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Tuesday, September 4, 2012

Four Months

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Hernia Recovery
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Today marks the FOUR MONTH anniversary of my surgery.

I've been going to the gym four times per week, increasing the intensity of the workouts according to what my body will allow. The right surgery side, the one that had given me the most trouble, has not hurt one bit during, or after, the workouts. However, the left side has bothered me the past couple days. I feel a pulling from the hernia site, down toward my left leg. It's not a debilitating pain, but strong enough to have me alter some of the things that I do. I will keep a close eye on it and visit my family doctor if it persists.

Over all, I feel a LOT better than I did a couple months ago.

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Pulmonary Embolism Recovery
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Continuing with the Coumadin every day, at 4PM. No chest pain and no shortness of breath.

Saturday, August 4, 2012

Three Months

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Hernia Recovery
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Today marks the THREE MONTH anniversary of my surgery. I am feeling *MUCH* better! I've made considerable progress over the past week. I can't point to anything that I'm doing different, but I can say with certainty that my pain has subsided to the point where I am finally doing things without thinking about the pain.

I ran two miles twice this past week and didn't feel ANY pain in my surgery area during, or after, the run. I call that progress! I am going to get back on my mountain bike next week. I've targeted the end of July, or the beginning of August, as the time I would see myself back on the bike and I'm right on schedule!
 
Have I finally turned the corner and now heading toward full recovery, without chronic pain? I can't say for sure at this point, since the pain can very well come back. But, I'm holding hope that I am over the last, or one of the last, hurdles in this ordeal.

Stay tuned for more updates!

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Pulmonary Embolism Recovery
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Continuing with the Coumadin every day, at 4PM. No chest pain, although a few times I've been out of breath for no apparent reason(one time while sitting still on a chair, doing nothing) and felt as though I was having an anxiety attack. That worries me, but like everything else about this journey, I will wait it out and see if it's temporary, or something more serious.

Sunday, July 22, 2012

Day Eighty

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Hernia Recovery
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Today is the 2 1/2 month anniversary of my surgery and I'm still having problems with my right side. The stinging, burning pain simply won't go away. It hasn't gotten worse, but it hasn't improved. Driving is very painful and difficult to do for more than 10-15 minutes. Getting in and out of bed is painful and getting up from a deep sitting position(ie. a low couch) is difficult.

Why the stinging, burning pain? The following site may explain why: http://www.nphernia.com/pop.html

 While many patients have some prolonged post-operative discomfort after any surgery, which may last for several months before resolving, approximately 3-5% of such patients may develop chronic or persistent pain in the region of a surgical incision. This can also occur and be especially bothersome after inguinal hernia repair. Post-operative pain, after inguinal hernia surgery particularly, can develop from a variety of causes.

There are many causes for this persistent, post-operative inguinal hernia area pain, also called 'Inguinodynia' including, but certainly not limited to:

  • Nerve damage (directly at the time of surgery)
  • Nerve entrapment in scar tissue, mesh or sutures
  • Post-operative benign nerve tumors (Neuromas)
  • Scar Tissue itself or tissue damage
  • Misplaced Mesh (if used)
  • Contracted, scarified and hardened mesh plugs ("Meshomas")
  • Infection (usually noted early post-op.)
  • Recurrent (or Persistent) Hernia.
  • Constriction or Narrowing of the Internal Inguinal Ring around the spermatic cord
  • Periostitis-Inflammation of the outer membrane of the bone (pubic) due to the presence of permanent suture material inadvertently placed into this layer resulting in chronic inflammation and pain
  • Pain from Unrelated Causes, associated with neither the prior inguinal hernia nor its operative repair (i.e., Non-hernia musculoskeletal, Intra-abdominal, Intra-pelvic, Neurologic, Genitourinary, Infectious or Vascular origin etc.)
The exact cause of any individual patient's groin pain cannot be determined of course, nor can specific treatment be recommended without an examination. The diagnosis is a clinical one, and imaging studies such as X-rays, MRI or CT scans are often normal in these circumstances. Imaging studies in cases of persistent post-operative pain are however of value in excluding intra-abdominal or other unrelated causes for pain that is not associated with the prior hernia surgery.
<end of quote from http://www.nphernia.com/pop.html>

That said, it's possible that the stinging pain that I'm enduring is due to nerve damage. Interestingly, I had this same pain(albeit at a *MUCH* higher level) on my right side the day after surgery. Yet, I've NEVER had such pain on my left side. This tells me that the nerve damage may have been done at the time of the surgery!

Will the burning, stinging pain eventually go away? I hope so. My surgeon seems to think it will and told me that there was no nerve damage to the right side during surgery and that the pain is due to muscles, nerves and the mesh converging in a particular part of my groin; a place where this type of pain is common.

Is my surgeon right? Will the pain ever go away? Or, will I have to visit another surgeon to have my scar tissue and/or nerve damage repaired?

Only time will tell and I will post more meaningful updates as I learn more about this condition.

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Pulmonary Embolism Recovery
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Continuing with the Coumadin every day, at 4PM. No pain when I breath deep. Progress is good.

Wednesday, July 4, 2012

Two Months

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Hernia Recovery
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Today is the two month anniversary of my surgery and all is not well. My left side is almost completely healed. I feel no stinging, burning or pain when I move in most any direction. The only time it bothers me is whenever I take a long walk or do any exercise. It feels sore.

By contrast, my right side still hurts and hurts a LOT! The stinging, burning pain hasn't subsided and it magnifies whenever I sit in a car(behind the wheel or in the passenger's seat). The pain got so bad the other day that I jumped out of the passenger's side door while my wife was driving in heavy traffic. I had been sitting down for an hour and a half, on a drive between our home and a neighboring city, and I couldn't stand the pain any longer. I had to get up and walk around. That's how bad the pain was!

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Pulmonary Embolism Recovery
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Continuing with the Coumadin every day, at 4PM. No pain when I breath deep, which I've been doing while exercising and no pain when I sleep on my side. Progress is good.

Wednesday, June 27, 2012

Day Fifty-Four

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Hernia Recovery
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I've been going to the gym a couple times per week, working mostly my own body weight and some light upper body workouts on machines. I've also worked out with a number of cardio machines and my heart and lungs feel very strong. I can work out consistently at 170 bpm, which is my max heart rate; yet, I don't get tired. A good sign!

The negative is that my right incision area hurts a LOT! Not always and, interestingly, not when I work out or walk or stand. It hurts mostly when I lay down or sit in a low chair(or car seat). When I get up off the chair, or turn over in bed, I get a STINGING pain in my right side, directly in the incision area.

By contrast, my left hernia area doesn't bother me at all.

I am calling my surgeon for an appointment and have him check out my right side. My concern is that the mesh hasn't healed properly and could possibly be unattached. That would be terrible!

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Pulmonary Embolism Recovery
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Continuing with the Coumadin every day, at 4PM. No pain when I breath deep, which I've been doing while exercising and no pain when I sleep on my side. This is VERY good news!

Tuesday, June 5, 2012

Day Thirty-Two

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Hernia Recovery
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GOOD NEWS!
 
My surgeon gave me the green light to begin swimming and riding my stationary bike. In two weeks, at the six week mark, I should be able to begin lifting weights again. Of course, not heavy, but light workouts.
 
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Pulmonary Embolism Recovery
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Continuing with the Coumadin every day, at 4PM. When I breath deep, I feel a little pain in the left side, under my rib cage. It will take a while before I don't feel any pain in my leflt lung. Part of the recovery.

Wednesday, May 30, 2012

Day Twenty-Seven

I haven´t been posting for the past few days. Moving forward I will only post every so often, whenever an update is warranted.

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Hernia Recovery
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For the first time in many days I'm posting about my hernias, first. My pulmonary embolism issue seems to have stabilized(at least for the time being).

I am able to walk approximately one mile without much pain. I only feel tightness afterward and some soreness. My right incision still burns whenever I bend or twist in certain positions. I find it's most painful whenever I sit in a car. It's not the seat belt, but the position I'm sitting in.

Something that has not been getting better are my legs. They are VERY WEAK when I wake up in the morning. When I stretch my legs in bed, first thing in the morning, my legs tremble uncontrollably, sending a pain shooting up to my abdominal muscles. I am able to get this under control once I roll out of bed and start to walk. I require a lot of stretching of my calf muscles in order to walk properly.

The other night, out of nowhere, both my legs kicked up from an extended position into a bent position, with knees nearly hitting me in the chest!!! Interestingly, I had no pain! But, it was certainly strange, to say the least. I'm wondering if there's some nerve damage, or nerve sensitivity at work.

Who knows what's really going on! Hernia surgery is a Pandora's box!

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Pulmonary Embolism Recovery
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No pain in my lungs and no blood in my sputum for the past week. Taking Coumadin, once per day, as prescribed.

I worked out my upper body with rubber bands(which simulate weight between 20-40 lbs) and raised my heart rate to 150(170 is my max, per my age). I was not out of breath, nor tired. A little sore the next day, in my shoulders and triceps; specially since I haven't worked out in a month.

Wednesday, May 23, 2012

Day Twenty

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Pulmonary Embolism Recovery
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Met with my family doctor and the results of the liver enzyme tests were encouraging:

AST = 48 (normal 5 to 47 IU/L
ALT =201 (normal 7 to 56 IU/L)

A few days ago when I went to the ER for the second time, Saturday May 19, they were:

AST = 146
ALT = 301

I've been off the Lovenox since last Thursday and only been taking Coumadin. It hasn't been a full week since I've been off the Lovenox, yet my liver enzymes are still high(but decreasing).
 
Evidently, Lovenox is the culprit behind the elevated liver enzymes. This should not be a surprise, since there is ample evidence and documentation pointing to Lovenox causing liver problems. Google for "Lovenox liver enzymes" and you will find a lot to read.

Bad stuff, this Lovenox. But, essential for what the doctors like to call anticoagulant "bridge therapy"; whereby Lovenox is used for a few days until the Coumadin kicks in(which takes 2-4 days for full effect). Those few days on Lovenox can hurt your liver. 

I will be going back for blood tests on June 4 and meeting with my family doctor on June14@11:15AM. Hopefully, the liver enzymes will be back to normal by then.

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Theory of Clot being caused by arm clot from anesthetic IV(see yesterday's post)
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My  doctor didn't rule it out, but said that "superficial" clots in the forearms are typically not problematic, unless they work their way into the deep veins of the underarm. Of course, there's no way to prove that my forearm clot worked its way up the arm. My doctor still clings to the notion that the clots came from the surgical area due to pressure applied to an artery by someone in the operating room.
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Hernia Recovery
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I overdid it yesterday, having walked over 1/4 mile on a trail near my house. I was in a lot of pain(burning and pulling) from the incisions and had a difficult time sleeping last night; even after taking 5mg of oxycodon.

Tuesday, May 22, 2012

Day Nineteen

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Pulmonary Embolism Recovery
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Something interesting happened to me a few minutes ago and it may shed light into what's at the root of my bout with Pulmonary Embolism: 

About 15 minutes ago I was chatting with my neighbor, an RN who a few years ago worked with the surgeon that did my hernia surgery, and she told me that some time back she had a clot in her left forearm. The clot occurred after she received the anesthetic Propofol for a particular procedure.

She describe how the "clot" formed as a ball on her forearm, a few centimeters from where the anesthetic had been administered. The ball was about quarter sized, hurt a LOT and was "hot" to the touch.

Interestingly, I had the SAME experience! This happened on day five after the surgery. This is my post on Day Five:

The first setback that I notice is a lump on my left arm, where the IV was inserted. Not necessarily on the spot itself, but a bit further up the arm from the original point of entry for the needle. There is no color to the lump, but it hurts a LOT!

By night time, the pain in my left arm is unbearable; and this after applying multiple ice bags.

Although I didn't post it on Day Five, the lump was very hot to the touch!

My neighbor said that she had an ultra sound to check whether the clot had traveled up the arm; but it hadn't. I didn't have an ultrasound done because, frankly, I didn't think it was a clot! I thought it was a slight infection from the IV/anesthetic and nothing to worry about.

However, the very next day after having this pain in my arm I begin to feel the effects of the Pulmonary Embolism. Could this be a coincidence, or is it the root of my PE?!

Blog post from Day Six:

10:30PM - A *NEW* pain comes into the picture!

While lying down on the couch I feel a stabbing pain on the left side, below rib cage. The pain is excruciating! I can't even take a shallow breath without the pain causing me to scream!

I feel comfort when putting pressure in the area and I'm able to pass gas and burp. Evidenlty, the pain is due to trapped gas.

Sady, the pain lasts another hour and I am finally able to go to bed at 11:30PM, when the pain is tolerable.  

Could the lump in my arm be the culprit clot behind my Pulmonary Embolism?!

I'm meeting with my doctor tomorrow. Let's see what he says.


Went for blood work today with the goal of getting my liver enzymes checked. Tomorrow I have a doctor's appointment and will know if my enzymes have shot up or down. The measurement will determine whether or not I will keep taking Coumadin(see post from Day Sixteen for more details). 


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Hernia Recovery
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I went for an even longer walk today, covering at least 3/4 miles round trip, along a trail near my house. It was a warm, clear day and a perfect day for a walk. I'm a bit sore, but each day I'm getting better.

Monday, May 21, 2012

Day Eighteen

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Pulmonary Embolism Recovery
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NO blood at all in my sputum. This is the first day since my hospitalization for Pulmonary Embolism that I don't have any blood in my sputum. One positive, at least.

My left lower to mid back still hurts. Feels like muscles aches, but I'm worried that it's kidney-related. After all, the ER doc told me that the ultra sound showed that I have "enlarged kidneys".

I will know more on Wednesday, when I meet with my family doctor.

Continue taking Coumadin at 4PM.

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Hernia Recovery
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I took a long walk today. The longest since the operation. But, I was sore. I still feel burning in the area of my incisions and I take one Oxycodon 5mg tablet after my walk.

Sunday, May 20, 2012

Day Seventeen

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Pulmonary Embolism Recovery
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No pain in my left side and little to no blood in my sputum.
Continue taking Coumadin at 4PM.

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Hernia Recovery
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I felt well enough to do some isometric and rubber band exercises. I felt a little sore later on in the evening, but it was well worth the effort. I felt like my body needed a workout.

Saturday, May 19, 2012

Day Sixteen: Back to the EMERGENCY ROOM!

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Pulmonary Embolism Recovery
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I woke up with a pain on my left side, running from my left oblique muscle all the way to the middle of my left shoulder blade. The pain was so great that I went to the ER, again!

They did an ultrasound of EVERY organ to ensure that I don't have any clots in any of them. No clots were found and the doctors concluded that the problem is muscle spasms.


However, a significant problem was found during the blood testing: my liver enzymes were VERY HIGH!

AST = 146
ALT = 301

The doctors believe that the Coumadin is the culprit, but it could also be the Lovenox, which is known for raising liver enzymes.

This is problematic. If Coumadin is toxic to my liver, I will not be able to use it! I will need to go on another medication, but all others seem to have a worse reputation than Coumadin.

Doctor recommended new liver tests within a few days to see if the numbers go down. If they do, then the culprit is most likely Lovenox(which I stopped taking 48 hours before the blood test in the ER).

I really hope it's the Lovenox!!!

If that weren't enough, one of the ER docs, as he was walking out the door and telling me that I was being released from the hospital, said to me: "Oh, we did find that your kidneys are enlarged....but, we didn't find anything pathological."

WHAT?! ENLARGED KIDNEYS! Could this be why my lower back hurts?! The doctors insist that the problem is with muscle spasms and NOT with the kidney/s/

My "simple" hernia surgery is getting more complex by the day :-(

Friday, May 18, 2012

Day Fifteen

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Pulmonary Embolism Recovery
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First meeting with my Coumadin manager; a very nice and well-informed nurse practitioner.

He had the results of my Hypercoagulation tests, which indicate my genetic predisposition for coagulation problems. All tests were negative, except for one: Factor VIII, which was at 200% and should not have exceeded 150%.

However, the good news is that Factor VIII is not a reliable measure if the blood sample was drawn from a patient recently diagnosed for Pulmonary Embolism. This article shows how Factor VIII can decrease if the test is done a few months after the Pulmonary Embolism event.

I will ask my doctor to redo the Factor VIII test after my six months of Coumadin treatment. Hopefully the number will be lower than 150%!

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Hernia Recovery
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Not much change from the day before.

Thursday, May 17, 2012

Day Fourteen

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Pulmonary Embolism Recovery
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Less blood in my sputum. I'm happy about that!

Today is my last dose of Lovenox at 9PM and moving forward I will only be taking Coumadin.

I meet with my family doctor who confirms that I did NOT have a DVT(deep vein thrombosis), hence a DVT was NOT the source of my Pulmonary Embolism. He was certain that the root of the clots was pressure applied(by someone in the operation room) to an artery during the surgery.  Hearing this didn't make me very happy.

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Hernia Recovery
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Each day I feel a little less pain, but progress is slow and I'm not moving around nearly as fast as I'd like to. 

Wednesday, May 16, 2012

Day Thirteen: First day home from hospital after PE

First day home after being hospitalized for Pulmonary Embolism.

From this point forward this blog will consider two distinct areas: (1) the hernia surgery recovery and (2) the pulmonary embolism recovery. With emphasis on the latter, since I consider it the most important of the two issues I have to recover from.

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Pulmonary Embolism Recovery
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Continue with my Lovenox injections at 9AM and 9PM, while adding Coumidin at 4PM each day.

More blood in the sputum; thick and deep, crimson red. However, no pain in the chest or lung area during the day, as I move about the house.

When I got to bed I try to sleep on my left side, since I'm tired of sleeping on my back. No problem with the hernias. I put a pillow between my legs and I'm able to keep my legs far enough apart where there's no pain.

I fall asleep right away, but wake up half an hour later with a LOT of pain on my left rib area. The SAME pain that put me in the hospital!!! Uh, oh! My wife wants to go the ER, immediately. However, I remind her that I had the same pain while in the hospital and the doctor said that it was expected, since my left lung(which took the brunt of the damage from the clots) was in the process of healing.

I turn to my right side and, even though my left side still hurts, I am able to sleep through the night without pain.

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Hernia Recovery
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I'm moving around much better, with the occasional burning of the right incision. I can move in and out of bed without any help. However, I cannot sleep on my sides. It's very painful in the area of the right incision.

An important step forward is that I can now walk up and down the stairs. Our home has three levels, so it's important that I walk the stairs, otherwise I am confined to an area of house. I can get around the entire house without much problem and can walk outside in and around my property.

I'm also extremely exhausted and go to bed at 9PM.

Tuesday, May 15, 2012

Day Twelve: 5th and FINAL day in the hospital for Pulmonary Embolism

I get a good night's sleep for the second night in the row.

7:30 AM - I receive good news! My INR index is at 1.7!
This is great. It's reached a level where I can manage the anticoagulants by myself, at home.

I will be injecting myself, in the stomach, with Lovenox twice per day for the next three days. During these same days I will continue my Coumadin, but at a lower dose: 6 mg. The goal is to not get past the 3, since that can lead to excessive bleeding while shaving or brushing my teeth, and to glide into an area between 2 and 3 of the INR.

My nurse comes to my room and has me sign the release paper work and gives me the prescription for the Lovenox and Coumadin.

I'M GOING HOME!

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Some notes about my first extended hospital stay:
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- Although the hospital is much more noisier at night than I ever expected, I feel well-rested and ready to go! The staff did everything possible to ensure that I was comfortable and well taken care of.

- The hospital is very organized and has streamlined a lot of processes. For example, they know the exact dosages and how long it takes to tune the INR for someone in my condition; ie. not a severe, but moderate PE. I was very impressed how they nailed it when they told me it would take between 2-3 days for me to be OK to leave. They lived up to the billing.

- The nursing staff, on average is good to excellent. The younger nurses don't show the same level of interest in the patient that the older nurses show. The older nurses had a deeper understanding of my problem and were able to fill in some holes by answering questions when doctors weren't around.

- Overall, a satisfactory hospital experience.

Monday, May 14, 2012

Day Eleven: 4rd day in the hospital for Pulmonary Embolism

My fourth day in the hospital is a carbon copy of the previous day, with one very big exception! I SLEPT!
I slept so deeply that I don't remember the nurses or anyone else coming into my room during the night.

My INR level has increased from 1.2 to 1.3. Not high enough for the doctor to release me.
Doctor is also concerned about the blood in my sputum. It's not increased, but he wants to make sure it doesn't!

Doctor would like to keep me one more day in the hospital.

The hernias are healing fine: I have some pain in the morning and some before going to sleep(requiring some minor pain meds). But, other than that, I am able to walk without the help of a cane and I can take a shower without any assistance. I can get in and out of the hospital bed with some minor discomfort and can even pick up an object that fell to the floor!

Progress! Well, at least in the hernia department. The Pulmonary Embolism will have to wait....

Sunday, May 13, 2012

Day Ten: 3rd day in the hospital for Pulmonary Embolism

The nurse gave me some ear plugs and I was able to sleep a little more last night; but not nearly as much as I needed. It's nearly impossible to get any rest when the RNs and CNAs are coming into my room every 2-3 hours to check my vital signs and to draw blood. The blood is used to analyze my INR level.


I take my second and third Lovenox doses(12 hrs apart at 9AM and 9PM).
I take my FIRST Coumadin dose of 7.5 mg.

The goal is ween the Lovenox and only use Coumadin to regulate my INR.


Interestingly, I am expelling MORE blood from my lungs than when I came in. Doctor said it was "normal" since I'm taking the anticoagulants.

What about the hernias? Why aren't you talking about them?
The hernias are healing fine. A little burning in the incision areas(specially the right side). No pain whatsoever, or discomfort, in the area of the mesh.

At this point, the hernias take a back seat to the Pulmonary Embolism.

End of my third day in the hospital.

Saturday, May 12, 2012

Day Nine: 2nd day in the hospital for Pulmonary Embolism

I've just spent my first night in the hospital and I didn't get ANY sleep whatsoever...and I'm EXHAUSTED. I haven't gotten any more than 2-4 hours sleep since the operation, if that.

I finally meet my doctor who will be taking care of me during my stay. He repeats a lot of what the doctor from the previous night had said, but, he is much more descriptive about PE having dealt with it MANY times.

The doctor tells me that my condition is a 4 on a scale of 1-10. That is comforting to know. However, he stresses that I need to be monitored for any more clots and that the anticoagulant therapy would begin later on today, with my first shot of Lovenox.

Something to note is that I am one of the rare cases of PE patients who doesn't need oxygen. In fact, everyone, from the doctors to the nurses are please that my oxygen level is perfect(96 at high altitude), my resting heart rate is as it should be(63) and my blood pressure is also normal(126/80).

At this point, all that the doctor wants to do is ensure that:

(1) he raises my INR to get it closer to the 2-3 range.
(2) ensure that my coughing up of blood doesn't get any worse.


9:00PM - I get my first shot of Lovenox in my stomach. Not painful, but a little sting.

Here begins my anticoagulant therapy.

11:00PM - Go to sleep.

Friday, May 11, 2012

Day Eight: HOSPITALIZED for Pulmonary Embolism!

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Highlights of the day:
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PULMONARY EMBOLISM!

The previous night's pain leads me to the hospital's ER where I was diagnosed with Pulmonary Embolism(PE), a condition that can be life threatening.

Why did I get PE? Because I didn't move enough, if at all, when I was home, recuperating from the double hernia surgery. I was stuck on the recliner-couch in practically one position for over four days. While not moving, blood clots accumulated and eventually shot up through my heart and into my lungs where they wreaked havoc!

I now have blood clots in my lungs and at the beginning the pain was WORSE than the strongest pain from the hernia surgery.
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Details of the day:
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9:00AM - I wake up without the pain on my side but coughing up more blood.

11:00AM - I call my surgeon - the one that performed the double hernia surgery - and he tells me to go to the ER IMMEDIATELY!

12:00 Noon - I arrive at the ER
12:30 - The CT scan reveals "moderate" Pulmonary Embolism in the left lung and less of it in the right lung.   What the medical community calls a "Bi-lateral Pulmonary Embolism".

Q: What can be done to fix this PE condition? A: Anticoagulant therapy.

5:00 PM -  I am admitted to the hospital, room #507. A nice room, with a single bed and a view to the South side of Colorado Springs, where I can see Cheyenne Mountain - my favorite place to mountain bike. It's difficult to be in this room, under these conditions, looking at that mountain. :-(

8:00 PM -  The on-duty doctor comes by to introduce herself and to tell me that she will only be looking at me tonight and that another doctor will be my primary caretaker during my stay, but he will be in tomorrow(Saturday).

The doctor gives me a detailed breakdown of what a Pulmonary Embolism is and what to expect in order to solve the problem. Without getting into too much detail(which can be found here), the way to heal from this condition is to undergo anticoagulant therapy.  The goal is to lower the International Normalized Ratio(INR).

In short, anticoagulant therapy will involve taking Lovenox by injection into the stomach(not as painful as it sounds) and then slowly introducing Coumadin via tablets until I can get the INR ratio between 2 and 3. The average person's INR is at 1.2; where mine currently is. But, since I now have the clots in my lungs I need to raise this factor so it sits between 2 and 3. This tweaking will be achieved with Coumadin.

The doctor also tells me that the clots in my lungs will NOT be dissolved by these medicines, but that the lungs will dissolve the clots over time. The medicine is to prevent NEW clots from forming. Clots typically form in the legs from either immobility or the body's inability to break down blood clots. Eventually these clots travel to the heart and lungs. 

She also reminds me that I am very fortunate to be alive, since clots can sometimes cause heart attacks and shut down lungs completely and kill a patient. The ratio is as high as 1 out of 3 people dying from this condition.

I will begin my anti-coagulant therapy the next morning, on Saturday.

11:30 PM - The wife, kids and grandma go home for the night. This is the first time that I've ever been hospitalized. I've had my ER experiences, but never have I had to spend one single night in the hospital. Being alone freaks me out a little bit. It finally hit me that I am HOSPITALIZED!

3:00 AM - I haven't slept a wink. The hospital room is not very quiet. In fact, it's incredibly noisy

My mind is racing and I can't sleep. I keep thinking how I brought this upon myself by not moving enough during the first days of my surgery.

Night turns into day.....and I haven't slept at all...

Thursday, May 10, 2012

Day Seven

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Negatives:
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Pain, LOTS and LOTS of pain. 

Again, more of the same from the previous day......GAS, LOTS OF GAS!

This has probably been THE MOST PAINFUL DAY of all. Ironically, the pain has nothing to do with the incisions or the mesh patches. The pain is from the gas that's trapped in my left side(either the large intestine or the colon).

I was in pain all day long and couldn't find a way to get comfortable. Lying down on the couch or sitting on the toilet was MISERY! At one point I was screaming at the top of my lungs, while sitting on the toilet, trying to push out the gas(which is not easy to do while recovering from double hernia surgery).

11:00PM - If the new gas pain wasn't enough...I am now spitting up BLOOD! What's going on?!
The last time I had blood in my phlegm was about 8 years ago, when I had walking pneumonia and pleurisy.

It's too late and I'm too tired to go the ER, but will do so first thing in the morning, after I get some rest.

Quite a thing this hernia surgery has turned to be, hu?!

Wednesday, May 9, 2012

Day Six

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Negatives:
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GAS, LOTS OF GAS! (see details below)

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Positives:
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Swelling in the scrotum after hernia surgery seems to be one of the most prevalent issues that patients face. The following should be seen as good news!

- The swelling in my testicles is 90% gone. Sleeping flat on the bed helped tremendously. The fluids no longer rush to the scrotum while lying down in a flat position. It's imperative that I wear an athletic supporter while walking or standing in order to avoid the scrotum pulling down on the surgery area.

10:30AM - I wake up! This is the morning after my first night sleeping on the bed(up until today, I'd slept on the couch).  

I feel like I'd rested(getting nearly 10 hours of sleep), yet, I CAN'T MOVE! I feel trapped and my whole body hurts and I have little to no strength to move in any which way.

For the first time I feel WEAK. I've felt varying levels of pain throughout this process, from the off the scale pain I felt the day after the surgery(see Day Two), to not feeling any pain and walking for 1.5 hours non-stop(with the help of a cane) from the couch to the bedroom and back.

But, today I feel like I'm stuck. I have absolutely NO ENERGY. Put it this way, it feels like I have the flu, without the headache or fever. You know that feeling: where your whole body hurts and you find it difficult, or impossible, to even turn over while in bed. That's how I feel!

I'm sitting on the couch, typing this post, and it's painful to do this much. My whole body feels overpowered by exhaustion.


10:30PM - A *NEW* pain comes into the picture!

While lying down on the couch I feel a stabbing pain on the left side, below rib cage. The pain is excruciating! I can't even take a shallow breath without the pain causing me to scream!

I feel comfort when putting pressure in the area and I'm able to pass gas and burp. Evidenlty, the pain is due to trapped gas.

Sady, the pain lasts another hour and I am finally able to go to bed at 11:30PM, when the pain is tolerable.

Tuesday, May 8, 2012

Day Five

Moving forward I will only post times of the day if I feel they contribute to the story. Otherwise, I will just explain what I'm going through with as much detail as possible.

The fifth day is a mixed bag of progress and setbacks.

9:30AM - I awake, but feel unusually tired(even though I slept through the night without much trouble). It takes me a LOT of effort to get up off the couch; even with my wife's help.

It takes me an unusual amount of time to make it to the bathroom, considering how much easier it'd become. However, once on the toilet I am able to defecate, for the first time since the surgery, without the aid of a glycerin suppository.  This is a step forward, for sure.

The first setback that I notice is a lump on my left arm, where the IV was inserted. Not necessarily on the spot itself, but a bit further up the arm from the original point of entry for the needle. There is no color to the lump, but it hurts a LOT!

By night time, the pain in my left arm is unbearable; and this after applying multiple ice bags.

BTW, I refrained from taking any Oxycodone/Acetaminophen 5-325mg tables throughout the day and pay the price in the form of PAIN! I finally take two before going to bed. Otherwise, I wouldn't get any sleep.

By 10PM I find myself going into a mix of panic, anxiety attack and shock! I am shivering uncontrollably and feel pain everywhere! I am completely EXHAUSTED!!!

I MUST get off the couch and to the bathroom(not because I need to go, but because I need to test myself to see if I have any energy left). Well, that was a HUGE mistake and I find myself trapped on the toilet seat without any energy whatsoever. I finally got off the toilet seat, but it was misery.

I couldn't sleep on the couch another night. My lower back pain was surpassing the pain of the surgery. So, I asked my son and wife to take me to bedroom in the lower area.

I won't go into details, because they are too lengthy, but suffice to say that it took me a long time to get comfortable in the bed, but once I did, I slept like a baby until 9:30AM! This was, by far, the  best sleep I've gotten since the surgery.

Monday, May 7, 2012

Day Four

(I'm still confined to my recliner sofa)

6:00AM - I wake up with more of the same burning pain that I felt the day before. This time, the left incision burns more than the one on the right. And, for the first time, I feel a slight burning sensation in the area where the right mesh was applied.

I take two more Oxycodone/Acetaminophen 5-325mg tables and fall asleep within a few minutes.

11:30AM - I wake up and for THE FIRST TIME I feel like I got some rest!
                
I walk to the bathroom, to urinate, with little help and using only a walking cane! We're making some progress. ;-)

The rest of the day is not much different than the previous day. I still feel burning in the area of the incisions on a scale from 4-7, but mostly in the lower end of that scale.

However, toward the end of the evening, around 8PM I try to get up off the couch by myself, using only the cane, and I succeed! This is a HUGE step forward! I feel some burning in the incisions, but nothing that I can't handle.

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Notes
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- I still need to use glycerin suppositories to help me defecate.
- The swelling in my testicles has not increased, but they are considerably swollen(but no pain at all).
- My back hurts MUCH LESS since we realigned the pillow that was under my back. We now have it where it runs lengthwise from the top to the bottom of my back. This is MIUCH more comfortable!

10:30PM - Shut down the computer and the lights and go off to bed!

Sunday, May 6, 2012

Day Three

4AM - The pain wakes me up. The burning sensation is too much to handle and my wife feeds me two more Oxycodone/Acetaminophen 5-325mg tables; and she applies an ice pad to the area of the incisions.

8:00AM - Amazingly,  I am able to sleep all the way 'til 8AM! I say "amazingly", because of the great pain I felt the day before.

9:00AM - I am able to walk to the bathroom with much less help. I still need a guide, but I no longer have to drag my feet! I can actually raise my feet about 2-4 inches off the ground, without any 'major' pain. Don't get me wrong, I'm still in pain! But, nowhere near the pain I was feeling the day before.

10:00AM - I eat a nice, hearty breakfast and turn on the TV for some ESPN and whatever else catches my interest. My mood is considerably better than it was the day before.

12:00PM - I look down and see that my penis is twice it's normal width....and PURPLE! My left testicle is twice its normal size. The doctor warned me that such things would happen. But one thing is to be told and another completley different thing is to see it for yourself!

3:00PM - I get up to walk around; the little that I can. With my wife's help I am able to make the bathroom in about 2-3 minutes and once again I defecate with the help of a suppository.

The problem that I have now is that my lower back hurts more than my incisions! This is because I'm not able to move while lying down on the couch. Also, since I can't straighten up while walking, my back is doing a LOT of extra work.  At this point I start applying ice to my left buttock; which is throbbing from pain!

I got a bit wired out tonight; perhaps because I walked more than I should have, and finding it very difficult to sleep.

It's 11PM and I'm wide awake....

I'm shutting down the lights, the computer and going to sleep.

Saturday, May 5, 2012

Day Two

6:00AM - I wake up needing to urinate....But, I can't get off the sofa! I'm feeling a LOT more pain than I did the day before. (The nurse was right! Once the anesthetic wore off, the pain set in).

I cannot walk to the bathroom without help. The pain is too great and I feel like the weight of my testicles is pulling on my midsection. (Later on in the day, my wife bought me an athletic supporter).

6:15AM: I finally make it to the bathroom(yes, it takes me FIFTEEN MINUTES to walk approximately 10 yards. That's how much pain I'm in. I cannot even lift my feet off the floor! I have to drag them, and even doing that I can barely move.

6:30AM - Sitting on the toilet for about 15 minutes, trying to defecate(I feel a strong urge, but I won't dare push! My wife brings me glycerin suppositories and I apply one which helps me to defecate in about another 10 minutes)

7:00AM - I'm trying to get up from the toilet when I feel THE STRONGEST pain that I've EVER felt, in my entire life!!! Feels like someone is applying a blow torch to the incision on the right! I quickly grab a towel and bite into it with all of my might. I can't righfully describe how painful this is. Suffice to say that I broke out into a cold sweat, while shivering from the pain, as if though I was going into SCHOCK!

7:30AM - My wife goes next door and brings my neighbor to the house. He patiently serves as my guide and it takes another 10 minutes to get back to the couch.

By this time, I was MISERABLE!

The rest of the day was pure MISERY!

It hurt to move in any which way while sitting on the reclining couch. Never mind trying to get up, off the couch! It was nearly impossible. I had to urinate into a makeshift plastic pitcher, instead of embarking on the dreaded trip to the bathroom.

By this time, I'm taking two Oxycodone/Acetaminophen 5-325mg tables every four hours. And that only brings the pain down to a tolerable level between, say, 4-5. Without the pain killer, I'm sure I'd be in severe pain.

I've come to the conclusion that this type of surgery should NOT be an out-patient procedure, but instead, the patient should be allowed to stay in the hospital for at least 2-3 days where morphine could be administered until the patient is able to walk on their own.

11:00PM - I go to sleep.....somehow, I am able to sleep!

Friday, May 4, 2012

The Day Of The Surgery

Friday May 4, 2012:

Today I go in for a double open inguinal hernia surgery. "Double" because I have TWO hernias. The one on the left is about golf ball size and the one on the right is slightly smaller.

5:30AM - Arrived at hospital for registration.
7:30AM -Wheeled into surgery.
9:00AM Surgery completed.

About 10 minutes after surgery, in the recovery room, I began to feel a burning sensation in the area of the incisions. The nurse injected pain medication via my IV and the pain went away almost immediately.

I feel well enough to walk out of the hospital! "Hey, this isn't so bad", I told my nurse. She quickly replied: "Wait until the local anesthetic wears away. You WILL feel pain".

1:30PM - Released from hospital.
2:30PM - Eating brunch at home: three egg omelet with chili ;-)
3:00PM - I'm outside, in front of the house, walking around with a cane and chatting with my neighbors about my operation. So far, feeling NO PAIN!

Once inside the house, I'm reduced to the sofa, since lying down on the bed is a bit uncomfortable(feels like my insides are being pulled apart, but not feeling any pain. Just uncomfortable).

10:00PM - I take two Oxycodone/Acetaminophen 5-325mg tables and go to sleep on the couch.

So far, so good......