Post-op days 1-4

Day 1 post-op

I remember my wife Kathryn being there when I was being moved from the ICU to a regular recovery ward, along with my various tubes and attached gadgets. When I got there I was baffled by the other folks in my room just talking and talking. On the phone, to visiting family who hung around for a long time, and to any nurse they could lasso into a conversation. How were they doing more than the bare minimum of speaking only when necessary and just enduring? Didn't make sense to me. Presumably they were all at a similar point in the process as I was? I don't remember much from this day, other than the general impression that there were still a lot of drugs in my system and that this was a harder day to get through than operation day.


Day 2 post-op

This started off as a tough day. While the fog of the surgery-day drugs was still quite strong, I was more aware than previous days. This was the first day I saw the physiotherapist, who got me on the incentive spirometer, and I realized that my maximum inhalation was about half a litre. Yikes. We did a series of exercises, after which I could immediately get a full litre, so that was great motivation to get on those exercises every chance I got. 

During surgery your lungs just get all smooshed up, compressed by the business that's happening adjacent to them. The alveoli collapse and stick closed, so no air will get into them. Of course you lose flexibility and mobility of your ribcage from the operation, but that's a long-term project. The immediate goal is to literally open up your lungs again so they can fill what space they have available to them.

The main breathing exercise to achieve this is a simple series of three stacked breaths: a full inhalation, hold for a count of three, sip in as much air as you can, hold for three, then sip and hold again before releasing. The first time I did this I literally felt the pressure in my lungs decreasing as the little sacs inflated again during each of the three holds. I asked the physio specifically how far I should push into pain, and she said as far as I could. This exercise won't do damage. Each day since, I've set a new best inhalation. As I write this on day 5 post-op, I'm at about 2.6 litres of my pre-op capacity of 4.5 litres. I can tell that my ribcage still is barely moving when I take a deep breath, so I think I'm getting into diminishing returns until my bone is healed and I can really start going for it up high. 

The big event of day 2 was the removal of my chest drain tubes, the pair of which sucked fluid from the surgery site out into a little suction machine that came everywhere I did. Aside from the main incision, one or both of the exit holes of these will be the only other long-term scarring from this procedure, just below the bottom of my sternum. 

Now, this whole recovery procedure is a long parade of tubes being removed from your body, and they all felt very different from one another. They all felt uniquely uncomfortable, and various degrees of unpleasant, but never painful. The drain tube was a weird one, but the strangeness of its extraction was immediately overshadowed by an incredible feeling of physical liberation. Almost in a blink, I felt human again. This, the extraction of the drain tubes, is the the goalpost for in-hospital recovery. After this, everything came easily and felt so darned great relative to what was before. Beyond this, it has been just fine. 

A blood draw was taken each night around midnight, and while I slept really well on the first night without the drain tubes, your sleep rhythms are so thrown off by the whole process and environment that this wakeup never felt onerous. My blood came back that night with an elevated white blood cell count, which might mean that your body is fighting an infection, or is sometimes just a thing that happens post-op, especially in younger patients. We had to wait and see.


Day 3 post-op

This is when it started getting boring. I was certainly up and walking, but I can't recall if that started a day prior to this. Anyway, I definitely felt foggy, especially when I was up and about. My vision seemed not quite right, which I hadn't noticed prior. I hadn't so much as thought of looking at my phone or reading a book before this day, so I was surprised at how my vision wasn't cooperating to do either of those things. I was assured that was a typical effect of the drugs still working their way out of my system, and indeed that has proven to be the case. 

I caught up on some podcasts and listened to some music, and slept a lot. It was great to feel like a person again, no matter how compromised.

This evening's blood draw ended up coming back with my white blood cell count still a little higher than normal, but less than the last night's. A good sign that there probably wasn't an infection.


Day 4 post-op

This had been the stated target day for me to be sent home, for the preceding couple of days. It was the first day that getting up to use the bathroom (since the catheter had been removed the same day as the drain) felt like a fun outing and not like a major hardship. It was also the day that I learned that there were POPSICLES in the fridge down the hall that NOBODY HAD TOLD ME ABOUT, so I went on lots and lots of walks, and reaped commensurate rewards. 

I was apparently low on potassium, so I had to take two of the biggest pills I've ever seen in my life. The least fun pills of the process.

The last real piece of equipment to be removed from my much-punctured body was a pair of wires that everyone gets during surgery to provide an easy and effective way to get electricity right to your heart at any time during your hospitalization, in case things are going south. The wires were removed, which felt novel as it had been more than a day since something was pulled out of my body. One has to lie still for a half-hour following this particular extraction for observation in case of any internal bleeding caused by the extraction or anything else funny. All good for me. I had to wait the mandatory four hours between wire extraction and discharge, and I managed to slowly and carefully dress myself, then I walked on out of there. What a crazy few days.