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Friday, October 17, 2014

Hosptial Stay

I felt great considering I had just had my pelvis broken.  PT came by and got me out of bed and I crutched into the hall and back to a chair in my room.  This was no easy task.  I did shed a few tears, but I did not yell at the physical therapist, so that was good.  My pain was initially under control with a dilaudid PCA, which was stopped in the afternoon and I had a foley catheter, which was also removed in the afternoon.  I had not had a bowel movement but I was able to urinate.  My dad went and got me a pumpkin spiced latee with whipping cream from Starbucks too--which totally made my day!! :)  I used the CPM every time I was lying in bed.  The surgeon came by after his work day at a different hospital and told us that the surgery had gone very well and that the right hip was in much better shape than the left hip and he expects me to get like 20 years out of this hip.  That puts me at 50 years old! I can handle never having another right hip surgery until I am 50! (excluding screw removal which will happen in hopefully 6 months time).

Early in the morning (maybe even prior to midnight, things are fuzzy as far as chronological order goes), I started having extreme nausea. I was given Zofran which did not help and ultimately Phenergan which did help but not before I was puking my guts out.  I think I threw up like 6 times.  Vomiting after having your pelvis broken is very, very, very painful. I don't think I had ever experienced pain like that before. And, not to mention this vomiting was not the normal 'let's throw up in a bucket type', it was projectile. YUCK.  But after this occurred, things settled down.  I had my drain removed in the morning as well as my surgical dressing.  Ok, so obviously they just slapped that dressing on haphazardly and didn't even consider where they were placing the sticky bit of the dressing because holy crap it hurt to remove the dressing from the sensitive areas!! Like COME ON, if I had wanted a full bikini wax, I could have done it myself with less pain than when they removed the dressing. Ouch.  On this topic, (sorry if TMI, but if you were a gal having this surgery, you'd have these questions too!), I thought I had 'cleaned up' down there enough before surgery.  I was all trimmed and shaved the day of surgery laterally just to ensure they didn't have to shave in the OR.  Well, they shaved me anyway! I was so put off, like I was NOT messy and it was not in the way and they still removed a significant amount of hair. So, best piece of advice, clean up WELL.

PT also came by today, which again produced tears. I was able to get up, crutch out of my room, and then up the stairs.  It was funny, there were only two stairs this time.  Last time there were four stairs.  Having said this, I could be wrong (was on a lot of dilaudid) and am just exaggerating the number of stairs because it was so painful to move last time that the stairs were very daunting. I passed the PT and was moving well enough to have her sign off.  I didn't need OT this time either since I was "a pro at hip surgeries by now". Oof, sad....8 hip surgeries later, you would expect me to be able to navigate and move around alright s/p an operation.

Today, I didn't throw up anymore, I didn't poop, and I did pee.  I was still using the CPM.  My appetite had significantly decreased from my nausea that comes in waves throughout the day.

My night was uneventful, slept a lot as my nurse was incredibly paranoid about controlling my pain. We had chalked up the previous night's events to pain which had got out of control and lead to my nausea (well, when I say 'we' I mean me because when my surgeon rounded later on this day, he took off the dilaudid and wanted the resident to take off the Norco as well and just suck it up with Tylenol, but the resident refused to remove the Norco as he understood I had a big surgery and didn't want me to suffer needlessly). This night also was the start of my urination problem. If you've ever had urinary retention after surgery, you will know it is a big ordeal. So, I had to pee around 2am. The nursing assistant got me up from bed and into the bathroom where I sat for 20 minutes trying to pee. Absolutely nothing was coming out. But I thought I could feel the urge, just I couldn't get it out.  They bladder scanned me and found 500cc on the scan, so I got straight cathed for 650cc.  This was such a relief to have my bladder emptied, but not a fun experience to have to get that done.  I've only ever had a catheter placed in the OR when I am out stone cold. Not the most fun experience.

My surgeon rounded again today in between his cases in the OR. He told me that he wanted to take off all narcotics (as mentioned above) to reduce the nausea.  He asked if he thought I could do with just Tylenol, in my head I thought 'ARE YOU CRAZY!?!?!?! YOU JUST BROKE MY FREAKING PELVIS!!!!'....I politely told him no, I didn't think that would be a good idea, so I got Tramadol in addition to the Tylenol to manage my pain. Sweet, no narcotics after breaking my pelvis, a hip scope, and screw removal. Rolls eyes. Anyway, he was so nice otherwise.  I don't understand his drastic change in personality compared to my first PAO round.  First time he was literally kicking me out of the door with discharge orders in on POD#2 and now he told me to take my time, we were in no rush to get me out of here and that I should stay as long as I felt I needed so that I was comfortable to go home.  The only thing we were waiting for was for me to ensure I could urinate decently and my nausea.

After my surgeon left, I decided that I had to pee. Ok, so really, shouldn't be a big deal right? Lug my sore and swollen body to the crapper and pee. Nope. Honestly, there was no way I could get my pee out! Even if my life depended on it, it was NOT coming out. The nursing students were instructed to bladder scan me. The one nursing student had to be a fresh as they come as she didn't know anything.  So I had two nursing students trying to figure out the bladder scanner.  They were scanning and saw 700cc in there, they quietly whispered to themselves that this couldn't be right when I told them that it definitely could be right, and probably is because it HURTS. They got their preceptor and of course my nurse was on lunch, so I had the covering nurse who was a crazy woman come and fix this pee problem I had so nicely developed. She didn't have an order for a straight cath so she decided to insert a foley catheter just in case they wanted to put a foley back in, then she called the resident who didn't answer, then she called my surgeon! (In my head I thought, great, she's totally over reacting and she was all frantic when talking to him, and all he said was straight cath the freak who won't pee...ok, I bet those weren't actually his words, but I bet that was what he was thinking). Anyway, the foley came back out since they just wanted to straight cath me. It's a joy having catheters put in and out of your bladder every 8 hours. While on the pee topic, they decided that I should be bladder scanned 8 hours later to ensure I didn't have pee in there.  Well, 8 hours rolled along and I did not have the feeling of a full bladder. They scanned me and looky looky--600cc of urine in there, my fabulously gorgeous orthopedic surgery resident (yes, he was HOT) so graciously put in an order for a foley catheter to give me bladder rest. Sweet. Not.

My night was uneventful. In fact, I actually slept through the night. My pain was worse since I was only on Tylenol & Tramadol, but I was managing alright.  My appetite was not there at all, and I was just simply exhausted.  I still used the CPM and was basically just waiting for my bladder rest to finish so I could go home.  The plan was to keep it in until tomorrow morning when they would take it out and see if I could pee.  There was a possibility that I would go home with a foley and then follow up in the urology clinic the following Wednesday to try and remove the catheter. This totally stressed me out as there was no way I was gonna go home with a foley! I came in for hip surgery, I did not want to leave with a freaking foley. UGH.

I basically chilled all day.  I got up with the help of my parents and crutched down the hall a few feet (maybe 10?) and then didn't do much. My appetite was completely gone, all I ate was cottage cheese and Jell-O.

I was determined that I was gonna go home today.  I got my tank top on under my hospital gown, put on my favourite Lululemon headband and sat up in the chair to eat breakfast.  While eating the resident came by and was all happy that I was eating and we would remove the foley for a trial of void.  I told him that I wasn't hungry but I was eager to try to pee. Not 10 minutes later, I was extremely nauseated.  I had the nurse and aid help me to the edge of my bed.  That's when the puking started.  But this time, it wasn't going away. I threw up over and over until I was just retching with nothing coming up (sorry for the disgustingness of this, but it is what happened). The hot resident came back in and was flabbergasted that I was like this, he was gonna tell me I was going home and now I was throwing up. He waited outside for this to stop and every time he came in, I started retching again.  At one point we were talking when I had to interrupt him to dry heave into the cute rose coloured barf bucket. He kept trying to talk to me while I threw up, but I couldn't pay attention to him.  Ended up the nurse, kinda sternly, told him that this was not the time to try and talk to me and he agreed to come back later. Before he left he told me that I would likely not be going home today.  Really?! I can't go home like this? Ugh. He didn't come back later that day.  All I was instructed to do was stay in bed and minimize movement.  I slept all day thanks to the Phenergan they kept giving me. What a waste of a day.  In the hospital another day. 

My surgeon was off this day and could not come in so he sent one of his covering partners to come in. Which was awkward. I was still puking and a strange man without a name tag wearing a plaid shirt and jeans came into my room and stood there staring at me. I turned to him (between pukes) and asked him 'who the heck were you?' In retrospect, I was kinda mean to him :/ He explained who he was and then was like 'Oh! You're the one with the urinary retention. We've had a lot of discussion about you with the residents and your surgeon." At this point I was writhing in pain because, again, that much pressure on the pelvis after having it broken was horrendous.  All this doc said was that I had to relax! RELAX?! You try throwing up after a PAO! He said he was gonna take a look at my medications and try to figure something out for me.  His solution: Valium for anxiety.  I wasn't anxious, I was in pain.  I didn't get any Valium during my stay.

I slept the rest of the day after the vomiting was controlled.

The night was uneventful again. Thankfully. I just chilled in bed with my buddy the foley catheter. In the morning they were gonna remove the catheter and then I was gonna try and pee.  The foley came out at 6:00am. The resident was by at 8:30am and I still hadn't peed, but we were gonna send me home with or without a foley, didn't matter because I needed out of here.  He got all of my medications ready and left me to do my thing.  I made it to the bathroom and...wait for it...I peed!!!!!!! Praise The Lord! As I was in the bathroom, the resident came by and was checking to see if I peed, and I told him I had.  Always nice having a conversation with a hot resident about peeing through the bathroom door.

Everybody was happy I peed. 400cc  And no big post void residual either! I got my medications and was discharged.  Though, I was instructed to stop my birth control pills for risk of clotting. Ugh, not that I'll be engaging in activities requiring birth control in the near future, but my periods will now be all messed up. Two months without birth control.  But at least I didn't have to go home with a foley.

So FINALLY is was discharged home. Nearly a week after my surgery.  What a crazy ordeal which I was glad I was over.

Wow, that was long.  I detailed this more for my own records than for your enjoyment because who really is gonna read a play by play account of my hospital stay? Ha, not many.  But, there you have it: a 6 day stay after a periacetabular osteotomy. Boom.

Over and out....

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