A quick post about surgery

My post-op appointment, as planned, was on Tuesday morning.  I have already written a post about it, which I will put up this evening (or tomorrow, because there are a few things I want to blog about before it goes up), but first I want to recap about surgery itself (that way everything makes sense and me personal record of things is complete). So here we go.

Like many of my previous surgeries, this one was planned for eight in the morning, which means getting up at four... a wholly unnatural hour to stumble out of bed at. By this point I have the whole morning routine down perfectly. Not having to take time to make breakfast helps of course. I just pull on some clean clothes, take fifteen minutes to hop around my room on one foot to I make my bed, thank my lucky stars that I don't stumble as I make my way down the stairs, and out the front door I go! The only real bright side of having surgery so early in the day was that we had first pick of the best parking spots.

Mum and I headed straight to same day surgery this time, instead of admitting, since I wouldn't be admitted overnight. There is little good to be said about the same day surgery nurses. While one of them was as sweet and kind as possible, all the rest where absolutely horrible. I don't know if I said something wrong, if they didn't like that I corrected the nurse when she was looking for my file (I told her my name and spelled it out for her, she then searched for my file for a bit only to say a completely different name later. I restated my name and then she got all huffy), or if they just have something against young female patients who are upbeat and friendly at such an early hour in the day, but it was not pleasant.

Here I am, about an hour and a half before surgery. I've gotten a much needed hair cut since... started having a mullet like thing going on in the back.

About a half-hour before surgery I was wheeled up to the holding area near the operating rooms. I wanted to get there on my own two feet, so to speak of course, since I can't exactly walk at the moment, but the porter said she wouldn't dream of it (see took one look at the fixator and insisted I stay on the stretcher). Let me tell you, the difference between the day surgery nurses and the OR staff is day and night! I had to talk with the OR nurses, anesthesiologist, etc., before going to the operating room. Surgery will likely be the only time in my life that I am the most popular girl in the room XP In true hospital fashion the OR lost my consent form... again. They seem to do this almost every time that I have surgery. My surgeon also stopped by to go through everything once more and answer any questions I might have. Oh, he also left his signature on my leg - hospital policy so they won't operate on the wrong body part. As if anyone could miss the external fixator! He then left to get scrubbed in (first patient of the day) and shortly after I got wheeled in to the OR.

Low and behold, the same operating room as the previous three surgeries. I was kind of hoping for a different one. But maybe I am not missing out; maybe they all look exactly the same. What I do know is that I don't want more surgery for the chance to find out!

I won't get into details about the operating room itself, because it is old hat by now. My surgeon winked at me reassuringly a few times, I breathed in some air, and before you know it I being wheeled into the PACU. This was just after nine. I stayed there for a bit, and around twelve or twelve-thirty I was sent back to same day surgery. The nurse who was assigned to me when I returned started trying to get me to leave the minute I got back. Patients usually stay down there for a few hours after surgery in order to make sure they are alright to go home, but she said I could go home right after I got down. She really seemed to dislike me. Note that this was a different nurse than the one I had seen before surgery, not the one who go my name wrong.

I was still pretty groggy, so I took my time. After a while I got up to go to the bathroom. In the matter of minutes it took to get back, the dressing on my leg had turned bright red. Mum called the nurse over immediately and asked her to call my doctor. She refused, stating that she would reinforce the dressing and that I could still go home. Still being groggy, I wasn't putting up much a fight, but my mum was! I am really fortunate to have her! Meanwhile, the red patch on the dressing continued to spread. So the nurse agreed to get my surgeon but said that he would do exactly what she would and still send us home. It was almost a kind of shallow threat, like are you really making me call the surgeon for this? It felt like she was trying to get us to back off and when we didn't, as if we should feel bad for getting the surgeon involved.

Here is the dressing on my leg. Bleeding.

 Bleeding some more...

Atfer a while, my sugreon still hadn't arrived, so the nurse went back to the fracture clinic to find him and get him to come over. And he did! *sigh of relief* He took one look at my leg and said "Oh, I wasn't expecting that to happen". It took him a couple minutes to figure out what to do. The idea of re-dressing my leg was briefly considered, but quickly shot down - not such a great idea to take the dressing off a fresh incision in an unsterile environment... couldn't go back to the OR just for that either. Then we thought about having the home nurses come over once a day or on an as needed basis to re-dress the whole thing, but that would pose the same problem and mean that someone un-knowledgeable about fixators would be making the decisions. My surgeon explained that the infection risk is the greatest during the immediate post-op period. Solution? Reinforce the dressing and come back to the hospital in case anything happened. He would be working the next five days straight, so we could go to the ER and tell them "direct ortho", which would somewhat by-pass the ER system and get us seen by him, or at least somebody from the ortho department rather than waiting hours to be seen by the ER itself. So that's what we did. It was actually really good that we got to see my surgeon after surgery. Not only were we able to sort out the issues with my dressing, but it gave my mum and I an opportunity to ask a lot of questions we hadn't even thought of until after surgery was done, like when I would start doing the turns again. These were important questions the same-day nurses wouldn't have been able to answer.

Reinforced dressing and my oompa loompa toes (from the stuff used to clean my leg in surgery).

My surgeon and have I a really great doctor-patient relationship. I have been seeing him for a little over four years now and, including this one, he has performed four of my six surgeries. He has seen me through a lot medically, from surgery in 2012, being given the all clear a year later, having to inform me that the bone infection had returned, installing the external fixator on my leg, and so forth. He is also one of the only surgeon's in the province to work with external fixators. As such, a lot of his patients who do have fixators seem to be younger, people more around my age. I think he does see how difficult this all is, especially at such a young age, and understands how much of an impact this has on a person's life. I should be embracing adult life right now, but instead I am sitting at home on the sofa. Not exactly what I wanted from life at this point.  Sometimes it feels like I went straight from childhood to being a little old woman. In this time, my surgeon has been so kind, professional and encouraging. Simply out, we have a good thing going!

Now back to the same day surgery nurses. Except for the one mentioned earlier, they were pretty unpleasant. The nurse assigned to me once I returned after surgery was not nice and she was very reluctant to call my surgeon, saying he would tell me exactly what she would. This turned out not to be true - it took some time to figure out what to do, followed by a bunch of questions from me and  instructions on what to do in case things went wrong from him. So it was good that my surgeon was called. As soon as the nurse saw how the surgeon and my mum interacted, her entire attitude changed. Instead of pushing me out the door as fast as possible, I was all of a sudden allowed to stay as long as I needed to. Meanwhile, the young man recovering next to me was given the time he needed from the moment he was wheeled back downstairs. He wasn't pushed out at all. It was quite odd to see how quickly her attitude changed and, now that I have had time to reflect on it, it makes me quite sad and a bit confused (at first I was just upset). Why should I be treated any differently? Is it because I am a woman? Perhaps because I am young and some older nurses who are unhappy with their own lives resent that? I have heard from others that some nurses do dislike young female patients... Could it be because I am willing to advocate for myself and they don't like that because it challenges their authority? Could it be possible that the nurse was just having a really bad day and took it out on me? Or she hates her job? Or she was trying to make a point to management or use patient satisfaction to put pressure on the system or responding to budget/staff cuts or other hospital decisions that she had no control over or would feel a negative effect from? Maybe it was as simple as hearing me restate my name when one of the other nurses called me by another name while looking for my file. Who knows. It could be any one, or even multiple, of these things. What I do know is that it shouldn't take seeing my surgeon and I interact to get a nurse to treat me kindly and respectfully. Having dealt with the health care system for over a decade as I sort out this broken leg/bone infection problem and now entering the nursing profession myself, I know that patients are often some combination of sick, in pain, tired, stressed out and scared, not to mention that many don't feel like they can advocate with themselves without backlash that negatively affects their treatment, or they don't know that they can advocate for themselves at all. Patients deserve better. They deserve empathy, reassurance, and professionalism... not to be sent packing or discharged of care as soon as they get back from the recovery unit after surgery for some trivial reason like repeating their name, looking like they can advocate for themselves, or something on the part of the nurse.

That being said, one of the other nurses I had was incredibly kind and caring. She remembered me from the surgery I had in August, which led to a nice discussion and lots of laughs. This whole experience is definitely teaching me which type of nurse I do (and don't!) want to be. So to look on the bright side, as I always do, this experience will shape the nurse I want to be and help me provide the care that I know (from personal experience) that all patients deserve. Anything else is a disservice.

Anyways, enough about that. It was just something that stuck with me. After all this, I sat a little bit longer, still really groggy and sleepy, sipping on some ginger ale. Then mum and I got a bit to eat in the cafeteria downstairs (sweet potato fries and a classic grilled cheese sandwich) because I hadn't eaten since the night prior before we drove home and I promptly feel asleep for almost twenty-four hours. I am still on all the long term pain medication I was on prior to surgery, but I stopped taking break-through meds within two days. This id good! I am stoned enough as is on the long-acting pain meds.

In the end, it was really nice to be back in my bed at the end of the whole thing. It was a bit scary because I have never had same-day surgery before and because my incision bleed through the dressing when I stood up for the first time; given how groggy and tired I was when I got home, I was a bit concerned about that too. But everything turned out okay and it was a big relief not to have to interact with anymore unfriendly nurses. The only concern on my mine was sleep!

Back to my usual view from mybed. My leg still the royal monarch of body parts, stacked magjestically on a ile of pillows.

 Sleep! And oompa loompa toes - they got a good scrub the next day when I was a bit more awake.