You will be in an altered state for many moons...

If your Achilles tendon is ruptured, torn, or even simply inflamed with tendonitis, your life is about to change. Mine sure has - so I decided to chronicle these events, and create a place for others to share their experiences, advice, resources and emotions during our journey toward recovery.

Nothing in this blog is meant to take the place of the medical advice of your physician. Follow the instructions of your medical professionals, not me.

Saturday, October 16, 2010

5. SURGERY and the hospital - good times, good times...

OK, I'm writing all this the day after my surgery, so please excuse any typos or weirdness - Vicodin is a powerful drug!

<em>'All doped up': Michael Jackson dangles his son Prince Michael II over a hotel balcony in Berlin in 2002.</em>

This is a picture of my team of doctors in the operating room:

Well, that's how I remember it, anyway.  But I'm skipping ahead.

My husband Michael was pretty smart - he quickly realized that we should take the car rather than his big truck, because it would be a lot easier for me to get into after surgery - and he was right about that.

So off we went - armed with our Kindles (which neither of us had time to even crack open by the way).  My husband made a mistake in judgment that your companion may want to avoid - he didn't eat before we left the house, and ended up not getting to eat anything till about 2 pm.  Between checking in, talking to both doctors, and prepping for the surgery, they kept us moving at a pretty quick pace.

Don't be alarmed if they have a little trouble "finding a vein" for the IV.  Remember, you are dehydrated at this point.  This makes your veins harder to find and tap into.  They had to try a few times with me, but they used Lidocain at the insertion points so it was not too painful at all.

If you tense up, you will bruise and be sore, so relax.  Don't look!

They'll hook you up to monitors for your blood pressure, heart rate, temp, etc. 

The nurse will ask you a lot of questions.  Be very thorough and honest in your answers.  Better too much information than too little.  Don't minimize anything - they really need to know detailed answers to these questions, especially regarding any allergies, surgeries, reactions and/or complications to anesthesia, etc.

The surgeon and anesthesiologist will come in to talk with you.  Don't be embarrassed to take out that list of questions you wrote up - they owe it to you to give you the time to answer any concerns you may have. 

I did something that my surgeon thought was hilarious - but he also said it's a good idea.  I took a Sharpie pen and wrote on the sole of my "good" right foot (upside down, I might add!), "Right foot, wrong foot!"  Then I wrote on the left sole (the messed up foot), "Left foot, right foot!"  He cracked up when he saw that, and whipped out his phone to take a picture!  But seriously - it's not a bad idea to mark the correct foot, and make a note on the other one as well.  Wouldn't it suck to have BOTH of them cut into?  People do make mistakes!

After all the questions, and laughter, they gave me a happy pill, which totally relaxed me.  I chose to have general anesthesia, but you can also have a block or epidural if for some reason general anesthesia's not the best choice for you.  Personally, I didn't want to be awake during the surgery. 

I remember cruising down the long hall to the operating room, and cracking some (I'm sure very lame) jokes about Six Flags rides, and I remember them saying, "OK, Melanie, let's move you over to this table" and they scooted me over, and then they said, "OK, ready?  This is going to be very quick."

And BAM - instant and total oblivion - not sleep, not gradually melting away - but sudden, total nothing.  I remember one instant of  "Oh, ___, here we go!" and that was it.

An hour and a half later, which seemed like, oh, one second, I heard a faraway voice saying, "You've had an operation, Melanie.  Time to wake up and go to recovery!"  (I think I must have said something like, "What's going on?" or probably something more stupid sounding than that!)  I woke up on my side, because they laid me on my side for the operation.  I am quite certain I was drooling on myself!

As soon as I realized where I was (in about five seconds of drowsy confusion), I suddenly started talking and asking questions, and someone said, "Wow, she sure did come alive quickly!"  I felt alert and pretty coherent within just a minute or two.

I felt discomfort, like a tight, burning sensation, in my heel and up the back of my leg, but it was not at all unbearable.  They immediately asked me if I was feeling any pain, and when I said yes, they asked me to grade it (on a scale of 1-10 it was about a 4), and they immediately gave me something in my IV which worked in about two minutes.

I forgot to mention this earlier, but they had given me something for possible nausea before the surgery.  I didn't feel nauseous at first, but all of a sudden I got a wave of it.  They immediately gave me some sort of pill which worked quickly, so I never did actually throw up, and the nausea went away.  One weird note though - you would think I would be starving, since by then I hadn't eaten in 15 hours, but I had absolutely no appetite -then, that night, or even now (the next day). 

The doctor came in and talked with me and told me that everything had gone great.  He said when he got in there, the damaged tissue was easy to clean out, and that the tendon looked very healthy, except for the tear, which was easy for him to sew up due to the healthy stability of the rest of the tendon and tissues.  He didn't have to do a lot of debridement either.  He said that my recovery time ought to be really great.

I could pretty much comprehend what he was saying, but it was sort of like when you're a teenager and you come home drunk, but your mom catches you in the hallway - you're trying to act sober and talk straight, but it takes a lot of concentration - and it's probably pretty obvious you're not really coherent.

If I had not had an earlier negative reaction to morphine, they would have given me that, but instead they gave me Demerol during my recovery room stay, which worked well enough.  The pain abated from about a 4 to a 2 on that pain scale, but I could definitely tell that someone had been doing something to my ankle.

I had another reaction to whatever - the surgery, or pain meds, or something - my teeth started chattering, and my hands started shaking, even though I didn't feel cold.  It was really pretty funny, because my chin was wobbling like CRAZY - but after a couple of minutes of this, it was tiring.  The nurse took my temperature and it was 96, even though like I said, I didn't FEEL cold.  She got me some warmed blankets and put one around my head and shoulders and one across my lap.  Immediately the chattering and shaking quit.  So if this fairly common shaking starts with you - ask for those warmed blankets right away.  Heck, even if you're NOT shaking, ask for the blankets - they feel great!

After the chattering drama was resolved, they moved me from recovery to a regular room.  I was feeling pretty chipper and alert.  My husband helped me get my regular clothes back on, and the physical therapist came in with (TA DA!) THE CRUTCHES.

I'll cover those in the next post -they deserve one all their own. 

By then I was feeling more alert, but also more tired, if that makes sense.  I was ready to go home.

Michael went to get the car and they wheeled me out to the curb.  Suggestion - try sitting in the back seat rather than the front.  If you can navigate (with some help) into the back seat and stretch your casted leg out across the seat, it feels MUCH better than letting your leg dangle over the seat.  I have found that elevation is CRITICAL to keeping the pain at bay.  Even a few minutes of lowering my leg stirs up discomfort and pain, which elevation quickly decreases.

After calling me "Miss Daisy," my husband drove to the pharmacy to pick up the extra strength Vicodin with acetaminaphen, and I fell asleep in the car.  When we pulled up at the house, I got my first real taste of the crutches.

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