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Thursday, August 20, 2015

post-operative recovery

Earlier this week I had surgery. Abdominal laparoscopy, admitted and discharged the same day. Now, I have had many friends and family undergo surgery before, from planned operations to emergency C-sections, and this was my first time. My second time with anaesthesia, due to a fractured coccyx when I was 15, but my first surgery.

Whilst spending a lot of time in bed, I have been thinking about the different tips and tricks for making hospital experiences better, for speeding recovery, for coping with post-op nausea, and so on. I'd love to hear your responses, especially if you have any more tips to add, so please comment below.

When you first go into hospital, a tip I was told early on is to wear the gown. I was told I could bring in my own pjs, robe, slippers, to wear in bed and around the ward before and after surgery, though I did have to wear the proper hospital attire during the op. But I was told, wear the gown when in hospital. Why? Well, funny thing about medics -- they're human. If a patient (or client) is dressed like a patient, a human tendency is to treat them with more kindness. If a patient looks more independent because they are dressed in their own gear, some nursing staff and doctors may hold a subconscious prejudice and treat the patient with less respect. I'm not saying this applies to everybody. I have met some outstanding nursing staff, especially during my recent stay, but there it is. Humans are human. We're all sinners, we all mess up, so don't get up tight about it but work the knowledge to your advantage and wear the gown. At the very least, if you puke or pee or bleed on yourself, there's less laundry to take home!

Dealing with nausea is the next big thing. I've now had two experiences with anaesthesia. Both produced extreme nausea. I had to have an anti-sickness injected into my bum after the first two IV treatments wore off, because I had such trouble keeping even the smallest amount of fluids in my stomach. I recommend some essential oils in this case. Now, what you can get away with may depend on a few variables -- shared ward versus private room, the area of your operation, meds you've been given and all. If you are at all in doubt, leave off the oils or ask medical staff. With other people around, it is best to stick to the most benign of essential oils, avoiding potential airborne allergic response.

Lemon and peppermint essential oils
are my top recommendations. Both are astringent, and very common scents with which most people are fine. A little bottle of oils under the nose can help greatly with nausea and headaches. Peppermint is cooling, too, and one drop on a disposable wet wipe rubbed over the back, inner arms, or feet can help significantly with the sudden feelings of heat that can suddenly rush over the body during post-anaesthesia sickness.

Operations that require the abdomen to be inflated with gas can result in wind. Lemon and peppermint dropped onto a disposable wet wipe will help with the bodily odors in the room, from you or from other people in a shared ward. A small amount of diluted peppermint applied gently to the lower abdomen or back (provided this is not near the site of incision) can help dispel trapped wind. Catnip, spearmint, and fennel seed oils are also good for this.

If and when fluids can be taken by mouth, sips of peppermint or Digestivi-tea, aka Tummy Tea, are a good idea. When I woke from anesthesia, my mouth tasted foul. It tasted like plastic, like metal, like the worst morning breath. Sips of water merely took on that same flavor. Even swirling a little mint tea around my mouth and spitting it back out helped greatly to dispel that nauseating flavor while wetting my mouth, even when I couldn't swallow the tea for fear of vomiting again. A fellow patient the next bed over was grateful to be given some Digestivi-tea by my mum who was with me in hospital.

I brought my herbal tea as loose leaf, in little zippy bags, and brought a basket mug strainer with me. Various herbal stores sell such strainers. These are brilliant as you simply pop one over a mug, add the tea to the basket, pour in hot water, and then remove the basket once the tea is infused. Very little fuss or mess for a single mug of tea. You can also buy empty disposable tea bags to fill with your own blends. I find, however, that small coffee filters are cheaper than boxes of press'n'fill tea bags. If you want the ease of disposable bags, add a couple of teaspoons of your herbal tea to the center of a small coffee filter circle, bunch together at the top, and tie closed with a small length of thread. Very easy to make and take in to hospital all ready to use.

Get yourself an IV bag of fluids, too. This was a tip from my mum, who is an operation veteran now. The more fluids you can get passing through your body, the more quickly you will flush out the strongest after effects of the anaethesia. You'll feel better for it, too, plus your skin will be craving all the moisture it can get from inside and outside to facilitate healing. The cannula was left in but I was taken off the IV whilst still in recovery, before even being returned to the ward. I later requested a new bag of IV fluids when I started vomiting. Even if you are not losing fluids by mouth as I did, you will likely find that you feel stronger, less headachey, and better all round if you manage to convince your carers to get you some IV fluids.

Hospitals can be dry places, and the oxygen mask I was given during surgery felt very drying. My throat has been extremely sore and my nose has been blowing out red in the mornings. A few simple things will help with this. A little Rapha salve or Sunshine salve applied up the nose will feel a bit slimy at first but really helps soothe dry mucous membranes. Saline nasal irrigation is very good, too. If you have not tried it, I highly recommend that you do. NeilMed brand makes handy sachets of saline mix to add to water, as well as selling a few different styles of irrigation tools. I prefer the squeezy bottle best. It is a soft bottle with a straw, and the water pressure is fully controlled by the squeeze of my own hand. Nothing is as soothing to a dry nose as saline irrigation. Take along some hard sweets or lozenges to suck on after the operation, too, for your throat. Anything that sounds good and doesn't irritate your stomach will do. Once you can drink, marshmallow root tea is mucilagenic and wonderfully soothing to a sore throat. It doesn't have much flavor to it and so blends well with peppermint or Digestivi-tea, or even other herbs and black tea.

Compression knee socks are brilliant. In the UK, the NHS provides toeless compression socks that go up to the knee for wearing in bed. These are much like flight socks that you can purchase for wearing on airplanes. They help to improve circulation and decrease the risk of blood clots. To my mind, it doesn't really matter what the hospital visit was for or why you're in bed -- you want these compression socks. Even if you've just had a baby in the comfort of your own home, merely not moving around as much as usual means your circulation is reduced. Exercises in bed, when possible, are great to do. Wiggle and flap the feet around, massage the calves, do whatever leg moves you are able and comfortable to perform, and get thee some compression socks! Seriously brilliant things. I've been a few days in bed at home now and I'm still wearing mine off and on. I'm not able to walk much so these socks are really helping to prevent the restless legs that I've had in the past when on bed rest.

Following on the same thread of thought, when you are on bed rest and not moving around much, it's not just blood that slows down. Digestion slows down, too. Drink your Digestivi-tea. Consume acidophilus daily, if possible. (If you are on antibiotics, it may be best to avoid acidophilus so that you don't diminish the efficacy of the meds. Depending on your meds and dose, talk to your care team about having acidophilus if you are at all uncertain.) If I have a tender tummy I like to break open a capsule of acidophilus and mix it into yogurt or apple sauce so that I can eat it slowly. Also, focus on soft foods. Banana, apple sauce, avocado, jelly/jello, cooked oatmeal, rice, scrambled egg, custard, lentil and vegetable dahl, soft cooked vegetable soups, bone stocks. Consume healthy fats. Keep the gut moving gently. After having a baby or experiencing surgery of any kind near the abdominal area, it is awful to find oneself a bit backed up, either constipated or merely with heavy, large stools. Take it gently. Use the bathroom when you feel the urge to void, don't hold it in. And drink fluids steadily throughout the day.

Now, chances are you have some bruising in places and some wounds in others. How you care for these wounds will vary, so I cannot advise you much. Talk to your doctors and nurses. They are there to help. That said, I can tell you what I am doing right now for my own bruises and wounds, and why.

The back of my left hand is where the cannula was put in. Normally I bruise like a peach. Other times I've had a cannula inserted, the entire back of my hand became purpled with bruising. It is a testament to my fabulous nurses this go around that I have no discoloration at all! However, it is still a little sore, and slightly more swollen than my other hand. I am applying an Arnica-plus salve, containing arnica with comfrey and St John's wort herb, to the back of my left hand.

The laparoscopy was done with two incisions, one into my belly button and one in the left side of my lower abdomen. Dissolving stitches hold the small wounds closed and I was allowed to rinse in the shower and remove the dressings only 24 hours later. Nothing compared to a C-section wound, for example. I am applying Rapha herbal antiseptic salve to the areas. I am not applying salve directly over the incision wound at this early stage, please note, as the wounds travel deep into my abdomen. I am smearing the Rapha salve all around the wounds, near but not directly on them, and all over the bruising around the wound site. Whilst arnica is fabulous for healing bruised soreness and for breaking up discoloration, I am aware that it does this in part by increasing the movement of the blood. Even on such narrow wounds, I do not want to increase the chance of reopening a flow of fresh bleeding by using too much arnica. I am trusting the comfrey in the Rapha salve to help heal the bruising in this early stage. Once the stitches have fully dissolved, I will begin applying Rapha salve directly over the wounds, and will feel more comfortable about applying arnica to any remaining bruised color on my belly.

One more tip, and this is something you never have to worry about forgetting to pack -- instant serotonin boosting. Simply raise your arms over your head in a victorious V for a few minutes. Studies have shown that even when the emotions are not feeling great, perhaps even downright depressive, the levels of serotonin in the brain are still increased in response to power poses made in the body. You may be feeling utterly vile, but if you can arrange your body in a power pose for just 2 minutes you can powerfully impact your overall well-being. Serotonin is a neuromediator that plays a key role in regulating mood, appetite, pain perception, GI function, and healthy sleep -- all of which are pretty important to your recovery. Low levels of serotonin are linked to depression, constipation, inability to sleep, and so on. Keep those serotonin levels at a healthy high! You can't overdo it with a power pose. There is no overload you can give your brain by thrusting your arms up in a V, by sitting with wide legs and a confident stance, by standing with hands on hips and shoulders relaxed and squared. But if your stress levels are reduced and your recovery aided by such a simple trick, why the heck not?! Get those arms up. Boost your serotonin.

Do you have any tips for post-operative recovery? What different things might you suggest doing or bringing into hospital? How would you go about treating surgical wounds with natural remedies?

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