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My Appendix Story... and how it pertains to your dog!

26 Jul 2017

Appendix

So, here’s my story and how it might relate to helping our animal companions to heal after any kind of surgery.

Saturday July 8th, I was awakened by stomach pains at about 5 am.  Just diffuse abdominal pain.  I went to the bathroom figuring that a good cleansing vomit would be coming shortly.  Three hours later, I was correct.  And that is when I had my husband phone my business partner to cancel my patients and ask if she would see the wheelchair fitting case that was coming in first thing. (I have horrible guilt about cancelling!)  The rest of my morning was spent going between bed and bathroom, but the results did end up with me feeling any better.  The afternoon was spent sleeping or trying to make myself vomit.  Just a typical healthcare worker – figuring it would go away if I just slept it off.  It had to be the flu or food poisoning (but nobody else was sick and we had all eaten the same things.)  Not until 5 pm did I start to think, “Hey, this could be something more serious!”  But by then I was so exhausted.  I wasn’t able to keep any water or ginger ale down and I had both fever and chills.  Hubby finally came home and asked if I thought he should take me to the Urgent Care Centre in town.  I said yes but to go ahead and feed the boys.  (Still a stupid healthcare worker… and my husband, not being one, decided to listen to me.)  Three hours later after he had made dinner, ate dinner, and cleaned up after dinner, he reappeared in the bedroom ready to take me away.  

 

Off to Urgent Care we went, where they were quick in diagnosing me with appendicitis and putting some meds on board.  By the time, I was on the bed in there, I had the shakes, so they hooked me up to a saline drip and added in the good stuff.  And that was my first experience with morphine.  Because of the state I was in, they decided to push in a big dose fast.  It was a second or two and then the world spun, and I had to ask for a bucket.  I don’t know where I produced that vomit from!  But then, bliss.  I hadn’t even realized what the pain had been doing to me until it was taken away.  I also enjoyed fentanyl and gravol/dramamine and some other drug that started with ‘z’.  I could hear them call into the hospital to transfer me, and order the ambulance.  Two hours later, the ambulance arrived!  

 

In the hospital, I got to spend time on a gurney in the hallways (it was a full moon and the first weekend of the Calgary Stampede… so plenty of folks joining me in the ER that night).  More morphine… but this time a really helpful medic diluted it and pushed it in slow.  Ahhhhhhhh.  Anyways, there I had a CT and spent extra hours in the emergency.  When all was confirmed and I had met with the surgical group, it was decided I’d have the laparoscopic appendectomy first thing in the morning.  I was transported to a room and bed by 3am and woken up again at 7am to be wheeled down to surgery.

 

So, perhaps many of you are aware, but for those who aren’t, when they do laparoscopic surgery, they pump your abdomen full of air in order to create a dome within to work.  Seem innocuous, but it’s not exactly so.  Firstly, the anesthetist came by to say that because of the air they pump in, I’d come out feeling like I’d done a million sit ups.  Okay, so I don’t know much about how things went intra-operatively, because I had a general anaesthetic.  However, I do remember waking up after extubation, and that was not fun.  I think I know what dogs with laryngeal paralysis feel like! I couldn’t get enough air in or out, and even though they tried Ventolin, I had a moment of thinking I just might pass out and then I’d need a tracheostomy!

 

Okay, so that was my surgical experience.  Post-op recovery and how I’ve been feeling is what’s more interesting (I think)!

 

Where has the soreness been?

My throat had a ‘lump’ in it from the intubation for two weeks.

For 5 days, I had a pain under my right rib cage that referred pain up to my collar bone and neck (common from what I can read on the internet.  It’s trapped CO2 from when they pumped the abdomen full of air.)

My abdominal pain is nowhere near my former appendix, it’s on the left side between my belly button and pelvis. (I can’t figure that one out.)  And 2.5 weeks later, that pain is still there.

The abdominal pain was bad when I stood up straight or walked too quickly, and coughing had me in tears.  Currently, I’ve found that stretching my abdomen (i.e. lying on my stomach and propping myself up on my elbows) is an exercise in mental toughness.  I’m doing it to help stretch out the scar tissue, but it’s not fun!

For the longest time the air in my abdomen made my stomach painful to any pressure, and distended to the point that I could only wear this one dress of mine for the first 3 days (I’m not a ‘dress’ person normally… except in Hawaii, but all things are good in Hawaii!), and I’ve just recently been able to get into normal pants with a button waist!

Oh, and my TMJ was sore too.  It was 3 days before I ate regular food and that’s when I realized that opening my mouth wide enough to put in a piece of lettuce was torture!  That lasted for 1.5 weeks!

 

What other effects have there been?

The night sweats were unbearable!  I felt like I was in a fashion show.  I’d wake soaking wet and have to changing my costume 4 times a night.  And to top it off, the sweat was like nothing I’d smelled before.  I was positively foul by morning!  (As an update, I’m now down to one wardrobe change a night, and I’m ‘smelling’ more ‘normal’!  Good to know if you run into me!)

The fatigue hits when it hits like a ton of bricks.  There’s no pushing through it, sleep is the only thing that you can do!

Stamina is also compromised.  I think I can stay awake past 11pm.  Nope.  I think I can walk farther than the previous day.  Nope.

Focus is compromised.  When I wasn’t at work, I thought I can get lots done on my computer.  Nope.  My brain is just not working in its finest form.  Focus has been out the window.

Short term memory is compromised.  What was I typing about anyways?

Overly emotional.  I am crying at the stupidest heart-tugging stuff on TV, or things that come into my head, or for no reason at all.  (Fortunately, my boys haven’t witnessed it… they’d tease me relentlessly!)

 

Things that have worked to help with the pain?

All of the usual things, pain meds (they only send me home with a prescription for Tylenol with Codeine), a hot pack, slow and steady walking / moving, and sleep.  

I was surprised that the CBD Hemp Oil I had at home did better at pain relief than the prescription meds.

Laser over my abdomen also seemed to help.

I also did some gentle abdominal massage and some visceral manipulation techniques that seemed to help.

One of the best things was the massage & acupuncture session I had.  It was a prescheduled session and I had thought about cancelling it days earlier, but it was heaven.  Nothing deep, none of my usual problem spots, but perfectly what I needed.

Yes, and ‘Smooth Move’ Tea to help with constipation.  That’s stuff is great!

 

And how does this impact my thoughts about canine rehab?

  1. Pain management, pain management, pain management (especially if the pain persisted for too long before the owner (or ‘self’ in my case) sought help for the patient).  I don’t think my post-operative pain was adequately managed by the Tylenol.  I’m a huge advocate for combining medications (safely of course, and with the approval of your vet) in order to prevent a ‘wind up’ phenomenon, where pain is all that the body can focus on.
  2. Abdominal massage (even if just gentle and non-descript)
  3. TMJ massage (and acupuncture) might be useful for dogs as well.
  4. Touch was so helpful to me.  I can see how massage, brushing, or petting (to / of non-impacted body parts) could be so healing for an animal.
  5. And as I move farther out from the surgery, I’m finding the need to address the abdominal scarring – myofascial releases, static stretches, and postural awareness.
  6. Allowing a slow return to normal activity… perhaps slower than anticipated.  

 

I think it’s useful for dog owners to be given this information, be aware of post-operative side effects, and be empowered to help their pets through the post-operative stage of abdominal surgeries… not just the orthopaedic or neurological ones!

 

So, there you go!  My experience has gifted me with a new empathy for people and dogs undergoing these kinds of surgeries.  (The silver lining, I guess!)

 

Until next time, Cheers!  Laurie

 

 

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