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Friday, January 4, 2019

How to Prepare for Major Surgery


This list is a work-in-progress and will be updated as I go. This is everything I've learned from my liver resection for a hemorrhaging adenoma.

1. Fill all  prescription meds you usually take and stock your medicine cabinet with the over-the-counter meds you rely on. Have everything you can think of on hand for your recovery. For example, I have asthma and I filled every prescription I could before my surgery date. I also made sure to have over-the-counter meds on hand for different GI issues that often come up for me. Plus, I stocked up on vitamins. You'll also need stool softeners and a mild laxative (which some hospitals will prescribe for you, but others may not so have it ready just in case).

Also if you find you're energy is really low, try sublingual B12 and a really good multivitamin. Sometimes bodies need a boost.

2. Set up a recovery station at home.  Sheldon has his spot, you have your recovery station where you'll be spending most of your time until you're back to normal. Set it up before you're in pain and high on meds.

I use a nebulizer for asthma and neglected to have it all set up and ready to go when I came home from the hospital. The problem with that was I felt like death and was pretty drugged up and unfit to be doing much of anything. It wasn't the best time to crawl on the floor to reach the outlet so I could plug in the nebulizer. I should have done all that prior to my surgery date.

Aside from meds and medical equipment, your 'recovery station' will need Kleenex, hand lotion, chapstick, lozenges, remotes phone charger, blankets, pillows etc... Think about the things you want within arm's reach and put them there.

3. Prepare for anemia. There's some level of blood loss in every surgery and that can leave you anemic. My body trends toward anemia and isn't great about self correcting, so I have to actively manage any anemia. Other people might have different experiences.

As per #1, if you end up with anemia, some vitamins and supplements might be in order. The big caveat here is that iron supplements are hard on the system, so trying things for the first time after surgery could be dodgy. If you have time, try some iron supplements before surgery and see how they impact your body. Iron supplements can either constipate you or cause diarrhea. These extremes aren't helpful when you are recovering from major surgery.

In my experience, the best iron supplement is a German product called Floradix (which was recommended to me by one of my nurse friends). It's very gentle and easily absorbed. I've used it off and on for several years now without issue. I order it on Amazon.

4. Stock your freezer and pantry for the initial recovery period. You're not likely to be too hungry right after surgery and will not be able to handle a lot of food. Stock up on jello, broth, bread, crackers, sorbets etc... for the first week+ after surgery. Think stomach flu foods.

5. Fill your freezer and pantry with nutritious food for ongoing recovery. Once you're past the jello stage, you'll need something more substantive to eat, but you still won't be ready for heavy meals. At a minimum you'll want some kind of light soup with protein (I prefer chicken, but whatever works for you).

It's also a good idea to make some high fiber cakes or bars. I made pumpkin cranberry bars with almond flour and ground flax seed. Fiber helps keep your bowels moving and counters the constipating effects of pain meds.

I also juiced greens, apples, carrots and celery to try and give my body as much easy-to-absorb nutrition as possible. However, I did find that I wasn't able to eat much, so don't be surprised if you're struggling to eat anything. In my experience, you won't be eating normal amounts of food for a while.

6. For major surgery, pain meds are an incomplete solution to pain in my experience. Be ready to sit through a lot of pain with no end in sight. Ice packs and hot packs are useful. You may want to stock up on those instant cold packs.

I used the lunch box pack in my freezer, but they were thick and lumpy and uncomfortable. The instant ones at the hospital were more flexible and softer...you might want to have a few on hand and you can send someone to buy more if they end up being something you rely on.

For hot packs, I used my usual microwaveable hot packs.

A key point to keep in mind...some pain needs one temperature over the other at first and then it switches as healing occurs. So try both and see which one you find the most relief with, then flip it as time goes on.

As an example, I had a bad pain spot in my back that needed ice for the first week and then resolved with the hot pack the next week.

Quick pain tip: Plan any postoperative walking or activity around your pain medication. Walk right after you've taken pain meds or right before you're due for the next dose. Activity early on can make pain worse so mitigate it.

7. Prepare for sponge baths. The first week or so after major surgery you might not be able to handle a shower. You also may not be allowed to shower for a certain amount of time due to your incisions. Enter the sponge bath.

I washed my hair in the sink for a while after I came home from the hospital and wiped down with a hot wash cloth. I was so weak and light headed, a shower or bath would not have been safe.

8. You're just not going to care. If you've ever wondered what it's like to give zero fucks, major surgery will show you. You're exhausted and cut up like Frankenstein. You're just not going to care about the little things, or the medium things, or even some of the big things.  You're going to be out of bandwidth.

Identify important things that will hit during your recovery and work ahead. Pay bills and tie up loose ends before surgery. Say no to people, places and things. The recovery period is not the time to do anything big.

9. Pace yourself. Early on, if you take a shower, plan to rest afterward. If you go for a walk, plan to rest afterward. If you vacuum, plan to rest afterward. For a while, it'll be do one thing, rest and then do the other thing followed by another rest period.

10. Get your laundry done. Have a week or more of clothing lined up for after you come home from the hospital. You're not going to be up to doing a lot of laundry. Thankfully, my hubby kept up with the laundry, but if I'd been on my own, I would've been wearing the same underwear for a week without some advance prep.

In addition, if you don't have soft, loose clothing, stock up before surgery. You want pants with very soft, stretchy waistbands (depending on your surgery) and baggy shirts. If the surgery is anywhere on your stomach, you'll likely be bloated a size or two higher than your usual size.

A warm sweater or fleece jacket and slipper socks are good ideas as well.

If you care about how you look, now's the time to figure out 'recovery outfits' that will make you happy. My soft stretchy clothes were pretty old and unfit for public viewing, so I got a few basics that could be seen outside of the house.

11. Prepare for hair loss. Major surgery causes the body to route all resources to healing, which means hair is abandoned as a non-essential. It might not fall out right away, but at some point you're probably going to be losing hair for a while. This is normal and it should grow back as you recover.

Give some thought on how you want to handle your 'do while you're recovering. I went with a short cut before surgery as short hair hides thinning better than long hair and is easier to care for.

12. Protect yourself from pets. I've known many people who've been nailed right in their incisions by over enthusiastic pets. My 80lb rescue lab almost got me and I knew enough to try and prevent exactly what happened! Pets are sneaky that way.

Some pets may need to be boarded for a while. Other pets can be managed by simply shutting them out of the room you're in. The main thing is to protect your incisions from your pets and prevent falls. You don't want to end up in the ER because the dog cannonballed your stomach.

13. Sleep as much as possible. Anesthesia and other meds can mess with your sleep. Not to mention pain can keep you up. Basically, you're a newborn again. Time doesn't matter. Sleep when you can and don't worry about being up at night...when pain is often at its worst. Just sleep whenever possible because that fosters healing.

14. Walk as much as possible. Exercise also fosters healing. Every time I made an effort to walk, my pain improved the next day. So keep walking. Even if it's miserable (and it will be miserable in the beginning). Ignore how you feel and just do it, but don't over do it. We're talking short walks. Nothing heavy.

If you're feeling ambitious, take your short walk as usual, then rest and do another short walk later. That way you don't get stuck in a long walk with no way out.

You can hurt yourself by doing too much, so if your energy is surging, don't trust it. Go slow.


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