23 Apr 2016
The First Five Days (post-op)
Author: myah | Filed under: THE FIRST FIVE DAYS - (post-op)POST AMPUTATION SURGERY UPDATES:
DAY 1:
The first half of night was rough. The second half of the night was better, with much less whining. We both had maybe 3 hrs of sleep in a row, twice. She seems ‘more loopy’ now, rather than ‘in pain’. 🙂
It was obvious that she only felt better if I was touching her. She was so confused, in Pain & drugged AND missing a leg,
Her only comfort was being next to me, preferably touching. So I got my camping mattress & sleeping bag out, and slept next to her bed on the floor.
Her doggie water-bed is a success. http://smile.amazon.com/Manufacturing-Cool-Large-Gray32-Inch-44-Inch/dp/B0009EUZWA/ref=sr_1_1?ie=UTF8&qid=1459622914&sr=8-1&keywords=coolbed+III
Another great idea I got from Tripawds!She seemed to be way more comfortable on it. The regular dog bed was painful (too soft?)
She finally ate a little food at 3am. She would’ve eaten more, but I didn’t want her to get sick. (Canned food with water soaked reg. food & a water soaked dog biscuit mixed in.) It’s a good thing I put a lot of water in her food, because she still won’t drink any. She did eat again at 6:30am
So far this morning, she is better than last night. However she still whines if I’m not next to her. As long as she keeps improving, I think it’s going well
Here is sleepy Myah is in the early morning, just before heading to her surgery.
The last photo of that nasty painful cancer-ridden leg (arm)
Here is Myah, going home in the back of my Jeep. I was about to drive away, suddenly the Vet assistant
knocked on my window and said they forgot to give me the meds. So I had time for this photo.
DAY 2:
About 48 hrs from her surgery, Myah is doing reasonably well!
I mostly let her rest yesterday. I only had her get up and move around to go outside. (She did ‘go’ on 2 of 4 trips outside.)
Late yesterday, I started some of the early ‘tough love’, as was recommend, I began to let her whine without reacting or comforting her ‘every’ single time. That was hard, but I read how her recovery can be prolonged if she is 100% attended to.
If someone did everything for me, while I wasn’t feeling well, or healing from trauma, I don’t think there wouldn’t be much subconscious incentive to hurry my recovery.
So the evening was hard, but paid off in the overnight. We both had a good night’s sleep. Sure we woke up several times. I only offered her verbal reassurance, and didn’t rush to her side. So she just eased back to sleep.
She needed personal attention & physical comfort upon waking this morning. Her 12 hr meds were wearing off. After the new meds kicked in I coaxed her outside, but she wasn’t interested, she just stood still, until I called her to go back inside.
Three hours later it was time to move her, and her cool-bed, out of the bedroom and into the living area. Once she was up on her feet, I took her outside and she was hopping along the best she’s done so far!
She relieved herself of what seemed like more than 2 liters. After that, she hopped nearly continuously from one end of the fenced part of the yard to the other. So she covered about 50-60 meters in total. She then needed a short breather, and then she made her way inside to her waiting bed. She then ate & drank a bit more than she would’ve on a normal day.
She’s taking a well earned nap right now❣
I probably won’t get her up moving again for another 3 hours, unless she initiates it. She still needs quiet healing time.
If I don’t notice swelling or increased pain signals, I’ll plan to get her up every 1.5 to 2 hours tomorrow. Perhaps I’ll even play some limited movement games with her? I’ll definitely make her eat and drink while standing too.
Right now she is laying down with her good side down. That is a first!
Previously she has been always laying in an ‘alert down’ pose. She had pain if I tried to get her to relax on her good side. I’d sometimes put a pillow or blanket behind her so she could relax a little more. She would often re-situate herself to make sure the lower part of her incisions were directly on her water-cooled bed. [its called a Coolbed III] I think this probably saved her a lot of swelling! I still iced the area as I had been directed by her doc.
I had also been advised to keep a Tshirt on her. That idea is to keep the wound area clean & protected. But for these first 48 hours, I preferred to keep a close eye on her and the incisions. However, I will ‘shirt-up’ her shortly, in anticipation of more activity & exposure.
Luckily when she was outside she was always on very clean fresh snow. The warm sun will be changing those conditions today. Slushy or crusted snow, and a few muddy areas will likely appear in spots.
I think Her recovery is going very well so far! 🙂 it’s much easier to keep positive and encouraging now. (I still catch myself feeling sorry for her. Or thinking ‘poor girl’ type thoughts. But I usually quickly catch myself.)
I give her verbal encouragement by saying things like; “You are an amazing Tripawd! Look at how good you’re doing! You kicked cancer’s butt! You are a survivor!” As well as general praise offered as often as I remember to.
She should be her Happy-Myah-self in no time.
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BONUS Material: (taken in the last hour or so)
Myah is now following me everywhere I go in the house. That’s a great thing!
my t shirts are way too big, I used medical tape to tighten it up
I think this is Myah’s, “Really, a photo NOW?” look?
She is normally wearing this donut 24/7, otherwise she will lick her wounds
Snow-tripawd… notice my expert t-shirt sewing taping skills (Yes its a Ringmaker t-shirt… seemed appropriate)
DAY 3
After Myah’s big 48hr day on Saturday, Sunday was a lot different. I could tell that her ‘only front leg’ was pretty sore, which is to be expected. I didn’t really think she did all that much on Saturday. However looking back, I realized she spent a lot of the afternoon ‘sitting’ rather than laying down. Probably to get up off the incision? I think that is why her only front leg is so sore. Just the change in balance is likely using her muscles in brand new ways. She really uses much more of her front paw. Picture her having a much longer footprint, with her dew claw almost touching the ground with each step. She definitely uses it to stand-up. Imagine formerly walking on mostly your front of your foot. Then when the weight is more, or you need the extra strength, you put the heel of your foot down to be more steady. (Perhaps similar to the difference between high heels and flats. 😉
I think her recovery is bound to have good days and bad. Yesterday it seemed like a mental adjustment day, compared to her physical adjustment day on Saturday. Her mood was pretty down. I hate to say depressed, but it seemed like it. So that made it really difficult to keep my thoughts positive. It is really hard to control your thoughts, especially if you are striving to convince a mind reader that all is happy.
Overall I think she physically needed the down time on Sunday. Her biggest issue was relieving herself outside. I can not even guess at how many times she wanted to go outside. Once out there, she realized how difficult (or painful?) it is to move around out there. Especially since she has always needed some time to find “the right spot”, especially because she likes to turn around, and around, …and around, in order to ‘go’. I would say that I took her out 4 times for each time she relieved herself. This was her only significant activity yesterday, besides getting up to follow me around. (I try to limit that, for her sake.She feels strongly about keeping me in her sight. I think that is probably a good amount of movement for her right now.
As for moving around with only three legs, I think she is doing great! I just know her surgical site causes pain, that likely increases with each hop she takes. She is learning to make many different tripawd moves inside the house. For instance, she is learning to hop-pivot to turn around in small areas. She has not tried walking backwards, I think that will be a big accomplishment!?
Last night after we went to bed, she got me up to bring her outside about every 45 minutes. this happened FIVE times before she finally urinated. Then we slept for almost 5 hours. I am still going outside with her every time, which is not our normal routine. (Its a fenced-in area) However with the melting snow getting harder to move through, I still think I should be out there with her. There are enough bare ground spots now, especially where I tromped down or shoveled a couple of small areas for her. I do not walk along side her anymore. I’m trying to gradually give her some independence. However when I try letting her out normally (I stay inside, watching covertly.) She just sits at the door and won’t budge. I think that will just take some time.
Her pain medication times are at 7pm & 7am, but she was obviously in need this morning at 6am. So she got them early. Her fentanyl patch should be finished today. I had been tempted to take it off early, I think that her ‘drugged’ feeling is a factor in her emotional funk. However, I realized that if she didn’t have it on, she would be moving way to much, too fast. One time yesterday she wagged her tail when a friend came to the door, she grabbed a toy, and was beginning her ‘spin-around-happy’ dance. But she yelped in pain and then stood, leaning against me, her rear legs shaking for a bit. So I think that only slow and less movements are still very important. I will just let the fentanyl patch trickle out its last meds. From my extensive caregiver experience with my late wife, I know that the fentanyl patches slowly lose their strength on the 3rd or 4th day. I figured that is probably way better than just removing it at once. Because she had been taking Rimadyl and Tramadol for almost 2 weeks before the surgery, I know how she acts on just those meds. When the Fentanyl is discontinued, I am allowed to increase her Tramadol dose from one tablet, twice a day, to 1.5 tablets up to 3 times a day. After the fentanyl is done, I’ll have to determine if the higher dosage twice a day is better, or the lower dosage, 3 times a day. I am comfortable that I am able to make a good decision for those options. I won’t change the rimadyl dose [anti-inflammatory-] The docs said perhaps 3 times a day, but seemed hesitant at that question.
I want to add some normalcy to her days. She always goes to work with me each day, and loves her job as a greeter in our family owned retail store. So my plan is to bring her to work Tuesday [day 5] and just see how she does. If she is happier with the familiarity, and is able to keep from getting herself up to greet every customer, I think it could work better for her, mentally? I’m also considering confining her at work, so she doesn’t ‘greet’ everyone, and then I can gradually allow her to greet more people as she progresses.
DAY 4:
I decided to revisit some pain control posts on tripawds.com. On one forum, I found some new pain blogs, and that brought me to more information off of the tripawds site. I then realized that Myah has been in more pain than she should be. I guess I’m overly concerned about giving too much medicine.
So, I gave Myah another Tramadol after reading about it. In about 30 minutes, she went outside, and then wanted to eat! (She ate a lot Saturday, but not much yesterday.)
She ate a really good sized meal:
I started out with a small portion, with 1/2 canned food, 1/2 kibble and warm water.
2nd small bowl was 1/4 canned, 3/4 kibble and water
3rd small bowl was very little canned food, mostly kibble with only a little water to spread the canned food smell around.
(all 3 portions equaled ~ 1.5-2 cup meal – The canned food is how I get her interested in eating. I normally never feed her canned food 😉
Just now I stopped writing this, to bring her outside again. Way more happy-hops this time! and she had a very large BM
amazing the difference with the extra Tramadol!
I have to share this quote from one article I found. It was especially interesting as it tied my own personal pain experiences to hers.
“Pain in cats and dogs (as in humans) causes other complications and can impede recovery from illness, surgery or injury. Pain spurs the body to release the hormone cortisol, which increases the heart rate, slows digestion, impairs sleep and reduces blood flow needed for healing.
Over time, pain also disrupts the nervous system, causing changes in the spinal cord and brain that make people and pets more susceptible to pain. Chronic pain affects the region of the brain that modulates human and animal responses to pain, creating more sensitivity, which in turn destroys still more brain matter that regulates pain—a vicious cycle. Chronic pain also gives the nervous system way too much practice at transmitting pain. The longer that nerves carry pain messages along their routes, the more efficient those pathways become at conveying that message.
“Chronic pain is like water damage to a house,” says Daniel Carr, a professor at Tufts University School of Medicine and director of its Pain Research, Education and Policy degree program. “If it goes on long enough, the house collapses. By the time most patients make their way to a pain clinic, it’s very late.”
I did use my sewing skills today. (I really only know how to sew on buttons) I found my smallest t-shirt, and removed one arm. then I tacked it so it was smaller, and tighter. I used button-like sewing spots to create this better shirt for Myah. I think she needs a real ‘tripawds dog-shirt’ So I have 2 styles on order from the tripawd designs on cafepress. She needs a proper work uniform after all.
BTW: You-all will begin to notice my hobby of making quick collages, rather than sharing several photo files.
On a side note, perhaps this is just a ‘brag’ but, I took a snip of a post I made on Facebook. This is to a closed group on Facebook, its a Golden-Doodle owners group. If you can’t read the small print, it says: 328 likes/reactions, and 76 comments! She has a lot of people pulling for her!
Today she decided to drink at her regular water dish, not the raised dish I set up for her in the bedroom. I think its is good physical therapy for her to drink this way. (if its her option) Although it seems most of what I have read recommends a raised food/water dish for front leg tripawds?
Notice her collar hanging to her right; Every morning when I put my shoes on to leave for work, I just tell Myah, “fetch collar” and she goes and gets it from where it is hanging in this photo, and then she sits in front of me, so she can get dressed for work, as well. Below it is her new EZYDOG Harness. Another great idea I found from tripawds.com! (The flash from the camera lit up the reflective portions of her para-cord collar, and the harness.)
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