Absolutely everything you want to know about abdominoplasty
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hapter n the Recovery Room
My surgery was approximately two hours. I awoke on a gurney in a recovery room with a few other patients whom had undergone reconstructive surgery that day. I was catheterized and wearing a binder around the trunk of my body and sequential compression devices on my legs. I also had two tubes coming out of my pubic mound to pull excess blood and fluids into bulb drains.
I was in a heavy stupor but still felt in a good deal of pain and my throat was utterly parched. The nurse gave me Dilaudid and Percocet and I was in out and out of consciousness for quite some time. At some later point, a nurse spoon fed me crushed ice and then some apple sauce. I mostly slept for the 3-hours in recovery, until my ambulance transport arrived to take me to the rehabilitation center where I would spend the night.
What had been running through my mind at this point was how painful it was going to be for me to move myself from the hospital gurney to the EMS stretcher. I recalled back to my Cesarean section when the medical team that had just delivered my baby made me get myself from the operating table onto the gurney. It was so painful that I remember it nearly 30-years later.
Fortunately, the two ambulance personnel and two nurses together lifted the sheet that I was on and moved me to the stretcher. This sent a searing pain through my upper abdomen but was not as bad as I had experienced after the c-section when I had moved myself. The team wrapped me in lots of extra blankets as I was to be taken through the medical plaza and out into the ambulance.
Overnight in Rehab
Some twenty minutes later, I arrived at the rehabilitation center (which also was a long term care facility). Here I was put into a suite with another woman that was recovering from surgery. And I was very thankful not to be placed into a room with one of the LTC residents. I was moved from the stretcher to the hospital bed, and again moved "up" to the head of the bed. It was painful. Then they put the bed into "beach chair" position and placed a pillow under my knees. All of this was done to make me as comfortable as possible, but all the movement had put me in a lot of pain.
A nurse, or maybe it was an aide, put sequential compression devices on my legs to prevent blood clots. Blood clots are perhaps the most serious risk associated with a tummy tuck, although the likelihood of a clot is low. I told the nurse (or aide?) that the device was not working properly but she insisted it was. Strike one for the rehab. TED AntiEmbolism Stockings were also to be put on my legs (I found this out later when I read my orders) but they were not. Strike two. Also a bilateral lower extremity doppler ultrasound would be performed the day of discharge to ensure there were no blood clots i my legs. And an anticoagulant would be prescribed a few days post op to further prevent clots.
I am in Pain
Unfortunately it was too soon to get pain meds upon arrival at the rehab. I needed more at this point from all of the movement. I'd previously had surgeries in the abdominal area: gastric bypass and a Cesarean section. I had expected the level of pain from the tummy tuck to be similar, but this surgery was much more painful than I had expected.
For pain, I was prescribed two Percocet every 4-hours as needed. However, the pain flared at 3-hours and then it took 30-min for the Percocet to take effect once I was dosed. So, I was in significant pain for 90-minutes of every 4-hours. And since the pain meds were prescribed "as needed" it meant that the nurse would not automatically give them to me every 4-hours. I had to watch the clock and ask for my pain meds when 4-hours had passed.
I soon learned that it took the nurse 30-min to get my meds -- so when 3.5-hrs had passed I would ask any and every aide and the nurse for my pain killers. This was not the fault of the nurse. The surgical coordinator at my surgeon's office, unbeknownst to me, was supposed to give the scripts to me ahead of time so that I could bring them with me. Strike one for the surgical coordinator. She also failed to provide me with pre-op instructions and post-op instructions. Strike two and strike three.
I also was prescribed three courses of Ciprofloxacin, and Colace twice per day.
I hardly slept a wink at the rehab that night. It was a very noisy place with patient "bells" for assistance going off almost incessantly. If I needed something, it took an average of 30-minutes for an aide or nurse to respond. That is not to say the staff performed slowly but rather the facility seemed to be a bit understaffed for how busy they were that night. They certainly were busy -- a nurse and the nurse supervisor got into an argument in front of me and my roommate over too many admissions.
The point is, the long response time was concerning to me -- what if I had a medical emergency? Since the staff did not provide wound care, I wondered why I was there? I think I may have received better treatment at home. In fact, the sequential compression devices on my legs that I earlier had alerted the nurse (or aide) was not working properly, completely stopped working in the middle of the night. Strike three for the rehab.
That said, the overnight stay allowed me to be near my surgeon if something did go wrong. At home I would have been a good 90-minutes away. So, I suppose that I have answered my own question. Weeks later in my recovery, I would learn how important it was to be near my surgeon - but by that time I was 700 miles away.
Continue reading Part 7 of this article.
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