6. Post-Surgery

 
 
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Be prepared for many sleepless nights

 
 

The Importance of Sleep


While sleeping was problematic before surgery, I’d slip in and out of sleep readily (except for when I needed medication) immediately after surgery. However, this is not to be confused with getting a good night’s sleep; that was still many weeks away. My unfocused mind made it easy to lose track of time. When my surgeon visited me and saw me reading a book, he predicted, “You won’t remember any of that,” and he was right. I continued to keep my journal during this period, and those notes are what I am relying on on now as I write this account.

Why is it so difficult to sleep during the first six weeks following surgery?

First, there are many more distractions during the day than at night, and a preoccupied mind is far less likely to notice pain.

Second, the slowdown in breathing rate that accompanies the body’s relaxation at night causes higher carbon dioxide levels in the blood. This, in turn, dilates blood vessels increasing nerve sensitivity.

Third, stress—both physical and emotional—can cause pain, as discussed elsewhere.

It seems grossly unfair, then, that the time when patients most need to relax is also when they are most likely to feel pain. Sleep deprivation significantly impacts sleep cycles and affects how much, if any, HGH is released during the first period of deep sleep. Sleep deprivation significantly impacts sleep cycles and affects how much, if any, HGH is released. There is a direct relationship between hours slept at night and the intensity of pain felt the next day; less sleep results in more pain.

These factors can create a vicious cycle. A dark, quiet room leads to fewer distractions, heightening the perception of pain and making sleep more difficult.

Lack of sleep results in a general feeling of unease, disquiet, and increased stress. Increased stress intensifies the perception of pain, and the cycle repeats. At the same time, inadequate sleep stimulates an increase in blood sugar and a decrease in the production and release of human growth hormones.

What can we do to promote the release of HGH and help ourselves sleep better at night? To begin, diet matters. A diet high in carbohydrates and sugar leads to a rise in blood sugars (glucose), increased insulin, and a corresponding decrease in human growth hormone. When the blood sugar is low, and insulin level falls, HGH rises. Remember this when you choose your bedtime snack!

Your mind can also be a powerful weapon against sleeplessness. Visualize a favorite place where you would rather be. Practice deep breathing to provide your body with more oxygen and concentrate on your breathing as a form of distraction. Experiment using ice to dull the perception of pain.

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Sleep with ice packs nearby

Nights can be very long when you are in pain, and waiting for the minutes, much fewer hours to pass, can make the pain in your leg that much worse. For the first six weeks post-surgery, I brought ice wraps in a portable insulated cooler to keep beside the bed at night. During the middle of a sleepless night, it was good to feel that I was doing something useful for myself when I put a new icepack on my knee. An icepack often brought me a measure of relief from the pain and helped me get back to sleep.