so I was cheerfully told it was time for my bed linens to be changed. Last time I had checked, I had been lying quite immobilized on my bed linens, tangled up to several types of wires, hooked to a CPM machine, and basically inextricably attached to my bed and, therefore, its linens. I also did not particularly care that my linens were at this point a day-and-a-half old. I don't even change my sheets at home every day and a half. But the hospital cared, and so I was -- strongly against my will, I note for the record -- forced to have my linens changed.

The linen change operation can best be pictured if one imagines how one moves a large sea mammal -- an orca, say, or a manatee -- from one tank to another at Sea World. A big sling is positioned under the enormous beast and then is hoisted; the animal is lifted, fins flopping out to the side, pulleys straining, as the tank is hurriedly changed or cleaned beneath the teetering mass of blubber. Finally, thankfully, the hovering sense of disaster is abated as the humiliated and panting celaphopod is lowered back down to its bed -- I mean, tank.

My CPM machine was not replaced after the linen change, since I'd had the machine on and constantly running since immediately post-surgery. This meant that my operated leg was in a new position and that a pressure sore that had, gradually and, at the time painlessly, been created by the support bar of the CPM machine against the underside of my thigh, had begun to make itself known as the sedation masking it wore off. Quickly and excruciatingly.

Physical therapy came and did some mild exercises with my legs and feet; I ate some broth. All the while the pain from my new positioning increased, the pressure sore began to liken a red-hot poker pressing into my thigh, and, somehow, the epidural began to decrease in effectiveness (despite being raised from 8 to 10 by Dr. Millis last night.)

By late afternoon I was probably at a seven or an eight on my pain scale, moaning and crying and repeatedly pressing the nurse call button to beg hysterically for help or a shotgun. Unluckily, my mother was out taking a walk at this point, so I was literally alone, sobbing into the abyss and the nurse call walkie-talkie.

The pain began above my hip, probably where the screws entered my iliac crest just below my waist on the right side. The pain widened and deepened at the hip joint itself, illuminating all the different moving parts aching inside the joint and around it, including the muscle along the outside of the hip joint. The pain then shot down the right side of my thigh and flared out again near the lateral tibial head, narrowing and dissipating down the lateral side of my right calf. This pain was steady and totally consuming, and I couldn't figure out why it would radiate out so far from the hip itself.

I cried and moaned and hit the call button again and again. Finally, FINALLY, a nurse came and brought Pain Services, who discussed my pain and did some sensory tests to determine the coverage area of my epidural. The Pain Services team eventually decided to raise my baseline epidural to 12 and to give me a jump start on pain relief by injecting a small dose of lidocaine directly into my epidural line. Although it was not instantaneous, the lidocanine did the trick and provided me with possibly my first (and only) pain free 90 minutes while in the hospital.

Once the lidocaine kicked in and my biggest crisis was resolved, some of my smaller irritations could be addressed. I'd been feverish all day, so my body temperature had been fluctuating between chills and hot flashes. When I was hot, I was dripping sweat and had to be packed around with ice packs all over me; when I was cold, I was swathed in blankets and chattering my teeth. When I was hot, my back would itch and drip and feel like an inferno pressed against the pillows and the bed, and I would stuff as many ice packs as I could between myself and the bedding. My fever hit 102 at its highest. My back itched and overheated horribly, only worsened by the enormous ace bandage dressing wrapped around my incision as well as my entire abdomen.

Needless to say, this was an incredibly uncomfortable day. I was in pain and/or discomfort almost constantly, as well as woozy for long portions when I was on Valium to help me relax and Nubain to help relieve the itching.

At 6:30pm Dr Millis came by to remove the large ace bandage dressing and replace it with much smaller dressing over the incision alone, which relieved some of the abdominal discomfort, but not the horrible itching and damp heat on my back. I saw my incision through the stitches and steri-strips -- it looks about five inches long and not horribly disgusting. Dr. Millis said my fever was normal. He looked at the pressure sore from CPM machine but declared it didn't look that bad, which was annoying since it certainly continued to *feel* that bad.

I ate my first food (some bites of scrambled eggs and a few crackers) so I'd be able to start switching to oral medicines in the next day or two.

I would have to say that today, Wednesday, was one of the very worst days so far, and that I am surprised and disappointed that I was so very uncomfortable and painful several days after the surgery. I didn't expect the recovery to be pain free, but I certainly did not expect the seemingly increasing level of durable, multivalent misery that I would be still be experiencing several days following the surgery.