caregiver tips after a back surgery?
January 6, 2017 8:06 AM   Subscribe

My partner will be having back surgery next week and I'm looking for tips on how best to support him and prepare for the surgery and extended recovery.

He's having a microdiscectomy, he will be on pain meds for likely 1-2 weeks and then relatively immobile, unable to lift, bend, etc. for some period of time after that. 4-6 weeks is what we've been reading, but I've also read anecdotes that said recovery was much longer, so I'm thinking of ways we can structure our schedule, etc. so that if it goes into the long term we can just roll with it. Other details - we have 2 children under 5 and I work full time at a fairly intense job, it can be a bit chaotic around here. We all know he can't lift them, and will not be involved with the daily routines of baths, down on the floor getting little ones dressed wrangling, school dropoff, etc. but what else we can do to make sure he doesn't re injure himself?

I've made a list of things I think would be good to have taken care of ahead of time over the weekend, including easy healthy food for all of us (all set) and setting up different sleeping options i.e. something downstairs in case he can't get up the stairs, and setting up the guest bed for me (and our children who come see me in the middle of the night) so he can sleep in our bed uninterrupted. Other comforts for him that would be useful to get set up ahead of time? I.e. when our kids were born there were various little hacks that helped such as having a giant water bottle on a table by the rocker for night time feeding, etc. The sort of details you didn't want to think about in the moment.

I'd also love to hear tips on how to be comforting without smothering when when someone is in extreme pain tips'? My family is not great at expressing empathy and tends instead to either 1) make suggestions of things that might help. Or 2) not say a lot and instead stay busy cooking, cleaning, etc. know my family's penchant for suggestions drives him nuts, so I've worked really hard at saying 'how are you feeling, is there anything I can do for you?' and stopping there. But my words feel unnatural and flat, like something is missing, and I'm not sure if the thing that's missing is the 'suggestion pattern' or something more empathetic I could be saying.
posted by snowymorninblues to Health & Fitness (11 answers total) 2 users marked this as a favorite
I was laid up in a hospital for a few weeks and in-home recovering for 2-3 more weeks several years ago, so can almost literally feel his pain.

The big thing I wanted to do, especially while on a lot of painkiller, was watch TV. It's hard to concentrate on work, reading, etc. for long stretches, and it gets really boring. The painkillers slowed my brain down enough to where typical TV was really interesting! :-)

have you talked with anyone at the hospital or the surgeon's office about medical equipment and in-home physical therapy? A hospital bed may or may not be in order (or desired), but going upstairs doesn't sound like a Good Thing at this point, so I would put a priority on making sure he's got a bed downstairs in a room that can be kept off-limits to kids as needed (but which can allow for visitors, including kids, when wanted). Nice thing about a hospital-style or at least a folding-style bed is elevating slightly to watch TV, eat, use a computer or tablet if he's so inclined

He's definitely going to want some kind of tray that he can use for eating, etc. Some kind of bedside storage where he can keep stuff within reach without getting out of bed more than necessary.

When I was in that spot the things that helped my mood were:
a) LIMITED visitors, meaning encourage people to come by but not to stay too long. :-)
b) spending time together talking about anything BUT what kind of shape I was in.
c) lots and lots of distractions.

I didn't really want *sympathy* per say. Mostly I was coping with the boredom.

Lastly, the tough times are going to be on the home stretch when he's feeling better and they are presumably weaning him off the pain-killers. I was fine as the pain-killers were reduced - until they got to nothing. And then I went through a couple of days of feeling just incredibly sad, which I attribute to no longer having the drugs. Make sure and talk with the doctor(s) to make sure there's a sensible plan for weening off/reducing painkiller intake.
posted by randomkeystrike at 8:41 AM on January 6, 2017 [3 favorites]

Maybe practice with the kids how they can be affectionate with their dad while he's laid up? They can give him a kiss instead of climbing on him for a hug - that kind of thing. Practicing might make it less scary for them if he seems really sick right after surgery, and less painful for him if they get it wrong at first!

And maybe you guys can also help the kids plan gentle activities: "Daddy won't be able to go to the park with us next week, but we can look at books with him when he wakes up from a nap."
posted by MangoNews at 9:07 AM on January 6, 2017 [1 favorite]

Be prepared for a lot of sleeping. Recovering from surgery last fall, I was mostly just very dozy or asleep. This had little to do with the painkillers -- I am used to taking opiates for hip problems. Twice I ran a higher fever and worriedly went to the ER; fortunately I didn't have an infection, and both times got 'loads of sleeping, and some bouts of low fever, are normal when your body is repairing itself' when I gave a run-down of my recent activity, which was: constant napping on the living room sofa.

I have a daughter -- nine -- and decided to recover on the sofa so I was not constantly squirrelled away in my room, but clearly present in the house; even if I was snoozing I was at least visible, and also right there to be woken up if needed (we only had help on weekends and the odd weekday). If you have the right kind of sofa for this, pull up coffee tables nearby, with a bag/basket of meds, carafe of water, light reading, tablet, etc, and cover the sofa well with blankets before a sheet and blankets to go on top so it doesn't get smelly/bloody. My kid slept with my pillow when I was in the hospital and liked anything with 'mum smell.' If it comforts your kids to sleep in Dad's unwashed tees, excellent. Be prepared for them to be a bit freaked out by it all; my kid cried, and still doesn't totally understand how people have operations without just bleeding to death. Beware of too few or too many details...!

TV that asks nothing of your brain is terrific. I watched the entire run of 'Family Guy,' which I had scoffed at a bit before, but which was hilarious at that time. Actually, I watched the entire run of 'Family Guy' twice, because my brain was not absorbing much, and I kept falling asleep mid-episode. (Eventually I realised it would be easier and more fun to stop going back and trying to figure out where I fell asleep, but to just plan on re-watching.) That is one thing the kids can do with him, watch cartoons. He might have the energy to read to them a bit.

I personally -- YHMV -- found it a relief when me getting off the sofa involved a bunch of "YEEOOOWWCH" and I was NOT asked any questions or otherwise paid attention to. Obviously I was in pain; please just hush and let me moan without bugging me about why I am moaning -- you know why I am moaning, which is because part of me got cut open. The absolute most I would have wanted to hear is strictly practical stuff -- "How's your ice pack; do you want a fresh one?" You can offer to refresh whatnot but I really bristled at 'suggestions' unless they came from a physician.

Gross to think about, but, consider a bottle for peeing in at the start to really minimise the need to get up. I think some post-surgical advice wants you to move around a bit, but it seems to come from people who have not actually had surgery. If heading to the toilet to pee is hell, just find another receptacle for the time being.

I've never known anybody to have difficulty weaning off painkillers as their pain abates after a very short stint of taking them. You just slowly take less, as needed. Weaning difficulties might have been a sign that the dosage was too high? One's brain responds differently to them when in pain vs not in pain, which is why most chronic pain patients don't have much of an ability to get high off them and the % of people who, on a correct short-term dosage, end up addicted is tiny. Make sure pain control is adequate, but he shouldn't use them for, say, trouble sleeping (I'd ask for a sleeping pill to be added to the mix if sleep is an issue). OTOH they are nothing to be scared of and if pain control is not adequate there is nothing useful to be gained from toughing it out; he should call his surgeon and ask for something different/stronger. (And he is not limited to opiates -- I took indomethacin and it was a total lifesaver, the difference between horrible burning at the incisions vs much lower-key pain there.)

I was told 'six weeks recovery' and it was almost double that; the timeline sounds optimistic; being prepared for longer is sensible. I ate mostly crap -- usually I love a giant bowl of salad but at the time my stomach wouldn't do raw. I ate a lot of noodles when I was up to eating.

Do set up friends to visit YOU with a bottle of wine in hand and arrange for breaks for yourself; caregiver burnout is a thing to steer clear of -- stay on top of caring for yourself.
posted by kmennie at 10:17 AM on January 6, 2017 [1 favorite]

I was couchbound for two weeks following surgery last fall, and the things that I would keep in mind are:
-Can he get to the bathroom easily from wherever he is in the house/are there any stairs or other weirdnesses?

-It can be helpful to keep a barf bucket by the place where he initially sets up (I had one and never used it, but it was very comforting to have to hand when I was super nauseated by painkillers and unable to swiftly move to the bathroom)

-On that tip, if his painkillers or other meds need to be taken with food, make sure that he has an adequate supply to hand for times when you're unable to fetch/reheat/whatever food for him. Water or Gatorade or whatever, too. Also on this note, if he has timed doses of meds, consider setting a timer after he takes each dose so that he's not caught in lots of pain if he forgets to check the time

-If he's taking opioids, make sure to also take whatever stool softeners/laxatives his doctors suggest, like, immediately

-Seconding setting up mindless entertainment that doesn't require any specific movements from him (I watched a lot of Great British Bake Off and rewatched all of Mad Men [nothing too grim, just in case they trigger weird painkiller-induced nightmares])
posted by quatsch at 11:03 AM on January 6, 2017 [1 favorite]

I was stuck in bed on pain killers for two weeks after a completely different type of surgery. No kids though.

- Strongly seconding barf buckets, including for the drive home. I needed them a lot.
- If nauseous, don't eat all your favorite foods. Oatmeal and chocolate peanut butter smoothies still make me feel like puking four years later.
- It's hard to predict which foods will stay down so don't be too attached to your healthy meal plans.
- Have a plan for ice cubes/ice packs before you need them.
- Week one was non stop netflix and napping, week two included quite a lot of Skyrim and some silly novels. I was not thinking very clearly.
posted by carolr at 11:22 AM on January 6, 2017

I had a microdiscectomy in August. I would recommend that you find a sturdy, hard-backed chair with armrests, like the kind you might find in an office waiting room. Buy one at an office supply store if you have to. The reason for this is that, post-surgery, it is impossible to get from a seated position to standing without bracing yourself on something, like the armrests on the chair. (Don't try to use a desk chair with wheels, as it might slip out from under him.) The couch will be too hard to get up from, and anyway it doesn't offer enough support for your lower back. Laying in bed is ok, but I was much more comfortable watching TV/reading/eating from a seated position rather than lying down. Also the hard-backed chair is good for holding an ice-pack in place on the lower back to deal with soreness.

Consider taking the week after his surgery off from work if you can, so you can do all his lifting, etc., and he is not tempted to, say, try and get something out of the bottom back of the fridge on his own. I probably could have cared for myself if I had to, but having my wife home for a week made things much easier.

I'm pretty sure his doctor will tell him to walk as much as possible after surgery, and for this he will likely need a cane, at least for the first day or two. The hospital provided me with one on discharge.

And in case you didn't already think of this: have anything that he might want to use while he's recovering available without having to bend/lift to retrieve it. So, if he'll want to cook, take any pots and pans he might use out of the cupboards and set them on the counter.

Good luck!
posted by crLLC at 12:17 PM on January 6, 2017 [1 favorite]

I did not mean to sound like I was saying to minimize use of painkillers as directed or needed. I was only saying to be mindful that some short-term emotional effects may be felt (or may not) as dosages are reduced. I would definitely agree that being in pain is NOT a good idea and inhibits recovery.
posted by randomkeystrike at 12:42 PM on January 6, 2017 [1 favorite]

Seconding the recommendation for a chair with a straight back and arms you can push off from. My mom recovered from back surgery at our house, and she found that to be the most comfortable thing for sitting in while eating and watching TV. Which was what she mostly wanted to do. There was no way she could comfortably sit on or get up from a couch.

I have no idea how common this is, but we also ran into an issue where she wasn't hungry, and figured out that all the heavy duty antibiotics created an esophageal thrush infection, making her nauseous. She was stubborn about calling the doctor, but when we finally did they were able to treat it and it helped quickly. So don't hesitate to call if something seems off.
posted by thejanna at 1:04 PM on January 6, 2017

When I was incredibly sick for a long time, it was stressful for the entire family. One night, my youngest son was behaving pretty badly and I just sent him to bed to sleep because he was simply exhausted. The next day, he was no longer a pill. I never brought it up again. I did not punish him or lecture him. I just chalked it up to the stress and moved on.

Expect this to take its toll on all family members and try to build in some leeway for less than stellar behavior, bad manners and stuff like that. It will go better if you just assume people are not going to be at their best and kids in particular may not know how to express this or process this other than just having a melt down once in a while. And if an adult can explain it as due to the stress, that will help the kids not feel like they are terrible people or something.

posted by Michele in California at 8:46 PM on January 6, 2017

I have experience playing nurse for my hubby after a microdiscectomy (twice!)
Some things:
They send you home with a big bag of meds that all have to be taken in different combinations at different times. We made a chart - morning, take 1 of these, 2 of these, etc. The doctor & the pharmacist will come & talk to you about each medication & make sure you understand what each one is, what it's for, etc.
Overall he didn't need too much from me except I managed his meds for the few days as he was much too out of it, and I had to change the dressing daily & dab it with a little rubbing alcohol as I remember.
We set him up in the guest room on the ground floor because there was *no way* he was getting up the stairs at least for a week. That was his little camp for a few weeks. Actually it still is.
I got a whole bunch of little snacks & whatnot (mixed nuts, breakfast biscuits, water, drink boxes, etc.) & stacked them up by the bed so he wouldn't have to go upstairs to the kitchen between meals. I brought all his food down to him.
Lots of sleeping & TV but they also want you to not be *completely* bed-ridden.

Some things I had to get from either a medical supply store or a walgreens that also stocks medical supplies:
A raised toilet seat
A device that holds toilet paper so you can wipe without twisting
A little bottle for peeing in
A walker (already had the cane)
A big piece of poster board to put the medication schedule on
posted by bleep at 10:41 PM on January 6, 2017 [1 favorite]

A reacher/grabber stick is useful to reduce bending/lifting/twisting. If they give him a walker, there are lots of accessories like table tops and pockets to carry stuff.
posted by ecsh at 5:45 AM on January 7, 2017 [1 favorite]

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