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Surgery, Recovery and the Road Ahead

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The glamorous side of surgery, pain pump and drains.

The glamorous side of surgery, pain pump and drains.

Last week I talked about the challenges of sharing challenging news. I shared my experience of sharing my cancer diagnosis. If you missed it check it out here! I was overwhelmed by the outpouring of kind words, phone calls, emails, facebook shares, etc. It is a bit scary how many people have faced similar challenges recently, are currently facing these challenges, or will learn in the months to come what is in store for them. I hope sharing my journey can help.

Because of my fitness level at the time of my diagnosis, I was eligible for a less invasive reconstruction approach and my recovery time was expected to be, by all accounts, speedy. When I met with my doc she confidently told me I would be working 7 days post-surgery. She also commented that depending upon my pain tolerance; I may not need pain medication post-surgery. Knowing the surgical approach and how my body would be affected, I was totally on board with this. Now my surgery was scheduled for a Thursday afternoon, the week prior to 4th of July. This was fortunate as many folks were out on vacation that week anyway. I cleared the entire week. Charles and I both worked the morning of surgery. Honestly what else was I going to do? I could not eat or drink anything and I did not need to report until noon. It seemed silly to me to not work that morning, even though, once again, it was met with skeptical opinions from many.

In a nut shell my surgical procedure was a skin sparing bilateral mastectomy with sentinel node biopsy. My incisions are underneath the breast, not the traditional mastectomy approach and my tissue expanders, phase one of the reconstruction process, are placed over the muscle. As opposed to between the pectoralis major and pectoralis minor muscles. Since my muscle was left intact my recovery was estimated to be much shorter in duration and my mobility was expected to be much greater from the moment I woke up. When I got to my room following surgery, I learned that the sentinel lymph node showed signs of cancer cells, therefore more needed to be taken making the lymph node removal more invasive. How many more was actually unknown until the pathology came back.

For anyone who has had a surgical procedure with anesthesia, you know the rule, no food or drink after midnight. It’s like your body has become a gremlin, don’t feed it after midnight or terrible havoc will ensue. My surgery was at 1:30pm. Still no food or drink allowed after midnight.

Once you arrive they hook you up to the IV and start pumping you full of fluids, to prep you for anesthesia and the other meds that they give you during surgery. This was a 4+ hour surgery, which started nearly an hour late. By the time I got a room for the night it was around 8:30pm. Remember I have not eaten since the previous day at 11:45pm. I stayed up special to drink fluids and eat something at the last possible moment. Then the nurse offers me a sandwich. This is a problem as I have Celiac Disease and cannot eat most bread. There were no real food options for me. My tech was great and hunted down some rice chex and soy milk. Honestly that did not really seem that exciting so I did not really worry about eating at that point.

Around 11:30pm I attempted to get out of bed for the first time. In that moment of attempting to get up I was immediately brought back to my hospital room nearly 10 years ago. The only other time I recall clearly being in a hospital overnight, I had a car accident. It was a head on collision at a force of about 80 miles per hour. My left knee joint was punctured, requiring surgery to flush it and an overnight stay for 24 hours of intravenous antibiotics to protect against infection. When I got out of bed the first time following that surgery I had body trauma and my left leg did not want to support me. When I woke from this surgery on June 30th, my upper body felt a similar type of upper body trauma as the car accident, achy discomfort.

Standing for the first time was a bit tough. Not so much because of the pain, because of the mental connection to that previous hospital stay. At that time the body trauma felt similar, but standing was also painful. When I went to get up I had a quick shot of pain in the area where the lymph nodes were removed, this is actually the spot that has been the most painful area of the full procedure, the area under my left arm. As I sat on the edge of the bed I was afraid to stand up. I finally said out loud, “I teach people how to stand up from a seated position without using their arms, there is nothing wrong with my legs, just stand up.” I then did just that and was fine. This is a great example of how our brains hold our bodies back and how the memory of a past event can hold us back in the now from moving forward. Since my core was strong, after that initial stab of pain, it subsided quickly and transitioning to the side of the bed was easier and less painful each time I needed to do it.

I mentioned earlier that thing about no food after midnight. Well I had fallen asleep without eating and when I woke in the morning the worst pain I felt was a painful pit in my stomach. I slowly ate the rice chex and my tech found me some real breakfast, fresh fruit salad and turkey sausage that I ate over the course of about an hour. Just for the record I was slow to reintroduce food back into my system, not because I am a notoriously slow eater, no matter what rumors you may have heard. After the initial extreme hunger passed my pain level was quite manageable with no additional meds.

By the time my doctor came by to spring me on Friday afternoon I was sooo ready to go. She apparently had some trouble finding me. I was taken to the wrong ward for my observation. She came in with a giant cookie and said since it took forever to find me and it was getting late so I got a cookie. I unfortunately cannot eat most cookies so I told her Charles would greatly enjoy the cookie. She then commented that he deserved a cookie! She went on to say how wonderful he had been and how she sees lots of people in her work and most of the spouses/significant others she wants to slap. I will say as unfortunate as this situation may be, I am very lucky to have Charles in my corner, taking care of me and all the things around our home I cannot do right now.

When I left the hospital I was sore, generally uncomfortable and I tired easily, but did not really have what I would classify as pain. Fortunately with this surgery they put in a pain pump (that big round thing in the pic) that drips anesthetic into the surgical areas for 3 to 5 days depending. When that came out after 5 days my discomfort was easily managed with ibuprofen. With this type of surgery you also have drains at the surgery sites. Sleeping in an upright position is a requirement post-surgery. This does not make for a great quality of sleep.

During that first week I planned on being tired and needing rest. I cleared my schedule to enable the healing my body needed. More importantly I had the help and support I needed to regain my strength. This is the most important take away here. If you or someone you know is embarking on this surgery or any major surgery it is important to have the support and physical assistance of a trusted person. On day three while dealing with my drains in the morning I started to feel lightheaded and spent 30 minutes sitting on the bathroom floor with a cooling cloth around my neck and Charles sitting next to me to make sure I was ok. On day four when I was sooo ready for a shower I needed help dealing with the bandages and by the time I got to actually bathing I was nearly out of strength. Having a person you can lean on for support that will not judge you while your body is healing and restoring you to your previously mobile, self-sufficient, self is the key to a safe and speedy recovery. Whoever that person in your life is, they are the person you need post-surgery. The one who you need to say, no really it has been 4 weeks I should be walking the dogs. Not the person that says it has been 7 days can you walk the dogs yet?

I told you up front my doc said 7 days to start working, not doing my own work out mind you, meeting with clients and putting them through their workouts. She was right. Given my surgery timing I had the luxury of 2 weekends as part of my recovery. I was off 5 full work days with 4 weekend days and a holiday. Fortunately my drains were removed at the first opportunity, 11 days post-surgery. This enabled me to comfortably get back to work on July 11th. I was still tired at the end of each day. However, my body felt good and I was able to keep to my almost normal schedule with some rest breaks in between.

Next week I will be talking about how I prepared physically in the weeks leading up to my surgery, how I started working on my arm/shoulder mobility immediately following surgery, and how I was back to fast walking 3 weeks after surgery. I will also be talking about the unexpected nerve numbing and the process of the nerves waking up following surgery. So much unexpected fun! Next week will be all about getting moving again. Hope to see you then. Please share if you know some folks this journey may benefit.

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Why I do what I do.

Habits are invisible. Movement just happens. You don't actively think about how to stand up and walk across a room. Right?? Unless a foot or knee or hip are not working as they should then it can be tough or downright painful.

The human body is an amazing instrument and everyone’s is different. Some people have long limbs and short torsos, some have long torsos and short limbs, some are lean and naturally muscular, others work hard to build strength and even harder to gain and maintain flexibility, while more still have such flexibility in their elbows, knees, shoulders and hips that the muscles need to work overtime to protect them from injury. Or more commonly learn how to recover.

Pilates and Yoga Therapy are tools I have used to rehab injuries for myself and post-rehab with my clients. I know what it is like to work through an injury. It is extremely rewarding to guide my clients on their path to strengthen, re-balance, and improve their overall functional fitness.

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