Free TRAM Rockstar (Part IV of IV)

My first few steps the morning after surgery led to a slow but determined promenade around a rectangular ward of 22 private and semi-private rooms housing patients recovering from surgery.  Just over 4 years old, the facility is brightly lit and cheerfully decorated, with patients’ rooms arranged on exterior walls to take advantage of the mood-lifting sunlight filtering in through fixed windows.  Interior spaces contain nurses’ stations, housekeeping supplies, food service, customer care reps, and scheduling.

Peering without invitation through open doors, I saw many of what I guessed to be orthopedic patients, with their limbs dramatically suspended from metal scaffolding arranged over hospital beds.  I later learned the remaining warm bodies also included urology patients and, the day after I moved into Room # 4362, a newly arrived TRAM patient.  I longed to connect with the latter, to swap complaints about the sweltering temperatures or compliments regarding the caring staff, but I never saw my sister in breast cancer.  Her door, like mine, displayed a sign declaring “Door to Remain Closed at All Times,” surely to conserve the greenhouse ambiance within.

Those 4 hallways became my refuge, a respite from the sweltering confines of the Bair Hugger blanketing my body, the thick Deep Vein Thrombosis cuffs encasing my calves, and heat retaining mattress reflecting all of this external (and my own) heat back up to me.  On that first day of relative freedom, I quickly developed a pattern of sleeping, waking from overheating, cooling down with ice chips, and escaping to the hallways for a refreshingly cool stroll before returning to my incubator of a room and starting the cycle anew.

Gradually the restrictions were lifted.  On Sunday morning, more than 2 days after my last meal, I was finally permitted both liquid and solid refreshment.  The nurses discontinued my saline supplement on Monday, when it was obvious that I was drinking copiously and frequently.  No longer requiring a constant infusion of liquid through IV, I was untethered from the IV cart.  And, joyfully, since my new breast had survived the 48 highest risk hours directly following surgery, Doppler monitoring was pared back to once every 2 hours, thus extending the potential duration of any of my frequently interrupted naps.

In my forays around the hallways, I had been using the IV cart as a lifeline, crutch, and steering device.  Newly bereft of my 5 wheeled sidekick, I felt strangely unsure and ill-equipped.  I worked harder without the IV cart to maintain the carriage of a 95-year old osteoporosis sufferer.  My well-meaning nurse spied me and recommended that I clutch a bed pillow to my abdomen for better support while making my rounds.  Unfortunately, this combination triggered a particularly painful reaction in my lower back, further exacerbated by days of semi-recumbent sleeping.

I looked for a replacement to the IV cart and found one leaning against the wall of my hospital room — a walker.  I quickly took stock of my appearance.  Could a walker further degrade my image?  Sweaty face, geriatric posture, matted hair, cotton robe in disarray concealing a back-revealing hospital gown.  Sadly, no.  I swallowed any residual pride, unfolded the walker, and test drove it around my own 24 Hour Fitness track.  Happily, I found the sturdy aluminum frame and front inline skate wheels offered excellent support, handling, and cornering.  As my walks continued late into the night and resumed early Tuesday morning, however, I realized the scraping of the walker’s back two legs on the linoleum floor might be disturbing the other inmates.  As it was clearly an unacceptable situation, I ditched the walker.

I eventually remembered some earlier Foundation reading and core training. Rather than hunching over, I kept my upper body straight and pivoted at the pelvis, right arm cradled behind my lower back.  This position removed the pressure on my lower back and allowed me to quickly shift my weight from foot to foot.  Amid the 3rd pain-free lap,  I realized I was moving like a speed skater and channeled Apolo Anton Ohno at the Winter Olympics in Salt Lake City.  Left, right, left, right, glide across the ice.

Dr. Orman checked in mid-Tuesday morning.  I had just passed my room in the middle of a 14 lap trek when I heard his voice behind me.  Feeling a bit like a recalcitrant truant, I dutifully trudged back to my room for a quick examination.  He wanted to keep me at the hospital one more day for monitoring, but discontinued the Bair Hugger and painful blood thinner shots.  I was now independent enough to send Earl home to the children until I checked out the next day.  My brother Dale had driven down on Monday morning to relieve David from his childcare duties, and with the end of my hospitalization in sight it was time to send Dale home as well.

I longed to be back at home, but did enjoy the final 24 hours of my stay.  I could now easily switch from bed to chair and back as my mood changed.  My day was filled with pleasurable activities:  blog writing, Kindle reading, True Blood watching, and of course speed skate walking.  I also collected new evidence for the ability of many little pieces to add up to something sizable.  Before David returned to Austin, he measured the length of one of my hospital unit laps with a pedometer, which came in at close to 1/14 mile.  Assuming my memory serves correctly, this is a log of my exercise those first few days.

Friday:  0 laps

Saturday:  9 laps

Sunday:  8 x 5 = 40 laps

Monday:  10 x 5 = 50 laps

Tuesday:  4 x 14 = 56 laps

Wednesday:  1 x 14 = 14 laps (+ another 1.3 miles after I returned home)

Total:  169 laps + 1.3 miles

At 14 laps per mile, 169 laps would be about 12 miles.  In the 5 days after surgery, I walked more than 13 miles.  Without any preconceived intention, I had covered the equivalent of a half marathon.

Could this have contributed to a better and faster recovery?  That Tuesday, Dr. Orman said that if I wasn’t his fastest healing TRAM patient so far, I was in the top 5.  Just the next day when he gave me a final examination before releasing me from the hospital, I think I had jumped to the top of the list.  And he’s not the only medical professional to have expressed that thought.

In retrospect, it’s odd to be recognized for something you do without thinking every day like exercising, roughly akin to being praised for breathing or talking.  But some very nice folks around the hospital stopped me in the hallway or visited me in my room and commented about how, in me, they were seeing something new and better.   My afternoon/evening nurse over the last few days said on more than one occasion that I was the best TRAM patient she’d ever cared for (because I didn’t have too many demands, I guess).  Another (younger) nurse summarized it a little differently.  In her vernacular, I was a Free TRAM rockstar.

Could exercise be the magic pill to ward away both pain and complications and also speed up healing and recovery after surgery?  From my one data point, this seems plausible.  But neither can this pill be purchased at your local pharmacy nor does it need to be covered by health insurance.  It is accessible via a very different sort of currency, some determination and a lot of hard work.

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