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Still haven't experienced the dreaded first BM. The milk of magnesia instructions say do 2 ounces, wait 6 hours, and try 4 ounces if that didn't work. That was last night, still no action. Took sitz bath this morning along with 4 more ounces (tablespoons?) of MoM, along with a cup of coffee, and a bowl of fiber one. No go on the BM front. Starting to wonder if the caffeine might be causing a problem, or the opiates. No discomfort or pressure, so not going to worry about it too much yet. A BM every 3 or 4 days is normal for me, so I am going to let it ride. Noticed a skin tag came off in the bath, looked like a piece of chicken skin. Another divorce-avoidance tool, the water pic, which was able to rinse the tub out from the shower next to it ;-) And yet another piece of good news, in spite of the depends being remarkably comfortable, I have not needed to wear them since day one...

Realized my medications are going to run out over the weekend so I called my surgeon to see about getting a refill. The valium in particular is starting to just knock me right out. Can't do anything over 5 minutes at a time without an overwhelming drowsiness taking over. So much for catching up on all of the stupid movies I recorded that I would otherwise never watch. Asked the doctor's office to drop the dosage down from 10MG to 5MG on the valium. Have no idea if I would even be in pain without the meds, but don't want to find out over the weekend when nobody is available. Also, I was never informed if I would actually need the meds for the entire two week recovery period, or if the scripts were just to get me through the initial few days after surgery.

I have decided the bidet is mankind's greatest mechanical device. Forget about traveling to the moon, everyone should have a bidet ;-)

I can finally lie on my back as long as I have pillows under my leg and a bed tray for my laptop. Sitting is out of the question, and doing anything that requires more than 3 minutes of concentration is futile. I may end up driving my wife to a divorce with the rewind button on the dvr, having to watch So You Think You Can Dance over and over again ;-)

So, so far, everything is manageable. Getting up out of bed is a bit of a challenge, but once I am up I am able to take short walks, go up and down the stairs, take the dog for a short walk, etc... Cannot lean over to pick things up, put on my shoes, etc, so the kitchen tongs have been invaluable. Either the drugs are working exactly as they should, or my surgery was nowhere near as traumatic to my system as other people's experiences I have read about here.

I will finish with a complaint. In spite of the Apple commercial claims, there is NOT an app for everything. Out of the hundreds of medical related apps in the Apple app store, there is not a single app that will allow you to enter a medication schedule and have an alarm sound when it is time to take your next dose. There are a couple that come close, if you jump through hoops like requiring you to leave the app running and not allowing the iphone to go to sleep. I have had to resort to using the Clock App and setting individual alarms for each individual dose, easier said than done when you are in a fugue state ;-)

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<RANT>
All right, time for some ranting and raving ;-)

Called the surgeon's office at 9:00 am to find out about a refill on the valium, which by my calculations will run out on Sunday afternoon. Have not heard back from them by 11 am so called again, was asked to leave my phone number. I have found that the front office people employed by these surgeons are extremely unreliable. They "lost" my first appointment which was 4 weeks after a thrombosed hemorrhoid kept me from working for over a week, only to reschedule a second appointment a month later. They still have not found my original chart from the surgeon whose practice they took over. After finally getting in to see the surgeon on a Thursday and going through a rather uncomfortable exam I was told to call back with a decision to do the surgery or not. I called back and discovered the surgeon I saw did not have privileges at my hospital. They did manage to get me another appointment for the following Tuesday with another surgeon with the same practice, who does have privileges at my hospital. After a 10 minute exam by the second surgeon and a recap of my history he suggested surgery, doh! He got me scheduled for the next Tuesday and told me a nurse would be in to give me further instructions. The nurse gave me no pre-op instructions other than to not take any medications 3 days before the surgery. After calling them the day before the surgery I discovered I was supposed to "go to Wal-Mart and get some Magnesium Citrate". After obtaining the magnesium citrate I called to find out exactly what dosage I should take, was told the nurse would call me back, and never got a callback. I took a wild guess and ingested the entire disgusting 10oz bottle ;-)

Note that I work for the largest health care system in the state I live in. Any medical professional in my state knows our employees are required to be treated at our own facilities unless there are special circumstances, trauma, etc... My employer was plainly listed on my insurance card, the paper work I filled out (separately for each surgeon), and in my old chart that they "could not locate". I was charged $40 copay twice, even though, as far as I am concerned, they mistakenly booked me an appointment with a surgeon who could not treat me. Hopefully my insurance company will pay twice for the same visit also, I suppose I will find out once the bills start pouring in.

Lessons learned....

Even if your primary care physician refers you to a surgeon, and the web site for your HMO informs you the surgeon is covered, verify by calling your insurance company rep for your employer. My HMO covered the surgeon, but not the hospital he had privileges at. Don't assume anything.

Refuse to leave the surgeon's office without written pre-op instructions.

If at all possible, have the surgeon call in your prescriptions before the surgery so you can pick them up the day before. Sitting alone out in a car in a twilight state in cold weather for an hour while waiting on your prescriptions to be filled is purely insane. Ask what you are going to be prescribed before leaving the office the day your surgery is scheduled. I asked for, and was refused, a prescription for lidocaine cream, to ease any localized pain I might experience during or after bowl movements. I also asked for and was refused a prescription for phenagran, for nausea. Not much point to taking pain medication if you can't keep it down. Although my surgeon refused to prescribe it, my family doc did. Luckily the opiates have not made me nauseous, so I have not needed it. If they refuse to prescribe something ask for an explanation.

When you do get your prescriptions, make sure the amount is sufficient to make it through a weekend. Getting oncall doctors who are not familiar with you or your case to prescribe narcotics on a Sunday morning is probably going to be next to impossible, and who can blame them for being suspicious?

</RANT>
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Well, called my surgeon's office at 9AM. Surgery Tuesday, still no BM on today, Friday. Discharge papers inform me to try an ounce of Milk of Magnesia, if it does not work, try again in 6 hours. No help and no further instructions. They took my number and told me he would call me back.

No callback by 3PM, called again, was assured he would call back after his "meetings".

7:30PM and still no callback. Called the number he left on the discharge papers, was disconnected. Plan on calling the medical exchange number on the same discharge paper around 3AM, perhaps that will get his attention?

Took matters into my own hands and scarfed down another ounce of Milk of Magnesia along with a teaspoon of mineral oil, perhaps that will get things moving and I won't have to resort to my payback 3am phone call ;-)

Beginning to believe all of the stereotypical malevolence towards surgeons might just be grounded in some reality ;( Not to mention I will be running out of valium by Sunday morning. For all I know I might not need the valium beyond the first few days post-op, but it would be nice to at least have that explained to me...

On a positive note, very little pain or discomfort. The sitz baths continue to put me to sleep like a baby.
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