Surgery 6-week follow up

My spine surgery was six weeks ago tomorrow; hard to imagine, really, that it’s been that long. I had a follow up appointment today with the surgeon and had smooth transportation to and from his office using the Meadow Lake van, which is equipped for wheelchair transport. I had a long list of questions for him that didn’t take that long to ask, really, but I felt that he listened and heard me, and answered what he could.

First, the small wound in my back isn’t bad and is superficial but it appears to be infected, so he put me on antibiotics for two weeks. Second, he is taking me off of Lyrica and Cymbalta which I started taking in the hospital. Neither of us thought I needed them, so I’ll taper off and then stop, which is fine with me. I don’t want to be taking meds just because someone put me on them. [And that reminds me that a doctor here, without talking with me or seeing any test results, decided to put me on liquid protein twice a day. It tastes foul and I’m refusing to take it, instead eating protein bars in my drawer that have twice as much protein.]

One of my biggest questions/concerns was bending. I can’t go home until I can put my shoes on myself, and I can’t do that until I can bend. The doctor told me I can start bending and twisting now as I can tolerate it, which should mean handling shoes and doing some bathroom cleanup that wasn’t possible before. I’m thrilled.

I also asked about the “heavy leg” sensation where my right foot feel as though it’s wrapped in a weight. Unfortunately, this seems to be related to the surgery and could last for quite a while. Full recovery for both the stenosis surgery and the conus swelling that’s causing the leg weakness will take 8 months to a year, and I need to be patient. There isn’t a road map as to what will come back first if at all; no two people are alike. So I just have to wait it out.

But he said I also need to be working to strengthen my muscles as much as I possibly can in the next months. I got the impression that could make a difference as to how much of a recovery I get. I’m doing therapy every day here, but when I go home, I need to keep that up and not limit myself to whatever days of additional formal therapy I get. The doctor was surprised, I think pleasantly so, when I told him that I was walking about 275 feet a day with breaks, and could swing my legs on and off bed, and he wanted me to continue with that progress. Me, too.

Because I am a nerd…

… I took my little pieces of paper with monthly weight and measurements and made a spreadsheet. It’s one thing to KNOW, but something else to SEE the progress.

And I can see patterns. I lose a lot and then I don’t and then I do. Since things shut down with coronavirus in March through August 1st, I lost almost 20 lbs instead of gaining the Covid-19. Measurements didn’t change much in the last few months, though, and I know that’s because my exercise trailed off.

And why was that, you ask? Because my back felt like someone was stabbing me with a hot poker in the middle of my butt sending pain down the right leg. And because I tore my MCL on the right knee as well as other tissues, without knowing I did it. I just knew it hurt. Right now more exercise is on hold until I get my custom knee brace to keep the knee from wobbling; then I can get back to doing more without fear of falling. I really miss the NuStep and want to figure out how and where to do pool exercise. It’s tricky because adult swim time at our local pool is during my work hours and I really don’t want to be in the pool with young, slim people who will make fun of me. Notice the confidence level.

Although I’ve seen a bunch of doctors in the last month (ENT, pain dr, orthopod) and had surgery, injections, and tests, I haven’t seen my primary care doctor since February. I decided I needed to make an appointment for a Well Woman checkup and will be actually seeing the nurse practitioner who is covering for her patients, since my PCP is out on maternity leave. My goal is to see how healthy I am now that I’m down 10 BMI points. I had a bunch of blood work done related to the surgery but not triglicerides and cholesterol, which are my problems. I would really like to get rid of some of the meds that I’m taking. I take 2 diuretics and then have to take prescription potassium for the heart because I’m taking the diuretics. I’m not sure that I need them so am hoping we can make some changes. That appointment will be Thursday; Monday I get fitted for the knee brace. The next week I see the ENT for surgery follow up. I would really like to NOT see any of these people but if it helps clear the decks, I’m all for it.

I Had my Annual Physical Today

The problem with having a physical exam at 1:20 is that anything you eat for lunch shows up instantly on the scale.  It’s short-term gain, mostly from all the liquid that I down on a continuing basis practically from the time I get up in the morning.  But I knew it was going to be bad enough going for the exam, so put off eating lunch until afterwards, which meant I munched on stray food like, oh, a sleeve of Thin Mints that were inexplicably in my office.

It didn’t start well.  For almost a year, I had my physical exam on the calendar for yesterday at 1:20pm.  Imagine my surprise to come home from work on Monday and discover that the exam was, in fact, on Wednesday, in direct conflict with a standing meeting.  Oops.   On the other hand, it’s spring break and the health center was almost empty.

On the other hand, the first part of any visit is getting on the scale.  It was not pleasant and it was up considerably from last year — I wasn’t surprised, but I hate hate hate hate having to do that first.  At least this time the scale was in a private room and not in the middle of the hallway.  It’s not surprising that my blood pressure was up a bit.

Next it was on to the tiny exam room and the Paper Gown.  I had a sinking feeling about this, too.  I was to put the Paper Gown on with the opening in the front, climb up on the little table, and wait for the doctor.  Except the gown was laughably small and I sat there, holding the Paper Drape up to my chin, tears running down my face.

It’s hard enough to go to the doctor in the first place, fearing that any problems or issues would be put down to obesity, whether that’s actually the underlying cause or not.  Waiting for the reprimand, the lecture, The Weight Discussion, is made more difficult by wearing the Inadequate Paper Gown.  One of these days I will actually follow through and buy myself one to bring so I can be more relaxed.

I know, I know.  The answer is to be thin and not have to worry about it in the first place. But I’m not there.

My doctor and I talked about the effect of stress on my general health, including the fact that when I’m stressed, I eat.  The goal now is to just stay on an even plane and not gain more, and take little steps like writing down my food and drinking more water.  I didn’t get a lecture on changing my diet, having bariatric surgery, or signing up for a personal trainer.  Thank God.

Getting regular physical exams, especially the routine ones, is so very important for all of us, especially those of Us who are now in the AARP age group.  I live alone and if I don’t take care of myself, no one else is going to do it for me.  I do routine maintenance on the car just because it’s time to do things like changing the oil or buying a new battery.  The same is true for having a mammogram or colonoscopy when it’s time.  I have both of those coming up later this year and despise them – but I will go.

Thoughts on My Annual Physical Exam

I hate having a physical exam and today’s was hard since I barely know the doctor – and I knew I’d gained weight since last August, which is the only time I’ve ever laid eyes on her. It didn’t help that I had a big bowl of soup and a drink immediately before going over. Getting on the scale was not happy thing and I could feel my stress level rising as I pushed those little weight things along the sliding scale to rack up the evil total. Miraculously I’ve only gained 12 lbs since August, though it seems like much more.

I was armed with a piece of paper with all my current meds and the questions I wanted to ask about assorted body parts, from the sore foot (x-rayed to see if there’s a stress fracture), unhappy knee (referral to orthopedics), to the sleep problems (arrange to have the CPAP data faxed to the doctor). Fasting bloodwork will come later this week.

And I couldn’t keep myself from raising the weight thing, my frustration at having gained and feeling a bit stressed at work. To her credit, she didn’t tell me I was an evil fat person who was going to die soon if I didn’t crack down and lose the extra pounds. She did ask if I’d considered gastric bypass or the lapband surgery, both of which are performed at our hospital.

I’ve always said flat out that I wouldn’t consider either of those options but lately I admit that the lapband one has been surfacing again. Whether it’s physically an option or not, I don’t think that I’m able to manage the mental part. Until I really get that sorted out, I’m not sure I’d have the motivation to eat the more restrictive foods and amounts. Hell, if I can’t even do the WW portions, why would I think I could do the other?

The doctor was supportive and didn’t insist, although she did tell me that if next year I want to talk about it, to think about a decision based on current research and not comments from people who had the surgeries a while ago. Things have changed dramatically and both surgeries are now performed laproscopically in 95% of patients.

The motivation has to come from somewhere, though, and if I can find it again, there’s no reason I can’t lose the weight without the surgery. I’m really relieved that there isn’t medical pressure to go another direction.