(Photo: Recovery Journal Logo By Maria Wulf)

Some significant surprises during pre-surgery exams. It’s not quite as simple as I thought. I’m re-starting the Recovery Journal; Maria already came up with a logo.

The Recovery Journal began after my open-heart surgery in 2014; it resurfaces from time to time, which is a good thing. I believe it did some good.  The goal is to pass on what  I am learning. So it’s launching today, and then again when I get my head clear from the anesthetics tomorrow.

I went to Saratoga to see two doctors today, my podiatric surgeon, for my consent and pre-op briefing, and my new and young pulmonary specialist, who stunned me by cheerfully saying he was considering blocking the surgery because of the severity of my sleep apnea. (I also returned to McDonald’s for lunch for the first time in 30 years and learned there are at least three healthy things to eat there. More on this further down after all the medical stuff.)

The sleep apnea issue surprised me, and I was also surprised by the healing regimen after the surgery outlined to me by the surgeon.  I need to be monitored closely for 24 to 48 hours and wear a surgical boot day and night (in bed included) for two weeks. No showers or baths, the foot has to be elevated for 20 minutes an hour for at least one week and most likely, for two weeks.

I declined the pain killers the doctor recommended and am going instead with Extra Strength  Tylenol, which got me through my recovery in open-heart surgery. I feel bad for Maria, who will be watching me closely for two days and helping me navigate when I can’t think straight (she’s used to that), and I can’t dress or walk normally or drive or do much standing up.

The surgeon said my toe would be in a unique cocoon to protect it from infection and keep the stitches from tearing,  a danger given the location.  I must not stand up without the heavy boot on.

The wound will need ice for some time every hour for at least a week. The foot will have to be elevated most of the time.  I have to see the doctor at least twice more, the first following Monday, the second a week later.

The extent of the disruption and healing work was unexpected; I had somehow talked myself into the idea the healing would take a day or so, and I’d be back to normal by the weekend—wishful and magical thinking. I have no doubt the operation will be successful; it just won’t be as simple a process as I thought. The doctor said I would remember nothing of the surgery and be disoriented and unsteady for a day or so.

She said I would need to be watched every minute for two days; falling over and losing balance was possible.

Then, after I signed my consent, I went to see my pulmonologist, which blew my mind a bit (above)  by telling me any general anesthesia about the waist would be highly dangerous for me, given the severity of the sleep apnea. He said he was prepared to cancel the approval for the surgery until he learned the surgery would be local, not general.

In the back of my mind (and for no reason, I can think of), I associated sleep apnea with snoring and did not think it was severe or essential. I never once thought this could be a serious issue or problem for me, let alone one that involved my heart and possibly, my life.

I was coming to terms with the idea that the mask would be good for me, but I had no idea how necessary and urgent it was.

My doctor walked me through it, and I get it now. My heart is stopping 79 times an hour at night, and the oxygen level in my blood is nearly 30 percent below average. Wow. I had no idea or even a slight suspicion I had breathing issues on that order. He said he would have halted the surgery if the anesthesia was general. I’m not sure why this didn’t come up in my heart surgeries; I suspect the reason is that they don’t dare delay those.

I was aware of growing mid-day fatigue but attributed it to growing older, always a dumb mistake. The doctor insisted I use the mask as soon as possible, which is the day after surgery.

When the heart beats that rapidly through the night, it affects the heart, the bladder. It floods the body with adrenaline, which raises the glucose and blood sugar for people with diabetes. It is not trivial; it is pretty severe—shame on me for missing it and fighting it. To have the heart pause 80 times an hour is big trouble.

I asked the doctor several times how it was possible that I didn’t know this, and he said most people with sleep apnea don’t realize it or take it seriously. I wrote a message to my urologist, who suggested sleep apnea the first time I met him, and I told him I didn’t believe it.

This is why surgeries have been good for me because they force me to pay attention to myself and wake up, and I learn something new about my health every time; it isn’t usually good. But there is almost always a way of making it better.

The doctor and I went over several things to decrease sleep apnea and help my heart and diabetes. When the surgery is over and the foot is healed, I have a lot of new and exciting work to do, which I will share.

People are messaging me assuring me I will be all right, and thanks,  but I don’t think I’m going to perish in surgery for a bone spur,  although my pulmonary physician says it was possible.

 

 

I’m excited and fascinated by this challenge and abashed at my cluelessness. Staying healthy takes work and concentration, and we also see doctors who are willing to talk to us. I’m grateful for that. I embrace this challenge and will work hard at it. I will also share the process; it’s important other people learn about it.

So Maria and I are scrambling to prepare for this very new reality tomorrow – she wants out to the pharmacy for Tylenol, sponges, wipes. I don’t think I’ll be able to get pants on over this bandage, which will be the size of an ostrich egg, I gather.

On Thursday, the medics come with my new sleep apnea mask, the recoveries begin. I have some thinking to do about this and some time to do it. I can blog every day (starting Friday or Saturday). I can’t visit the Amish for at least two weeks, and I’m not sure when to drive or walk around. I’m guessing two weeks when the stitches come out, and the doctors are confident the healing is clean and without any signs of infection.

As to sleep and breaking, I’ll know more in a few days, and when I see, you’ll know. I will have plenty to write about and will find a way to creep around with my Leica (after a few days). I’m not good at being. Still, I see it as a spiritual challenge. I also got my first jar of protein powder. I’ll be out of commission for at least 24 hours and possibly longer. Thanks for hanging in there with me; I shall return.

The surgery goes on, 10:15 in the morning.

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Now, as to the McDonald’s. I had two hours to kill between doctor’s appointments today and was surprised when one of my doctors suggested I could get a quick lunch at a McDonald’s down the road. I have stayed away for nearly half of my life, horrified by almost everything I knew about McDonald’s and how it prepares its food and what’s in its food. I’ve never heard the word “healthy” together with McDonald’s. So I was surprised by my doctor telling me that at least six or seven things on the menu were low in fat and calories, and sugar and high in protein healthy to eat. Not health food, the doctor cautioned me, but pretty good for a quick meal on the run.

I am a diabetic, so I was wary of this recommendation.

The doctor took out his cell phone, and I took out mine, and we went over the foods he recommended. Don’t underestimate the power of a happy meal, she said, even with fries. It’s a well-balanced meal and not bad for children. But fries and cheese are bad for me, so the Happy meal wasn’t a happy lunch choice. He also mentioned the Southwest Salad (350 calories without all the dressing), a fresh salad with grilled chicken.

I asked what might be suitable for a person with diabetes. I only had a few minutes to get to my second doctor’s appointment, and I was hungry. He suggested I try a plain old hamburger without the cheese or fries. I could order extra lettuce and tomato if I wanted. And perhaps a small bag of fresh apple slices. The burger – some meat is suitable for people with diabetes once in a while – has only 250 calories, 13 grams of protein, and 31 carbs (no sugar.). I ordered the burger and the apple slices. It wasn’t the best meal I’ve ever had, but it was a good choice for lunch – light,  good tasting, and not full of glob or mush (you do have to tell them not to crap it up). I was happy with it and would get it again.

My doctor also suggested the Artisan Grilled Chicken Sandwich, a favorite among dieticians, she said. The sandwich has 380 calories, 6 grams of fat, 45 carbs, and 36 grams of protein. If I ever get to McDonald’s again, I might try that. McDonald’s was a big part of my adolescence and a wonderful place to meet girls. It was fun to go back.

I should be clear, this isn’t the healthiest food or the best, but it is pretty healthy for a lunch meal on the run. McDonald’s knows how to move people quickly through a line and get them the food. My doctor was right; it was a perfect choice for me today.

I pulled over in their lot and ate my food; the apple slices were fresh and crisp, the staff was friendly and efficient.  In a day full of surprises, this was yet another one. This is not the greasy and smelly McDonald’s of my youth.  I’m not moved to have dinner there, but if I’m ever pressed for time, I wouldn’t mind going there again. I see this is going to be a time of learning and trying. And next time, I’ll have a girl to bring.