Sunday, June 23, 2013

6.5 weeks postop

My husband and I made the trip back to San Diego on Wednesday, post op day 42. Due to some traveling situations I had scheduled to see Dr. Goldstein at 6 weeks and 1 day. We had a later flight so we spent the last day doing some of our favorite things in St. Louis - the Zoo in Forest Park and eating at Zia’s on The Hill (the Italian district). I was able to walk without any problems for over 3 hours at the zoo. I managed most of the day without needing my donut pillow, but used it at the airport and on the flights just in case. My pain was a solid 0-1 until I got searched a little too aggressively at the airport, and it increased to a 2.

On Thursday I saw Dr. Goldstein and the nurse practitioner. They still seemed to be impressed with how well I am doing. All of my external stitches were gone and there were no signs of cysts! Dr G said the internal stitches should dissolve around 8 weeks so he’d like me to stay off work at least until then. Honestly, I’m not in a rush because I’d rather not mess anything up. Plus it’s kind of nice being lazy. While we were at the office we discussed plans for physical therapy. I hadn’t planned on doing anything until the three month mark, but Dr. Goldstein said that some people have been having good luck starting early with skin rolling and other manipulation through the rectum. He said that the physical therapist can do a lot of the same things through either entrance. He recommended that I talked with Debbie the physical therapist to see what her thoughts were. I saw Debbie that afternoon for a PT appointment. I think the plan is to work on some pelvic floor stuff as well as getting me ready to go back to work. I’m not really concerned about being strong enough to go back to work.  I’ve actually been on my feet 8+ hour for the last 4 days and have been fine. Although my pain increased to a 2, I expected it to go up a little bit. I haven’t been using any ice or heat in about a week, and I haven’t taken the Vistaril since we returned to San Diego. I only use my donut pillow if I’m sitting very upright like in a kitchen or office chair. The plan is to continue with my boring (but apparently great) recovery!

Monday, June 17, 2013

Post Op Day 40 and a Note on Surgical Billing

My recovery is still going well. On Saturday (6/15) my husband and I went to a wedding. We had a good time, and I was able to dance in moderation for 2- 2.5 hours without pain, at least not surgery related pain, but my feet were killing me! I’m not sure why I thought it’d be a good idea to wear high heels the entire time since I haven’t worn any shoes besides flats and sandals since the surgery. Live and learn, I suppose.

My pain is still totally tolerable at a 0-1 most days. The itching seems to be better as well. I think I’m mostly using the ice out of habit although it does help when the itching starts. I’m still taking half a tablet of vistaril at night for itching; it helps me sleep, too. When we get back to our own bed in California I think I’ll try to stop taking the Vistaril unless I really need it. I haven’t been using the heat pack at night lately either.

On top of the bill for Dr. Goldstein I received my bill from Alvarado hospital a few weeks ago. My insurance isn’t the best and was really only planned to be used for emergencies. I have to pay out of pocket until I hit my deductible before my insurance covers anything and of course the deductible is higher for out of network, which is why the billing department at Alvarado hospital suggested that I pay the flat private payment amount. I’m thankful that they did because the hospital bill alone would have been almost $24,000 had they billed the insurance company! As a nurse you hear people talk about their bills and how much medicines and procedures cost, but it never really hit me until I was looking at the individual charges. I’ll really be thinking about those sutures when I’m the circulating nurse in the OR and see one of those get dropped on the floor and subsequently be thrown away. Anyway, you will also probably receive bills for anesthesia and a bill from Alvarado pathology department. If you look on the detailed bill from the hospital there are anesthesia charges including time and meds as well as pathology charges for your labs. Those are the hospital charges. The individual bills that you receive are the professional charges. For example, the pathologist views the labs and examines the vestibule tissue. It seems weird, but that’s just how it goes. FYI you can pay the pathology bill with your credit card if you call the number on the bill. They will send a receipt in the mail that you can submit to your insurance and save for taxes. So far the surgery has cost a little less than $8,000, not including my unpaid time off work, but it could have been a lot worse. Thank you Alvarado Financial Department for being so easy to deal with…

Friday, June 14, 2013

Post op Day 35…a few days late…

It's hard to believe that it has already been five weeks. Things are continuing to go well. I have very little pain most of time, but occasionally it creeps up to a level 1 or 2. Even still, I haven't had to use anything for pain in over a week. My Percocet bottle is still mostly full and I'm sure my stomach is happy to have a break from all that Ibuprofen. When I do have pain, I've noticed it's because I've moved a certain way or have been on my feet for a long period of time.

We had a garage sale on Saturday and I had been on my feet on and off for about 8 hours. The pain did make an appearance that night, although it wasn't too bad. It makes me nervous about going back to my 12 hour shifts with little rest periods as a nurse. Before the surgery Catherine the NP at SDSM had mentioned that it would be really tough to bounce back, and that six weeks may be a bit unrealistic. She is probably right. I also do a lot of moving heavy patients numbed with epidurals, pivoting patients to wheelchairs whose legs may still be a little numb, and pushing hospital beds or stretchers. I will have to talk to Dr G about what he thinks is the right thing to do. I've come too far with recovery, unpaid time off work, and paying for the surgery out of pocket to do anything to risk messing up. In the mean time I'm trying to increase the speed, duration, and number of walks to increase my endurance.

Dr. Goldstein assured me everything looks great based on pictures. It looks like quite a few stitches have dissolved. A few times I've noticed a stitch on the toilet paper after wiping which kind of makes my heart sink. I always pray that they are just dissolving and I didn't pop one out! Even with those stitches out it's still pretty itchy. The ice still works well during the day to alleviate the annoyance – I find myself using it at least 50% of the day. It seems to be a little worse at night so I'm still loving that Vistaril. Due to scheduling difficulties I had my 6 week appointment with Dr. Hartzell via phone a few days early. Honestly as nice as she is her appointments are what stresses me out the most. I'm just not comfortable talking about my feelings. Thankfully, I think the therapy thing is much easier over the phone. She said everything seems to be going well, but is nervous about me returning to work. Chances are I'll end up with a longer recovery than I first anticipated, but we'll find out for sure soon.

My donut pillow is still one of my best friends; I take it pretty much everywhere. I can sit without it unless I'm sitting straight up on a hard surface or if I'm using an ice pack. Rather than shell out the money for a real one, my husband cut the center square out of a cheap kitchen chair cushion and I sewed the material shut. It works well for me with plenty of room for ice. It sounds a bit ghetto but works perfectly and was a fraction of the price! In fact, I like it better than the foam one from Walgreens that my mother in law has :)

Wednesday, June 5, 2013

Post Op Day 28

Things seem to be going pretty well. I spent another weekend surrounded by my nieces, nephews and siblings trying to interact without hurting myself. On Monday I went to a St. Louis Cardinals baseball game and was able to sit comfortably in the bleachers section on my donut pillow for the whole game (which we won, of course). I can sit without my pillow as long as I’m not sitting perfectly up right because of pressure from my ice pack. There were a few stairs to climb at the stadium, but I took it slow not caring if I held up the line behind me.

My pain is still well under control – something like a 1-2 out of 10. I haven’t taken any pain medications the last few days—not even Ibuprofen. I take a vistaril and use a heated rice pack at bedtime. The heat pack does feel nice, but I think it just keeps me warm more than anything. The itching is still annoying so I have continued to use ice most of the day instead of the Vistaril since it makes me so sleepy. I've still been taking 2 baths a day for 90 minutes each time. I’ll do anything I can to help speed up those stitches coming out! My muscles are pretty achy from inactivity and laying around. I've been walking 3-4 times a day for 30-45 minutes and walking around the house every hour or so.

I called yesterday to schedule my six week appointment at SDSM. It’s hard to believe I’ll be seeing them in two weeks. I’m actually surprised at how fast this recovery has been going by.