VATS pleurectomy: Day two post-op

Wednesday 13th May 2015
Recovery from a pleurectomy and bullectomy to treat reoccurring spontaneous pneumothorax.

The sleep

First of all with a chest drain in your side you don't have much choice but to lay on your back and the surgery leaves your chest feeling heavy if you lay flat. So the end result is sitting as upright as possible and piling up the pillows to try and prevent your neck from lolling from side to side. It took a while, but eventually I was felt that I was comfortable enough to try and get some sleep. During the night however I began to feel quite rotten and realised that it might actually be the morphine making me feel the way I did. I was sick, lethargic and I could feel my pulse in my throat when i tried to sleep. It was absolutely racing and I was sure this couldn't be good for me...which led to me feeling anxious and my pulse rate increasing even more. 

It is difficult to describe the feeling properly, I felt a little like every time I relaxed to fall to sleep there was pressure on my windpipe, as though someone had just placed a finger lightly on the area. It wasn't stopping me from breathing, but it it felt so uncomfortable that it was all I could focus on. It is something I have experienced since then too, however reading online it seems it may be to do more with anxiety. On this night in particular I feel that I was extremely anxious, I was much more aware of what was happening and spent a lot more time thinking about this and panicking as oppose to relaxing and sleeping. Looking back to one point in particular I think I may have been having a minor panic attack. As before, my pulse was racing and the more I focused and worried about this the worse I got and I began experiencing heart palpitations. The sickness and dizziness, alongside the discomfort from the drain, made it difficult for me to move and become more comfortable and I felt horribly trapped. In hindsight it seems silly, but it did cross my mind that maybe my body was just failing, and maybe if I fell asleep I would stop breathing. I know it seems overdramatic now to say I felt like this, that I was actually worrying about not seeing people again, but you cant help where your mind goes at times like that and mine wasn't in a very positive state at all. Apparently I don't get the good kind of high from morphine...quite the opposite. These thoughts of course made me panic even more and becoming very upset I ended up calling for a nurse. The nurse helped me up and tried to get me more comfy. She said my stats were fine but let me have some oxygen to help ease my concerns. This did help, and being so exhausted I eventually did my best to try and relax and fall asleep. It must have happened eventually and I awoke in the morning feeling a little less tired than the day before and also a little silly. 

Please...no more morphine

Having woken up with the memory of that nights traumatic sleep, I decided that it was time to stop pressing the magical morphine pump to ease my pain. I figured its purpose was to dull the pain enough that I could do things and get moving, not turn me into something that was barely able to sit up in bed without feeling unwell. So I told the nurse I wanted out and I waited for the awful pain that would surely start to creep over me.

It didn't. I was given other painkillers instead, which had time to build up whilst the morphine wore off, and did the job. Maybe not quite as well, but enough that I was comfortable. And so toward the afternoon I began to feel a little more like me. In fact considering the lack of sleep and the fact that yesterday I was basically unable to speak or move and practically passed out...the difference in my energy was quite miraculous and was noted by those who came to visit :)

Physio

Today was a better day as far as physio was concerned. I was able to get the magical spiroball up to around 2000ml regularly and occasionally to 2500ml! The arm exercises were still not too great, I was very stiff and the feeling of the drain moving in my side made it feel very strange. I also still felt a little dizzy standing, although was informed it would be the morphine still leaving my system. 
Coughing today was also better. And when they say don't be afraid to cough hard, trust them. It's difficult because you are terrified your lung with collapse again with the strain, but it won't. In fact most of the discomfort you will feel has nothing to do with your lungs and is more to do with your muscles and the drain in your side. So cough away!! Also a pillow held over the chest as you cough helps no end, just stops the rattling of the ribs a little. 
So anyway...coughing was much better today, a lot stronger and no bubbles in the chest drain! WOO!! NO BUBBLES!!!! You will be as excited as I was when you hear that because it means things have healed :) The pleurectomy had worked and my lung was no longer losing air. This meant I might get off the darn suction!

Numbness

Still numbness under the armpit and down the inside of my arm. My hand also felt like it was very weak and I was having difficulty holding things properly. Asked the doc again and was once again told it should go away with time, it will likely be nerve damage from the op and also from the drain pressing on my nerves whilst it sits in my chest. I will keep an eye on this though. Worries me slightly. 

Suction off!

So by about 10 o'clock I was off the suction and able to walk about the ward a little. Had to take it very easy at first, remember the morphine! But it was nice just to walk down the corridor and look out of the window. Freedom! It was also very strange having to carry around a lovely drain full of bodily fluids, you definitely got some strange looks off of some visitors and I don't blame them, it is pretty gross. Also take care not to catch the drain on anything. I happened to sit down and upon standing up again the drain had looped under the chair. Just a slight tug to the tube in my side which freaked me out, but all was OK. I think they are in there pretty securely, my neighbour stood on hers in the bathroom and yanked it hard but it stayed in place. Also another thing I will note here is that although the drain tube looks huge...the part that goes into your chest is a lot thinner, so don't panic if you arrive and see someone like me wandering around with this monstrosity sticking out of them, it isn't as bad as it looks and it doesn't really hurt at all.

A couple of hours later and the surgeon had come round to see me. I was told hopefully I would have the drain out tomorrow and be going home :) Wow!! This was all suddenly improving very quickly. I had another X-ray to ensure that the lung was doing well off the suction and waited to get the results. 

Wait over...things looked good :) So I started to prepare myself for the idea of being home tomorrow, at last :)

The wonderful chest drain that you get to carry around with you. 

Using a proper toilet again

This may seem like a strange milestone to include, but it was amazing! Having used comodes for the past two days and been restricted to the bedside (usually the bed) it felt so good not only to WALK to the bathroom, but be able to use the loo in private. Granted it wasn't all that easy, after sitting down I realised the toilet paper was in an awkward place to reach with a drain in the side, so that was a challenge and so too was making sure you didn't catch your drain in the process of sitting down, getting up, washing hand etc. Some advice from me would be to ask for a chair in the bathroom to stand your drain on, it helps to keep it out of the way and is easier to pick up than reaching for the floor. Also, grab the loo roll before you sit down.....makes life a lot easier. 

Organised mess

I was informed by the nurses on numerous occasions that "oh aren't you a messy one!" "Do you make this much mess at home?" Well, firstly yes I am and yes I do...unfortunately for him my poor boyfriend tends to be the tidy one out of the two of us, but also....what do expect at the moment!?
I may be messy at home, but I wouldn't normally take the opportunity to make a mess in someone else's home or indeed a hotel etc. I have to say though that at that moment being tidy was not not high up on my list of priorities, especially as I could barely lift myself up out of bed. I might be off suction and able to do a bit of walking about, but when laid in bed and having finally found that perfect comfortable spot, moving wasn't an option. You lift yourself off the pillows and that's it, they have fallen out of place and you are doomed to be uncomfortable until a loved one comes back again to fix them for you. The nurses did their best, but unfortunately for me their suggestions of a comfortable way to place the pillows was never quite right and I felt like I was being a little too picky to keep asking them to alter them slightly. 
So...messy I was. If it fell on the floor, it stayed there, if it was left at the foot of the bed, it stayed there too. Annoyingly they kept placing rolled up blankets on the foot of my bed as spares, which only served to take up leg room that I already didn't have (6ft tall remember). I fell asleep every night with my feet pressed up against the bottom of my bed and woke up every morning with cramp in my heel....my heel! I didn't even know this was possible!
As for the little table that becomes your go to place for everything, this was also undoubtedly messy. I spent a long time before getting comfortable organising every inch of the table so that everything I could want would be within easy reach. So my phone, water, any remotes or tablets were placed as near to the edge as possible with card photos etc placed so I could see them. It was just as I wanted it...until lunch time when they came along and ruined all my hard work by placing a tray on the table full of food that I was never going to eat anyway. On one occasion I couldn't even reach the cutlery to eat my meal. And good luck calling a nurse to help you out during lunch hour, they are as they said "too busy serving food to answer the buzzer" This happened once when I was using the commode. I called the bell as I told to once I was finished, and waited and waited and waited with the annoying sound of the nurse alarm going off above my head. I called out a couple of times to no avail, and eventually just sat there frustrated and upset at the fact the all I could smell was my own wee and the fact that I was too weak to lift myself up and do anything about it. To make matters worse, because it was lunch I had a plate of food next to me the whole time which I became very put off eating during this experience! Eventually the nurse arrived and asked if I was OK. I said "not really, I rang the bell as asked about 10 minutes ago and no one has come" The reply..." Well it's lunch time, everyone is busy" Not even an apology. 
Anyway I have wandered off topic a little here, but my advice is, place items that you really need on your bed, by your side...this way they cant be out of reach, and always make sure they leave the water close enough, especially as you will probably need this to swallow food with as the pain killers give you a dry mouth. Also, ask your family or friends to bring food with them, I found it best to ask for the kind of sandwich that you crave when your hungover, for me it was tuna. At least this way you are more likely to eat something other than a yoghurt! 
Also, as I found it difficult to eat a lot all at once, the nurses were kind enough to fetch me toast throughout the day to nibble on which was a great help. 

So the rest of the day involved trying to get up and about more, visits from the family and an attempt at eating some food. Tried to watch the TV but found this just made me feel more dizzy, so I was left to just ponder my own thoughts.