I have divided this blog post on hospital surgery into five installments. They treat different aspects of hospital surgery in general and my surgery in particular.
The first three parts apply to virtually every reader of this blog:
– 1: What Everyone Must Know – hospital documentation and infection prevention
– 2: That Scary Anesthesia – minimizing the risks from anesthesia
– 3: Recovery & Departure (This Post) – what you can expect after waking from surgery
The final two parts apply to men only, especially men over fifty. They talk about my specific surgery:
– 4: Prostate Enlargement Versus Cancer – problems of the prostate and their cure
– 5: Prostatectomy Cures BPH – prostatectomy as the definitive cure for an enlarged prostate, also known as BPH
I’ll now discuss what I experienced after surgery until my discharge from the hospital.
Post-Surgery: Tied Down Like Gulliver
A disconcerting feature of waking up from hospital surgery is to find that they have tethered you like Gulliver in Lilliput. I counted seven ways in which something connected to my body:
My Many Encumbrances
– My left hand had a peripheral IV (intravenous) connection. The IV drip came through tubes from bags of saline solution hanging from a rolling IV stand. The IV connection gave me hydration, antibiotics, pain control, stool softener and perhaps other meds. (For several days after discharge, the back of my left hand was purple from bruising.)
– A clip on my nose anchored a tube providing supplemental breathing oxygen.
– A cuff on my right arm took periodic measurements of my blood pressure.
– A sensor clipped to one of my left fingers monitored my blood oxygen level.
– An inflatable cuff wrapped around each of my calves. An air pressure pump at the foot of the bed periodically pressurized and then released each leg, to keep my peripheral blood circulating.
– A tube protruded from my abdomen that terminated in a plastic bulb a few inches in diameter. This turned out to be a Jackson-Pratt drain. The plastic bulb provides steady suction to drain excess blood from the abdomen, beneath the incision. The tube collecting the blood has several inches of perforations where it lies within the surgical area. This drain removed over 100 ml of blood from my abdomen during my stay in the hospital.
– Any surgery involving the bladder or prostate requires installing a urinary catheter. This catheter contained a tube fed by two 3000 ml bags of saline solution hung on the IV stand. The saline solution rinsed my bladder and prostate to remove blood from the surgical area. Another tube in the catheter drained the rinse into a 2000 ml bag hung on the side of the hospital bed.
My Pleasant Hospital Room
My wife Nola had inquired with the admissions office whether I could have a private hospital room. The office told her that Beaumont Hospital has converted most of its rooms to private use. Not only could I have a private room, but there would be no additional charge for that amenity.
From my perspective, a private room was great news for my recovery. I expected to be tired, feeling pain, and wanting no visitors except my dear wife. I feared a hard-of-hearing roommate who kept the TV at top volume every hour of the day and night. Either that, or a patient continually visited by dozens of family members, who talked loudly and milled around the room while I tried to sleep.
My solo room had formerly accommodated two patients. For that reason, it had loads of room, good storage areas plus seating for my visitor. It also had plenty of room for the stands of equipment that my recovery required, plus the rolling table I used for storage and eating.
On the rolling table was a device to practice inhaling. The nurses suggested that I use this to exercise my lungs. The hospital intended me to speed my recovery while fending off congestion and pneumonia.
There was a combination device to adjust the bed, call the nurse and control the TV. There was also a private telephone. Through the window I had a pleasant view of the Healing Garden in the hospital’s central courtyard. I could see patients who did not have my tangle of attachments, walking there with their visitors.
Move It or Lose It
A prominent sign in my room stated “That bed is NOT your friend!” To speed my recovery the hospital wanted me to eat every meal sitting in a large armchair, not in the bed. They also wanted me to walk the hallway several times a day.
I was willing enough to get out of bed, but every time I did it was a major production. The nurse assistant had to remove my blood pressure cuff, my oxygen sensor, and my oxygen breathing tube. She or he had to disconnect my leg cuffs from the air pressure machine. My urinary drainage bag had to be unhooked from the bed and hung on the IV stand using a friction loop improvised from an examination glove. My abdominal drain, once empty, was light enough to ride along with me.
These changes allowed me to oh-so-carefully pry myself out of the bed. My nonslip socks imprinted “Beaumont” insulated my feet from the floor. The hospital gown of course, even when tied, provides a fine view of the patient’s derriere. One sympathetic nurse assistant helped me don a second gown to cover this dramatic rear view so that I wouldn’t shock visitors in the hallway.
The Hallway Glamour Walk
With this preparation, I was able to stroll out of my room, rolling my IV stand and also using it to steady my walk. I could walk about a hundred steps to the end of the hall, passing other hospital rooms, turn around and return. On the few occasions that I encountered hospital visitors in the hallway, I nodded cordially. The visitors, shocked at my disheveled appearance and the many tubes emerging from my body, averted their eyes and politely went about their business.
This modest amount of recovery exercise reinforced an opinion I had acquired almost right away. That opinion was that when I became a hospital patient, I gave up all aspirations to modesty and personal privacy.
In general, I don’t recommend spending time in the hospital. After all, a hospital is simply crawling with germs from a huge number of strangers, both patients and staff. Hospitals are for sick people, and if you want to be well you want to stay the hell away from them.
However, I must grant that being a hospital patient is a refreshing experience in equality and lack of conceit. Like strangers who are thrown together by a natural disaster, people in a hospital go out of their way to be considerate of others. This courtesy seems to apply to patients, medical staff, volunteers and in fact everyone who passes through the space.
Hospital Support: Loose Ends and Mistakes
Those of us who have assisted elderly relatives in navigating health care have seen how easy it is for them to be ignored, neglected, even mistreated. This is particularly true in assisted living settings, where critical assistance is provided by minimum-wage staff with little training. Horror stories from the healthcare world generally make the point that patients need to take a lot of responsibility for their care. They, or a close family member, need to ask questions and make sure that care is prompt, competent and appropriate.
As a conscious patient with a wife who was often present, I could take personal responsibility for my recovery. And generally, I was very happy with the attention and treatment provided by the nurse and nurse assistant on duty. However, I did notice a few glitches requiring my personal intervention:
Prompting the Staff
– One of the nurses assigned to me tended to forget my requests and had to be reminded. These were not emergency requests, more of the nature “Would you please disconnect me so that I can eat dinner / take a walk / go to the bathroom?”
– One nurse took the initiative to increase my catheter flushing rate. Apparently she felt that this would speed my recovery by better keeping my surgical area clean. However, this led to overfilling of the urinary drain bag, leading to back pressure that was noticeably uncomfortable. I had to use the call button to get the staff to correct this problem.
– Once when I returned to the bed after a walk, a nurse assistant re-connected my leg cuffs but neglected to turn on the air pressure machine.
– On the day of my surgery my bowels were not moving. I pointed out to the nurse assistant that since I was on a “clear liquid” diet, I was unlikely to ever produce any poop. Whereupon the assistant contacted my surgeon and got permission to move me to a normal diet of solid foods. This was a good outcome, and it might not have come about if I had passively accepted the hospital’s program.
– Just before discharge, the nurse carefully instructed me on care of the catheter to avoid a urinary infection. She also provided printed materials from the hospital website. Unfortunately, some of this material seemed contradictory and I had to place a couple of phone calls to get clarification.
These were minor hiccups and no damage was done to my recovery. Offsetting them, I would point out that I found every staff member to be friendly, sincere, caring, ready to help and fully competent. On balance, I have no quarrels with Beaumont Hospital.
Recovery and Discharge
My surgery took about 90 minutes, after which my doctor reported to my wife on the operation, which had concluded without incident.
The following morning my doctor visited me twice to check my recovery status. He asked whether I wanted to go home that day, or stay an additional night.
I asked whether I would heal any better or faster by staying in the hospital for another night. He said that he did not expect any change in my healing, either way. I then proposed that I should check out that day. After all, a hospital is full of germs and my recovery would be less prone to infection in my own home. He agreed with my reasoning and wrote a discharge order.
The discharge order took about an hour to be entered into the Beaumont record system. It contained instructions for post-surgery care to continue my recovery. It also had an itemized list of every prescription and supplement that I should take, or refrain from taking. The nurse on duty then taught me how to minimize risk of infection as mentioned above.
Once these details were complete, nothing remained but to wait for a volunteer to bring a wheelchair to transport me to the front door of the hospital. I could have taken the elevator and walked to the door. However, I was still unsteady on my feet. Self-propulsion posed a risk I did not want to incur.
This concludes Part 3 of this five-part blog on hospital surgery, recovery and discharge. Parts 1, 2 and 3 should be of concern to every reader, since virtually everyone will experience hospital surgery more than once in their lifetime. Parts 4 and 5 will focus on male readers, discussing prostate problems and their cure.
Image Credit: Photos taken by Art Chester