Top surgery 2: recovery

I had top surgery on Monday 21st July 2014. This is a record for me, and for anyone who would find an account of the process useful.

Recovery: first 10 days
(Pre-op and op)

I'm still alternating two binders; each morning I take the binder off, use baby wipes to freshen up, check that my dressings still look ok, and stretch out my shoulders a little. I take a few deep breaths (which I can't properly whilst wearing the binder) then line the fresh binder with absorbent lint and brace myself against the wall so my partner can wrap the binder round me as tightly as possible. 

I could do it myself, but when the nurse fitted the binder in hospital, she showed me both options - fastening in front, and fastening behind - and I found the latter vastly more comfortable. I'm sure I could fasten it myself behind my back, if I really tried, but I have a lovely partner who will do it for me, and there's no reason to risk stretching everything out and potentially slowing / harming the healing process if I don't have to. 

Donning the binder is about finding the right balance between being able to breathe and making sure everything is strapped down nice and tight, to prevent fluid build-up and make moving around during the day easier. It might sound counterintuitive, but the tighter the binder, the more comfortable I am (in terms of the wound sites themselves). The binder restricts movement, so the movements I do make are smaller and less painful. I wear my binder as tight as I can bear. Sometimes at night I will loosen it a touch, for comfort. 

My pain is almost always bearable. It's worst first thing in the morning and then from late afternoon onwards. I take 2 500mg paracetamol and 1 30mg codeine every 4 hours (ish). I usually take the first set at 9am, and the last at 9pm, and during the day I skip a codeine or two (the middle doses) so I can take one before I go to sleep and again if I need to during the night. Maximum codeine is 8 in 24 hours, so I've still got some to spare if I get desperate. I lowered my pain relief on the 3rd day, since I felt so well, and almost immediately regretted it, so now I'm back to the full dosage and will continue until it runs out. It's said that you should not 'grin and bear' pain during recovery from surgery, as that will probably make you more tense and slow the healing process. I knew that, but I still thought I knew better and started taking less pain relief too early. Don't do that!

Oh, I'm also taking arnica (2 'pillules' 3 times a day). My paperwork instructed that I do this 7 days before and after surgery. I'm still on the fence about it: I don't believe in homeopathic remedies, but this is prescribed by the hospital, so I guess I do believe in it enough to follow the instructions? If it's a placebo, well, the whole point of placebos is that they do in fact make a difference, and it can't hurt. 

I struggled to pee for a while after surgery - the nurse said it was due to a combination of the general anaesthetic and me being tense - but was going normally by the 2nd day. I'm still quite constipated, though, which is apparently a standard side effect of codeine.

As far as exercise goes, I have been diligently doing the physiotherapy that I was given at the Nuffield. The first time I did it (with the physiotherapist) it was difficult and painful, but the next time (2 days post-op) it was easier, and my range of movement was better, and it's been slowly improving ever since. Now I do it without thinking and it makes me feel really healthy. I guess I do it 6-10 times a day.

On the other hand, today I walked to the village (exactly half a mile) and back, and had to rest for the rest of the day. You don't realise how little you're doing until you try to do something! My advice would be, in trying to get a little exercise, take it very slowly and be prepared to stop a lot sooner than you think you should.

I have been sleeping upright. I'm not sure if this is recommended, but when I sleep flat, I am blissfully pain-free when I wake up, and then sitting up is agonising as the blood rushes back to my chest (this is my totally non-medical guess at what is going on). So I am choosing to sleep propped up, which is less comfortable overnight, but also less traumatic in the morning, and doesn't leave me desperate for my first dose of pain relief. I also try to stay mostly upright during the day (this involves sofas, armchairs and sunloungers). 

My appetite fluctuates a lot. On days 3 and 4 I barely wanted anything to eat, and sometimes I'm ravenous until I try to eat and then can't manage much. Most of the time my appetite is smaller than normal, but I drink as much water as I can (I'm terrible at drinking as much as I should) and eat lots of fruit and vegetables (which is basically my normal diet). Also, ice lollies, as it's been abysmally hot this week.

On day 8 I started to get some localised pain beneath my armpits, where the ends of the wounds are. I also noticed I was swollen above the top edge of my binder, at my armpits. The whole area was achey and tender. When this continued into day 9 I called Ginny (Andrew Yelland's secretary) to find out if I had anything to worry about. She asked me if I had noticed any visible changes through the dressings (I hadn't) and told me to loosen the binder, suggesting that as my swelling had gone down over time, I had probably been binding tighter and tighter and might have gone a bit too far. 

On day 9, incidentally, I met some friends at a local pub for dinner, and although I didn't feel up to walking there or back, I was pretty pain-free the entire time (although quite tired by the end). I feel like I'm getting there.

Coming up on day 10: post-op appointment with Mr Yelland.