Note: This is part of a series of posts. If you haven’t read Hysterectomy: day 1, I encourage you to pop over and read that post first.
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I hear beeping, and the buzz of lots of people talking. I can’t open my eyes. Thinking is like trying to swim with concrete boots on. I have an oxygen mask on.
Gradually, I become aware that a nurse is standing by my bedside. “You’ve had surgery love, and everything went really well. You’re just waking up in recovery now. How are you feeling?”
Keeping hold of a thought long enough to speak it is like trying to keep hold of a wet, wriggly piglet. But I eventually manage to get out, “I feel really sick”.
She pats my hand sympathetically. “The anaesthetic makes some people feel that way. We’ll give you something now to help you.”
I’m slipping in and out of consciousness, still not really with it. But an all-consuming nausea is piercing through the fog, as though it were poking my brain with a sharp stick.
They give me a shot of Ondansetron (Zofran).
“How are you feeling now?” another nurse asks, a few minutes later.
But I’m like a disc set on repeat. I only have one track.
“I feel really sick. Please, I just feel really sick”.
They give me another shot… and then another. It doesn’t help. The nurses are confused because Ondansetron is the champion of anti-nausea medication. But eventually they realise that it’s just not going to work for me. They give me a shot of Droperidol.
The nausea slinks away.
I gradually become more aware of where I am, and what’s happening. My surgeon comes over to tell me everything went really well. He’ll be back to check on me tomorrow.
Pain starts to seep into my awareness. The anaesthetic hasn’t completely worn off yet, so I’m not feeling the full brunt of it. But I hurt. Thankfully, the surgeon was able to do the operation without any external incisions – so there’s no giant slash down my abdomen or anything. But my stomach is hard and sore, like it’s recently been inflated to accomodate a small hippopotamus (they pump gas into your abdomen for this operation, to help the surgeon see more clearly, and have more space to work). My hips are screaming, like the ligaments have been removed, used for bungee jumping, and then replaced. And the way I feel downstairs leads me to suspect they may have removed my uterus with a piece of equipment that looks like this:
I’m wheeled to my room, which (thank goodness) is a private one. My husband and my mother-in law are there waiting. The pain is becoming stronger. I ask for a heat pack, and am told they don’t have any, so hubby ducks down to the car to grab the one I packed.
While he’s away, the nurses are asking my mother-in-law questions about my health.
“Her blood pressure is very low. Do you know if she normally has low blood pressure?”
I still not quite with it. I can’t keep my eyes open, and talking is a struggle, especially with the oxygen mask on. But when I hear my mother-in-law reply to the nurses, “I’m not sure, but I think so. She does have dysautonomia,” a wave of shock and delight sweeps through me. I’m proud that she’s remembered what my illness is called.
Hubby returns with the heat pack. The nurses frown for a bit, explaining that heat packs aren’t usually allowed on the ward, because of the risk of burns. But they decide since it’s my own heat pack, and they aren’t the ones giving it to me, they’re not really breaking any rules. I’m so thankful, because the heat pack feels amazing on my shrieking ligaments.
I had an appointment with my anaesthetist a week before the surgery, and we went over how my health issues would affect the operation. One of the things we discussed was post-surgery pain management. It’s tricky, because I’ve become allergic to nearly every painkiller available. During the course of my last two surgeries / recoveries, I discovered that a) I’m not allergic to IV Fentanyl and b) IV Fentanyl works really well at managing my pain. But I also learned that a) it doesn’t last very long in your system and b) doctors / nurses don’t like giving it to you. So I’d end up having one or two shots of Fentanyl post-surgery (which would work really well), and then they’d try to transition me to something else (which not only wouldn’t help with the pain, but I’d also end up covered it hives).
My anaesthetist decided that the best option post-surgery would be to hook me up to a PCA (a machine that lets you press the button to deliver your own painkillers – up to a set, safe amount) with Fentanyl for the first night. After I’d gotten through the first night, we could try some tablet options, so that hopefully we could find a painkiller I could take home with me.
She kept her word, and after they’d finished setting me up in the ward, they organised the PCA. It made the first night so much more bearable. When I’d wake in excruciating pain, I could press the button again, and get some relief. I didn’t have to call the nurses and explain how much pain I was in, and then wait an hour for them to have time to come and give me some pain relief. I didn’t have to argue with anyone that yes I am allergic to all those other painkillers and no I can’t have such and such instead.
I put on the ‘The Peter Rabbit Collection, by Beatrix Potter’, an audiobook that some lovely family gave me for Christmas, and slept when I could…which wasn’t much. If I wasn’t already awake from the pain, the nurses woke me every hour anyway, to check my temperature, blood pressure, heart rate and oxygenation. And when they’d come in, they’d burst in, flinging open the door like they were being pursued by an axe murderer, dragging the rattling cart of equipment in behind them. I’d get a massive fright every time, jolting awake, ready to fend off an attack. “How are you feeling?” they’d ask, pen poised to note my answer down on my chart. Shaking with adrenaline, I’d stutter something eloquent like, “um… I was sleeping… and… you frightened me…”.
The Fentanyl in the PCA runs out in the early hours of the morning. The machine starts beeping loudly, summoning several nurses. One of them gives me a disgusted look, exclaiming loudly, “She’s used it ALL?! I’ve never seen someone empty it! She must have just sat here all night pressing the button every five minutes to get more!” I want to sink into a hole. I’m no delicate flower – I have a high pain tolerance. But this surgery has left me seriously hurting. Even so, I haven’t lain awake all night pressing the button every five minutes; I’ve only used it when I really needed it.
Thankfully, one of the other nurses shakes her head, and says firmly, “I see it all the time, in patients who’ve just had gynaecological surgery. It’s very painful, so they need a good amount of pain relief. And the anaesthetist has this PCA set so that the patient has a small amount of painkiller being constantly delivered, with the option for her to press the button if she needs a top up. So even if she doesn’t press the button, the painkiller would eventually run out.”
I want to give that nurse a hug.
It takes them about forty minutes to replace the bag of painkiller and reset the machine. There’s a special key that’s needed (um… who has that key at the moment?), and then a code that has to be inserted (we need the senior nurse’s code… no, that’s not working… try my code… no, that’s not working… go and get such and such and ask her if she knows the code… no, that’s not working either. Oh look, it’s written down here on the card attached to the special key), and then they have to fiddle with the settings. Eventually, they get it all sorted, and I’m left alone again…until the next nurse bursts in to check my stats.
The first night is always the longest.