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Medical Adventure

This page contains some somewhat graphic descriptions. Nothing is here to purposely shock you but this is not a description of a day out having a picnic. This page covers some of the medical tests and procedures I went through over a 6 month period. It was all new to me which made some things more difficult than they needed to be. Hopefully reading one person's experience will help prepare you for similar procedures.

Please Email me if you find any problems with this page.

GoodRX and other discount coupon sites

This is amazing and still little known. For nothing more than a free coupon, you can save 90% (maybe more) on drugs. One of mine was $178. With the free coupon, the price is less than $19.Some give you a coupon for a specific quantity, dose and others offer a card that's good for most prescriptions. I prefer the coupons because it gives you an estimate of what you'll actually pay.


eBay isn't good for buying many things but for some medical supplies, they excel. For example, some of the tapes mentioned below are $40/roll from a medical supply house. You can buy sealed surplus from those who didn't need it for $10. There are many other items available that are genuine items from respected medical manufacturers (dressings and such) at huge discounts. Just make sure that anything with an expiration date is not expired and that all dressings and such are sealed.

When buying dressings (especially specialty dressings with special properties) you need to be careful with regard to the size and quantity. If you search for a part number of a dressing you want, you need to look at the quantity and size as well as shipping costs. The sellers may have the same part number for a single dressing or for a box of 10. A single is rarely worth the included shipping but you'll have to decide what's best for you. When buying multiple sealed dressings, try to order a size that will allow you to use most/all of what's in one or more of the individual packages. That will leave the rest sealed and as sterile as possible.

When buying dressings for small incisions, you will likely cut larger dressings to size. Using an entire dressing 4" x 5" (for example) makes no sense for an incision that's 1/4" wide and 3" long. For a wound that';s producing very little discharge, you only need to have a piece of dressing slightly larger than the what the discharge can fill between dressing changes). When cutting dressings, use a clean, dedicated pair of scissors. Using a pair of scissors that have been used in the kitchen to open meat packaging or in the garden would not be a good choice.

When buying multiple sealed dressings, try to order a size that will allow you to use most/all of what's in one or more of the individual packages. That will leave the rest sealed and as sterile as possible.

Statins have been around for a while. I could not take the early ones due to muscle pain. The newer ones like Crestor or Lipitor have been OK, though. If your cholesterol is low/good, these drugs may still have a benefit. They tend to stabilize the plaque in your arteries. The plaque is what causes a stroke in many instances. It builds up on the artery walls and then can break off and go to your brain, blocking the blood flow to some part of your brain. This can cause part of your brain to die and cause mobility, speech, knowledge loss. If you've tried statins in the past and they have caused you problems, keep trying different ones until you find one that works for you.

There are several common neurological problems that can cause paralysis/numbness. Some will reverse themselves (belle's palsy). Some 'may' reverse themselves (Transient Ischemic Attack) and then's there's the stroke. A stroke can vary in degree. Minor ones may only lead to minor weakness (generally on one side of the body). More serious strokes will cause total loss of feeling and control on one side of your body.

I don't often speak of anything regarding myself but I think this is important. I had a very minor stroke. I never lost complete control of my left side but it was like my hand and foot had lost all knowledge on how to do anything. They had to re-learn everything. It took about a month to get back to about 90% of the original function and that's the best it's going to get.

That's not all that came with the stroke. There were severe sleep disturbances that require drugs to control. There were instances where I believe the brain was trying to re-route signals and got it wrong. This process evolved and some of the faulty connections broke but it was odd having your body function in strange ways.

Carotid Artery Surgery:
The stroke I had was due to a piece of plaque that broke away from the larger deposit in the carotid artery. To make things worse, the right carotid artery was about 85% occluded. Before surgery, the surgeon wanted to know what he was dealing with (my health, in general). The news was not good. At rest, my heart was receiving a (barely) adequate supply of blood. Under stress, the blood flow was much worse. This left the only option the surgeon felt comfortable with, that was to have me fully awake while they stented the artery. This took about an hour and one of the oddest experiences of my life.

This surgeon used a relatively new procedure that could only be done in a specially outfitted room that was only available at one hospital in the area. When carotid artery surgery is done, there is a possibility that a piece of plaque could break off and cause a second (possibly more serious) stroke. This procedure reverses the blood flow so any bits of plaque flow away from the brain. The other carotid artery is forced to push blood through the blood vessels from one side of the brain to the other (the side where the surgery is being done). The blood flowing from the site where the stent is being installed is passed through a filter and then fed back into the femoral artery in the leg/groin. This procedure reduces the risk of a second stroke from about 3% to just under 1% (if I remember the numbers correctly)

A note about stress relieving drugs...
I think that most people would be terrified to have a surgeon work on them while wide awake. I think I would have if it hadn't been for Sertraline (generic Zoloft). About a month before surgery, I began taking a fairly high dose (for me), 100mg a day. I've taken it before at 25mg a day for periods when life was being a bit less than cooperative but 100mg was a big step up. Initially (first few days), it made me sleepy. After that, it just kept me calm. For the artery surgery and the bypass surgery, I was completely calm. I don't like taking it long term and quit soon after I got home. I had other anti-anxiety drugs (Xanax, for one) but was worried about dependency. That's not a problem for me and Sertraline. I can get on or off of it with no significant side effects.

Nuclear Stress Test:
Since I had had a stroke, I could not do a treadmill test so a chemical injection was used to get my heart to the state needed to determine its condition. I feared this test more than I can describe. I had heard that it was absolutely terrifying during the 4 minutes when the injection was being made. After the tech told me to inhale through my nose and exhale through my mouth, it became much less stressful. After all of the fear, it was not bad at all. I don't think it's going to become a fad at nightclubs but it was in no way terrifying. Before the test, a radioactive isotope was injected. After about an hour in the waiting room, the final stage was performed. It involves taking a series of photos with a camera that's essentially a Geiger counter. The seat rotates and it takes a series of photos from various angles. The highly oxygenated areas of the heart show up as bright orange. Those with little or no blood flow remain black. There is a second part of the test. For me it was on day two. The second test involves the isotope injection and photo session but no stress test injection.

After the various tests, I was told that I had had a heart attack (news to me) and an artery in the back of my heart was 100% blocked.

Bypass Surgery:
This was the most serious of the procedures I had to have. The blockages around my heart were too bad to fix with stents. The surgeon thought that I needed at least three grafts but ended up doing five.

After surgery, I was in very little pain from the actual operation but as always, this body of mine was going to make things difficult. The pain from surgery required only a couple of days of pain medication.

Possibly due to something done in surgery (or maybe not, no clue) i developed an unbearable pain in my right shoulder. IT was at a very tiny spot. Nothing would alleviate the pain. Dilaudid only stopped the suffering because it made me sleep. No one had any answers or help for the pain. After about a day and a half of suffering, I found that elevating the arm on a pillow or two made the pain stop. The discovery was accidental because the pain didn't stop when elevated. Initially, there was no reduction in pain. After about five minutes, the pain began to subside and after ten minutes, the agonizing pain was gone. Something similar happened to my left abdomen. It was, again, agonizing. After another day of pain, I tried elevating my left arm and with similar results to my right shoulder, the pain began to subside. I don't know why elevating an arm made my abdominal pain stop (and didn't care). I was just glad it stopped. The reason I include these examples is because you may want to try something similar if you have the same strange problem.

One thing you will have to accept about the surgery is that you will have many restrictions as to what you can do. You will not be able to use your arms for much. You won't even be able to clean yourself after a trip to the restroom. Prepare to have a significant other or a hospital employee do it for you. This will continue for weeks, depending on your surgeon's instructions. When you begin to self-serve, you will have to be careful. If using your right hand, I was told to grab your right shoulder with your left hand to keep the sternum from separating.

For me, I was retaining too much fluid after the surgery and had trouble clearing my lungs. Coughing was initially very painful. I was given a soft pillow to hold tight against my chest when coughing but it didn't allow intense coughing without much pain. I later got (for a different reason) a thick, relatively hard foam cushion. THAT allowed me to put much more pressure on my chest and allowed more intense coughing with very little pain.

This should be common sense but... if you have visitors who are sick or simply have been around someone who was sick, tell them to stay FAR away (don't even come to the hospital). Going though this without being sick was difficult. Fighting something like the flu would make it a living hell.

Following surgery, you will have to endure a few things that are unpleasant but not significantly painful The first is the breathing tube that's inserted into your airway. That was very uncomfortable and I kept asking (motioning) for it to be removed. They waited a while and I kept motioning for it to be removed. I was likely as annoying as a drunk who keeps repeating something but I was till somewhat sedated and it was uncomfortable. Before surgery, you will likely see your anesthesiologist. Ask him/her about the tube and how long it will be (after waking) before they remove it and why they have to wait. That will save you a bit of anxiety (it's always good to know what to expect).

The rest of the odd things you'll have to deal with are more strange/surreal than painful. The first is the removal the the chest tubes used to drain and allow monitoring the drainage from your bypass procedure. There will also likely be wires that can be used to connect a pacemaker or other device directly to the heart. I had a tube in my neck. I don't know what it was for. There was an arterial line (in an artery, not a normal IV in a vein). I think it was used to monitor blood pressure directly. It was one of the more painful IVs I've ever had. It was inserted in an artery that was not visible from the outside so it was sort of hit and miss with a large needle. This IV was held in place by a suture so it could not pull out.

I was one of the unfortunate people who retain too much fluid after surgery. It was so bad that I could not bend the fingers on my right had more than a few degrees. To help get the fluid out, they gave me diuretics. When I still had the catheter in, this wasn't a problem. What they didn't tell me about that Lasix given into my IV was that the effects were going to be unlike anything I'd experienced before. Generally, when you have to urinate, you can hold it well after you feel the need to go. With the injected diuretic, the time between the urge to go and time when you would go (whether you wanted to or not) was about 1 minute. My hands were still too swollen to hold a urinal and there was no one around to assist so... The nurses are not phased by accidents like this but as a full grown man, I was quite embarrassed.

Incentive Spirometer:
I don't know why but I hated this device. It's used to help get your lungs back in shape after surgery. I was told that your lungs are collapsed during bypass surgery and using the spirometer helps get all of the alvioli back to full inflation/size. It's simple and painless to use and the reason that I hated it was that everyone EVERYONE who came in the room (family members included) would try to make me use it. I was using it about 1-2 times an hour and that was enough (for the doctor) but since I did it while alone, no one believed I was using it.

I'm a technical person by nature and if something has markings to show a level of performance, I want to know what the goal is. With this, no one could tell me what I was supposed to reach on the display. The answer I got was 'everyone is different'. If I would have known that I was going to have such an issue, I would have ordered/purchased one in advanced to see what my normal baseline was on it. The one I had to use was an Airlife Incentive Spirometer 4000 ML. You may find one at a local drug store. If not, you can buy them online for about $10. Buy a new one, sealed on its original packaging if you buy from eBay or other online retailer. In the hospital, this thing will likely come in contact with other things on your tray (they always want it within your reach) so I'd recommend being able to wipe the mouthpiece off with an alcohol based mouthwash before use. Keeping it in a ziplock type bag may also be a good idea. The last thing you want to do with a healing sternum is to get a respiratory infection from a dirty spirometer (now that's a sentence that I never could have guessed I'd ever write).

Harvest site:
Where the vein in your leg was taken, you will have 2 or 3 incisions. These will likely be held together by a surgical adhesive and possibly a reinforcing strip to help the adhesive keep the incision closed where there may be stress on it, particularly at the knee. For the most part, you will be told to leave these on until they fall off on their own. When only adhesive is used, you will only lightly clean it and only remove the bits of adhesive as they begin to fall off on their own. This will likely take about a week or so from start to finish. Your doctor or nurse can give more specific instructions (ask them about it) but this is basically what you can expect.

Preparing a Wound to be Bandaged:
This isn't typically needed for a surgical wound unless it accidentally gets contaminated or hasn't been cared for properly. When applying a bandage, the wound should be absolutely free of debris. The open wound should be red, pink or flesh colored. It should not be or have any green (pus) in it. If it needs to be cleaned, do so with gauze (preferably sterile, not all gauze is sterile) and something to flush it out. Understand that this is not for deep wounds. The simplest flush for a wound it 'wound wash'. It's a saline solution that you can flood the wound with. Another good cleaner is Betadine. It's messy but it's a very good anti-bacterial. If the wound is raw and it hurts to clean it, you can use something like Dermoplast (red can). It has benzocaine to ease the pain and benzalkonium chloride as an anti-bacterial. There are many other cleaners (hydrogen peroxide...). These are the ones I've used.

Wound Dressing:
Quick note... If you have to dress an area that has a lot of hair (arms, legs...) you may want to shave the area (being very careful not to get any hair into the wound). This will make removing tape a lot less painful. If you are going in for a surgical procedure, ask the doctor if you can shave. In some cases, the risk of micro breaks in the skin from the razor cause too great a risk of developing an infection. The prep for the surgery will include shaving with a special clipper/trimer.

If you have particularly oily skin where the bandage will be located, you may want to prepare the surrounding area before applying the tape. Cleaning the area where the tape will be applied with rubbing alcohol will remove the oils and allow the tape to adhere better. When doing this with an alcohol prep pad (preferred) or gauze dampened with rubbing alcohol, be sure not to let the alcohol to drip into the wound. Have only enough alcohol to lightly dampen the gauze. If your fingers will have to touch the adhesive part of the tape (best to avoid), remove the oil from your fingertips as well.

Specialty Dressings:
My use of the term 'specialty dressing' applies to a material that's applied to the wound that has special properties. These are not typically readily available locally. Many are supposed to be available by prescription only and therefore may be difficult to buy from a local medical supply house. eBay to the rescue.

One of my incisions had its dressing fall off too soon and it opened up quite a bit. To help it heal, it needed to be kept clean and naturally moist. The nurses added a small amount of calcium alginate material (directly in contact with the open wound) to the standard dressing (gauze and tape). At home, I had to dress it for several more weeks. I had a dressing called Aquacel AG extra hydrofiber (cheapest at ebay). These remove, absorb and gel the wound exudate (discharge) and help produce the best healing environment for the wound. For the wounds to close properly, they can't have a hard scab (as they will develop if left to open air), which prevents a relatively deep wound from closing.

Bear in mind that there are many types of specialty dressings, the Aquacel was what I had. Calcium alginate is a material made from seaweed (at least in part). The 'AG' in the name indicates that it has silver (the element) in it. Ionic silver is supposed to have broad spectrum antibiotic properties. Manuka (Leptospermum) honey is another type of wound dressing that's supposed to have special anti-bacterial properties. Do your own research to decide if you want to pay slightly more for a dressing with ionic silver or Manuka honey or whatever the latest/greatest is at the time.

The dressings mentioned above are typically applied with no antibiotic cream. If a wound gets infected (hot, red, green discharge...) contact your doctor. A special antibiotic cream may be needed for nasty infections and they may require a prescription. For me, Mupirocin was prescribed. It may have been used instead of a more common antibiotic cream due to the risk of MRSA in a hospital environment.

Don't Cross Contaminate:
If you have to apply antibiotic cream to a would, do so with cotton swabs. Apply the cream to the swab and then to the wound. NEVER go back to the tube to get more cream with a swab that has been in contact with the wound. Get a new swab. Reusing a single swab could contaminate the antibiotic cream in the tube. This may not seem like a big deal snce the cream kills germs but the would/skin may contain organisms that are not affected by the antibiotic. If used on a different wound or someone else uses the cream, it could cause more problems than it solves.

Bandaging Tapes:
While manly men may want to use duct tape (or even more manly, camouflage patterned duct tape) to dress their wounds, there are more suitable options. The best tape I've found is 3M Medipore H. It's very flexible and sticks really well. Since it's very flexible and the adhesive is so good, it would be difficult to tear across so it's perforated every 2 inches. My second choice (of common bandaging tapes on a roll) would be Durapore. It's often called silk tape or silk-like tape.It tears across very easily along its surface pattern. Both of these are generally unavailable locally and very expensive from medical suppliers. Buy them from eBay. Expect to pay about $10 per roll. Order the width that is best suited for your particular wound.

Another wonderful (if that's possible) tape is Tegaderm. It's a clear tape that's extremely flexible. You've probably seen pieces of it used over an IV where it's inserted. This is available in many different sizes and shapes. It's even available on a roll but that's likely to be more difficult to apply. The most common types have a frame that surrounds the Tegaderm material. You peel off the various parts of the frame as you apply the tape which makes it very easy. This tape is waterproof. You can even shower with it. If you have a wound that can be covered by one of the sizes of Tegaderm available, it may make it easier to get the wound sealed off (so you can shower) than trying to put a bag over it. Unlike other dressing materials, you want to order the right size. If you try cutting this into smaller pieces, you'll likely end up with an unusable mess.

It's important to get leg wounds sealed off and completely waterproof because when you wash areas like your back-side, bacteria laden wash-water will flow down and could contaminate the wounds. If you take an especially long shower, it's possible (no matter the type of tape/bandage) sweating could cause the tape to lift. Monitor any bandages on the lower body/legs until you know how the tape will perform.

Leg Presses:
As was previously stated, you will not be able to use your arms for much. This includes standing from a sitting position. What you will have to do is get you feet set out just in front of your seated position, then rock forward to get you upper body mass and center of gravity over your feet. Then you will stand. Practice this for a few weeks prior to a scheduled bypass surgery, Getting your leg strength and balance before weakened by surgery will make it much easier to do after surgery.

When practicing standing from a seated position, you need to do so from various seating locations (kitchen chairs, recliners, bathroom facilities...). Practice sitting down as well as getting up. For seats that allow you to sit far back and sink in, you may need to either avoid them or modify them. Remember, you initially won't be able to use your arms without risking re-breaking your sternum. For some chairs, a slight modification like putting a relatively thick pillow or cushion behind you will make getting to the edge of the chair easier. Remember, to get up without assistance, you need to get your center of gravity over your feet so you can press your body weight straight up. That's why you need to be near the edge of the seat when you attempt to get up. As a side note, this is much easier to do from a chair (or whatever you're sitting on) with a relatively high sitting position than one that's very low.

In my hospital, they made you hold a pillow to your chest to help prevent you from accidentally using your arms. For that reason, I'd suggest that you practice leg presses while holding a pillow. It's more difficult to maintain your balance without extending your arms. It's best to be as well prepared for this as possible.

Physical preparation before surgery:
The pre-operative nurse will instruct you on what to do but they don't hit all the same points. You will be given a soap with CHG. It's an anti-bacterial cleanser. You will be instructed to shower normally, using your normal soap/shampoo. Then you will use the CHG soap but only from the neck down, concentrating especially on the area of the operation. You will do this the night before and the morning of the day of the surgery. It's also recommended that you put freshly bleached linens on your bed the night between pre-op showers. If you normally sit in an old or dirty chair (or seat of the vehicle), also cover those with freshly bleached sheets. Your doctor may be different but mine didn't want me shaving the areas where the operation would be performed. A normal razor could cause tiny nicks which could allow infections to begin. They use special clippers to shave you. Let them do it. After shaving, you may be taken to a shower to take another shower to remove all hair clippings. Again, you will again use CHG soap.

Dieting Before Surgery:
Many operations are easier all around if an overweight patient loses as much weight as possible before the procedure. While it's somewhat controversial, if you want to lose weight quickly, go VERY low carb. Even my cardiologist recommends a low carb diet and had no problem when I told him that I was back to eating virtually nothing else other than mushrooms, bacon, eggs and ground pork. I am a carb addict. After I'm off of them and eating a no carb diet, something as low carb as lettuce can trigger carb cravings. I have to go as close to 0 carb as possible Eating this way gives me the best blood test results that I've ever had. Even if your cardiologist doesn't want you on a diet like mine for long term, it can help to bring down your weight quicker than virtually any other diet and that may be what's important for you before surgery.

Don't expect rehab facilities to offer ANY freedom. For many, you have to have an employee accompany you no matter what you intend to do (in regards to movement in your room). You even have to have an escort to go take a pee. This even applies to people who can walk perfectly fine.

There are multiple types of rehab. Most facilities have many types of therapists to help you through any post-op problem your having. Cardio rehab is slightly different than generic physical rehab because they almost constantly monitor your heart will exercising and other physical therapy. The facility I went to was more general but had a full medical staff like a normal hospital..

I needed rehab for several reasons. The breathing problems -previously mentioned were treated with breathing treatments every 4 hours as well as an inhaled steroid. It took almost two weeks before I could breathe without wheezing so bad that you could hear it across the room.

For me, the problems that I had overcome from the stroke, regressed after surgery. Physical therapy helped greatly.

One problem developed (do you remember I stated that this body hates me?) was that I would hyperventilate when I did anything requiring me to move significantly (including standing). After simply standing, I could hyperventilate for 15 minutes, even my O2 levels were 95%+. They couldn't find the reason for it (blood pressure wasn't dropping enough to cause the problem) so I told them to try something for anxiety. Even though I didn't feel anxious, it seemed like a panic attack (which I've had in the past). A weak anti-anxiety drug helped greatly. After about a week, the hyperventilation had gotten much less severe and I no longer needed the anti-anxiety medication.

The medical staff attended to several items related to the surgery. The harvesting of a vein to make the graft was taken from my left leg left me with three incisions. One in the upper groin, one at the knee and one near the ankle. The one near the ankle was the only one that needed attention. It drained very slightly for about a week and a half so the dressings had to be changed about every second day.

I also developed several blisters that were (I'm guessing) due to the fluid I was retaining. Two were painless. The third, (on the left foot) required more attention.

Other things to think about:

Don't Become Addicted to Pain Killers:
When in the hospital, you may be offered a lot of narcotics. Don't look at this as a vacation or spring break where you think you should be constantly delirious. Narcotics are addictive and some people are more sensitive to this than others. My suggestion would be to take only what you really need. For significant pain, take what you need to make it bearable. When the pain subsides and is easily bearable, tell the nurse that you don't need it. If the nurse comes to give you medicine, including your normal meds but also the pain meds, tell him/her that you don't want it before they start breaking the pills from all of the individual blister packs.

Don't Feed A Junky's Habit:
When you leave the hospital, if you don't need the types of drugs that people abuse (narcotics, anti-anxiety drugs like Xanax... don't take the prescriptions for them. You can always contact your doctor if you need them. The reason I say this is having things like oxycodone and xanax available (even if you don't get them filled) may tempt family members to go get them filled without telling you. If you get them filled and have them at home (especially the oxycodone), you may be more likely to be the victim of burglary or home invasion.

Don't Slip:
In the hospital, you'll likely be given grippy socks to wear so you don't slip on the smooth hospital floors. One thing you may not think about is putting on a pair of long pants while sitting on the edge of a relatively high bed is that you MUST not get the pant legs under both grippy socks at the same time. Doing so will make it possible that your feet will slip and you will fall to the floor. This can be very serious just after your sternum has been cut and has yet to heal.

Take (only) what You've Paid For:
When leaving the hospital, ask what you're allowed to take with you. Of course, you won't take any towels or linens. In many (most?, all?) anything that's considered a 'consumable' (tape, sample size lotions...) that's brought into your room has already been charged to your account. Ask the nurse or PCA what will be thrown away because it cannot be used for other patients. It's likely that anything that's been opened (ace bandages, packs of gauze, wound care materials (alginate...) tapes...) will be tossed in the trash when your room is cleaned when you check out. There's no point in letting useful materials be thrown away, especially if you have paid for them. You may also ask the nurse if you can have a bit more of whatever they've been using for wound care so you will have them until your can order the materials when you get home.

Budget Shower Seat:
Most people don't have a seat in their shower. Since you will need to shower daily (bathing not initially allowed), you will need a seat. Some insurances will pay for a solid shower seat. Others will not. Since a good one is well over $100, you may want an alternative. An ice chest will work well enough. I know this may seem a bit 'redneck' but when people get sick, they can't work and money is tight. To reduce the chance that it will slide or scratch your tub, place a towel under the ice chest. Place another towel on top to sit on. If it moves too much when you go to sit down on it, fill it with (cold) water just before showering (get help with all of this). Empty it after showering to prevent the water from building algae or other nasties.

You will not likely be able to reach up/down like you could before the surgery. The hospital may recommend a pick-up tool but the ones they generally recommend are not very good. Harbor Freight has a 3ft grabbing tool that works very well. Even after you've recovered from surgery, you will still likely use it daily.

Speak Up if You're Uncomfortable:
For some people, hospital beds are very uncomfortable. For me, they're excruciating. I'm a bit overweight but due to genetics, I have a lot of heavy muscle on my lower body. Since there isn't enough padding/fat to act as a cushion, by hips and thighs go right down onto every piece of suspension and mechanical crossbar under the mattress. For a couple of days, it was less painful to sleep either in a wheelchair or in a recliner (they call a cardiac chair). Finally, one of the nurses suggested adding an egg-crate type pad on top of the mattress. Wonderful idea and it made sleeping in the bed doable.

As a side note, the recliner may be a good option to sit in most of the day. A hospital bed can be difficult to get out of if you have painful wounds. It's also easier for some to use a urinal from a seated position where there is a drop-off where the urinal will have to be positioned. This is especially important if the amount of urine will be more than a couple of ounces.

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