.
Recovery from RP surgery has shown me some new things about
breathing and diet important even to life before/beyond surgery. Breathing
exercises and control of breath are a central part of yoga and of yoga-like
exercises all over the world, so I was surprised to learn a little something of
real value this week that I didn't know before. Diet likewise, though the week
raises questions more than answers. I will go into detail below.
As for the surgery itself - I had high expectations for my
surgeon, Dr. Chung of INOVA Fairfax, but outcomes exceeded even those
expectations. One result: much less pain than expected. I still remember the
awful pain I felt for a week back when I turned 14 and had my appendix taken
out; this has been far less. Operation on Monday 8AM , out on Tuesday 2PM
(though they offered longer stay if I chose). As I left, I asked when last I
had Tylenol or percocet for pain. The nurse said "none at all today. You
asked it be used only as needed, that you would tell us if you needed it."
From then to now, I still get pain easily if I make the wrong move. Some people
just don't move if they risk pain, but we can move by choice and will. The pain
signal allows me to move with less damage to the body than without it. Does
pain also turn on reflexes bad for a person recovering from surgery? I am glad
my pain has not been so serious that I have to worry about that. Even on
Monday, when I woke up on the same intravenous (IV) hookup they inserted at 730
that morning, dispensing some pain medication, Luda noted that I was clear and
normal, not like others under heavy narcotics at that stage.
That's the good side. On the bad side, living with catheters
turned out to be more restrictive and obnoxious than expected, and diet issues
are tricky. I am glad it comes out in 6 days at 9AM! At the hospital, until I
left, I was wired up in 4 ways - catheter, IV, and two "sequential
compression" sleeves on my legs. The sequential compression sleeves
felt really great and really right for doing their job (massaging legs in the
best way to prevent clots or Charley horse) - until I saw how they were hooked
up, with plastic pipes, not consistent with medical orders to just walk around
5-10 minutes each hour (partly to avoid leg clots but not only). One reason I
decided it would be better for my recovery to leave the hospital: the IV. Hard
enough to move around with big catheter avoiding pain; IV was too much and
unnecessary by then.
Another reason: diet. As I prepared last week, I found a recent
paper explaining what is really known about digestive systems relevant to
surgery and more. https://www.researchgate.net/profile/Angel_Catala/publication/18525695_Nutrition_in_Clinical_Practice_httpncp.sagepub.com/links/09e4150ae8ad87bbd6000000.pdf
My ex wife, who recently
went through more serious surgery, said she wished she had seen that paper in
advance. Issues like strain, nausea and bloating can be problems after any kind
of surgery, or even in normal life. But a broad spectrum of nutrients is also
vital to the rate of healing, and to the "microbiome".
From day one, I knew I should drink lots of water, and I made a
pest of myself asking for refill after refill of the water pitcher. But: I
think this helped improve my score in one key metric of progress after RP: the
color (blood content) of the liquid in the bag. As Dr. Chung looked at that, he
said the catheter could indeed come out Wednesday or even Tuesday.
But the paper also stresses the need to use the natural
digestive system more, while taking foods and medicines tailored to minimize
problems. Maximum fiber, minimum fat (though many oils help), protein. Lots of
pious stuff exists on the web about sacred beans and rice, and I remember still
the crackers and tea for flu decades ago, but last week I simply checked
numbers I hadn't paid much attention to. At DC Costco, ever so many cracker
boxes proclaiming great fiber benefits and such.. but the real labels didn't
fit the hype. At Costco, we did buy kashi, dried apricots, and a zero-fat bag
of crackers/pretzels. But at home.. canned salmon is more stellar than I
realized.
And so, for these tricky initial days, I prepared juice and
broth, Miso soup with canned salmon instead of my usual clams, and a bowl of
plain yogurt with heated frozen berries and kashi. That fit the research a lot
better than the choices at the hospital, and was one more reason to leave.
But today I still wonder. Even the best scientific knowledge
about the body leaves very basic questions unasked, let alone unanswered. I
suppose I shouldn't get too deep on that right now.. but I still don't know yet
what the first solid output will be like or how feeding the microbiome factors
into this. Those questions (and some loud "meows" from the abdomen)
persuaded me to give in and say yes this morning when Luda offered me to share
the delicious duck soup she made for breakfast this morning.
Breathing... Since my pain was low and my consciousness intact
even as I woke up in the recovery room Monday, I was bemused and curious when
they asked me to inhale through a plastic device called an "incentive
spirometer." They wanted to be sure my lungs didn't suffer from
surgery/anesthesia. I was happy and proud I could pull the blue disc almost all
the way to the top, and happy to see surprise on the face of the nurse. But
then she said: "OK, but now you must do your homework. Every hour, you
must do this ten times. It strengthens the lungs, but more important, it
prevents you from having too much coughing. Coughing could really hurt your
sensitive internal organs trying to heal." A kind of treadmill for the
lungs.
Later when they finally moved me up to the GI Ward on the 11th
floor, I saw another one of those plastic spirometer in a plastic bag, sitting
next to the one I had used already. It seems they give these out like soap in a
package in hotels. I wish I had asked whether they planned to discard the one I
had used, and, if so, just taken out home. It did not look big or expensive.
Training for the lungs, to reduce coughing, pghlem and snoring, could be very
handy. More seriously, the kind of deep breathing which this device trains
plays a key role in all kinds of activities. The Wikipedia article on incentive
spirometer notes that people who play wind instruments, who really have to get
their breathing right, already use this training tool. Of course, one can do
deep breathing without the artifice, but extra feedback can be very helpful.
Many people may do breathing exercises and other exercises over and over..
getting it wrong always due to lack of feedback. Still, a trick would be to use
the device in a way which does not distract from other dimensions of such
exercises/experience.
Just last night, I realized I might be about to risk a painful
cough... and remembered to do that kind of deep breathing, which did work.
So many other details which I should cut short. I wish instructions
had been clear to bring small extra bag to hospital (toothpaste, Kindle, cell
phone). Was impressed how the whole surgery depended on one older nurse, Irene
(maybe Latin American) who could insert IV so much more than others. A supply
problem with beds left me hear other conversations in the recovery room a long
time, and in the DC area they were interesting. Less intensity upstairs on the
ward, and less hand washing. Luda searched months ago for best urologist in DC
area, and showed me just two choices, one reason my expectations were high. But
now my GP warns what all this could do to kidneys... Oh well, man is still
mortal.
No pictures. Would violate esthetic standards. I write this on
my Galaxy Tab. Laptop too heavy; desktop violates rule against sitting with
legs not elevated. I copy this standing in front of desktop. Heavy fluid intake
rules out use of small leg bag – constraining but healthier and i need to be as
healthy as possible about this.
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