About Recovery — from Surgery

by Tom Shafer

May 9, 2019

Okay, so I guess I need to chat a little about convalescing after major surgery. As most of you know, I am currently recovering from two lower lumbar procedures, decompression and fusion (L4-L5). I started rehabilitation three weeks ago, and everything is progressing nicely. However, my physical therapist discovered an underlying muscular issue (iliopsoas syndrome) that has gone undiagnosed until now, likely because of damage sustained in my lower back after a climbing fall two years ago. Essentially, the two primary hip flexors on my right side (the psoas and the iliacus) have contracted so much that they have locked my hip, now allowing a very limited range of motion. According to my physical therapist, my contraction is the worst he has ever seen. Fortunately, because of my fitness and relatively young age, I should be able to regain full range of motion, which is really good news for me. It may well be that I have been dealing with this problem for more than a decade, stretching back to my left knee replacement in 2008.

But back to my convalescence. Those of you who have dealt with major surgery fully understand the frustration that follows it. First, no one wants to schedule a major surgery. I know for me, surgery is realization that the quality of my life has deteriorated to a point where I almost gladly welcome a procedure that will disrupt my whole existence, and in so doing invite disorder, pain, exasperation, worry, and boredom into my world. I have had to make this decision over twenty times in my life, and trust me, that’s twenty more times than I would like to admit. I so envy people who have never faced decisions like these.

The period right after surgery is all about pain management. Because of powerful pain relievers and blocks, post procedure discomfort is minimal and masks the agony that is coming. Though opioids can help through this time, they typically only minimize the pain and carry with them the complications of constipation and potential addiction – and minimally an interval of opioid cleansing. Depending on the type of surgery, the pain management period can last up to two or three weeks. For me, this is always lost time because emphasis is wholly on pain. My appetite is suppressed, my concentration is minimal, and my sleep is disrupted. I don’t welcome visitors and find myself grumpy and terse with any caregivers. I don’t want to be this way, but misery always seeks to be a solitary experience.

As pain starts to become more manageable, boredom and frustration set in. Each of my surgeries offered their distinct and individual limitations. Knee procedures regulated mobility, so I was always dependent on others for everything from dressing and grooming to eating and transportation. My back surgery has had some similar limitations, but I have been able to return to my own care – including travel – much quicker. My abdominal procedures created their own sets of issues; the ruptured colon was by far the most restrictive of all of my surgeries. All of the limitations help to generate the boredom that leads to frustration. Before my operations, I would try to map out my recovery so that I had things to look forward to. This might include working with my numerous hobbies or watching DVRed television shows or reading or writing. But, when you are trying to schedule eighteen or nineteen hours of every day – for several weeks or months – well, as you can imagine, time becomes the biggest obstacle in the equation.

Frustration sets in as you watch the rest of the world continue to revolve around you – and without you. People are living their lives normally, and you begin to feel forgotten, even overlooked. Sometimes “why me?” reflections take hold, exasperating these feelings even more. Of course, all of these thoughts are mere perception, but it is perception difficult to ignore. Prior to and after my back surgery – and my knees – I was and am jealous of people who can walk without difficulty. I watch them advancing with unlabored steps, knowing that they are taking for granted this freedom of movement. I want to shake them, to instill in them how grateful they should be for this ability. Secretly, I hope they witness my struggle and realize what they have. I know how petty this sounds – but it also rings true. Because of all that I have been through in my past, I have seldom diminished the totality of just walking, but once I am on the good side of this experience, I know I will never take mobility for granted ever again.

The last of the complications with any surgery are the good and bad days – and their randomness. Unfortunately, recovery is not an even path. Progress is followed by setback, and sometimes setback is followed by more setback. This all happens seemingly without rhyme or reason. Now, this is baked into the recipe for every surgery – and you know it. You are always warned about the pratfalls of recovery, that good will be followed by bad. But when it happens, it is still a slap in the face, a reminder that the process will be fraught with complication – as if the surgery and events that led up to it weren’t enough. I know that when I am having one of these bad days, I always play the theory of relativity game – that life is relative and though I am experiencing this setback, someone somewhere is having it way worse than me. And, it could be way worse for me!

At this point in the process, I am having more good days than bad, and I can see light at the end of the tunnel. I still have many more months of healing and rehabilitation, but all signs are pointing to a full and successful recovery. Considering that this has been an almost three-year struggle, I welcome an end to this particular journey of my life.

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