Sunday, July 21, 2013

Appendix Removal - Not So Bad But Here is What You Can Expect


Last November I had appendix inflammation and had to be taken out. The procedure was called a laparoscopic appendectomy. If you are wondering about recovery after appendix surgery because you need it or just had it, my experience will help prepare you for what is to come. As long as your specific case does not have complication, the process is not bad so do not be afraid. However, there are certain things to be aware of that are going to come up for you.

I started feeling something was wrong down on my right side but it was not very painful. It just ached here and there or felt like a cramp. So I went to the doctor at my walk-in clinic Sunday afternoon and he did a urine test and had me jump up and down. That hurt to do so he then immediately sent me over to the emergency room. I asked him, "Do you mean I need to go right now?" Moreover, he laughed and said, "Yes, right now!" I did not realize it was that serious. I did not think for a second that I had a problem with my appendix because the symptoms seemed tolerable.

At the emergency room, they did more tests and lab work at a deeper level. Therefore, after about 40 minutes and a CT scan I was told I had an inflamed appendix and they had set up a room for me. Thank goodness I married a teacher and I have health insurance!

Once up in the hospital room I got asked more questions and was told the doctor would see me the next day. They had me on antibiotics to try to bring my appendix inflammation down and I had a lack of potassium in my blood. I am not sure how I got that since I eat a lot of bananas but I will say that potassium hurts when given intravenously. Your arm aches and if the IV delivers too fast, it really aches.

So the next morning my surgeon comes in and tells me he has me scheduled for surgery that evening but wants to see how the antibiotics take and he may hold off appendix removal if they work. I was not too interested in holding off because I knew it had to come out at some point and I'd rather it be sooner.

After the surgeon left, I began to take note of what it is like to be in the hospital since I never had been there before. Hospitals are not restful places. There are people coming in and leaving all day long. They take your vital signs, chest x-rays and ask you questions. In addition, the beds in this hospital were set up so you do not get bedsores. The mattresses automatically move and it is annoying. As soon as you get comfortable, the bed moves and now you are not comfortable anymore. This would later prove to be a problem during my next operation.

By the end of the day, I am starting to get a very strong headache. I had not eaten since Sunday morning and it is now Monday evening. The nurse tells me that the headache is common when not eating and being on an IV for several days. She cannot give me a pain pill because we get word I am going through with surgery after all and it is going to be that night at 8:00. At that point, I am a little concerned the doctor will be tired. I know I would be but I am assured by several nurses he will be fine. I am lucky because everyone tells me my surgeon is very good and this information is unsolicited.

An hour before the scheduled surgery I am wheeled down to pre-op where they shave my belly area with a Bic shaver. It does not hurt even though they shaved it while it was dry. I am surprised the single blade works great. Now my major concern is a catheter. I am deathly afraid of having one put in and I do not know if they plan to do that. Mostly I am worried they will do it while I am awake. The nurse tells me they will not use one for this minor operation so I feel much better.

They wheel me into the operating room and I first thought it did not look very official. It looked to me like an extra room fixed up to be an operating room. Several nurses and attendants helped me move from the wheeling bed to the operating table. After that happens it is literally seconds before you pass out from the anesthesia.

I awake later in post-op and I am pretty out of it. I have no sense of time past. I can see people, hear them, and answer them but I am goofy as hell. The surgeon comes by, grabs my foot, and says, "Everything went great. You'll be fine." I thank him and the nurse tells me that she is going to remove my catheter. It turns out they decided to put one in after all. I could not even focus my vision on her. I just acknowledge it is going to happen. She pulls it out and it is uncomfortable for a second but not nearly as bad as I thought it might be.

Later they take me upstairs to my room. It is here in the middle of the night I learn that the new theory of getting better has to do with getting you moving as soon as possible. This means I need to start walking up and down the halls pushing my IV bottle, which is on a wheeling rack. Awkward but it can be done. Bed rest is out. Moving is in.

Several nurses wake me just hours after surgery and get me out of bed to walk the halls. In addition, because I had bowel surgery, in order to get everything over the shock and working again you need to move your body physically. This restarts your digestion system. Walking was not so bad. In fact, I enjoyed it and started doing a walk almost every 45 minutes. It was better than staying in that self-adjusting bed that would not let me sleep.

The next hurdle to overcome is the doctor wants you to pee and past gas. This signals to him things are back to normal. The next morning the RN nurse was all over me to pee. She said she would have to put a catheter in if I did not empty my bladder. She did a sonogram and my bladder was full. I started to panic because I did not feel the urge to pee and now with so much emotional pressure from the catheter threats and the pain meds throwing me off, I could not go. In addition, I had a little pain after the catheter so I did not feel like peeing.

For a good hour or so before the nurse called the doctor and asked him what to do I fretted about it. Thank God he said to not to put a catheter in. The nurse told me and within ten minutes, I relaxed and went to the bathroom. Later the doctor told me the nurses tend to want to rush that process and he prefers to let it ride for a while. I am thankful.

Now at this point I still had not passed any gas. Having not eaten in almost 3 days, there was nothing there to make gas. This is a big deal in the recovery process. Luckily, I had a weak bowel movement shortly after that. This was good enough to get the "okay" from the surgeon to go home. Who would have thought farting was so important?

In general, they really want you to go home. The hospital is not a good place for recovery. Recovery happens much faster at home and you are not in danger of getting some bacterial infection, which can be common in some hospitals. I did so much walking and by pushing myself to be that physical it turned out to be the reason I was allowed to go home so quickly. (This physical activity served me even better during my next operation two months later.)

I found it odd that I was one of the only people doing this. There were several heavy people there who had had stomach stapling or similar procedures done who would hardly ever be up and moving. I heard from the nurses that these patients were supposed to but many were a bit lazy. Interesting.

Getting into the car was hard. I found certain movements were difficult and crouching down to get into the car was one of them.

My belly was bloated and distended because of the appendix being removed laparoscopically. There was still gas in there and it took over a week for the gas to leave. The gas is pumped into your abdomen to lift and separate the area so it is easier to see during surgery. It felt weird being bloated like that and I felt vulnerable.

I had three small wounds with staples in them and tape over them due to the laparoscopic surgery. I did not see how they could remove my appendix or work on my insides through such small incisions but they did. The doctor told me I was fine to shower regularly and get the tape wet after the surgery. I just should not rub the tape. Oddly, several nurses did not think I could shower.

My first night at home was a little tough. I got too cold in bed because I was not regulating heat well and it was cold in the room. I started shivering uncontrollably which frightened me. I ended getting up and putting long johns and socks on and that did the trick. I also had to walk around the house for a while to relax.

The first couple of nights I had to take a pain pill as well as sleep on my back without moving much. The pain pills were Hydrocodone 5-325 one or two every four hours. (It is a combo of vicodin and 325mg of Tylenol. The vicodin is to keep you from coughing and the Tylenol is for pain I read.) I think I took two that first night. That was tough because the doctor told me first that it would take longer to get well the more I relied on pain pills so I was hesitant. Moreover, sleeping on my back is hard for me. Both things got taken care of over the next couple days as I was able to stop pain pills first. I still had to sleep on my back for about two weeks.

Another thing I learned not to do was sneeze. It was excruciatingly painful the first time it happened two days after I was home. I stifled every sneeze I had for about 4 weeks after that. Coughing was also scary but easier to handle.

Four days later, I played in the Tomasina band at Disneyland for three consecutive nights. It went fine. I just took it easy. The hardest part was my bass kept hitting my wound when I moved around too much so I mostly just stood there.

A week later, I went back to the surgeon and he removed my staples. I thought that was going to hurt but it did not. Just kind of pinched but it was over with quickly. I never had to go back after that until my next problem two months later, which is what caused my appendix problem in the first place. (Read my colon surgery story for more hospital fun.)

When I got the bill from the hospital to show what was being billed to my insurance, it was for around $35,000 for my three-day stay. Please get insurance if you do not have any. Without it, this bill would have crushed me.

Full recovery I figure after actual surgery took about 5 to 6 weeks.

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