An Energetic Look at Recovery From Surgery

Recovery from an anesthetic and surgery is a highly individualized experience. Some of the best advice is to instruct the patient to listen to your body. I cannot emphasize this enough. There is a quote by Edgar Cayce, in one of his readings:

Remember, healing--all healing comes from within. Yet there is the healing of the physical, there is the healing of the mental, there is the correct direction from the spirit. Coordinate these and you'll be whole! But to attempt to do a physical healing through the mental conditions is the misdirection of the spirit that prompts same . . . But when the law is coordinated, in spirit, in mind, in body, the entity is capable of fulfilling the purpose for which it enters a material or physical experience.

Reading 2528-2 Edgar Cayce

Here is an example of someone who doesn't get this point in a big way--a patient, a high-ranking official, scheduled himself for hernia repair surgery on a Saturday. The whole team came in on a non-surgery day just for him.

He let us know he had plans to attend a baseball game later in the afternoon.

'Good luck, buddy!' we said, thinking he had no clue about what he was in for as far as his recovery from surgery is concerned.

Mind over matter doesn't work while you are recovering from surgery. The fact is that you have been through a major healing experience that will have lasting effects physically, mentally, and energetically.

To guide you in your recovery, here is more detail about the post-operative healing process, both from Conventional Medicine and also what Reiki Doc adds:

Immediate Post Op Recovery (Day of surgery):


you can expect nausea and vomiting. Here are some risk factors:
female
non-smoker
motion sickness
prior episode of PONV
brow, breast, nose/throat surgery (drainage down throat irritates stomach)
laparoscopic surgery (insufflation of abdomen with carbon dioxide gas)
longer than three hours of general anesthesia
surgery on a large joint (knee, shoulder, hip)

here are some conventional remedies:
drugs to decrease nausea:
zofran, compazine, reglan, decadron, scopolamine patch, Emend (aprepitant),  phenergan, Tigan suppositories, diphenhydramine
half juice/half Sprite combo fluids
take pain pills with food
supplemental oxygen, either by face mask or nasal cannula

**any local anesthetics, pain medicine, and anti-emetics given in the OR will wear off 6-12 hours after surgery**

Reiki Doc advice:
self-Reiki on stomach and/or other surgical site
hydrate--aim is to have frequent, hourly urine output to keep nausea under control
Preggie Pops, lollipops made with herbs/flavors to fight morning sickness
ginger in any form you can tolerate ginger ale, crystalline ginger, ginger remedies sold OTC
homeopathic remedies--those sugar pellets you dissolve in your mouth
acupressure points on inside of wrist. There are magnetic bands for this.
Avoid TV, reading

Consider risk of interaction with narcotics and anesthesia before using medical marijuana or alcohol or other street drugs this is risky

Ibbuprofen, advil, other non-steroidal anti-inflammatory medication, and aspirin increase risk of post-op surgical bleed that would require an emergency trip to the operating room to stop it.



POD 1:


goals are pain control, resolving atelectasis, preventing blood clots, removal of foley (urinary catheter)


here are some conventional remedies:
pain--stay ahead. Keep theraputic level in bloodstream of analgesic
itch-benadryl or nubain
ambulate (walk) as much as possible with assistance
OOB to chair (out of bed, again, with assistance)
Incentive spirometer, deep breathe and cough

**if you want to be discharged from the hospital, know that ladies need the 'lipstick sign' and men need to shave. Freshen up!**

Reiki Doc advice:
sunshine and fresh air
listen to body
self reiki
family support
rest
soothing music (I bought the entire series by Kauilapele music, six CD's of Hawaiian slack key guitar)


First Week after Surgery:


goals are pain control, first bowel movement, preventing pneumonia from atelectasis, preventing blood clots


here are some conventional remedies:
have help in house, have a driver to help with errands
Iron pills if high blood loss (warning, these can be binding)
stool softeners ( pain pills with prune chaser!)
chicken soup
switch to ibuprofen when surgeon approves, and get off narcotics. (kidney disease, omit this)
increase ambulation

**be very clear with your family and loved ones what your limits are. Once you 'are home' they may assume you are 'normal'. You are not, you are recovering from major surgery**

Reiki  Doc Advice:
Journal
cycles of activity then rest
nap
sunshine and fresh air
shower, get hair done--appearance more towards normal

unless given the okay by your surgeon, refrain from baths and driving a car at this time



Second Week after Surgery:


goal is to increase stamina back, to transition towards prior level of functioning


here are some conventional remedies:
cut back on pain meds
switch to NSAIDS if surgeon approves
cut back on naps
follow-up visit with surgeon
stitches out
continue increasing activity as tolerated; build stamina

**consider going to see a movie or taking short walks in the neighborhood to 'reconnect'**

Reiki Doc Advice:
Try short trips driving car if surgeon says it is okay
Meditate and allow for deeper healing (an energy worker did distance healing on me, and I released grief and loss from twenty-four years ago)
continue Journal, also be sure to look back at earlier entries
Plan for caregiver to exit, but be sure to keep things simple around the house yourself

be sure to allow yourself ample time to rest. Stop any activity when fatigue and pain set in.



Third and Fourth Weeks after Surgery:


there is a risk of depression at this point, one that is typically mild and self-limiting. If it lasts, seek professional help. There is frustration at this point in progress: it seems one-step forward, two-steps back.


here are some conventional remedies:
listen to your body
work with family, doctor to establish when to return to work
Upon return to work, expectation is to be at full capacity--think wisely on this
Disability is ended upon return to work. If tired and goes off work after, new phase starts ticking.

**you may be feeling 'back to normal' but know that you must be in top condition to resume all of your normal activities from before surgery**

Reiki Doc Advice:
this is your last chance to really assimilate all the healing and lessons from the illness
continue on your journal and reflection
give thanks to your body for its ability to heal
listen to your heart and higher self on what to do next

Namaste,

Reiki Doc

The Letter D Extruded: The effect of Anesthesia Drugs

It's odd, sometimes the answers are right in front of you, the ones that you can't see. Something that has bothered me as an anesthesiologist and psychic is the nearly united sentiment of the natural healing community that Conventional Medicine is Bad.  I have gotten into it online with several people, trying to inject some reality into childbirth, anesthesia drugs, and this perception that Conventional Medicine is Bad. And that Conventional Medicine is Designed to Make Someone Rich.

I see it as one way to address Common Human Suffering, through Disease. And the people who are from the granola-forces just refuse to see it.

Then it occurred to me: both are correct.

General Anesthesia uses very strong medicines, that produce severe side-effects. For some people, in their perception, the benefit is worth the price. And for others, the price is not worth the benefit.
What can be done to bridge the chasm between both points of view? Begin open discussion! Here are some of the side effects I experienced personally this past week. And here are some tips on how to avoid them. That way, anyone out there on whatever side can know the facts, and apply them to their benefit if the need for General Anesthesia should arise.




Anxiety Going under anesthesia and having surgery is frightening. You don't have to be aware of it. I asked, 'Please don't let me remember what the inside of the O.R. looks like; I have seen too much.' And my friend gave me anxiety medicine in my i.v. in PreOp Holding. What I remembered was patchy at best.


 Awareness Being awake in the O.R. CAN happen. If you are having cardiac surgery, conscious sedation without an anesthesiologist, OB anesthesia, emergency surgery you are at higher risk. (Your blood pressure is low and more anesthesia would only lower it) Obesity, female sex, and chronic use of prescription or non-prescription mood altering substances can increase the risk. Open discussion with your medical team and anesthesia provider can tip them off that 'you might need MORE' to stay 'out'. And if possible, BIS intraoperative monitoring can measure your level of consciousness while you sleep. For most people this sticker on the forehead is enough to ensure that appropriate levels of anesthesia are maintained. Then it is only if you have low blood pressure due to profound illness, that less anesthesia (which lowers the blood pressure) can be used, and that risk of awareness is present. 


 Muscle Relaxation For some surgery, it is important that you do not move (delicate, such as neurosurgery or cardiac surgery). For others, it is important that your muscles relax so that the surgeon can see inside (abdominal). For this strong muscle relaxing (paralyzing) agents are given. These are separate from pain medication and 'forget' (amnesia) medication. Although there is the chance you can 'wake up and not move', more often the case is that you will feel weak when you wake up. It will seem hard to take a breath, and your movements will be shorter and weaker.  Time will take care of this. Do not be afraid, for your oxygen is being monitored continuously and help will be given if your saturation is low. Five minutes or more and you will be normal again. Not to worry!


 Dryness of mouth Eating a cracker was miserable. I had no spit. It took glasses and glasses of water to get it to go down, and it stuck on my teeth. To reverse muscle relaxant, anticholinergic drugs are given. They dry up spit, and slow the gut. Sometimes you will feel the need to be thirsty for days following surgery. This is a normal side-effect of those drugs. It will pass. Note that the oxygen given is not always humidified too. It can be drying. 


 Dryness of eyes  tear production is decreased under general anesthesia. If dry eyes are a problem, ask for lubricant to be put in them while you are asleep. This worked wonders for me. Vision might be a little blurry when you wake up, but it is better than very dry eyes.


 Nausea and Vomiting Gut motility is slowed considerably by 1) surgery 2) anesthesia 3)pain medicine 4) reversal of muscle relaxant. I am on toast and tea for three days after surgery. Here is what to do--mention to everybody you have the problem and don't want to throw up. This justifies the expense of MORE medication. Get 1) a long-acting antiemetic (in pre-op) like scopolamine patch 1.5 mg transdermal or Emend (aprepritant) for three days of fighting nausea after 1 dose. 2) zofran round the clock 3) decadron round the clock 4) intraop benadryl 5) hydration at least 20 ml/kg intraop 6) avoid triggers (reversal, nitrous oxide).  Keep on supplemental oxygen and walk as much as possible to get the gut moving again. Until you pass gas from below, don't try to eat too much. Your gut is still asleep.


 Incisional Discomfort Take enough pain medicine so you can cough. I prefer non-steroidal anti-inflammatories (ibuprofen, toradol) for my pain. Sometimes in surgery these can affect bleeding and surgical outcome. So I took narcotics, which made me throw up.  It was a vicious circle--your options are to stop taking the narcotics and just hurt (I switched to ibuprofen except at night) or to take strong antiemetics. A good alternative is i.v. acetamenophen 1000 mg q 6 hours (Ofirmev).


 Itching  Itching was a serious problem from the narcotics. I scratched under my leg squeezers, on my back, on my arms and legs. There are scabs from clawing at myself. Benadryl usually is used in this situation, but it gives me nightmares so I opted to itch. Nubain also is excellent for stopping itching from narcotics.


 Constipation  Because the motility is slowed and the colon keeps absorbing water, constipation is a problem after most surgery, especially abdominal surgery. Keep on stool softener colace as long as narcotic pain killers are used. Walk. Increase fluids. Take psyllium. Mineral oil and prunes are also useful. Give yourself an entire day after surgery to get used to normal bowel function again. This is day two to day four. It is painful.


 Airway Obstruction  standard of care is to use a Masimo pulse oximeter on the patient post-op on the surgical ward. I have mild sleep apnea. I do not wear a mask. I was surprised at how often my oxygen saturation dipped below 93%. It would alarm at 90%. A few deep breaths would fix it. What happened is ATELECTASIS (drop in lung volume from shallow breathing after surgery) and NARCOTIC RESPIRATORY DEPRESSION (I would forget to breathe). Insist on a monitor on you or your loved one. It is the standard of care. And do incentive spirometry, breathing exercises, sitting out of bed in a chair, and walking to reverse the atelectasis process.


 Bleeding and Hypercoagulation Surgical trauma to tissue makes the patient hypercoagulable (more likely to clot). This is a risk for deep venous thrombosis and pulmonary embolus. Stockings, leg squeezers (sequential compression stockings), lovanox injections, subcutaneous heparin injections are for decreasing the risk. My surgeon was concerned about bleeding from my daily aspirin, and had me stop it. So I was sure to do  leg exercises and wear the compression hose. Take these same risk-reduction measures for long distance travel by car, train, or plane to reduce clotting risk. A friend of mine diagnosed a PE on himself mid-flight, and on landing had to be transported to a hospital for anticoagulation with a heparin drip.


 Risk of Falling/ Impaired Balance Getting up after surgery makes you light-headed. Have someone there. Hold on to an i.v. pole or a walker when walking at first. You will get your balance back again.




Urinary Retention Anesthesia and narcotics upset the cholinergic balance on the little muscles that tell your bladder sphincter to relax and let urine flow. For some with big prostates, the normal balance is lost for good, and medical intervention is necessary through a catheter or surgery to open the flow. If your first void or two after surgery is difficult, push as hard as you can, and know it will improve with time. Do not allow your bladder to overdistend, or else it will need bladder rest. Have your nurse help you with a quick in and out catheter first. Foley catheters tend to increase risk of infection, and need to be out by three days.




Sore Throat Your throat is likely to be VERY sore after any kind of surgery. My entire mouth burned. For days. Roof and tongue.  It is from intubation, laryngoscopy, and the bite block that is hard plastic that is used in the mouth. I lube my patient's endotracheal tubes and use soft cotton for a bite block, and they never get a sore throat unless intubation was difficult. Avoid citrus and you will get better.


 Nosebleed  My nose was full of dried blood. For days. I am not sure why. Perhaps a tube was passed through the nose to empty the stomach while I slept? I am still working on this one. You are not alone!


 Annoyance Everything bothers me! T.V. People talking. The way other people drive me in the car (they hit lots of painful bumps). Now it is post-op day five, and getting better. I have not experienced annoyance like this before, and am not sure where it comes from. Glad it is going away.


 Amotivation/passivity  My Life Force is weak. Daily Reiki is helping. And sunshine too. Eating to raise my vibration back to its natural state. Caring from friends, family, and coworkers helps with this one too.


 Chakra Imbalance  I have a sense for my chakras. Having surgery imbalanced them. But others chakras in the healing process are overcompensating. As I achieve balance, I am gentle with myself, as it is not going directly from imbalance to balance. Instead, it is going through many 'rebalancing' combinations that are uncomfortable along the way. I focus on my Heart Center. I listen for Guidance, which is quiet. And I Trust and Envision being back to normal for me again. Let me restate: I avoid low vibration, I am patient, I take in High Vibration whenever possible, and I wait. Sleep is one of the best things out there to heal the physical and non-physical alike.




 Miscommunication/being misunderstood Everyone working with you, be it professional, friend, or family, is going to see you through the distortion of how they see themselves. For me, the most extreme is my son, who is too young to understand the consequences of what I have been through. He cannot comprehend my being sick. I extend myself to a limit that I place on myself, for him. I protect my incisions with pillows against accidental harm (for example, he went to hit my arm at seeing an 'out of state' license plate, missed, and socked me square in the incision!). You are a perfect creature in illusion. It is all right to take steps to 'bend the illusion' somewhat in order to protect yourself. And have patience that everyone is doing the best they can, based on their individual state, to help you. Their intentions are good.


 Difference in Vibration/lack of Telepathy I went quiet. I missed it. The only thing I get is right before I wake up. It is coming back. There is only so much energy to go around. Be patient. And it will come back. Concentrate on Now, and know that everything is blessed and Right.


Healing is a lesson in itself. It is a powerful lesson. And when you see for yourself what surgery can do, and how you can bounce back, you will be inspired by the body's ability at reparation.

If you do not wish to undergo surgery, that is okay. But inform yourself so you can help others.

Imbalances that become physical are only lessons that have become harder to not notice.

Everyone has their lessons. As healers you shall experience them too.

One day all of this will seem antique. Better things are ahead. Until we get to them, add Reiki to the mix. And Namaste.

Reiki Doc

On Facing Surgery

Tomorrow I am having robotic laparoscopic surgery for a mass. It is causing pressure and discomfort.

How do I feel about having an operation? Better than I have before, but not so great. Let me explain...

My first time having anesthesia, I was ten. It was oral surgery. I remember being given square blocks of rubber to bite on in the dental chair, my arm being strapped into a metal holder, looking up at a big bottle of clear liquid labeled Sodium Pentothal and a long tube that connected that bottle to my arm. The next thing I remember is hearing the characters on the T.V. show 'Three's Company', slowly coming to and realizing I was not dead. Joy overcame me. Eventually I went home and recovered with my family.

My mouth being what it was, I had oral surgery twice after that. Once for extra teeth, and the other time for wisdom teeth at sixteen. I didn't phase me. I was nervous, but had good experiences and support. What meant the most to me at the time, was that my teeth were given back to me in a little plastic treasure box. I still have those teeth today.

The worst surgery is the one that came next: pituitary adenoma. There was something growing in my brain, giving me headaches. For some reason, that totally freaked me out. I had to go to a big university center. I remember talking with the anesthesiologist in the pre-op clinic about having some signal or code to indicate that I was actually awake. He saw my earnestness, and smiled, and shared that my neurosurgeon had actually worked on HIM, and he was okay.

It was the wait that was unbearable before that surgery. I tried alcohol, shopping, tears, journaling, going on a trip to the snow which I love, but nothing could take away the fear I had for going through this surgery. And afterwards, I was shocked at how I walked IN to the hospital on my own power, but had to be wheeled out after five days in house as an inpatient.

Slowly I learned how this was a gift to let me take some time to adjust my perspective on life. To take walks gently around the neighborhood. I lived in Berkeley at the time. I had two dreams, one to go work at Chez Panisse and become a famous chef. The other was to follow my childhood dream to be a doctor.  Here I am with you today--guess what dream won out? Not to say that I don't wish I could have had BOTH dreams come true, but I am genuinely happy with my life and how it turned out.

In a belly dancing class I tore my anterior cruciate ligament. I was a surgical intern at the time. I wore the brace for nine months, often whacking my good leg with the bulky brace by accident in the process. I never figured out if it was better to wear the brace inside or on top of my scrub pants. It was miserable! I got my surgery, knowing I had to have a repair to stop my knee from going out on me when I stepped off a curb or was in the grocery store. And to stop wearing the brace! I recovered well, and got back into ballet, my true love in dance. Getting my life back was one of the profoundest miraculous events, for I had resigned myself to never dancing again. Being let out of that prison truly gave new life to my soul.

Because I brushed like, too often, when I had braces on my teeth, I ended up needing periodontic care as an adult. While I was an anesthesia resident, I had a graft done at the periodontist's office. That was scary, and I tried to do it just on valium alone because they use a cocktail of things to put you to sleep that made me afraid I was not going to breathe. The valium wasn't working. They  asked, 'do you want to go all the way out?'. I said yes. Everything went fine. But my husband at the time, was a nurse. We knew the post-op for this would hurt. So he placed an i.v. at home, and dosed me with toradol i.v. I felt NO pain! For that I was working it to my benefit, applying what I knew at work to have a better recovery.

My last operation was cesarean section. I was ready to go home to Jesus by the time I was cut. Labor was awful! I never felt any pain, and healed up nicely.

I also had a root canal one day when I was pre-call as an associate professor. It was hard to schedule it, and those hours before work were the only ones that fit. I took no pain medicine, and worked a full overnight shift on Trauma and OB, supervising residents. It hurt like heck, but to survive we all do what we have to do.

I share my experiences with you, out of a selfish reason: I think doctors who have gone through surgery are better at taking care of their patients. My stomach is so sensitive to anesthesia I have to take toast and tea for three days following an anesthetic. Guess who's patients never throw up after surgery? That's right! I was so miserable that I figured that one out to help MY patients. Who threw up flat on her back in a c-section, wondering if she would aspirate right then and there while giving birth? You got it! Me! So who has the driest suction canister in the OR on L&D? Yes! I figured that one out also. Who is the best with the most anxious, neurotic, controlling patient in the Pre-Op Holding Unit? Good old Reiki Doc, that's who! I was bawling my head off while waiting for neurosurgery when I was twenty-five, in the flimsy gown hearing the other patients getting their hair clipped off in the other pre-op beds next to mine.

So what about this operation ahead? I got to pick my team. My surgeon, anesthesiologist, scrub tech, circulating nurse, and RN-first-assist. That helps to cut down on the fear of it. It is a luxury those of us that work in the OR have. I have to be honest with you--the tech who usually works on the robot is a male. I just couldn't face him knowing he had worked with my--'modesty'--the whole case! I told him why I picked a lady for that, and he understood. And he teases me about it, and it still makes me blush.

I was worried about my 'appearance'. Some people really go to town on their grooming, with landing strips and waxing and all. I spoke with my circulator, because I didn't want to look bad 'down there'. She reassured me that 'no one would care' and that 'in our day no one "landscaped" anything so not to worry'. It helped. As my surgeon says, 'we all look the same under our scrubs'. If you are having surgery, and are worried about how your body will look while you are sleeping, know that it is okay. Our surgery teams have seen just about everything. Unless we are working on a body part specifically, the more 'modest' ones are typically covered while we work in the OR.  Even in a c-section we hardly see the breast because the gown is never taken off the patient. It is okay.

I color my hair, so I made sure I covered my roots today, so they would not show. Anesthesia sees the head. And I packed a little bag with what I would wear to the hospital, a couple books, lotion, and my tooth brush. I got a Hello Kitty bag to cheer me up.

My greatest worry is for my son. I am a single parent. Although I co-parent with his father, my son and I are close. He will worry, and want to see me. But they do not let children in the surgical ward at the hospital. It will feel so long until I can hold him in my arms when I get back.

I am thankful for the robotic surgery, and the skills of all my peers. I feel the healing power coming through all of them. I never noticed how talented they were until I realized I would have to be going to them for my care. I am impressed at all of our skills from this perspective.

I have also put myself on the Reiki Healing List and the Divine Peace Healing Lists of my friends. I know I am in Divine Hands, and thankful for this peace of mind and comfort that Light brings.

I will do my best to let you know how things go. In the meantime, if you don't mind, and if it resonates with you, please pray for me in your heart. I am most grateful for your kindness in this respect.

Namaste,

Reiki Doc