POST OP HOSPITAL STAY TIPS, RECAP AND PAIN MANAGEMENT
Okay so reading through other diaries, a lot of people describe the first few days in the hospital after the surgery as a nightmare. A lot of people have even said they fainted or cried the first day they got out of bed.
Meanwhile, my pain during this period never really went above a 3, and on average I hovered around 1 or 2. You would walk into my hospital room and see me chatting and laughing with the nurses. Everyone's experience is a bit different, and everyone has different pain tolerance. In hindsight, I think I have an above average threshold for pain, which has helped a lot, but here are a few things that helped me stay ahead of the pain.
1) Pain Med Discipline: So they have you on Toradol and Tylenol through the IV, staggered every 4 hours. This helps a lot. However, the oxy is given as needed based on what YOU communicate to the nurse as your pain level. I would tell my nurse I need pain meds every 3 or 4 hrs, and they would give me 5 or 10 mg of oxy. I set a timer on my phone, to inform my nurse So you see, I was never chasing the pain or reacting to pain, instead, I got ahead of the pain by taking a disciplined dosage of Toradol, Tylenol, and Oxy, at a fixed cadence. I don't encourage abusing this or getting hooked on the pain meds, just managing it wisely by staying ahead of it. As the pain crept up to a 2 or 3, I would take the meds before it went any higher (as opposed to waiting till it shot up to a 6 or 7 to bring it back down to a 3 or 4.)
2) Upper body strength and thoughtful weight distribution: Upper body strength is key to mobility during this time. Your legs are next to worthless. Stryde is a game changer, but all your legs are good for are taking little tiny baby steps, leg raises, quad stretches etc, you have to go in with the mindset that your legs will not be primary when it comes to functionality and mobility. That leaves you with your upper body- the key areas being your triceps to lift yourself up, your core (abs) to maintain stability, and your back (lats to pull yourself up, these areas of your body are working over time while your legs are taking a break. So getting out of bed, I would lift myself up using arms, use my core stabilize myself, and use my arms to move my legs along by lifting them little by little. When my feet touch the ground from the bed, I'm not pushing up with legs to stand, I'm extending my legs out so there is no weight on them, and using my arms to push my entire body up to get on the walker. When I'm on the walker, my arms and core are keeping my body stable and bearing most of the weight, with my legs just taking little baby steps. Occasionally I'd let go of the walker to see if I could stand, which felt fine, but still, any core movements and weight distribution were handled by my arms and core.
PRO TIP: If you have your surgery booked more than 3 months away, I would advise you to hit the gym and work out your upper body, build up strength and endurance in your triceps and shoulders, core abs, and back. They will offer incredible utility when your legs are gone.
Ice Pads Post surgery your legs are going through trauma. Ice those legs to keep the swelling down. The ice also helps with the pain as it numbs the area a bit. Remind the nurses to refill your ice pad bucket whenever you have the chance.
Mindfulness and meditation After this surgery, your body might go in shock because you're not use to this. Personally, I've never broken a bone in my body, so this was all new to me. There are new, weird, foreign feelings throughout your body, you don't know what to expect. During this rollercoaster of a time, it's best to stay cool, calm, collected and rationale. You hear something pop or feel a weird tingle in your leg as you get on your walker? Don't freak out, panic, have an anxiety attack, etc. That will only amplify your pain and trauma. Focus on the present, the task at hand, rationalize your thoughts, be aware that you are in a hospital surrounded by RNs and MDs, you are fine, embrace the new, weird, exeriences, and breathe. Continue to breathe. When my pain shot up to a 3 in a rare case where maybe my leg was dangling or angled weird when getting off the bed, I just took a deep breath and focused on the present. Sorry not trying to sound like a yogie guru, but breathing and mindfulness helps!
In summary, I'm thankful that my post op hospital stay was a success with low pain. Not trying to brag at all, because you'll see in my next update, right now I'm struggling with pain during the night, the kind of nagging pain that wakes you up.....I'm still trying to manage that, so it's not a walk in a park, there are real challenges in this journey. Stay tuned!
Diary: Stryde Femurs with Dr. Paley September 2019
Wow amazing update so far brotha. I'm going to compare it to my experience since it's still fresh on my mind... . I remember it being a nightmare to do transfers from bed to walker cuz my nurse wouldn't let me cheat and raise the bed lol. Transferring from car to walker on the way back was a nightmare (I had a 4 hour drive back home after leaving hospital)
Sitting on the commode was a nightmare for me till about 9-10 days post op. I'm talking 10/10 pain the first couple days.. My quads were just sooooooo tight.
My left leg was basically non existent the first 4 days. Till this day it bothers me and I can't move it laterally while in bed. Right leg is much stronger and 0 pain.
Awesome diary so far and I'm glad you're finding this easy even though it's not lol. After starting the lengthening the first 3 days I had sharp pains in my knees that would switch up from knee to knee (6-7/10 levels). No pain since then though and lengthening has been extremely smooth outside of pain on where your marker is that you just walk off after. Everyone's definitely different though, your body seems really strong and reacting well to everything.. don't mean to jinx u lol! Hopefully the trend continues wishing u the best!
Couple questions:
Are both your legs responding well to movements or is one stronger than the other?
Can you get in and out of bed by yourself?
Sorry if you mentioned this in an earlier post, but how was your flexibility pre-op?
E Z - when you say the pain was super intense when trying to sit, was that even with a heavy dose of pain meds, or without?
It would be awesome if you attach your latest x-rays !
Btw nice posts....Happy to hear that you are doing so good!
It would be awesome if you attach your latest x-rays !
Btw nice posts....Happy to hear that you are doing so good!
Knocking it out of the park with the posts! A lot more coherent than the early posts in my diary so it seems like you are doing great.
Good call emphasizing the importance of upper body strength, I can imagine the process being very hard(at least solo) if you aren't someone who works out.
Fingers crossed that things are going well in these rough days fresh out of the hospital, for me they were quite hard but as the body recovers slowly things transition from painful to boring.
I strongly recommend being sure to have whatever your preferred sleep aid is on hand incase you run into the difficulty with sleep that so many do. Once things settle down cumulative lack of sleep is really the biggest hurdle that can impede you.
Quote from: programdude on September 26, 2019, 10:13:36 AMKnocking it out of the park with the posts! A lot more coherent than the early posts in my diary so it seems like you are doing great.
Good call emphasizing the importance of upper body strength, I can imagine the process being very hard(at least solo) if you aren't someone who works out.
Fingers crossed that things are going well in these rough days fresh out of the hospital, for me they were quite hard but as the body recovers slowly things transition from painful to boring.
I strongly recommend being sure to have whatever your preferred sleep aid is on hand incase you run into the difficulty with sleep that so many do. Once things settle down cumulative lack of sleep is really the biggest hurdle that can impede you.
Thanks brotha! Yes, upper body strength has been my savior. I'm channeling my inner Lieutenant Dan from Forrest Gump whenever I move.
Sleep and pain throughout the night and morning has been my biggest obstacle these past few days. Right now I'm on Tylenol PM to help as a sleep aid, but I'm still waking up throughout the night due to the pain. I'm getting 6 hrs a day (cumulative made up of a couple 1 to 2 hr sleep/nap sessions broken up by pain) of sleep a day so far. Everyday is a battle but I'm doing ok all things considered.
Quote from: Dreamer57 on September 25, 2019, 01:46:04 PMIt would be awesome if you attach your latest x-rays !
Btw nice posts....Happy to hear that you are doing so good!
Thanks man. Haven't got x rays yet, once I have that scheduled I will!
Quote from: E Z on September 25, 2019, 04:41:47 AMWow amazing update so far brotha. I'm going to compare it to my experience since it's still fresh on my mind... . I remember it being a nightmare to do transfers from bed to walker cuz my nurse wouldn't let me cheat and raise the bed lol. Transferring from car to walker on the way back was a nightmare (I had a 4 hour drive back home after leaving hospital)
Sitting on the commode was a nightmare for me till about 9-10 days post op. I'm talking 10/10 pain the first couple days.. My quads were just sooooooo tight.
My left leg was basically non existent the first 4 days. Till this day it bothers me and I can't move it laterally while in bed. Right leg is much stronger and 0 pain.
Awesome diary so far and I'm glad you're finding this easy even though it's not lol. After starting the lengthening the first 3 days I had sharp pains in my knees that would switch up from knee to knee (6-7/10 levels). No pain since then though and lengthening has been extremely smooth outside of pain on where your marker is that you just walk off after. Everyone's definitely different though, your body seems really strong and reacting well to everything.. don't mean to jinx u lol! Hopefully the trend continues wishing u the best!
Couple questions:
Are both your legs responding well to movements or is one stronger than the other?
Can you get in and out of bed by yourself?
Sorry if you mentioned this in an earlier post, but how was your flexibility pre-op?
Thanks brotha! Happy that you have moved forward from those nightmare-ish times.
1) My right leg is definitely stronger than my left, but my left is more flexible than my right. I can get through all PT motions with both my left and right leg, but there are certain elements of PT where one leg is easier than the other.
2) Yes, I am able to get in and out of bed myself. The mornings are the toughest as your legs are super stiff from restlessness the whole night. In the morning, I usually warm them up by doing heel/toe flexes and quad flexes for 5 to 10 min. I may take Tylenol for pain relief if needed. I let me upper body do most of the work for getting out of bed. I sit upright, rotate my body to the side of the bed using my arms and core. If needed, I'll lift my legs with my arm to rotate them, I also have a leg lifting extension from the hospital to aid in this. Once I have my feet off the side of the bed, I'll extend my feet as far away form the bed as possible to put less weight on them. Then I'll push myself up with my arms, and then get my feet under me. From there I'll reach for my walker and transition to my walker.
Outside of the morning, after I get my PT session in and my legs warmed up, with Tylenol on board, getting in and out of bed is not bad at all.
3) My flexibility pre-op sucked, especially my hamstrings. 6 months pre- op I could not touch my toes while standing or seated on the ground. Then, 3 months pre - op, everyday I spent 30 minutes working on stretching. I made some progress and before my surgery I was able to touch my toes. Right now post op, I'm still able to touch my toes while seated on floor.
POST OP DAY 10
Approaching midway through week 2. It's been a battle. A recap of the past couple of days and nights.
Pain
The pain has risen to a 4/5 throughout the night, peaking at a 6/7 at its worst. There were times were I had to vocalize the pain, even finding myself yelling or screaming. Laying still throughout the night gives rise to restlessness in your legs which leads to pain, and although I can get sleep sessions of 2/3 hrs during the night, when the restlessness sets in the pain is strong enough to wake you up and keep you awake in agony. The pain is like living with a bruise throughout your thighs where pressure is constantly being applied to it (imagine someone poking or squeezing your bruise). I've found that there is no sense in fighting the pain, the best solution I've found is to make the most of that time and do PT/stretch. Doing PT beats staring at the ceiling in pain, might as well make it productive. It distracts the mind and gives you a sense that you are somehow moving forward. Outside of that, I've tried to set alarms every 3 hrs and 30 minutes to take pain meds (Tylenol) so I have a steady dose on board throughout the night. I've also added heat pads to my arsenal, this help a lot to relax your muscles and ease the pain.
In addition to the generic leg pain, around day 8 I developed concentrated pain in my knee. I would describe it as a throbbing, intermittent pain, that comes and goes for a few seconds. When it hits I'd say it could escalate to a 7/8 level pain, and I can only endure it because as I said, it's a throbbing pain that last for a few seconds, then leaves. Honestly, the worst part is not knowing when it's going to come again. There's no rhyme or reason. I've messaged Paley's team and hope to get it checked out soon.
The mornings are rough. The lack of sleep starts to compound (I'm now averaging 4 to 6 hrs a night) and you wake up stiff and in pain (level 4/5). It takes patience and a whole lot of determination to get out of bed and push through the pain each morning. Once you wake the legs up and get the blood flowing (and get the meds to kick in) you bring the pain down to a 2/3 and that's when you truly start your day.
During the day, the pain isn't a huge issue. Thanks to stretching 3x a day, keeping myself active with walking (still using my walker), and disciplined pain med intake, I'm able to manage the pain to a 2/3 where at times it may peak at a 4.
Mobility
I still rely on my walker, but I'm able to walk comfortably, heel to toe, no swaying, with the majority of the weight on my feet. My goal is to ditch the walker by the end of week 3 and use a combination of my cane and crutches.
I can get in and out of bed pretty comfortably by utilizing my upper body and decent to good lateral movement with my legs.
Physical Therapy, strength and stretching
I started PT exactly 1 week after the surgery, I'm 4 days deep right now. So far, so good. . The PT's give you a set of stretches and strength exercises that you go through 3x a day (2 at home, 1 at Paleys). They are challenging, but doable, and honestly, when completed, they are rewarding. Based on feedback from all the PTs my flexibility and strength are good for week 2. My hamstrings are doing well, I can still touch my toes while seated. My quads are just decent, I'm able to meet expectations with strength and stretch exercises.
A lot of the stretches really require another person for you to get the most out of the stretch. People who come with friends/family who can help them stretch will really benefit from that, as for some stretches you can only get about 50% effective by yourself....highly recommend that you come with friends/family unlike me.
I know that the more I lengthen, the harder it will be to stretch, so I'm doing my best to get ahead of the curve now. I actually look forward to PT. Probably because it gets me out of my hotel room.
Independence
If you are doing LL solo without family and friends, everyone else's diaries are right, you will need to hire a caretaker during week 1 and 2. From a risk management perspective, you just need someone looking over you to make sure you are healthy. Everything takes longer to accomplish. Getting to and from the bathroom, brushing your teeth, dropping something and needing to pick it up...there's really no room for error, so you want someone there to assist you.
My caretakers for the most part have been solid. I don't have a dedicated one unfortunately, I had 3 that rotated. One was pretty much useless, so got rid of her. Although I am dissapointed that they limit the amount of assistance they can provide for PT at home, I want them to help push me during my stretches, but due to liability the agencies don't allow them to.
Mood and Mindset
Still positive despite the pain at night. Although the evenings have become nightmares, the positive mindset comes from the belief that I'm at the low point, as other diaries have pointed out, week 1 and 2 are hell weeks, and while the rest of the journey is no walk in the park, it gets better from week 1/2, the sense of only going up from here gives me hope.
The isolation and loneliness hasn't gotten to me....yet. Between managing pain, resting, PT 3x a day, and everything taking longer due to being crippled, there isn't a lot of idle time to feed depression and loneliness. I'm constantly working on something or trying to find a solution to something. From a social perspective, honestly, LL has been a unique social experience, I've come to Florida with no identity and no consistent contact with my family, friends or coworkers back home. So I've been more proactive about making social connections with other LLers here at my hotel or at Paleys during PT. I've even found some of my caretakers to be interesting and cool to chat with. It's put me out of my comfort zone, but in a good way. Let's see how long this will last. I can see this going south after some time here. I'm hoping that if my pain and condition improves over time so will my ability to focus on other matters (dedicating a few hrs a day comfortably reading, hobbies, skillsets.)
Keep going brother....Just think about the reward at the end....You r gonna taller...! Best of luck keep fighting...!
Great update Alchemist. Nights are hard with my 1 leg...with 2 legs I’d be a wreck...I just added Ambien yesterday since I pretty much felt like I hadn’t slept in a week...worked well but I’m hopeful I don’t have to use it consistently. I had some weird dreams but got almost 6 hours of sleep with only 1 bathroom break.
So far I haven’t had the pain but it may come soon, I’m a few days behind you. Going solo is rough, glad you’ve found some decent help.
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