Post op in Paradise continues: how long does this take?

After over two weeks of showering on one foot with a bag over the other, or bathing with one foot propped on the edge of the tub, I was looking forward to getting my stitches out.

I imagined that I could not only shower, but go down to the pool and go for a swim. I can dream, can’t I?

I went to have my stitches out and unfortunately, I was told to wait a little bit longer before I attempted swimming. In fact, the day I was supposed to be able to shower without keeping my foot dry, I took one look and changed my mind. The incision just didn’t look healed.

The stitches were out, but I had all that dry, scabby skin around the incision. It seemed like there were small patches where it hadn’t healed yet. I waited a day.

My first shower was actually a little painful. Water on the foot hurt. Trying to balance on one foot hurt, but trying to put even just a little weight on the bad foot while I was barefoot in the shower? That hurt. It was exhausting. It was back to bathing with the foot propped on the edge of the tub, although at least I could wash it and rinse it under the tap. Those Tortuga bags could be used for something else.

So life without stitches continued on a lot like life with stitches. I reviewed my journal from the first surgery and indeed, I had waited at least four weeks post op to go swimming.

Another two weeks of hobbling around, gradually putting more weight on the foot, and I was sure I’d be ready to swim. I was still in the post op shoe, which made my foot feel safe and protected, but was also very bulky. I managed to spend more time outside. I was feeling a little more confident about getting back inside in case I needed to go to the bathroom, but rarely made the trip back outside again. One trip up and down the stairs in a day was enough.

Next step, x-rays and maybe it would be time to venture into the pool? Oh, how optimistic I was!

 

 

 

Post op in Paradise; adjusting to the pain

After my first surgery, my doctor told me after about 3 days that I could probably stop taking the acetaminophen/codeine combination. It made me drowsy and one of the complications is  constipation. Besides, the ibuprofen was a strong dose, and it also helped with the swelling.

I thought I would follow the same protocol this time, but again, I underestimated my pain level this second time around. I woke up on day 4 and decided I wouldn’t take any Co-dydramol. By midday I broke down and took my dose.  At bedtime I decided to skip it again. The next morning I was back on it, but I only took one instead of two. Tapering off in this way, I think I had stopped taking it by the end of Day 5.

Meanwhile, I was trying to eat fruit and fibre. Co-dydramol really can make you constipated.

I started feeling more alert, which gave me more incentive to use my brain and planning skills. I went to work on some of  my projects. I could read without falling asleep!

I still experienced a lot of swelling. My foot swelled up when I was sitting. It swelled up if I stood too long. It fell asleep sometimes when I had it elevated. I started feeling cramps in my foot. My back and knees started to tighten up due to the awkward sitting positions and lack of exercise.

For the first two to four days, there was a lot of pain and swelling, but doing nothing at that time is easy. It’s the next 2 weeks that are difficult. Bathing or showering without getting the dressing wet is exhausting. Sitting with the foot up while trying to type something on the computer is very uncomfortable after about 30 minutes. Depending on someone else for your meals is frustrating, and humbling.

I started making the morning coffee after about one week. I wake up before my husband and I need my coffee. I’d given up having an omelette for breakfast, although he does cook eggs. I started eating cereal, or yogurt and scones or croissants, which were a nice treat.

One week post op, I ran out of the prescription ibuprofen, so I started taking my own. It was half the dose, so I noticed a difference in pain control. I also noticed that it was really hard on my stomach. I took the regular, over-the-counter ibuprofen for a day, then I stopped. After that I had to pay more attention to what my foot was telling me; to sit down and elevate it!

At this point, I started noticing the large pile of laundry, the dirty toilets, the dust on the furniture. I don’t have a cleaner, or a helper as they call them here. My husband finds it challenging to do all the cooking, errands and grocery shopping as well as his work. I started trying to do a little each day. The first day, I probably overdid things. The next day, I was sore, swollen and exhausted, so I did very little. I try to do one chore each day now.

Household chores remind me of what it would have been like to have surgery in the winter in Canada. Our house with two staircases wouldn’t have worked. I’d have had to set up in our living room. I wouldn’t be able to start going in and outside so easily on the treacherously slippery sidewalks.

Here, I can relax on the deck for the entire morning, eating breakfast, doing puzzles, reading and surfing the internet. If I’m energetic I can hobble down to the pool and relax on a recliner. It is either blissfully quiet, except for the sound of the sea, or I am entertained by the goings-on of the island.

That is how my recovery has been going. One day, I feel great and think I can do more. The next, I need to rest, which is pretty easy when you can sit outside and enjoy the sound of the waves.  The next day I have a better idea what I can handle. My next big step would be getting the stitches out.

Recovering in Paradise: showering with Tortuga and keeping my feet up

With two different prescriptions for pain medication filled, I fully expected another easy recovery from this second bunion surgery, at least from a physical point of view. I was surprised then, to find that the pain and swelling the first day were significant.

First of all, I had to take the medication with food. That meant waiting for my husband to make breakfast, as I was supposed to do absolutely nothing. I was also experiencing a headache, probably from caffeine withdrawal, having had my last cup of coffee at 6 am the previous day.

Usually I wake up and make the coffee in the morning, then either I eat cereal or I make an egg dish. That way I have some coffee in me before I start cooking. I’m grateful that my husband made breakfast for me, at least for the first few days, but that first day my head was exploding by the time I got coffee. I’d waited for breakfast to take my pills, so they still hadn’t started working. When my doctor called later for an update, my pain was down to a 3 or 4 on a scale from 1 to 10, but I estimated it at a 5 or 6 when I first woke up.

I was relaxed enough and comfortable enough by the time the meds started to work. I updated my Facebook, Snap chatted with my kids and read. I started doing Sudoku and crosswords again. The first two days post-op I was instructed to do nothing, to keep my foot elevated above my hip, and to only get up to go to the bathroom.

After my doctor called, I peaked under my elastic bandage and realized that my gauze dressing was soaked through with blood. It was dry to the touch, so must have bled the night before. I emailed him and he replied that I should come in the next day, which was only a day early, for the wound check.

The printed instructions from the doctor said I could take a shower the next day, as long as I protected my foot with a plastic bag. We find that Tortuga Rum Company bags are very sturdy and make a good cover, and my husband had made a serious effort to collect several in the time leading up to the surgery.  The taping is the tricky part. If you aren’t careful of the folds in the top of the bag, there could be an unseen opening for the water to seep in. For that reason we double bagged my foot and my husband taped it up so tightly I thought he was making a tourniquet.

That first day I kept the shower very short, being unable to put any weight on my bad foot.  I was still in good shape then, so it wasn’t too exhausting to stand on one foot and try to keep the other one as much out of the shower as possible.

We visited the doctor and he cleaned up the wound. He noted a lot of bruising and said the bleeding was good. It shouldn’t be trapped in the wound. He poked and tweaked at my stitches, which was a little bit painful, but more of an irritant to my foot. Once the foot was all wrapped up again, he got me a wheelchair to get to the front door and instructed me to keep the foot elevated.

Wow! I had a shower and a visit to the doctor in one day! What with going up and down the stairs to get in and out of the apartment, I was tired at the end of the day. Maybe I wasn’t in such good shape after all!

Once we got home, I played some computer games and emailed family to let them know how things were going. After dinner I had an early night. I planned to continue my  focus on rest and healing. My next couple of days my goal would be to taper off the pain medications.

 

 

Surgery in Grand Cayman; my experience

I can’t really compare my experience here with surgery in Canada, as I was only a child when I had a tonsillectomy. I wasn’t present for my father’s surgeries, so I only have my own experience in Cayman to talk about.  I’m sure it’s a mix of British and American style procedures. My surgery was in a private, for-profit hospital, but the team was completely British or Caribbean.

I thought I would describe in greater detail what it’s like to have surgery here, at least from my point of view.

After ten days of having no ibuprofen or aspirin type medications, and 3 days of no alcohol, I checked into the hospital. I’d had breakfast at 6 am as my surgery wasn’t scheduled until 2 pm. I’d had nothing to eat or drink since 6. I arrived at the hospital at 10:45 where they took me to my room. For my first surgery I had a room to myself. This time I had a roommate, also waiting for surgery.

I was given a hospital robe to wear; yes the glamourous kind with the open back. It makes it very easy to go to the bathroom, but awkward for getting in and out of bed and up and down off stretchers without baring one’s butt.

I was also given some disposable foot covers and hat. I put on the hat and one foot cover, leaving one foot uncovered for the bathing that was to come. I was started on an intravenous drip to keep me hydrated. I would have nothing else to eat or drink before evening.

Unfortunately, even though I wasn’t drinking anything, I had to walk my IV pole to the bathroom with me at least 3 times, all the while trying to keep my robe from opening wide at the back.

The nurse came in to wash my foot very carefully for 3 minutes. Those were her instructions. She then put the disposable slipper on that foot. Not long before my surgery she came in to put the antibiotic dose through the IV. In the meantime, my surgeon popped in to say hello, give me post op instructions and make sure I had my post op shoe from last time. That saved us $45!

Not long after my antibiotic dose, someone from the anesthesiology team came in to wheel me to the operating room. There I met my OR nurse, an older lady who was very kind and very thorough. She checked and double checked my file to ensure everything was ready and I was ready, etc.

One thing I noticed at my first surgery was that everyone in the OR was male. I have seen many more male nurses here than I ever worked with when I was a dietitian in a hospital. I don’t know if that’s happening everywhere, but I like the balance. This time, the first nurse I met was female and the member of the anesthesiology team who did my pre op interview was female. The anesthetist was a man, as is my podiatrist.

Once in the OR, I felt something happening to almost every part of my body. I was getting a clip on my finger and a blood pressure cuff on my right arm, while the anesthetist was putting something into my IV that made my left hand feel temporarily frozen. My surgeon was preparing my foot and I was also getting little snaps put on me in various places, I assume to connect to sensors to keep track of my heart rate and breathing. I was given an oxygen mask to hold over my nose and mouth, and I took deep breaths while I listened to the sound of my own heartbeat in the room. Occasionally, the blood pressure cuff would inflate. They started the anesthetic and I was feeling very calm and very drowsy.

I woke up in the recovery room with someone removing a tube from my very sore throat.  I had those little nodes in my nostrils connected to a tube leading from an oxygen supply. My foot hurt more than the first time. I was very sleepy. They wanted me to wake up, and I did, very slowly. I was taken back to my room. My roommate had returned while I was gone, but the curtain between us was closed.

The nurses must have had a shift change on the ward, as they had last time. I had a new nurse. I had been given something for pain in the recovery room, so my next dose would be at 8 pm. They brought me a meal of soup and crackers and ice water. Oh, I was thirsty! The soup wasn’t exactly clear, but it was ok. The crackers were dry and flavourless, so I broke them up and put them into the soup. That made both soup and crackers more palatable.

My husband texted our family to let them know things had gone well. I got some nice texts back from them full of love and good wishes.

Before I could eat, my nurse came back to take me for an x-ray of my new foot. That went fairly quickly. I’ll need another x-ray in a few weeks.

I was still sleepy, CNN was on the tv, my husband was sleepy, and we were both dozing off. My roommate was told she could go home. She just got dressed and walked out. I wonder what kind of surgery she had!

I finally got another dose of painkillers and another dose of IV antibiotics. As soon as the antibiotics had run through, I was allowed to get dressed. I’d kept it simple with a dress, but I still had some difficult moments trying to keep my weight off my foot while I went to the bathroom and changed into my clothes. I discovered those snaps all over me. I was tempted to keep them and take a picture. I felt sort of cyborg-ish! They came off easily, though, much more easily than the adhesive tape holding my IV line in place in my hand!

The nurse helped my get my things all into my bag and helped me into the wheelchair while my husband brought the car to the front door of the hospital. I got into the back seat so I could put my foot up on the seat, buckled up and away we went.

It was pouring rain when we got home, so my husband had to get a bag for me to put over my foot. I have to keep the dressing dry! I hobbled up the stairs and into the house in the pouring rain.

I had instructions to keep my foot elevated above my hip and no weight-bearing. That was a little difficult going up the stairs to our condo. Later on, my foot swelled up so much I thought it would burst, even though I immediately sat down and raised it onto a pillow.

I had meds to take before bed which helped with both the pain and swelling.

I will describe in future posts what it’s like to recover from bunion surgery, but I’d love to hear if other hospital surgery experiences are similar. I found the first surgery to be a little easier on me, although the surgeon said the second one was easier for him. The staff was busier this time and I didn’t have a private room. I also had more experienced staff on the ward last time, but I have no complaints about the care I received.

 

 

 

 

 

Leaving Paradise: Life challenges made easier

We’re off island as they say in Cayman. We’ve fled the Christmas and high season madness for six weeks to spend Christmas, not in the deep freeze of Canada, but in sunny Southern California. It’s not Cayman hot here, but we’re getting some very nice weather.

The thing about being here is that it’s so easy to go for a walk or even a hike. It’s not too hot and we won’t be hit by a car or attacked by dogs. There is also a pool. It’s quite a long pool, so swimming laps is that much easier. I can do 20-25 laps and get the same distance with fewer turns than I do at home doing 50-60 laps.

Unfortunately, it is the Christmas season, and I’m in full treat-making mode. We are also in close proximity to the best Mexican food outside of Mexico. In fact we are only about an hour away from Mexico, so we have Mexican food everywhere. Have I mentioned how difficult weight loss is when consuming Mexican food regularly, not to mention shortbread and tarts?

We also find alcohol much cheaper here, but fortunately that hasn’t yet affected our consumption. We’ve limited ourselves to wine with dinner and the occasional cocktail while the sun is going down.

My shoulder is much better and I feel energetic enough to do both a swim and a walk now. I think I can fit in some yoga and a strength circuit. I attempted push ups again for the first time in weeks, but I’m not there yet. Don’t pull your trapezoids  if you can help it! It’s painful and affects so much of your day to day life.

Yes, the challenge to eat healthy and lose weight is actually a much greater challenge here. The exercise part should be easy.

One thing we do have going for us is the abundance of fruits and vegetables. Everything is so fresh when it’s grown just a few miles away. We enjoy the local Farmers’ Market and stocking up on beans and greens and oranges and grapefruits picked yesterday. The market also has tamales. As I said, it’s a challenge!

Life challenge update: now what?

My father said to me the other day, when I finally remembered to call in the morning before his lunch, “This getting old is not for the faint of heart.” He is 26 years older than I am, but I know exactly what he’s talking about.

I felt great on Saturday morning, did a few extra lengths in my swim, did a 10 minute strength circuit later, and felt fine. We went out for the afternoon to check out the last of Pirate Week. It was really windy so it felt lovely to be out and about downtown. We stopped for food, talked to some tourists, and checked out the pirate ship. By the time we walked back to the car, my feet were sore. I didn’t think much of it, but later on at home, I really needed to put my feet up.

Later, in the evening, I was overcome by fatigue. I waited for the fireworks, which we were able to see from our place, but after that I was done. Even the lovely neighbourhood bonfire couldn’t tempt me.

I was in bed, sleeping, shortly after 9:30. For me that is unheard of! I am a night owl! Midnight has nothing on me! I slept for at least 10 hours.

You would think I’d wake up feeling refreshed, but no. I woke up feeling tired and sore. My shoulder was sore. Days later, my shoulder is still sore. Swimming seems to help, or maybe it’s just that the water numbs everything a little.

Here’s the thing: I’m afraid to get this checked out. Maybe I pulled something and this is only something temporary. At this stage of life, I’ve been discovering that the little aches and pains are a sign of something bigger. Apart from the fact that our insurance coverage for doctor visits has run out for the year, I’m just not ready to go for another x-ray and find out that yet another joint is defective. I’m afraid to find out that swimming is actually bad for it. What forms of exercise do I have left?

No, getting old is not for the faint of heart, but I’ll figure this out. My aches and pains are nothing compared to what my own parents have gone through and what many people live with every day. I still have so much left to do and to offer.

There’s just one thing bothering me and that’s the fact that too long at a keyboard also seems to bother my shoulder. I’ll have to find a way to improvise on the writing.

 

Challenge update: It’s a real challenge now!

Not only have I not been writing about my life challenge every week, but I’ve had more setbacks than I care to count.

At first I was doing great. I was getting toned and fit and I lost a few pounds. I could fit into some of my old clothes again. The first setback was being sick with the flu in the spring, then going to Canada for two weeks. I didn’t gain weight, but I had a set back in my fitness regime.

I was back into my regular activity, adding new challenges regularly, until my foot surgery. Major setback number two.

The recovery from surgery seemed endless. Even now I have twinges in my foot and it seems swollen at the end of the day. I can’t do all the exercises I had added to my routine.

Next came another trip to Canada. That one wasn’t too bad, because by then I could go for long walks and I could do a little exercise circuit in a small space, like in my parents tiny guest room or in a hotel room. I returned home feeling like I had made some progress since surgery, but it was time to get serious again. I had gained a couple of pounds back.

I started swimming again regularly, trying to increase my laps every day as my tolerance grew. I tried to add a workout or yoga every day. Things were going moderately well. Our daughter came to visit. She’s all about fitness, so I was able to mostly keep up with the swimming and yoga.

Now, I’m fighting a cold. This isn’t the every day “permacold” that I put down to allergies. That daily congestion that is actually relieved by a good swim. This is a wake up feeling fatigued, stuffed up and my throat feels tight kind of cold. This is a sinus headache, “I just want to read while lying outside on the anti-gravity lounger” kind of cold.

It’s a challenge, but that’s life. If you let every setback stop you, your goals will always seem unattainable. The thing is, I don’t have an end goal. My goal is to be fit and healthy and to find a routine that works towards that, and that I can live with. I think I’ve found it, but sometimes the challenge is to keep it going, even with the setbacks.

I’m Back! The joy of the rhythm of routines

My foot surgery and healing, as well as the Summer Olympics were the dominant themes of the summer for me. Hurricane season got a little attention, but fortunately our little island has been spared so far this season. Routines went by the wayside as I focused completely on healing.

Fast forward to the end of August and it was time for a trip off island. Once in Canada with sidewalks and slightly cooler weather, I imagined taking long walks to get back in shape. Surprise! The walk from the plane to the customs area of the airport almost did me in! Swimming is good exercise, but it wasn’t really doing the rehab my foot needed, simple walking.

After a bit of time my foot did start to improve. I went for those long walks, initially with my foot wrapped in an elastic bandage, but later just wearing socks and sneakers. By the time I returned home I thought my foot was fully recovered. Not so much. I still feel some twinges of pain at night. I still see swelling sometimes.

I can do most things now; swim, walk, yoga, balance, core and strength exercises. I realize my foot will still swell and feel sore for another month or so. I’m not an Olympic athlete, but I am gradually getting back to full fitness.

My only problem now is finding time to finish those projects I started! You think of retirement as kind of a long holiday where you can do what you want. Fortunately, because I don’t think that’s necessarily what I want, that’s not the case. There are family obligations and celebrations and reunions. There are friends to catch up with and reunions of every conceivable group with whom I’ve ever associated. There are home obligations and maintenance. I don’t have a maid or a cook or a “helper” as we call them on the island. I am still a parent and my children are still finding their way in the world. I like to be available to help out and give advice when needed.

This is a good life. It’s an extension of the life I left behind in Canada. The climate is more pleasant year round, but the logistics of keeping up with everything are much more complicated.

I don’t understand the need for people to leave the island every 3 months. I have no such need, but I often have the obligation. I would very much prefer to stay here and have everyone come to me!

Right now, I’m happy to be back and trying to establish a healthy and productive routine. One thing I’m looking forward to, however, is getting back into my sandals and flip-flops.

 

 

Life Challenge: Surviving surgery

I had surgery on my foot on Wednesday. It was a day surgery, but I was under a general anesthetic and the surgery lasted 2 hours. It ‘s my first surgery since I was a young child and had my tonsils out. I remember some things about that surgery very clearly. I remember getting a needle in my hip. I remember being told to count backwards from 10 and I don’t remember finishing the countdown. I remember having a sore throat when I woke up and a sore bum, from the needle.

This time it was a little different. I remember chatting and joking around with the doctors and nurses in the OR, breathing in oxygen and getting something to make me “woozy” in my IV. I woke up in recovery with a sore throat, this time from having had a tube down my throat. I still felt a little woozy.

My husband had brought me in to the hospital in plenty of time to prepare for the surgery, and I had a very nice nurse from Jamaica  to prepare me. He set up an IV with saline and antibiotics. He washed my foot and put my booties on.  When it was time, he helped me onto the stretcher to take me into the operating room.

By the time I came out of recovery I had new nurses to take care of me. In order to start me on pain medication, my doctor requested some food for me. The nurse brought me some soup, crackers and apple juice. It was very familiar to me as the post op “light meal” we would send patients when I worked as a hospital dietitian. The soup, a chicken broth, was very good!

By 7 pm I was allowed to go home with a huge bandage on my foot and a post op shoe, instructions to rest and keep the foot elevated for 4 days and to take my medication three times per day.

I’ve been managing to follow the instructions, mostly because my husband is a tyrant, the good kind of tyrant, who makes sure I keep my foot elevated and don’t stand or walk too much. He makes meals for me and cleans up. The first 2 days he brought me water, food, my phone, whatever I needed, so I wouldn’t have to get up. He is still cooking and cleaning for me.

The pain has been surprisingly minimal. I credit my doctor who did the surgery and was taught to treat the tissues and bone delicately during surgery. I have also been following directions well. I feel very fortunate. The most pain I’ve had is when I get all cramped up from trying to type with my foot raised up higher than my hip!

Of course, this affects my life challenge. I can’t do anything.  I can’t exercise. I can’t swim. I’m home all day and I have to eat when I take my medication. I’m having a hard time regulating my intake and figuring out how much or how little I should be eating. I want to eat enough to help my healing process, but I don’t want to gain back all the weight I lost. I am also a little worried about losing all the fitness and strength I’ve been working on.

I was told, in the literature I was given about the surgery, that the first day or two would be the most painful. Again, I feel very fortunate at how little pain I experienced. I know I was on 3 kinds of pain killers, but still…

Five days post op and I am finding this is my most difficult time. I haven’t slept well, not because of pain in my foot, but because I can’t get the rest of my body into a comfortable position. I wake up several times each night. Consequently, I am very tired today.

I am also feeling a little queasy today, which is surprising, considering that I am only on ibuprofen, which I am taking with food. I also find myself studying my foot and worrying about the bruising. Is it normal? Is it excessive? Should I ask the doctor?

The projects I had lined up to do are still there. They will take longer than expected. I guess that’s a good thing, because so will my recovery.

I am feeling the loner side of my personality taking over. When I am active and physical, doing things like cooking, swimming, snorkeling and other forms of exercise, I also feel more sociable. I take part in grocery shopping and running errands with my husband.

When I can’t do those physical things, I find myself lost in a book, either reading one or writing one. I lose my desire to socialize and I just want to be alone.

I’m not lost to the world yet. I still have a burning curiosity about what is going on around me.  I’m sure as I become more mobile again my social skills will gradually return.

For now, I’ll use this opportunity to have quiet time and reading and writing time.

How the April Challenge is about to become my year long challenge

I talked about “cruise weight” and my April challenge to take it off. In the past 25 days I’ve been working out, swimming, watching my food intake and keeping a record of everything.  I’ve lost two pounds. I lost two pounds in the first week. I weigh in regularly and I’ve still only lost two pounds. Clearly I need to do more…or eat less.

I’ve also been monitoring my blood pressure, which hasn’t been a problem in the past. After three weeks of regular exercise and moderate eating, my blood pressure is high. This can’t be happening!

Who am I kidding? The cruise weight is gone and my clothes still don’t fit like they used to. The truth is that I gained about ten pounds in the first year we lived here, before we even went on a cruise.

Technically, I’ve gained 15 pounds, but that wouldn’t be a fair assessment. I unintentionally lost five pounds in the 2 or 3 months before we moved. I gained that all back in California eating gourmet meals and drinking too much. It was an unwinding and recovery period before we got on with our lives.

Those ten additional pounds came after living here, despite a routine that includes a daily swim and yoga.

Since it took a year to gain the ten pounds, I can’t really expect to lose it all in a month. That’s why my April challenge is going to become my “Spring challenge”. If I’m not successful, it’s going to be a year-long challenge and to be quite honest, a lifestyle change. My current level of eating and activity appears to be fine for maintenance. If only I could get to the weight I want to maintain!

I guess for starters, I could cut down on the wine with dinner, or the happy hour cocktails. I’m also hoping that as the iguanas become more active in the summer months, my regular sprints down to the pool to chase them away will help burn off some “retirement weight”.

My other challenge, in addition to getting fit and losing ten pounds, is to write a weekly report about my progress, or lack thereof, in hope that it will motivate me!