Let's get practical

I know that at the moment, most of my readers are friends and family, or people who 'know' me off various internet forums (hi everyone! *waves* and apologies to those who are disturbed that I have a real name! lol).

But I started this blog mainly with the intention of it being helpful to people planning to have bunion surgery, because a lot of what I knew in advance about the recovery period was gleaned from blogs.

So this post is probably only really of interest if you are going to have bunion surgery, or a friend or relative is. But of course, everyone is welcome to read!

I found that my surgeon and hospital did not give me any information on how the recovery process would go, or what I might need to make it easier. If you go private, or live in a country where you have to go private, you might get a better level of information, but if you are NHS, you may well find this really useful.

So here are the things I think you need to know, or need to get.


THINGS YOU NEED TO GET

* A beany lap tray (or two). These are so useful, for using a laptop in bed, eating meals in bed, writing things in bed, you get the picture. Or even as a kind of table to have next to you on the bed. You definitely need one. I borrowed two.

* A pouffe or high footstool. For elevating your foot when you're able to get out of bed. Get one as high as you can, or add pillows/folded blankets to make it high enough. Your feet should be higher than your hips ideally. This also has the advantage of marking you out as needing special care, and even small children seem to honour that (well, a bit, anyway).

* A wheelchair. Not absolutely vital, but if you'd like to be able to leave the house before you can walk on crutches, or if you'd like to go further than you can walk on crutches, then a wheelchair means you can be pushed places. I used mine to go to the Little Lady's nativity play, which I would otherwise have had to miss. I got mine from the Red Cross.

* A decent pair of ergonomially designed crutches. Another thing that's not absolutely necessary, but they are much more comfortable than the NHS ones. I imagine you can get them from the Red Cross, although I borrowed mine.

* A toilet frame. Another Red Cross item. I've already said in another post how much I have valued this piece of equipment. It has enabled me to go to the toilet by myself, which is vital for dignity. Without it I would have had to have someone lift me on and off the toilet.

* A large pair of soft socks. For keeping your toes warm when/if you go outside. You can buy fleece things on the LimbO website but they are a tenner (!) and of no use afterwards. You could always make a fleece toe cover, but socks are easier. I bought a supersoft thermal pair in a size larger than my usual one (6-11 when I am a 6).

* Lots of pillows. For elevating your feet and propping yourself up. I use three behind me and about four for my feet, plus a rolled-up duvet tied to keep it rolled. Yes, it is a lot!

* Lactulose. We covered this before but both anaesthetics and codeine cause constipation. Lactulose is a gentle way to resolve it. Nuff said.

* Help at home. There is no way you will manage on your own, even if you have batch-cooked and/or live on ready meals or takeaways. You will get tired easily, you have very limited mobility, it is not going to work. Try and organise someone to be with you 24/7 for at least four weeks (ideally more), or for someone to come in to do mealtimes and cleaning if that isn't possible. If all else fails, employ a cleaner and cook. Seriously. Do not try to do it yourself.

* A TV in your bedroom (if you don't have one already). I hooked up an old computer in our bedroom so I can watch catch-up TV. I haven't used it all that much, but I prefer it to watching TV on the laptop, and it's nice to have it available.

* Waterproof cast covers if you want to be able to shower (or you can strip wash at the sink instead). If you do want to shower, I suggest you might also want a waterproof chair to sit on while you do it. Personally, I haven't bothered with showering but am just washing at the sink. My surgeon recommended LimbO covers, but at £15 each, I decided to live without. YMMV.

* Mobility scooter I think I'm going to hire one of these when the hubby goes back to work. I can walk with crutches a little now but as I have the Little Lady, I'm concerned I won't be able to keep up with her or keep her safe. With a mobility scooter, she can sit on my lap while we ride into town or to preschool. I definitely think it will give me more freedom than I would otherwise have, and would enable me to go shopping.


WHAT YOU NEED TO KNOW

* You will need help washing your hair. If you don't want to be a greaseball for nearly two months, then you will need to get help to wash your hair. The way I have found works best for me is to sit on a chair next to the bath. I sit on the chair sideways with my back facing the bath and then lean back on the edge of the bath, which I pad with a folded-up towel. You will get wet! Get a friend or loved one to wash your hair for you. If you prefer (and I do) they can just wet and rinse it while you do the actual shampooing and conditioning. This does make the back of your neck hurt so sitting up at points throughout is helpful.

* You will have to strip wash. Before I had my casts changed, I sat on a chair at the sink, then washed with a flannel. I am lucky enough to have a tilting wall mirror so I could see my face to wash it, but you could use a standalone mirror, like a shaving mirror. Now I have the smaller casts, I am able to stand at the sink instead of sitting.

* You will have almost no concentration. Before I had the operation I thought I could spend my recovery time knitting, writing and generally catching up on things. But I have found that I can't concentrate on things for too long, so have spent most of my time surfing the net, reading magazines (even books are beyond me!) and doing only things that I can spend small amounts of time on. This is not the time to decide to write that novel, IMO.

There are probably more, and I'll edit and add to this post as they occur to me or as I encounter them. Feel free to add your own in the comments.

Freedom is a new cast.

Ah! The sweet, sweet joy of being freed! The deep blue of the living room carpet! The brighter daylight through the front room windows! The smooth exapnse of the kitchen floor!

Yes, dear readers. I have been downstairs. T'was a momentous occasion.

Obviously, I had to go down the stairs in order to go to hospital yesterday. I didn't abseil out of the Little Lady's bedroom window.

But when I got home from hospital, I scuttled straight back upstairs again, to my cosy pit nest where I've been very happy hibernating from the cold this last fortnight.

See? It's all set up for me. Who wouldn't want to be there?

But today I had a friend come round for a cuppa and I thought 'why not entertain downstairs?'.

Why not indeed, verily and forsooth? (Sorry, I'm in a funny mood today. Must be all this freedom.)

Employing the 'puppet crab' method, I edged sideways down the stairs, clinging onto the bannister. Classy and graceful, as always.

I ditched the crutches because I have found that I can walk around as long as take weird high steps (because I can't bend my feet). It's a bit like powerwalking only it is very very slow. And hilarious to watch. Kudos to the hubby for not laughing.

My friend and I sat in the living room, my feet perched on a borrowed pouffe (thanks Hannah!) and it was nice to be out of the bedroom.

So nice that I had lunch at the kitchen table. I know! Living dangerously is my second hobby.

But sadly, after a couple of hours my feet were objecting. Despite the surgeon telling me to continue to elevate them, I forgot while I had lunch, and that short period - around half an hour - of them being down was enough for them to swell.

I could feel the casts getting tight, the incisions throbbing.

So I scuttled back upstairs to my lovely pit and took some paracetamol and ibuprofen. I also remembered to do my heparin injection and damn that stuff stings when you're not on codeine!

So freedom is great, for sure, but I think too much of a good thing can be dangerous. Maybe I'll ease myself back into the world slowly.

Shake me and I'll rattle

In my last post, I mentioned the amount of painkillers I'm on. Some of you might be wondering why I'm on so many different drugs, and why I'm taking them all at once.

The short answer is: the nurses told me to.

But anyone who knows me, knows I don't take anything the medical profession says to me at face value, and I always ask questions.

So yes, I did ask why I was taking three painkillers.

Specifically, I asked why everyone on the ward was being given paracetamol, as in my experience, paracetamol does absolutely nothing to manage pain at all, not even the slightest headache.

I almost think of it as a placebo, so useless have I found it.

But the nurse explained that it works WITH the other tablets, increasing their effectiveness.

I did try to find some kind of study or article explaining this but was defeated by not really knowing the best keywords to Google. I ended up reading a slightly shocking chatroom discussion on how best to get from various legal drugs, and a few illegal ones, which was illuminating in a number of ways but shed no light on the drugs synergy issue.

Anyway.

I already knew that ibuprofen is an anti-inflammatory, and so it helps to prevent and bring down swelling.

And of course, codeine is a strong painkiller. As well as being, for some people, a bit of a high. Sadly, I'm not opne of those people. There's no buzz for me when I take it, more's the pity, although if I were constantly high at the moment my Christmas cards wouldn't be getting written, so I guess I should be grateful.

And on a serious note, codeine is known to be highly addictive, which I'm assuming is because of that high so many people get from it, so I'm glad that I will be spared the possibility of becoming hooked on it, especially as I have 100 - count 'em! - tablets of it in my bedside table drawer right now.

Apart from the painkillers, I'm also taking heparin, which I inject daily, to thin my blood and prevent DVT, which I am more prone to anyway because of my Factor V Leiden, but which anyone who is bedridden and immobile is at risk of.

In hospital, we injected it around 10pm, but at home I've been finding that a really bad time of day for finding the mental strength to stab myself in the tummy and inject a liquid that stings, so on Saturday I skipped my evening pincushion session and instead injected the next morning, about 45 minutes after taking my meds.

That worked much better. I felt mentally more prepared, and I also seemed to feel the pain a bit less because I wasn't tired like I am at the end of the day.

I don't think I put myself at too much risk by postponing the dose 13 hours, but if they had set the injections at a decent time when I was in hospital, by giving it to me in recovery as I expected rather than late at night when I finally demanded I have it, then I wouldn't have had to do it anyway.

In addition, I'm also taking Pregnacare, which is a vitamin supplement designed to get your body ready for, and keep you healthy during, prenancy, as well as supplement your diet during breastfeeding.

I'm taking it because the Hubby and I plan to TTC (Try To Conceive) soon, and it's recommended that you take it for three months before conception. With our history of miscarriages, even though they are caused by the Factor V Leiden, I'm not taking any chances, so I'm popping a Pregnacare pill each evening to ensure my body is as healthy as possible.

The other medicine I'm taking - I think drug is too strong a word - I began taking yesterday, but if you are going to have this or any other surgery that will mean you having a general anaesthetic, and/or you are going to be on codeine for more than a couple of days, it is one you should get ready in your medicine cupboard.

It is Lactulose.

Look away now if you are squeamish or don't have any desire to know about my bowel habits, because here's the thing - Lactulose is great for constipation.

General anaesthetics give you constipation, and so does codeine.

If you're going to have this surgery, or even any surgery requiring painkillers afterwards, you need to know about this stuff. The hospital weren't very bothered about my constipation because it's not like people die of it, but when it's you, it is very uncomfortable and makes you feel yuck, so my recommendation is to get some Lactulose in.

I recommend Lactulose rather than senna, because Lactulose is much more gentle in the way it acts on the body, and yet is very effective. Considering how much medication I'm putting into my system, I want to try and be as gentle as possible.

This link explains what's different about them and how they each work.

I'll be doing a post soon on what I think you need to get ready in advance of having your bunions done, which will include medicines but also will cover lots of other things you might not have thought of and which your hospital is unlikely to tell you about.


*Your Mileage May Vary, or, your experience may be different to mine.

Tales from hospital part the fourth: day 3. Homebound.

My extra night in hospital was marginally better than the first one. The nurses were quiet but I still found it very hard to sleep. I had even kept myself awake all day after my fainting episode so that I'd be exhausted enough to get off, but there was something about being in hospital that made it impossible.

I forgot to mention I'd had loads of visitors the night before: two colleagues from the Breastfeeding Network popped in around their wards shifts, my mate George and of course Andy, my husband.

We were woken in the morning and the nurse said: "Do you want to have your breakfast sitting in the chair?"

"Do I take it that means you think I ought to?" I asked (Bet those nurses just loved me!)

"Yes," she said, so I agreed I'd eat breakfast sitting in the chair, but first I needed the loo.

I got her to wheel me there,and when I came back my bed had been stripped! Seriously. I know I'd said I'd eat in the chair but I'd been planning to get back into bed for a nap afterwards.

"We need the bed," I was told. "We've got people backing up in recovery. You need to go home."

Charming. Way to go with the bedside manner.

So I had my toast, then sat around waiting to have some X-rays, get my drugs, that kind of thing. I also had a little practice at stairs under the guidance of the physios, and tried out using crutches.

We also got to have a wash! I assume we should have had that opportunity the day before, but it didn't happen, but we were brought cardboard bowls of hot water with disposable cloths, plus a washbag with soap, toothpaste, etc.

So I had a nice strip wash and felt so much better afterwards.

Here's my bowl:

In the end, a nice nurse let me stay on the ward till Andy picked me up at 2pm.

This post is quite dull, really, as all I did then was come home and get myself into bed.

So here are some pictures of my bandages to liven it up:

You can see that the bandages are like cocoons, rounded underneath. This is to stop me from putting any weight on the front part of my foot. I also have to wear some super-sexy velcro shoes whenever I get upright.

Tales from hospital part the third: day 2

So, I knew it was all going too well, despite the utter lack of sleep.

The day after surgery the physio came round to see me. Up to this point I'd been on bed rest, not allowed to get up at all, even to go to the toilet. I'll gloss over the details but suffice to say I'm glad I have good core body and upper arm strength. How elderly people manage to use bedpans without spillage is beyond me.

Anyway, I'd been lying down for hours, my feet raised above my hips, maybe sitting up a bit assisted by the rather whizzy electric bed.

And then the physio gets me up, out and walking around.

Does anyone sense disaster?

Using a walker frame, I edged gingerly and painfully around the corner of my bed, and then thought: "While I'm up, I might as well use the toilet instead of the bedpan."

In a demonstration of complete lack of judgment by both the physio and me (although she's the professional so I'd have thought she might have said no) I got her to wheel me on a chair to the toilet.

And there she left me.

I managed the business part fine. Washed my hands, then realised the world was going a bit grey, my stomach was feeling rather nauseous, my limbs were going heavy...

I pulled the help cord and heard the alarm go off.

After a while (probably not that long but it felt it) I was unable to support myself any more and getting panicky. The nausea was so bad I felt I was going to throw up all over the floor, I couldn't keep my eyes open, my head was swimming, my body was just. so. heavy.

Somehow, I managed to open the tricky bi-fold toilet door a bit.

"Please help me! Someone help me!" I called out. I felt like I was shouting but it might have been just a whisper. I recall the frightened face of a woman lying in bed in my sightline as I began to collapse.

Suddenly a nurse appeared with a wheelchair.

"Get in the chair!" she barked at me.

"I can't," I gasped. "I feel so ill. I need to lie down."

"You can't lie there! Get up! Get in the chair!"

"I can't..."

The next thing I knew I was slumped in a chair next to my bed, with another nurse slapping my face.

"Emma, Emma, focus, open your eyes. We need you to get on the bed."

Like a sullen teen, I replied: "I can't."

"But if you won't, then we will have to get the hoist."

"Get the hoist."

The world went black again.

Slap, slap.

"Emma! We're getting the hoist. Focus! You need oxygen."

An oxygen mask was put on my face, blasting air into my nose and mouth at hurricane speeds, suffocating me.

I pulled it off. "Don't like it!" (there's that sulky teenager again).

They turned it down and put it back then hoisted me onto the bed.

I passed out again.

...

Later, I gradually came round and lay for a while breathing the oxygen before I felt well enough to pull the mask off.

"Welcome back," my fellow patients chorused.

"You were grey! You were the colour of the sheets! We thought you were dying! It was so scary!"

Yeah, me too. In fact, I ended up crying while a lovely nurse gave me a hug.

It wasn't so much the faint; I've been there before. It was the fact that I was left in a toilet, with no-one answering the alarm call, and then being almost shouted at as though I were an inconvenience.

The physio came back later and apologised, which I appreciated. For while I shouldn't have suggested going to the loo, it was up to her to say that it was too much too soon. She's the professional after all.

Later, I indulged my time obsession by asking my neighbour how long I'd been out for. I was expecting her to say about 15 minutes. She looked at the clock, calculating. "Oh, about an hour and a quarter," she said. Crikey. no wonder everyone was so worried.

The rest of the day was uneventful. I was supposed to go home but it was decided I had to stay in another night after that episode, and there was much checking of my obs because my blood pressure is naturally low and they were worried.

The only other excitement was learning to inject my heparin that evening. I'm such a wuss I actually cried while Queen of Hunter called over: "I do it every night! It's easy! Just do it! Stop working yourself up!"

And actually she was right. The needle didn't hurt going in at all. The heparin stings afterwards but by then it's all over. I can do this!

Two weeks in bed? aka preparations for being bedridden

As the weeks march by (less than four to go!) I've been thinking more about what to do with myself when I'm stuck in bed.

I've no doubt that much of my time will be spent saying, "No! Don't jump on the bed! Get away from my feet!" to the Little Lady, who at three years old really cannot understand the concept of Mummy being ill for a day or so,let alone being bedridden for a fortnight.

But apart from that, which will be mucho fun, obvs, I was thinking about what I can do.

I'm really into sewing at the moment, using my machine, but I won't be able to use it while my feet are recovering (must get projects finished before then, must get projects finished before then, must get...) and I'm not a huge fan of hand sewing because it is so laborious.

So it's back to my knitting. I have an, ahem, Easter jumper that didn't quite get finished for Easter. The endless repeats of the lovely lace pattern killed my interest earlier in the year, but it is such a pretty top I think I'll knuckle down in bed and actually finish the darn thing. I've done all the hard part now anyway and it's just rounds and rounds of the body to do then sew up underarms and done! Maybe I should rename the Christmas jumper? Or even the bunions jumper? Hmmm.

There is also a WIP (work in progress) that will be a lovely cabled bag one day so I will have to have that on my bedside table too. I've no idea if I actually have enough yarn for that one as I was gifted a skein of bee-oo-tee-ful Rowan tweed which I don't think I can get another of.

But how fun will it be to get nearly finished and then run out? Oh too fun!

Lots of reading (any book suggestions gratefully received) is a shoo-in, plus time writing this blog, of course.

Maybe that will keep me busy enough? I am assuming that the pain and the meds won't conspire to make concentrating on things impossible, of course.

I guess if all else fails I could put my mind to creating some kind of preschooler-proof leg protector.