Saturday, May 15, 2010

The realities of recovery

This blog post may be filled with a little bit of "TMI" (too much information), and I debated how much I wanted to share. While this blog is intended to serve as a chronicle of my recovery primarily related to my goal of getting back into riding/racing, I also want to showcase the realities to those who are considering donation themselves. I knew a lot going into this, but there are certainly some painful and uncomfortable unknowns that have popped up and while it wouldn't have changed my decision to donate, it would have been nice to anticipate some of these things.

My last few blog posts were updated by cell phone while I was in the hospital, so I wasn't able to share much. This will also serve as a summary of those last few days.

The day of the surgery was probably my best day. The anesthesia was still roaming around my body, so I was constantly passing out. They had put me on a patient controlled Dilaudid drip (which means I push the button when I want some), which is a pretty heavy narcotic. One of the side effects is itchiness, and it had hit me pretty hard. I scratched my way out of recovery and into the next morning, so I didn't get too much sleep. Because I was so out of it, I didn't notice, but once it was discontinued, I stopped scratching. Greg was with me for much of this time and he told me that I was constantly scratching. Had I known that this was a side effect, I think I would have asked for a different narcotic (like Morphine) to be placed in my IV drip. It may or may not have made a difference, but it would have been nice to try. At the time I was thinking it was just itchiness from being in the hospital beds, or the pneumo boots on my legs, but not a side effect.

On day 1, they discontinued the drip and put me on PRN IV Morphine (not a patient controlled drip). Unfortunately, this meant that the nurses controlled when I got my doses. This didn't help to control my pain as well, so day 1 was a tough day.

Day 1 was the day that they took out my catheter and I was expected to pee on my own. And pee I did!! It took about 4 hours from the time when they took the catheter out and from when I could actually pee. That was an uncomfortable time! I could feel that I had to go, but my body was still numb from the anesthesia so I couldn't go. Ugh! But when I did start to go, I pretty much went on the hour. That was hard, because that meant that I had to get out of bed every hour to go to the bathroom. And since it was only day 1 post-op, getting out of bed was really painful. I have three incisions on the left side of my abdomen. The lowest one is my biggest one, probably around six inches long. This, in combination with a belly full of surgical gas, made for some constant sharp pains in my gut.

The surgeons use surgical gas to inflate your abdomen so that there is enough space for them to use their instruments in your belly with a lower risk of nicking something unintentionally when they remove the kidney. Otherwise, all of your abdominal organs just lay on top of each other, so the gas keeps them apart.

Day 2 was much of the same. Unfortunately, this was also the day I was assigned the nurse from hell who pretty much ignored me all day. Luckily, Greg was with me most of the day, so he helped me get in and out of bed when I had to pee. Later in the day, after one of my many walks around the unit, I started getting severe cramps in my belly after I returned to bed. I couldn't breathe, and that made me cry from pain, and all of this together made for a very painful experience. I called the nurse for more pain meds, but he ignored my request and then when Greg went out to yell at him, he told Greg "I've given her everything she has orders for, there is nothing I can do!". The MDs came in with the nurse (the MDs and NPs rocked, by the way) and listened to what I had going on. The MDs and I decided that a muscle relaxer would be helpful to calm down all the spasming in my belly. One of the downsides of being fit is that they had to cut through a lot more muscle than normal so the pain tends to be much greater than in the less fit population.

Later on the nurse came in to tell me that "when your boyfriend was yelling at me, I was trying to call your docs to see what we could do, so I apologize for doing my job". Jackass. Meanwhile, it was my friend Shelby who came to visit me who changed my bedsheets, the NP who had to come in later in the day to back-document all of my intake and output (since my nurse hadn't seen me all day, there was no record of my input-output and for a kidney patient, this is very important. And this is NOT the NP's job, it is the responsibility of the RN). He came back one more time at the end of his shift to give me a dose of pain meds and told me "I've taken you off my patient list". I got fired as his patient!! Which was a good thing, but wow, what a jerk.

The overnight of day 2 into day 3, I had a wonderful nurse who stayed on top of my pain meds and helped me control my pain. Finally. And since I was experiencing good pain control, I was able to go home in the afternoon! I was still experiencing a lot of pain from the surgical gas, but I had slowly started to pass the gas, so I was anticipating that this would continue.

We left the hospital and went straight to Walgreen's to pick up my meds. When I was walking around the pharmacy, I could feel that I had to poop. YAY! One side effect of narcotics is that your stools get hard, and in addition, the surgery itself shuts down your GI system, so pooping is one of the last functions to return. Greg and I promptly returned home so I could bunker down in the bathroom and go to work. Because my incision is where is it, bearing down is risky and painful. Starting at 5pm, I sat there and just waited....and waited....and pushed...and waited. This may have been one of my lower moments of recovery. I was impacted so badly that I couldn't go. And I couldn't push because it would have overstressed my incision. It was so awful that I actually spiked a bit of a fever, probably because my body was reacting to all the toxins in my system. Finally, at around 10pm after five hours of misery, Greg went to the pharmacy to buy a dreaded enema. Greg deserves a medal of honor for all that he has does for me thus far, but he really went above and beyond on Friday night. I don't know what I would have done without his help. Greg administered the enema, I let it sit for 15 minutes and lo and behold, after some pretty painful pushing, I was cleared. I know that this may be a bit more than you wanted to know, but again, I think its important for those who are consideration donation to be aware of the challenges. Looking back, I'm not so sure what I could have done differently to prevent this, but I am sure if I thought enough about it (and asked the right people), there could have been some dietary changes I could have made to have minimized the impaction.

Once I took a shower (one of the best ever...) I went to sleep in my own bed. It was the first time I had laid down flat, so it was pretty painful at first. But it was nice to start back my normal routine again. I think things will only get better from here....:)


  1. Bless your heart! I'm so sorry to hear about that awful nurse and about the impaction. I'm glad Greg was there, and Shelby was able to come show off her mad skillz. How's your pain management now?

  2. Guess I should have put some Ex-Lax in those cupcakes! ;-) Glad you're home and away from the evil nurse. Sounded almost like Kathy Bates in the movie Misery.

  3. Roz:
    Am amazed you can be so articulate in the midst of a grueling recovery. It sounds like we need to expand the scale of pain assessment to include exacerbation by health care providers... Am glad you are home - don't overdue it! Let Greg pamper you - he is a dear indeed.


  4. You know what, I think it's really important that you mention all these details about the recovery process, and I'm glad that you have! I can't imagine anyone who genuinely cares about what you're going through being affronted by the reality of the situation. Your blogging about the whole experience is also just another generous act - thank you for helping me to keep my perspective on life where it ought to be!