Post-Op Confusion

After Surgery

Once you are awake, alert, and comfortable after your procedure, you will be discharged with a family member or friend. You will want to go home and rest for the remainder of the day.

There’s a contradiction when dealing with certain outpatient procedures. On the one hand, you have a nurse who’s determined to work the word “rest” into every other word of the conversation. On the other hand, that same individual stresses the importance of stretching and movement to prevent a relapse into the previous situation the doctor just spent an hour repairing.

My brain reflects on the past six months of hell: limited range of motion, lack of sleep, and the humiliation of needing assistance to put on my bra.

My “family member” hears only the admonishments to take things easy and is already planning to strap me down to the couch for the next week.

There is no happy medium.

At Home Care

Someone should be available to help you for the first couple of days. If you had a nerve block, your hand and arm may feel numb and weak until the block wears off. Local anesthesia is also given in the injection sites during surgery. This will begin to wear off in 12-24 hours.

The nerve block was created to limit the amount of anesthesia required by an individual patient. Less medication, fewer side effects. And, of course, less need for opioids to manage pain control. (Everyone wins)

It’s fascinating to witness the gradual loss of sensation from your shoulder down through your fingertips. Only to realize you’ve also lost the ability to move the limb. Your brain strains to send signals you can (ironically) feel extending down into your digits, but they accomplish nothing.

You have a rubber arm attached to your body.

Poking and prodding it produces nothing: no sensation whatsoever.

Regardless of how often you manage to smack it into doorways or furniture.

(This is not why they recommend you have someone to assist you, by the way. It should be, because the temptation to inadvertently injure yourself is hard to resist, but it’s not)

Pain Medication

You have been prescribed pain medication. You should start the medication on the day of surgery and take it as prescribed until the nerve block has worn off and you have full sensation. Once that happens, you can better determine how much and how often you need the pain medicine.

“Stay ahead of your pain.” Everyone in a surgical mask and scrub cap delivers the stern warning. (As if anyone who experiences pain on a daily basis needs that reminder)

They don’t take into consideration that the prescription came with no refills. And a limited supply.

The encouragement to down your narcotic as you blissfully tote around your dead arm feels contradictory to common sense. “You feel nothing, so let’s get your body warmed up to those opioids, shall we?”

The flawed logic seesaws in the brain as you stare into the medicine cabinet. If I can still jab a finger into my arm without even a pins-and-needles response, what sense does it make to swallow a pill designed to circumvent pain for four hours? Shouldn’t I wait until I can at least wiggle the tips of my fingers—the prelude to the return of my screaming nerves?

Why throw my entire body out of control while it’s still blissfully unaware of what happened? (At least at the pain level)

Ice

Ice is a very effective pain reliever. Use ice for 20 minutes every hour. Do not use while sleeping; you don’t want to get frostbite.

The constant battle of swollen soft tissue and healing. Plasma delivers the necessary components for a body to regenerate. But it brings excess fluid to the region, as well. And all the water, goo, and waste material make for uncomfortable tissues. So what do you do?

You freeze them.

Is it pain relief or simply the numbing of the nerve endings?

Or is it the sneaking attempt to prevent excess movement as you’re stuck with a giant ice pack on your shoulder for a chunk out of every hour? (Move? Don’t move? The messages are so mixed)

Only while awake, though, because a pack left to melt through the layers of your clothing is a health hazard. (What fool can tolerate the chill against their bare skin?)

A swirling dance of swapped ice packs, attempting to achieve the perfect frozen temperature. The ever-present timer on the phone, letting me know when I’m once again free.

Bandage

Keep your bandage dry. You may notice some blood soaking through the dressing. A small to moderate amount is okay. Expect to have swelling and bruising around the shoulder. This is normal following surgery.

Is there a rule among the medical community that an opened tape package must be used entirely? No scraps left on the roll, saved for the next patient? (Can you resterilize tape?) Or is it simply amusing to pack on a shoulder pad worth of gauze and tape for three tiny incisions?

How could I see bruising or swelling when I looked ready to step onto a football field? The monstrous bandage suggested I’d had an entire shoulder replacement! I’d have been concerned if even a drop of blood had managed to soak through the twelve dozen layers. That would have represented a significant hemorrhage!

Excessive and unnecessary.

Unless they were trying to protect the site from accidental damage while I recovered from the nerve block. In which case, they could have done me a favor and extended the padding down my entire arm. That would have been useful, at least.

Incision

Your incisions will have absorbable sutures under the skin with pieces of tape over the incision. These sutures will absorb on their own. The pieces of tape (called steri-strips) can stay on until they fall off on their own in 2-3 weeks.

No one ever discusses the irritation of the absorbable suture. (Why would they?) So discreet. So convenient.

So itchy!

Within days, I want to shred my skin.

The slow, tantalizing peeling of the adhesive through daily wear and tear. Gently rubbing against clothing (once I figured out how to get dressed within the limitations of my movement). The sloughing of the dead skin cells, replaced at a rapid rate, courtesy of my body’s accelerated healing.

And I was stuck under the observant high of my family member caregiver. Who refused to let me scratch at the unceasing irritation.

Showering/Bathing

Please do not submerge your incisions in a bath until your incisions have completely healed. You may shower following surgery if you cover and attempt to seal the incisions with a plastic bag or wrap.

A bath is the only thing a human being wants after a surgical procedure. A shower. Some way to wash off the clinging sensation of surgical prep. To scrub off the remnants of iodine turning one arm into a different ethnicity. To attempt to remove the endless list of purple signatures that proclaimed, “Yes, this is the appropriate shoulder to cut open!”

And it’s the one pleasure denied.

No glorious waterfall of soap and hot water for days. Instead, you’re left with evidence that you were in a sterilized operating room. You were sterile for an hour. It’s all over your body. And you can’t get rid of it.

Then, you’re confined to the humility of wrapping yourself in cling wrap—souring the joy of scrubbing away that lingering surgical scrub. The steri-strips stare up at you in ridicule. (Because they know the touch of that washcloth would ease some of the itching) And any hope of removing that purple goes out the window. It’s safe and sound in its plastic barrier.

Physical Therapy

You will need physical therapy following your surgery. It would be advisable to start therapy the day after surgery, if possible.

I am a connoisseur of physical therapy.

I know everyone in the office. They know me. I can rattle off the names and exercises common to every machine, tool, and gadget. Nothing surprises me—not even when a therapist goes to work on my mobilization.

I live in physical therapy.

This is my eighth time walking through those doors.

I deserve to have a cubby named after me.