Surgery Post Op Day 0/1

When talking about my inpatient surgical stay they speak in terms of Post-op day numbers.  The day of surgery is considered post-op day 0, the day after is considered post-op day 1 etc.

The night after surgery I guess would still be post-op day 0.  This was challenging night to say the least.  I expected pain after surgery and I also expected to be heavily medicated.  What I did not expect, however, was that that pain would not be relieved and I would told be that I could receive no more medication.

Being immobile is a funny thing.  Not using my surgical leg and being bed bound for the first 24 hours was expected.  But you often expect that being immobile will prevent pain from movement, but immobility causes pain of it’s own also.  What I failed to factor was pain caused by the trauma of surgery.  Never having had surgery I had no idea what to expect.

I can’t really provide a reliable time frame due to all the mind altering substances I had running through my body but I can provide an approximation based on what I was told.  After I was moved to the floor I was given IV and Oral medication every couple hours for pain.  It wasn’t until after my husband had left for the night (about 3:30pm) that the spinal really wore off and I began to experience what I would classify as the worst pain of my life.  Worse than natural childbirth in severity and duration.

I required medication for pain about every 2 hours and this was to be expected.  I was receiving Dilaudid in my IV and Oxycodone by mouth alternating so that I received one or the other every 2 hours.  Both were effective but neither lasted the full 2 hours.  At least twice throughout the night I was in so much pain that I was in tears and one of those times I was crying out in pain and trying to stifle my cries with a pillow over my face.  I pushed the call button and asked for pain medication several times and was told that it was too soon for me to receive anything else for pain.  The nurses gave me my medication as often as they were able but it was a miserable night.

Several times I asked the nurses to turn me to take the pressure off my hip, which in an of itself was intensely painful and almost unbearable.  This only worked for an hour or less.  I slept in 30-60 minute intervals and each time woke in intense pain.  My instinct was to re-position myself which of course was impossible due to the immobilization device I had been placed in while I was under anesthesia and the pain that made me afraid to try to move. I was unable to pull myself up in bed despite the trapeze device over my bed.

At about 6am the doctor made his rounds and was friendly and sympathetic.  He saw the exhaustion and pain on my face and I told him it had been a very difficult night.  Other than the pain everything looked good and was progressing as expected.

Some time later that morning 2 people from anesthesia came in to talk to me and I told them that my pain had been poorly controlled overnight.  Apparently for the first 24 hours pain control falls under the anesthesia department.  They told me that the nurses should have called them so that they could have adjusted my medications accordingly.  Of course, as a nurse, I should have asked that a doctor be contacted in regard to pain control but it was never offered and I was not thinking clearly enough to ask them to do so.

Thankfully, Tuesday was a better day.  I was able to get cleaned up with the help of one of the Aides, the chaplain I worked with visited with me in the morning and I was able to start eating a little.  Later in the day, with better pain control now in place, I was able to get up to a chair for a time and the change of position was welcomed.

Tuesday afternoon my pain management was put back in the hands of the orthopedic surgeon and the Dilaudid was changed to Morphine which  allowed me to be more clear headed and alert.  I remember the nurse saying the the dosage of Oxycodone had been increased so that I was not getting as much Tylenol with it.  The reason for increasing the dosage has to do with the Tylenol contained in the medication.  The Percocet(Combination of Oxycodone and Tylenol) comes in different strengths.  Tylenol can be toxic to the liver if too much is taken in a 24hour period, generally 3000-4000mg max daily.  So by increasing the amount of Oxycodone in each dose and having the Tylenol amount remain the same the risk for liver toxicity is reduced because less Tylenol is being given.  While this wasn’t lost on me I could have cared less and to be honest I’m not sure why they even bothered using Percocet vs. just Oxycodone alone.   I assume due to the anti-inflammatory benefits of Tylenol but I’m sure they were minimal.

My friend Zupash visited with my in the afternoon for a little while and it was very nice to see her.  I hadn’t seen her in some time due to our crazy schedules with kids and work etc.  She was also kind enough to make dinner for the boys, as were a few others that week, which was greatly appreciated.

Tuesday evening my parents brought the kids to see me after dinner and I was glad to see them.  It was also important for them to see that I was okay.  My older son Aidan was a bit upset when I told him he wouldn’t be able to see me the day of surgery because I would be very tired and not feeling well.  Both of the kids were worried about me I’m sure but Aidan being older and more sensitive than his brother was particularly worried.  They didn’t stay that long and that would be the only time I saw them during my hospital stay.

Thankfully Tuesday night was a little better than Monday night and my pain was far better controlled.


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