How can I be the best temporary caregiver?
June 20, 2012 11:44 AM   Subscribe

I will be taking care of my friend after her surgery. Help me be the best caregiver ever.

A close friend of mine is scheduled for spinal surgery (anterior cervical decompression) next week. The surgery is to address severe herniation of her C5-C7 discs. She has tried PT and cortisone shots with no improvement, and her doctor is very concerned about the level of weakness and numbness in her right arm. So, surgery is imminent!

She will be staying with me for a couple of days after she is released from the hospital because she lives in a walk-up and I don't, and the hospital is literally across the street from my place. I want to make her as comfortable as possible and have everything I need on hand. Other than medications, her favorite foods, plenty of water, and a never-ending supply of on-demand cable, what should I have? Will she need a supportive neck pillow? Are there symptoms or issues I should watch out for? I have read many previous questions about surgery recovery, but I'm concerned specifically about this one because it's her spine and spines are pretty important.

She is also super freaked out by the reported difficulty with swallowing that people experience after this surgery. Is there anything she can do to minimize that? For those who have been through this surgery, how bad was the swallowing thing and how long did it last? Are there foods/beverages that are particularly easier to swallow or tolerate during recovery?

Possibly relevant details: she is 42, otherwise in good health, has no other medical issues and takes no medications aside from pain meds. Her doctor has told her what to expect from surgery and recovery but she wants to hear personal anecdotes from people who have actually gone through it.

In summary: my friend is having spinal surgery and I will be taking care of her for a few days. What can I do to make her comfortable and what can she expect to feel as she recovers?
posted by bedhead to Health & Fitness (16 answers total) 4 users marked this as a favorite
With her permission, get in touch with her surgeon or surgeon's staff and ask for aftercare instructions. They will have printed materials and will also answer questions you have that may not be addressed by the materials.
posted by rtha at 11:47 AM on June 20, 2012 [2 favorites]

It sounds like you are really motivated and trying to think of everything. What a great friend!

I would try to follow her lead. She will want to sleep a lot, and otherwise not want to interact much, even with a super care giver.

So, relax, and let her tell you what she needs, when.
posted by Danf at 11:48 AM on June 20, 2012 [1 favorite]

The swallowing thing is only for the first hour or so, and they'll monitor that while you're in the hospital. They don't send you home with that!

Lots of liquids are the order of the day. I got a bit dehydrated. Something with bubbles if she's a nauseated. Coke or ginger ale or 7-up (ask her what her mom used to get for her). Grape or apple juice, Gatorade. Get bendy straws!

The foods that seemed really nice to me were macaroni and cheese, red jello and fruit cocktail. I also enjoyed McDonalds hamburgers without onions and chocolate shakes.

I was sleeping a lot, on and off, so just let her be, don't fret, or fuss. Anethesia makes you very fuzzy, it's a nice feeling actually. Depending on pain meds (I had morphine, HOLLA) she might be very in and out, not to worry.

One thing you do have to be careful about is DVT. I was advised to get up and walk around a bit every so often.

Also, some MiraLax or some other laxative. I've never in my life needed this, but I sure did after surgery. I had laproscopic, so I was pumped full of gas. That was more painful than the surgery!

Have her bring her own pillow, so she'll be comfy (I travel with mine.)

You are an awesome friend!
posted by Ruthless Bunny at 11:55 AM on June 20, 2012

Whenever you ask her a question, try to make it something she can answer with headshakes for yes or no, or thumbs up/thumbs down! It can be super frustrating to be all exhausted and hurty and fuzzy-headed from painkillers and have to formulate actual answers sometimes. It is even more frustrating to feel frustrated with someone you know only wants to help you as much as they can.
posted by elizardbits at 11:56 AM on June 20, 2012 [2 favorites]

Do you have backup (no pun intended) friends lined up for when you leave your house?

Do the things people recommend for the elderly: put away area rugs, make sure there are wide clear paths between furniture, handrails in the bathroom if possible.
posted by mareli at 11:58 AM on June 20, 2012

Response by poster: The swallowing thing is only for the first hour or so, and they'll monitor that while you're in the hospital. They don't send you home with that!

The swallowing thing is a known side effect of this procedure because they go in through her neck and retract the esophagus during the procedure. The doctor (and all the patient literature she's read) says it persists for 3-5 days after surgery, and they do send you home before then. It's not that you can't swallow, but there's some discomfort.

Another thing to note is that this is in her cervical spine (i.e, neck), so she shouldn't have too much difficulty walking, except maybe if she's all hopped up on painkillers, in which case I will assist her.

Thanks for the answers so far! Keep 'em coming!
posted by bedhead at 12:25 PM on June 20, 2012

If she runs a fever after surgery, push the fluids. You can bring a temp down an entire degree just by making sure someone is adequately hydrated. I did this for my sister post surgery (different surgery) and it helped her cough up phlegm, so it may have prevented post surgical pneumonia. I got two hours sleep the first night but her recovery went well.

I also helped her shower so she could shower sooner than would have been safe to do alone. For several days, I helped her get up. She was cut front and back and could not get up unassisted. This was not a case of "shouldn't". This was a case of couldn't. I am bigger than my sister. I would get my arm around her and stand up with her, using my higher body weight as leverage. That way there was no tension on stitches or anything like that.

We also went out to dinner a few nights after she came home. Her husband dropped her and I at the door and then parked. We went to a buffet and I went through the line with her and got whatever she wanted and got her seated, then got my food. I went back for her for any seconds she requested. Her hubby picked us up at the door again when we left. All the special accommodation made it possible for her to go out without creating some crisis, and going out just once helped keep her from getting cabin fever.
posted by Michele in California at 12:28 PM on June 20, 2012

As someone who has been through icky medical procedures before - what a good friend you are! Kudos!

Do you or she have an iPad available that you can stream mindless movies/cute YouTube videos of kitties and birdies on? Can you get a Kindle and equip it with feel-good books? When I was recovering from surgery, I lay in bed watching "Pirates of the Caribbean" movies and reading romance novels and napping off and on (post-anesthesia she will be drowsy and muzzy, and opiates are also drowse-inducing). Being able to faff around on the internet is nice if you are stuck in bed, too.

And oh yes, MiraLax. Again, if she's on opiate painkillers, SHE WILL WANT THAT. Opiates constipate you like you can't believe.

Swallowing: stock up with different flavors of protein shakes or Ensure and soft food like chicken noodle soup and macaroni and cheese. And liquids, lots of liquids. Since I'm a tea drinker, I had to have some tea ASAP because of the caffeine withdrawal on top of everything else.

Laundry - can you make sure she has lots of clean pajamas, sweats, and undies waiting for her? Living in the same unwashed pajamas/sweats feels really really icky after a few days. Ditto clean sheets.
posted by Rosie M. Banks at 12:30 PM on June 20, 2012 [2 favorites]

Oh, and speaking of showers - SHOWER CHAIR! You need a shower chair - it makes a world of difference in being able to shower post-surgery and also makes helping her shower so much easier.
posted by Rosie M. Banks at 12:31 PM on June 20, 2012 [4 favorites]

Love the shower chair idea. If not possible, consider stocking up on baby wipes. They make for an easy sponge bath if a shower is too much work, or for cleaning up other, uh, accidents that might occur with constipation/MiraLax, particularly if mobility is limited.

You're a good friend for helping out! Best of luck.
posted by absquatulate at 12:44 PM on June 20, 2012

I have a friend who had this exact surgery six months ago. I have to tell you, she was AMAZED at how scary spinal surgery seemed, compared to how relatively easy and smooth her recovery has been. I think you've got all the right moves in this thread, but she may feel less anxious if she hears it may be an OK recovery! And my friend feels almost 100%.
posted by thinkpiece at 1:06 PM on June 20, 2012

I recently took care of a friend who had a similar surgery, but with a posterior approach which I understand is typically more traumatic/painful.

Yes to MiraLax, or at least have Philips Milk of Magnesia on hand. As unpleasant as it might be, ask her every day if she's pooped. If she's on pain meds for awhile, time can get distorted and she might not realize a week has gone by without pooping.

In the hospital they should have an occupational therapist come by a few times to help your friend learn how to get in and out of bed, how to sit on the toilet, etc. We found that at our hospital they tended to treat all spine patients like they'd had a spinal fusion, so they get really conservative about how to move and all of that which may not be 100% necessary but it is a good place to start. I'd recommend that you try to be there when the therapist visits so you can hear the same thing that your friend hears. Then you can help to reinforce the use of cervical collars/walkers/shower chairs as advised by the therapist. Remember that the anesthesia and post-surgery pain medication will mess with her brain, she may not even remember being in the hospital much less any aftercare instructions they give her.

The biggest issue for my friend, by far, was pain management. He was on serious pain meds for weeks and it seemed like the pain was not getting better and he was really whacked out all the time. What we discovered, far too late, was that the surgeon's office had a very sledgehammer approach to pain meds and was throwing the strongest stuff at us like it was candy.

It wasn't until we went to my friend's primary care physician and had him take over medication management that we discovered that he was being way overmedicated. Once the PCP got things straightened out, changed meds and reduced the opiates and such, my friend improved rapidly. I guess what I'm saying is, make sure that your friend knows that she is in control of how her pain is being managed and that she can work with others, such as a family doctor, if appropriate.
posted by cabingirl at 1:17 PM on June 20, 2012

In terms of swallowing, you can get problems after this kind of surgery for several different reasons. One is things like bruising or or minor damage to the structures involved like the oesophagus. A second is swelling and suchlike compressing the very important nerves that control speaking and swallowing in that area. A third would be permanent damage to those nerves. I wouldn't highlight those to your friend! In most cases everything is temporary and you should work on that assumption. However, an important role for you might be reading up a little about the signs of a swallowing problem and keeping an eye out for those kinds of things as well as any change in your friend's voice that doesn't improve quickly.

If your friend has swallowing difficulties, they should be able to access a speech therapist to give them advice on managing them.
posted by kadia_a at 1:37 PM on June 20, 2012 [1 favorite]

Activia is cool, easy to swallow, and good for digestion especially if she is given antibiotics.
posted by Cranberry at 2:40 PM on June 20, 2012

My hospital sent me home after various surgeries with a particularly nice water bottle with a long straw that I could drink out of at any angle without any spill (iwithout holding it up, etc.) Hopefully she will come home with one of these, but if not, do get her one. Maybe just go buy one now if you can find one. It made all the difference in staying hydrated, to be able to drink comfortably when lying in any of the several random positions that I needed to stay in to be comfortable.

What a good friend you are! Your question has made me happy.
posted by fingersandtoes at 3:14 PM on June 20, 2012

Make sure you take care of yourself too! If she's going to have a medication schedule which requires nighttime waking, or any help getting to the bathroom, it can be exhausting to be a caregiver, so make sure that you give yourself a break on feeling frustrated, and try not to get down on yourself.

Check if your friend has any bedding she likes, along with her own pillow, a blanket might be nice to have, along with some easy, slip in sandals or slippers.

If you have netflix, add some tv shows to your queue, a whole season of something is nice to watch while recovering at home. Additionally, if the pain meds aren't too bad and her attention span is good enough, I'd suggest some audiobooks. They give your eyes a break while still keeping you entertained.

You're a really good friend, she's lucky to have you!
posted by nerdcore at 10:12 PM on June 20, 2012

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