Wednesday, March 24, 2010

Recovery and Fitness

It is now one month since my surgery and I am starting from scratch in the fitness category. My eyes have been opened to how wonderful it is to feel good and how badly I want to re-invent my life and make fitness and active living a part of it. I thought I would share this part of my journey on my blog - since Crohn's Disease can wreak such havoc on our ability to be active, maintain a healthy weight, eat well, get rest and more. Also, watching Biggest Loser can be so motivational! So, here it is.

The Plan

- Gain at least 12 lbs to reach a healthy weight of at least 128 lbs.
- Increase cardio and weight training exercise slowly.
- Build some physical activities into my life. (Buy rollerblades!)
- Get better sleep. No more snooze button!
- Eat a well rounded, healthy diet.

The Status

I am truly starting from scratch. I can only do some stretches and a few very light exercises. The snooze button is my enemy. I have gone nuts on foods I haven't eaten in years - I need to ease up and introduce foods slowly.

Weight: 115 lbs
Energy: Low
Strength: Very Low
Cardio: Low

And thus begins a new adventure!

Sunday, March 21, 2010

Signs & Symptoms To Watch For After Bowel Surgery

I might have caught my obstruction sooner if my doctor had told me what to watch for after she discharged me following my small bowel(intestine) resection. Then I would not have thought it was the flu. Here's a list for anyone interested:

  • Vomiting (possibly with nausea) - make note if there is blood in the vomit, this usually looks like dark coffee grinds.
  • Fever.
  • Change in pain - cramping pain or sharp pains that are new.
  • Constipation or new diarrhea. If you are not passing any stool or gas call your doctor asap.
  • Blood in your stools (looks almost black).
  • Lightheadedness or dizziness.
  • Infection around the incision site: redness, pus, odour.
This is not an exhaustive list- there may be more things but these are the ones I know about. Hope this is helpful.

Saturday, March 20, 2010

Rest. Lots of Rest

I'm feeling better and better lately, the incisions on my abdomen are healing up nicely. I still have swelling right around my belly button, but it takes a long time for swelling to go down.

The main 'symptom' affecting me is fatigue. The slightest activity exhausts me. Going out to a friend's house leaves me utterly wiped out by the end of the evening. However my surgeon warned me of this so I'm trying to take it easy and not push myself too hard.

The other thing going on is my ravenous appetite. It's like I've been freed from 5 years of food prison and am suddenly on a food-gone-wild binge. Fruit, Subway, tomato sauce, juice, freezies, yogurt, cookies, you name it. Though I'm not sure how well I'm tolerating these things, because I've had mr. D constantly since the surgery. I think I need to take it a bit easier and just introduce new foods one at a time. I also need to gain weight. I'm still way under what I should be. Ensure Plus is helping with this.

All in all I can say that so far, I'm glad I had the surgery.

Tuesday, March 9, 2010

A Complication & Back Home Again

Well, I haven't actually been home for the last week. A day after my last post, having only had a day and a half of relaxation at home, I woke up in the middle of the night and promptly vomited into my garbage can next to my bed. This led to me moaning to BF to "Get me a bucket! And some garbage bags! And a wash cloth! *Groan!*". A wonderful beginning to 48 hours of throwing up, nausea, weakness and unable to keep anything down. I would sip water for a few hours then throw it up. Repeat. Spent hours lying on the bathroom floor. It's the flu I said to myself.

After 2 nights and a day and a half of this, my home-care nurse arrived to change my bandage. She took one look and me and decided she couldn't leave me here in my apartment by myself. She called my surgeon to consult and then an ambulance was called and I was brought to the hospital. And admitted again. *sigh* I was there from Thursday till Monday.

Turns out I had a bowel obstruction. The solution to this (before resorting to surgery) is a new kind of torture called a Nasogastric Tube ( Don't be fooled by the calm video. It took them 4 freaking tries to get it into me. The first 3 were rammed down my nose at hyper speed and came out my mouth, leaving me with a bloody nose and the shakes. They then gave me a rest, some 'numbing gas' to breathe then a doctor came and inserted it slowly and nicely. Better.

An NG Tube is a torture device. You feel it constantly. Your body wants to gag on it, it's like a finger in the back of your throat as you talk, turn your head, breathe, swallow, etc. When you want to get up and go the washroom they unhook you from the pump that is emptying your stomach and you get to have a length of tube swaying from your nose. This made me walk like I was on eggshells trying to minimize the swaying of the tube. Luckily coming out it's much easier and a big relief.

I also was 'NPO' which means nothing to eat or drink. Thirst is a powerful motivation. I found myself raving madly in my head about how much I wanted water. That ice is a product of heaven, and why wouldn't the cruel, cruel nurses let me have some ice. Ice is the opposite of hell because hell is fire and water is salvation. On and on raving for hours. It was odd. I would even sneak a straw into the bathroom to take tiny sips of cool water from the sink. It was strange... but kinda funny.

If there's a bright side here, it is that after they pumped about 3 to 4 liters of junk out of me, it relieved the pressure on the blockage which resolved itself. Yay- no surgery required, so the NG torture Tube was worth it.

After a few more xrays (am I glowing yet?), some medications and the tube taken out I was sent home yesterday, now able to keep food down again. I'm taking it easy though, soft light meals, lots of liquids and soups. I also retained water while I was there so my feet, legs and abdomen are a bit swollen. I'm elevating my feet constantly and they are slowly getting better.

Whew- quite the adventure eh? I'm so glad to be home though. Maybe I'll go have a shower.... I think it's been a while. *laughs*

Tuesday, March 2, 2010

Surgery Success!

Eight days after my surgery I am finally home from the hospital. I was there for about 18 days total. According to my surgeon it was a big success. No surprises, everything in the right place, 30cm of damaged small intestine removed along with the end of my colon and my appendix, as well as the fistula abscess area badness and even my previous scar was removed and re-stitched so it heals nicer this time. She was able to do it all laparoscopically so I have two small one cm long incisions, a 2 cm incision where my old scar/fistula was, and a 5-6 cm "C" shaped incision around my belly button where most of the work was performed. Each one is closed with disolvable stitches. The middle one around my belly button is the only one that still needs a bandage, it's very puffy and swollen and still draining a bit of blood. This is where the work was performed- apparently they can stretch a small incision like this quite wide as they work, but it is now very sore. She said she went along my entire small intestine and found no other signs of the disease. yay!

Prior to the operation I was on a TPN IV to gain weight and strength for about a week and a couple days. At the start of the operation, they gave me an epidural. I was a basket case of fear! Would the epidural hurt? Would I wake up with a massive incision? Complications? The epidural was not as bad going in as I expected. I had to sit on the table/bed in the OR and hunch my back and put my head down. A nurse was holding me in place with a big bear hug to keep me from straightening up. She had quite a comforting bosom for hugging lol. I tried to study her name tag to not focus on what was going on with my exposed spine. He sanitized the area, gave some small shots of freezing, then I just felt pressure as the epidural was put in. *shudder* It is a very long metal flexible wire. Then they taped it all the way up my back. I then laid down, and they starting giving me the 'good stuff'. My last thoughts were of my family and friends then out like a light.

I next woke up in the OR groggy and totally numb and was told that it was a success. My entire abdomen felt like someone else's body- utterly numb. I was confused and thirsty. I kept gasping for air. After about an hour and 45 minutes in the recovery room I was wheeled back to my room, my parents and boyfriend meeting me in the elevator. I don't remember much of the next few hours except asking repeatedly where my boyfriend was despite him being right beside me. I started coming around more in the evening and remember discovering the catheter that was now my new friend for the next few days (ug) and the oxygen tube in my nose, IV bags going into my PICC line (a more permanent type of IV line), epidural line coming out my back, and slowly creeping presence of pain. Whew I was a mess.

For the rest of that day and the next I was allowed nothing at all to eat or drink. Only a sponge on a stick that I could wet and wipe on my lips and tongue. I cheated and took little sips out of the sponge, but god I was sooooo thirsty. I remember my Mom preventing me from taking too much.

By far the most poignant memory is the first night after surgery. My epidural line turned out to not be in quite the right place. As a result it was numbing my left side and chest, but barely at all for my actual painful areas. You cannot have much in the way of extra pain meds when on an epidural without permission from the anesthesiologist, who had gone home by then. By 1am I was in agony. By 3 am I had passed my previous 10 out of 10 pain level by a mile and reached new levels of pain. I was nearly hyperventilating and gasping for breath. I couldn't even breathe enough to cry. My poor nurses were beside themselves. They gave me a low shot of Dilaudid which brought my 10+ pain down to a 9.5+ for only half an hour but was only allowed it every 2 hours. The poor nurses were not allowed to give me anything else, but there was no anesthesiologist on call who could authorize it. As a result, I went though an entire night of true torture. By the morning, if someone had said- give me all your money and secrets and I'll take away your pain.... I would not have hesitated. *shudder*. By 8 am or so my surgeon came in and took one look at my gasping, pale face and said "This girl has no pain control!" (clinically put but a sorry understatement) and swept out of the room.

She tracked down an anesthesiologist in short order who swept in with a shot of something heavenly into my epidural line and then rolled me onto my side (groan) and adjusted the epidural by pulling it out a few inches, lowering the position of the numbing effect. A few hours later and a shot of morphine on top of it all and I was finally able to put coherent thoughts together and then fall asleep a bit. Fortunately for other people this 'incident' with the badly placed epidural is not common... I don't want to freak out other people before their own surgeries. But whew, worst night of my whole entire life. Times 100.

For the next week I was slowly introduced to a liquid diet, and dealing with considerable but non torturous levels of pain, and helped to hobble to the washroom lugging my IV pole with me. Eventually the catheter was removed and the epidural line. After a day or two I didn't need the oxygen line anymore, and they unhooked my IV nutrition line after about 4 days. I was brought onto solid food but could only pick at it, and drink down Ensure drinks. Food seemed a battle, I was 'full' after a few bites, and crampy and nauseous. But I made myself eat what I could. The last 2 days I was taken off morphine shots and reduced to 2 percocets every 4 hours.

Yesterday I was discharged and I already feel the difference. I'm more rested, down to IBUProphen every 8 hours and 1 perc as needed. Eating is much easier now, I'm sticking to easy things like soups and Mac&Cheese (ate that for the first time in years! Woot!), and going to the washroom is much less arduous. Very gassy and lots of big D, but I feel things improving each day. I can now walk across the apartment with only a bit of a hunch and hobble, and can sit upright for long periods. woot!

So.... that's my whole story, whether you wanted it or not. All in all I'm still worn out and very sore, but getting better each day. Time to go eat some cream of potatoe soup my mom made for me. Mmmm. Calories! :)