Monday 19 November 2018

Post op para...





Well I thought I write a short piece about how I am coping after a small operation on my wrist. I have suffered with symptoms of carpal tunnel for about 5 years. Carpal tunnel is a syndrome due to the compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness and tingling in the middle finger and the thumb. This is a common condition and the major causes are trauma, overuse and pregnancy!! WTF I am defiantly not pregnant. I have been suffering with pain/buzzing sensations that have kept me awake at night for years and since my spinal injury this wheeling around everywhere has totally exacerbated the symptoms and at times brought me to tears as it’s so painful but also so debilitating.

Since my para status I have had pain in my right wrist and my left, but the right hand has been so much worse, to the point that I drop things, when am holding the phone or pen at work I find it so uncomfortable. Well I was initially referred to the CATS team for physio. I saw a great physio and we discussed exercises, which I did and it didn’t really help much, then we discussed having cortisone injections. Well over the last 18 months I have had 4 cortisone injections into my wrist, these injections are given directly into area to help reduce the swelling of the nerve. Symptoms from nerves generally take longer to respond and it would normally take about a week for it to work. They have all worked really well and once the symptoms have gone it feel’s great. But this was only masking the condition and the injection only ever lasted about 12 weeks ish and then the symptoms came back!! After 4 injections the doctors were reluctant to do anymore.

I was then referred to a consultant Mr Amirfeyz, he has been really helpful and discussed all the advantages and disadvantages, to be honest the advantages long term out way the short term discomfort. So through my work I have private medical insurance so we booked a date to go in for the surgery. As you can imagine the surgeon says it’s a 10 minuet operation and you can go home the same day!! Well that was when I started to get some concerns as to how I would manage. In trying to be as organised as I could I set about trying to make my life as easy as possible. I obviously called on my contacts from my District Nursing team where I use to be team leader, so I was able to order a hospital bed to be delivered for uses downstairs as I knew I wouldn’t be able to transfer very well, let alone get up 2 floors in a town house.

So as it’s been nearly 9 months since I started my extension and building work, I still don’t have a downstairs wet room in, the tiles and floor has been done, just waiting for the Plummer to fit the suit now. So sleeping down stairs is a good idea from a transferring point of view but not great from a showering and bathroom point of view. Well I am as ready as I will ever be; I asked the consultant if I could stay in hospital for a rest and recuperation post op, he said go home!! You get less infection risk!! Hahah has he seen my house??? Well I got my date and my right wrist carpal tunnel release was planned for October 8th. I booked 2 weeks off work to recover and it falls well with my holiday also as am off to Cape Verdi for a bit of sunbathing. Hopefully after my recovery and holiday I will be like a new person!!

 

Well on the morning of the 8th I went into the Spire hospital in Bristol, I was first on the afternoon list and when I got in I was met by a great team of staff each wanted to do their job, assess, admit etc.… Mr Amirfeyz came in and I transferred into the bed and he gave me a nerve block into in right hand.. let’s just say ouch that was not comfortable, well after a good hour I had no feeling at all in my hand, this was due to the aesthetic and as I was having the procedure under a local anaesthetic and not a general once I had no feeling I knew it wouldn’t  be long  till I went down. It’s strange being a patient when you’re a nurse as you look at things differently; I was wheeled on my bed into theatre and then transferred onto the operating table, which apparently is heated!! The staff said you’ll feel comfortable and warm; well it always makes me laugh as I can’t actually feel quite a lot.

Once the procedure was started I couldn’t feel pain, but odd sensations, I could hear the diathermy burning and smell scorching flesh!!  Reminds me of my nurse training days, I actually watched a carpal tunnel op in the days of Frenchay hospital. Well the consultant talked to me all the way through telling me what he was doing and true to his word he took less than 10 minutes!! More like 5 minutes.. And having no feeling in my hand I had no pain either. I had a cortisone injection into my left wrist to help with the symptoms and this was numb as well.  Back to the ward I went. I had a sandwich and a cuppa tea on tray with a tea pot and cup and saucer, this is the difference between private and NHS and then I saw a physio who gave me a sheet of paper with exercises on and an appointment for 2 weeks’ time in hand clinic, I saw the pharmacy who brought me loads of pain killers!! I wonder if they know something I don’t for once the nerve block wears off??? . Then I was free to go home. Think I was in there a total of 4 hours!

Well it was only when I tried to get off the bed back into my wheel chair I think then I suddenly realised how hard this was going to be. I managed to flop in to the chair with my PA Janes help and get to the toilet. Once in the loo I had my ISC catheters, and one hand to remove my trousers and use the catheter!! Well let’s just say it took ages... Good job I’ve got 2 weeks off work as it takes that long in the bathroom….. Getting into the passenger seat in the car was entertaining too. I had to use my slide board and like pull in with one arm, the whole thing was extremely difficult. I had realised how hard this would be for me as I have become so independent asking for help is hard. I even hate being pushed in my wheelchair, but needed help as pushing with one hand makes you go round in circles!!. I can’t really do the method of using one hand on both wheels as can’t reach over me with left hand to comfortably get grip on my right wheel. So I will have to have some help.

So with both hands with no feeling and both numb made being an independent para impossible, I was so glad I had ordered a bed for downstairs as the transferring was not easy at all, I went to bed early taking only paracetamol as I didn’t want to bung myself up with codeine.. As managing my bladder and bowels is always my worst fear. Well once the nerve block wore off then the pain was quite bad, if I didn’t move my hand or knock it, it was fine. I suddenly was finding my bladder playing up and started being wet, by waking up in a puddle and not being able to shower or move it was getting quite hard to manage, I carried on trying to manage for a couple of days but the bladder obviously has been upset by the ?? Anaesthetic, or something as so sensitive and can’t transfer to the loo, I have been using catheters kits with a bag attached to minimise the need to transfer, but it was still proving too much.

I made a decision to put a indwelling catheter in. I have passed lots of catheters over my time, but not with one hand and while not being able to move my legs!! Well my skills are still pretty good and I managed with not too much difficulty.  At first I just went free drainage and drank loads to flush out traumatic insertion it wasn’t but flushing out is good. I used a flip flow and night bag while in bed. Straight away this made things easier so I can now concentrate on recovering and resting. Without being wet and having to keep changing, washing and transferring. To be honest I should have put one in straight away, but I was trying to put off needing one. Just to make things easier, well doing bowel care with a left hand is more difficult than it seems.

Getting dressed with one hand, trying to wash and change all the small things I take for granted now, it makes me think how hard it must be for individuals who are tetra-pelagic. Well now each day post op things are getting easier, I haven’t left the house all week, I haven’t brushed my hair, as Stella’s been doing it for me. By Friday I am managing a bit better, getting use to using my left hand and right arm instead of my hand and making a fist to transfer. I went out with my daughter Stella and sister Vicky and niece Jasmine to St Brendon’s college open day on Saturday, This was the first time left the house, Vicky drove my car and we managed to slide me in!! I did struggle a bit trying to push myself around as my daughter does find it hard in public to push me if needed. Had to take some extra paracetamol after today and I had an early night as was pretty shattered again.

It’s quite difficult and I can’t drive yet, I think after the weekend I may find that I will be able to do a bit more, I am doing the hand exercises that the physio gave me. I  have removed the pressure dressing of my wrist now as I was told to do and I will be having the stiches out in another 7 days, I will continue to write a blog of how my week goes and let you know when I have BWO!!!! Hahaha  

Over the last few days I have been able to manage a little better, now I have actually stopped wheeling in a circle as can actually gently push myself now using my right hand. I still can’t put weight on it very well but it is improving and I can now manage a transfer on to the loo.. #goals!!!!! I am well chuffed. I am actually doing as I am told, using my fingers and doing my hand exercises, but I remember the consultant saying the pain could last up to 3 months, I hope this isn’t the case as I am really missing my activities like swimming, the gym and riding. I really want to step it all up and push myself more.

Yayyyy 7 days post op and I managed to transfer myself out of bed this morning into my wheelchair, not gracefully let me add.. But I did it. I am using this quiet time to catch up with all my admin, which actually takes over my life at times. I really like doing my blog as I’ve said before I can be like therapy, looking back how far I have come, not only me but my children, family and friends.

The week is going so fast and I can’t believe it’s nearly 2 weeks since the op. I am now well and truly rested up. I don’t think I’ve spent so long in the house being quiet, resting, reading pottering in the last 3 years. Well I can now transfer independently and have managed to go upstairs on my own for a shower, I have decided to leave my indwelling catheter in as I am due to go on holiday soon, and I always have to put a catheter in for the holiday and flight. As long haul flights I am confined to the seat for a few hours, I will also wear flight socks and a leg bag so I can drink plenty of fluids as not to get dehydrated. But the catheter can sometimes be quite easy when you are away.

I am well into the second week post op now and things are getting so much better, I have been to see the consultant for my post op follow up. I had the stiches removed and the wound is dry and healing well, just need to get some Bio oil apparently this will help the scar and heal the wound by moisturising it. So I have been signed off as the team are really pleased with the progress, I am still wearing a hand bandage so the wound is not exposed as when I push my wheelchair it feels dirty. I need to keep it clean and infection free. Well I am now happier that I can go on holiday and not worry about my hand, also the horrible symptoms that I had for so long have gone now.

I waited a full 2 weeks before I drove the car and only went a short distance, it was difficult getting into the car as I couldn’t push on my right hand but I used the steering wheel to pull myself up into the car, and I use my right hand on the break so I just tried to make sure I was steady and didn’t apply the break to hard, it seemed to go well. Which I am glad as I will be driving to Gatwick in a couple of days!! That’s about 3 hours away. As the days went by things have been gradually improving. Which is great as I am looking forward to a holiday to Cape Verde to celebrate my dad’s 80th birthday?

As the weeks go by post operation the wound is healing well and I am becoming more independent. I have the hand/wound uncovered now and 2 weeks in the sunshine did wonders for my recovery. Now back home and it’s sort of hit the ground running, washing, loads of it!! back to work and driving. I am now getting a bit of pain in my hand and wrist and especially over the new skin on the wound it is very tender.

I find putting my weight on it hard for transferring and it’s defiantly lost a lot of power, it’s very weak. I think now at 6 weeks post op things have got easier but I am still cautious about looking after it. I have enjoyed this small journey explaining how such a small operation can affect my independence so much. I have to go back to see the consultant in December and he is thinking of doing my other hand!! If I’m honest not sure I want it done this soon, but it’s good to get it over and done with its causing me concerns as I want to get back in the saddle as soon as I can but obviously I have to listen to the advice from the medical team as my hands are so important to me. Well onwards and upwards now!!

This para lark is hard going at times!!!!!