Things I've learned

Over the last couple of weeks, I have learned a few things. Gentle readers, I know you are always on a quest for knowledge, so I will share the highlights.

• If you need to have surgery, schedule it first thing in the morning. Since my surgery was not an emergency sort of thing, I had a fair amount of flexibility in scheduling. They wanted me to have it done in August but that would have meant missing two obedience seminars, a five-day cluster show seven miles from my house and a three-day cluster show with amazing shopping. So that wasn’t going to happen. 

I scheduled for mid-September. I had a 2:30 p.m. time slot. All fine and good except when you factor in no food or drink after midnight. That’s left a lot of time the day of surgery for sitting around hungry and thirsty. Plus when you schedule first thing in the morning, you don’t run the risk of having previously scheduled surgeries taking longer than expected, thus pushing yours back. This happened and my 2:30 p.m. turned into 3:30 p.m. What's another hour of being starved and dehydrated?

• If you have multiple meds to take after surgery, it helps to write down which drug you’re supposed to take and when you’re supposed to take it. Then check it off when you take it. Seriously. I thought I could remember but more than once, the concept of counting forward six hours from 1 p.m. and remembering it at 7 p.m. was more than my anesthesia- and narcotic-fuzzed brain could handle.

• Always take ibuprofen with food.

• Ice cream is food.

• Pain makes your heart beat faster. Lower the pain, lower the heart rate.

• Ask for specifics. When I was discharged from the hospital, my doctor only said “If it hurts, don’t do it.” The problem was that what felt fine on Wednesday had the potential to hurt like hell on Thursday.

• Take a notebook to doctor appointments so you can write things down. It’s amazing how easy it is forget the simplest answer when you have a lot your mind. I even took one to the hospital and kept it on the bedside table. I’ve spent the last 25 years writing down what other people say, why stop now?

• You only get once chance to heal right.

• Nurses are amazing. I don’t know what they get paid but it’s not enough. Appreciate them.

• Steri-strips need to stay on for one week after surgery. Mine were apparently applied with cement. When I peeled them off on Day 10 (with permission), they took a layer of skin with.

• Gals, if you are having a female kind of surgery that might result in bleeding afterward, take your own lady things to the hospital so you'll have what you're comfortable with. After being repeatedly assured by my surgeon and nurses that I would experience “occasional spotting,” I was handed a pad that could have soaked up Lake Michigan. Seriously? 

• Before going to the hospital, I made several of my favorite salads, thinking it would be great to have some tasty things to enjoy when I came home. I don’t know if it was the anesthesia or what, but food didn’t taste right for about the first week. Nothing but toast tasted very good and I ended up throwing out most of my pre-prepared food.

• It’s helpful if you can get any prescriptions filled in advance so you don’t have to mess with an additional stop on the way home from the hospital. My doctor wouldn’t do this (not sure why, I think some will, some won't) so the Farmer went into our local pharmacy on the way home while I sat in the van. In reality, it didn’t take that long but it sure seemed like an eternity while I was waiting.

• Stool softeners + apple cider + grapes = sprint to the bathroom. You have been warned.

• Give yourself permission to do nothing after surgery. I’m one of those people who is always doing something – working, gardening, training, cooking, cleaning, laundry, shopping, teaching a class, helping at a trial, etc.  I’m really lousy at doing nothing. 

Realize that while healing after surgery, the last thing you need is to feel guilty about going back to bed for a nap after breakfast or watching a Harry Potter movie marathon while your co-workers/significant other are working their butts off, doing their jobs and covering for you. Too bad. They didn’t just have their bodies cut into and their guts re-arranged. Make your health your number one priority.

Takin' it easy

When I left the hospital a week ago, my surgeon said “Don’t lift anything heavier than 10 pounds and don’t do anything that hurts.” Well. All right then.

That got me through the first week. Everything hurt. I had four abdominal incisions and each seemed to tag a different group of core muscles. It hurt to move but moving jiggled loose the gas that was lurking in all sorts of places and made it go away, which in turn made everything else hurt less. So I walked. Slowly. For short distances. And probably drove Phoenix crazy. (For the love of doG, woman, can’t you go any faster?!)

But then something miraculous happened. On the seventh day, I FELT GREAT.

I decided this was dangerous business. I felt great but that didn’t change the fact that I’d had major surgery and my guts were held together with stitches – stitches that most certainly were NOT healed after seven days.

I’m not the personality type that believes in no pain, no gain. If a doctor tells me not to do something, I won’t do it. I know people who don’t share this world view, waving a hand casually and saying, “Oh, I’ll be fine.”  Fine for them. Really. Knock yourself out. I will err on the side of caution. A return trip to the hospital for a second surgery to fix something I broke trying to prove how “fine” I was did not sound like fun. Yeah. I’m a weenie like that.

The first week was rough. Did I mention that? I’d never had any kind of surgery before and wasn’t prepared for the post-anesthesia haze. I took care of my animals and slept.

The Farmer was fixing his own meals. He wasn’t fixing mine (he tried) and I wasn’t either. I wasn’t hungry.  (Me? Not hungry? Are you serious?) Food held no allure. I nibbled. I grazed. I lost 3 pounds. (At some point I assume my appetite will come roaring back and this situation will be remedied.) I drank water, took pain meds, ate toast and slept.

The highlight of my day was going to the mailbox. We have a long farm lane so going to get the mail counted as one of the four “walks” I was supposed to take each day. I laughed every time I opened the mail box. Get-well cards from neighbors, co-workers and family all said “Take it easy,” ”Take care of yourself” and “Wishing you rest and recovery.” Cards from dog friends said “You’ll be training soon,” “You’ll be back in the ring in no time!” and “Happy heeling.” 

I love my dog friends. They came to see me. They brought flowers, chocolate and Extra Strength Tylenol. They took me to the bank, the vet and the grocery store. They threw balls for the dogs that actually went further than 10 feet.

Today marks the start of Week Two. Things are looking up. Most of the pain is history and I’m holding a tight rein on the desire to do something stupid like start a gardening marathon or take a long hike in the timber. Walking has progressed beyond a slow plod. Phoenix and Jamie are taking careful care of me. The safety pillow is often employed since Phoenix is prone to fits of exuberance and forgets I am still broken. We still nap a lot. We sit in the autumn sunshine and just . . . exist.

Yep. Life in the fast lane.

Part III: Home

I was discharged from the hospital the next morning after a visit from Dr. R. He told me I’d only lost about a teaspoon of blood during the surgery. Wow. Robotic surgery’s claim to fame is less blood loss, less pain and quicker recovery time than traditional surgery. This sounded great on the surface until I stopped to think that no matter how they get inside, they’re still doing the same procedure once they get in there – cutting ligaments, severing nerves and blood vessels, removing organs. I tried not to think about it.

The Farmer picked me up and we headed home.  From my check-in at 12:30 p.m. the previous day to my checkout the next morning, I was in the hospital 21 ½ hours.

After a stop at the pharmacy for drugs, we were home by 11 a.m. It was a beautiful warm sunny day. I sat at the patio table and the Farmer turned the dogs out to see me, one at a time. Jamie anxiously snuffled me from head to foot, the poster child for gentle concern. That’s my sweet big red dog.

Phoenix shot out of the house like he’d been launched from a cannon. I thought he was going to spontaneously combust. He turned himself inside out, bouncing and squeaking like a deranged chipmunk and tried to jump on my lap (TG I had my “defense pillow” at the ready). That’s my crazy malinut.

I was in bed by 11:10 a.m. and slept for five glorious hours. Phoenix stayed on the bed the whole time, snuggled close and quiet.

I had two different pain meds, one to take every four hours and one every six hours. This was great in theory and sucked in reality. For the first couple days, I was inevitably asleep when it was time to take one or the other. I started a list for each med and when I should take the next dose. This quickly turned into a list of when I should take the next dose and when I actually did take it. Somehow I stayed ahead of the pain. Not sure how, since I don’t think I ever took anything on time.

The first couple of days were a fog of moving between the bedroom and my recliner in the living room. It took Phoenix about 2 minutes to decide I wasn't "right" and needed to be monitored closely. He knew something was wrong with me but couldn’t figure it out. His answer was to get as close as he could. He watched me intently. He napped on the bed with me. He curled up on the recliner with me. I made sure I had my defense pillow clamped across my belly and it all worked out. He was determined to turn my laptop into his own personal pillow and was quite disgruntled when I kept shoving his head off the keyboard.

By the third day I worked up the energy to go outside and sit on the patio and toss a ball. The dogs enjoyed this tremendously but it clarified in their minds that while I throw like a girl when I can stand up and put my whole body behind it, I throw like an even worse girl when I am sitting in a chair. They didn’t actually say that but I caught Phoenix looking at a couple of my weenie throws with an expression on his face like, “Really? That’s all you’ve got?” But he really didn’t care and happily returned the ball with slobbery joy.

We ventured out on short, slow walks. We got the mail. We walked around the farm.  We sat in the sun and petted the cats. We practiced doing nothing. I am generally not good at doing nothing but the combination of pain and drugs changed that. I’m even mastering “endurance napping.”

This is Day 5, I think. The wonderful side-effect of taking narcotic drugs and not going to work is that I don’t have any freaking clue what day of the week it is. The pain is a bit less. The bruises are as colorful as ever. Not only do I feel like I’ve been beaten with a 2x4, I look like it, too. The incision sites, with their sub-q sutures and tight seal of steri-strips, are starting to itch annoyingly, which everyone assures me means the skin is healing. 

I’ve not been eating much, no appetite, which I am also assured is a side-effect of the narcotic pain meds. Unfortunately, I am not allowed to take them forever, so they’ll be gone soon and my appetite will probably come roaring back. In the meantime, friends and the Farmer have actually been concerned I am not eating enough. Me, not eating enough? What are the odds!

Part II: Post-op

I woke up in recovery with no sense of time having passed. My gut felt like someone was stabbing me with jagged knives and I felt like I was going to vomit. The combination was my ultimate nightmare. I have very little pain tolerance (I’m a certifiable weenie) and am prone to motion sickness, which the nurses told me can make the reaction to general anesthesia worse. I remember thinking if I feel this awful with only four incisions in my belly, how do women who get cut wide open for their hysterectomies or have a Caesarean delivery deal with it?

The recovery nurses were great. The minute I started waking up they were right there, telling me I was okay and everything had gone great. I had a hard time talking because my throat was raw after the breathing tube but they understood my raspy whispers and had pain meds and anti-nausea meds in my IV in no time. Within an hour, I was in a private room with family and friends, tired but feeling relatively decent.

I was hooked up to oxygen, IV fluids, pain and nausea meds and antibiotics, a pulse/O2 monitor and had these funky compression wraps around my lower legs. My nurse was talking cheerfully about getting up to go for a walk. Good luck with that, I thought. I had advanced from ice chips to water when the consensus was that I wasn’t going to barf. They were the best ice chips in the world. My nurse's only concern was that my heart rate was pretty high (120 beats per minute, 60-70 is normal) but she felt that would drop as my pain level lowered.

Through the next few hours, I got unhooked from enough equipment that walking became a little more realistic. I wanted to walk because walking sounded like a perfectly normal activity at the end of a very un-normal day. Getting out of bed was the worst part. Ever try getting up from bed or a chair without using your abdominal muscles?

Two nurses accompanied me on my walk. I think one was there to manage the IV pole, the other was there to manage me if I looked like I might tip over. One had an Australian shepherd and the other had an Australian cattle dog so we had a nice conversation up and down the halls of 5 West. I brought my old flannel bathrobe from home so no risk of becoming a bum-flasher. One thing I noticed about patients walking in hospitals is that they are so intensely focused on what they’re doing, they probably wouldn’t notice if the other people in the hall were starkers.

Lisa, my primary nurse that evening was a total rock star when it came to pain management. Really good nurses are like really good dog trainers – they know what you need before you know you need it and they do it without someone else having to tell them. Of the four nurses I had during my stay, three of them were fabulous and one was an idiot who should probably reconsider her career choice.

Anyone who has been in the hospital knows sleep is a rare commodity. I learned that when I had a surprise overnight stay for my heart a few years ago. This time I was prepared for the constant stream of nurses and med techs going in and out of my room all night long, taking vitals, drawing blood, bringing medicine, messing with the IV and constantly asking, “What’s your pain level?” This was usually followed by, “You need to get some sleep.” 

The pain level question was tricky. If I lay totally still and didn’t move, it hummed along at about 3 or 4 on a rising scale from 1-10. If I shifted positions in bed or got out of bed, it rocketed to a dizzying 8. Once I was up and steady on my feet, it dropped back to 5. I asked one of my nurses if it was realistic to achieve a 0 pain level after major surgery. No, she said, not unless you have a morphine pump. I didn’t.

The compression wraps around my calves inflated and deflated rhythmically to keep the blood circulating and prevent clotting. That was all fine and good except several times they would start to inflate just as I was dozing off, giving me the unnerving sensation of someone grabbing my leg in the dark.

Through all of this, I’d been drinking water like mad. My mouth was constantly dry and sticky. I could not get enough water. What goes in must come out. Bathroom trips meant having to get unhooked from the leg compression wraps, then juggling the IV pole and all nine yards of fabric in the stylish hospital gown to get to the potty.

About those gowns - apparently one size fits all if you are a 250-pound man. If you are a 145-pound woman, well, it still fits but the look is a little different.

The type of surgery I had involved CO2 gas being pumped into my abdomen to inflate it, so the surgeon could have a good view of where he was working via a teeny-tiny camera inserted near my belly button. When surgery is over, they try to remove as much of the gas as possible but some remains in the abdomen. It rises and lodges in the area of the right shoulder before dissipating. Bizarre, but at about 3 a.m. the pain in my shoulder dominated pain anywhere else.  Fortunately, it was short lived.

I had been entertaining myself in pre-op by thinking about being able to eat supper later that evening. When the subject of food came up, about 10 p.m., I found I had no appetite and did not want to tempt fate. Lisa suggested I needed to eat something to get my gut functioning again. I ate a small container of applesauce and some crackers, washed it down with another gallon of water and called it good. So much for my much anticipated meal!

Tomorrow, Part III: Home

Part I: Life

“Life is what happens while you are busy making plans.” John Lennon

Regular readers of this blog (all 4 of you) know I spent a couple of months in the spring and early summer doing the Great Purge of 2013. I went through our house room by room and got rid of everything I didn’t use or didn’t need and tons of things that didn’t work right or were just plain outdated and taking up space.

In keeping with that theme, I had a total hysterectomy on Sept. 18.

It wasn’t intentionally part of the Great Purge of 2013 but it worked well with that theme since my lady parts fit into a number of the above categories.

The hysterectomy wasn’t my idea, but after yet another visit to my gynecologist because of yet another abnormal test result, he finally said, “I think we need to talk about taking everything out.” Since I assume I have some male readers, I’ll spare you the details. If you’re like the Farmer, calving cows is one thing but talking about “woman problems” is something else entirely. (Poor Farmer. It took him awhile before he could talk about it with me and now that it’s over, I’m not sure who’s more relieved, me or him.)

I’m 48 years old and have all my original parts: tonsils, appendix, gallbladder, adenoids, spleen and whatever else an otherwise normally healthy human might have parted company with over the better part of four decades. I’d never had any type of surgery. Never had anesthesia. I’ve never even had stitches. (That’s not the same as never needing stitches but that’s another story.)

“Think about it,” said Dr. R.

I thought about it. A week later, Dr. R. called me with the latest round of test results. The endometrial biopsies had come back abnormal. He felt my chances of developing uterine, cervical or ovarian cancer were high. Combined with the endometriosis, fibroids and periods from hell, that was the last straw.

In mid-June I scheduled the surgery for Sept. 18, the earliest available date for my surgeon. It would be out-patient surgery and I would spend one night in the hospital, technically a “23 hour observation.”

I told my mom, the gals I work with and my closest dog friends. I did not tell everyone in the world because I did not want to deal with three months of listening to how someone’s neighbor’s sister’s niece had similar surgery and how she had horrible complications, stayed in the hospital for a week and was in pain for months afterward. I needed positive energy and stayed away from people who tend to be energy vampires.

I spent three months making pre-surgery lists: things I needed to buy, things I needed to get done around the house, things I needed to get done at work, things I needed the Farmer to do and things I needed to take to the hospital. I had sticky notes plastered on every conceivable surface at work and a never-ending stack of lists scattered like leaves on the kitchen counter.

The time flew. I had a wonderful summer. By Sept. 17, I had everything crossed off all my lists. The day of surgery, the Farmer, my mom and my aunt (who is like a second mom) came to the hospital. My good obedience and agility friend Michele came, too. Amy, another dear dog training friend who works at the hospital, stopped to see me while I was in pre-op.

Hospitals are very thorough places. They want to make sure they have the correct information. The admitting nurse, the pre-op nurse, the surgeon and the anesthesiologist all asked me questions. The same questions. Repeatedly. I was starting to feel like it was some kind of memory test.

Thank the Lord for friends whose sense of humor rises to the occasion. I am so grateful for Michele and Amy being there. It’s wonderful to have friends who can laugh about totally inappropriate things. One nurse commented on the “party” going on in pre-op room #12. She made a passing reference to calling the cops. She was kidding. I think.

My surgery ended up being delayed about an hour. We were laughing so hard I didn’t have time to worry about it. (Note to self: if I ever have to have surgery again, it’s going to be scheduled at 7 a.m., not mid-afternoon. What was I thinking.)

The anesthesiologist came in and we chatted. He asked if I was feeling anxious or panicky and offered me a nice drug cocktail so I could relax. I said no, thanks. I was not feeling anxious. Hungry, yes. I can barely go between meals without eating and it had been almost 48 hours since I’d had solid food. Thirsty, yes. No liquids since midnight and now it was 3:30 in the afternoon. Slightly hollow, from having an empty stomach and empty bowels from doing a colon prep the previous evening. But not anxious. I was honestly excited to get this behind me and get on with my life.

Besides I wanted to see the inside of the operating room before they knocked me out. I had a DaVinci robotic hysterectomy, where the surgeon guides the robot but the machine does the actual procedure. If I was going to get spayed by R2D2, I wanted to see him first.

Finally, after an eternity of waiting in pre-op, a nurse came to get me.

The operating room was big, cold and very busy. There were a lot of people there – the surgeon, the anesthesiologist and four nurses. The robot was big and draped with cloths so I really didn’t get to see much of it. I transferred myself from the gurney to the surgical table and they gave me a pillow and covered me with warm blankets.

I remember the anesthesiologist saying, “I’m putting something in your IV now,” and that was that, no counting down backwards, no time to go to my happy place, just instant oblivion.

Tomorrow, Part II: Post-op

The ultimate photobomb

II was taking street scene pics in Amana this afternoon for a community guide when this little guy literally got in my face. He came up out of a flowerbox about 6 inches in front of my nose. After deciding no, I hadn't peed my pants, I abandoned the street scenes and focused on him.

My previous experience with trying to photograph hummingbirds (or is this a hummingbird moth? I'm pretty clueless) is that the instant you point a camera at them, they disappear. Or they move so dang fast my elementary photo skills are not up to the task.

Not this time. This fellow was very amenable to being stalked. He even buzzed me a couple of times. Do you know what it feels like to have hummingbird wings brush your ear? Slightly more delicate than malinois teeth snapping in the same vicinity. Both qualify as a religious experience.

Who says you shouldn't stick your tongue out in pictures? I think he's kind of adorable.

If any of you bird-y peeps out there could identify his species, I'd love to know more. We have several who are regular visitors at home, too.

Mountain and molehills

Where does failure begin?

That’s kind of a depressing thought, sorry, but it’s a valuable concept. Denise Fenzi spoke about it briefly at the seminar I attended last month and I thought it was worth sharing.

Let’s look at ring failure - executing an exercise so badly you do not receive 50 percent of the available points for that exercise. Most of us would agree that going into the ring amplifies every weak element of our dogs’ training. Small molehill errors in training become large mountainous failures in the ring. Most of us would also agree it’s easy overlook the implications of those weak elements when we train. We may have gotten so good at overlooking them, we don’t even realize they exist.

Here’s an example. You’re training your dog at the club building. You throw your dumbbell and send  your dog. He’s looking at a dog in another ring and responds slowly. He heads toward his dumbbell then stops and sniffs a spot on the floor. He quits sniffing and continues on toward the dumbbell. Someone opens the door and walks in. Your dog stops and stares at them. He eventually remembers what he’s doing, pounces on his dumbbell with delight and sends it spinning across the floor. Your dog finally picks up his dumbbell and slowly ambles back to you. You take the dumbbell and praise him for the wonderful retrieve, affirming in his mind that his performance was acceptable if not downright brilliant.

Now you’re at a trial. You throw your dumbbell and send your dog. He starts off toward the dumbbell but gets distracted by something on the mats. He begins to sniff. He sniffs and sniffs. He sniffs so much he completely forgets what he is doing. Finally, the judge picks up your dumbbell and says, “I’m sorry.” You come out of the ring and wail, “But he’s never done that before!”

Really?

I’m as guilty as the next guy of letting things slide in training. It’s so easy. A second command here, a do-over there. Just a little help. A little cookie to get the attention back. A little body language to help the dog remember what to do. It wasn’t until Denise’s seminar that I started to see all those little “helps” for what the really are: the beginning of failure.

Look at the dog in our training example: he began to fail four different times throughout that exercise and each time his trainer SHOULD have stopped and addressed the issue at hand even though it wasn’t a black and white immediate failure. 1) He wasn’t engaged with his handler at the start of the exercise. 2) He stopped to sniff on his way to the dumbbell. 3) He stopped to look at the person who came into the building. 4) He had a horrible pickup that could have knocked the dumbbell completely out of the ring. Instead of addressing lack of engagement, inability to work through distractions and poor technical skills, the trainer let it go because each time it wasn’t technically a failure to retrieve.

But when the team went into the show ring, it became exactly that because showing amplifies the tiniest of performance glitches.

So what does this mean? Should we all become obedience Nazis who nag and nitpick every tiny error in practice, whether real or imagined?

Of course not. Just be aware. Stop and think about the times you let your dog have do-overs and second chances in practice. They mean something. They are an indicator of confusion or misunderstanding or the dog making a choice not to perform. It doesn’t matter how fabulous a retrieve your dog has — he’s going to fail if he gets so distracted by spots on the mat that he forgets about his dumbbell.

Working Phoenix the last few weeks, I’ve gotten much better at identifying our “beginning to fail” moments. With him, they tend to come between exercises, while moving from Point A to Point B or while setting up, when he starts to check out or look around for things he might rather do. Being able to pinpoint those “aha!” moments allows me to address the molehills before they become mountains. It’s not nearly as easy as giving him a do-over but I am confident it will produce a more agreeable outcome down the road.