Foot surgery with a 6-month old...

[VillainV]

So I found out last week that I need to have foot surgery.  I've been having issues since I was a teenager that up till now had largely been alleviated by custom orthotics.  But it's a progressive deformity (bunion), so it's only going to get worse.  And the pain is pretty bad now.  So we decided to go ahead and do the surgery before C starts crawling.  We scheduled surgery for next week.

A few things I'm worried about:

1.  General anesthesia/pain meds and breast-feeding.  Obviously I'll ask the medical team, but does anyone have experience with this?  How long might I need to pump and dump after the surgery?   I have only a very minimal freezer stash (like 1-2 days).

2.  Am I even going to be able to pump on the day of the surgery?  I won't find out until the day before what time they need me to show up.  It's day surgery...but I'll probably be there for maybe 6 hours, so I'll need to pump a few times or else be REALLY uncomfortable.  

2.  General care and feeding of a 6-month old while on crutches.  I'll be on crutches for 3 weeks, completely non weight-bearing.  My H is super-helpful, and C can spend the day in day care. But I guess this means H will have to bring him to me in bed for MOTN feedings?  We still don't have furniture (it's enroute from the UK) , so we're changing his diapers and getting him dressed on an old blanket on the floor....which means I won't be able to do this either.  

Delaying this surgery isn't really an option because of my work schedule....also, my husband will likely need knee surgery sometime this winter, and we'd like to get THAT done too before C becomes too mobile.

Hold me.

[Deleted]

1) Generally, once you're aware enough to be safe to bf, you're safe to bf. You can ask for what meds they plan to use and then look them up on lactmed or infantrisk.
2) Ask for it. It's a legit medical need and they should accommodate you.
3) No idea... hopefully others can make suggestions!

[rbp]

I was non weight bearing when M was born. Can C sleep in a bassinet or something so he's right next to your bed? Or is he too big for something like that?

I have no idea whether general anesthesia is a concern for BF. But if it is, can you ask for a spinal block and IV sedatives? This is what I had while pg (propofol).

Good luck! Feel free to page/pm me any time if you want to chat further.

ETA: just put a waterproof changing pad on the couch and change him there!

ETA2: I used a knee scooter while I was NWB. Might be worth looking into? www.rentakneewalker.com

[arch01]

I had bunion surgery a few years ago and start to finish I was there *maybe* 4 hours. I had both feet done at the same time. I'd pump right before going back for surgery and as soon as you're reasonably coherent after.

I'd call a lactation consultant about the pump/dump. Stuff is all over the place about anesthesia and meds.

Diapers-can you do that on a bed?

Depending on your setup-could you ask for a wheelchair instead of crutches? Logistically it might make things easier.

[VillainV]

Sept 22, 2014 20:52:13 GMT -5 arch01 said:

I had bunion surgery a few years ago and start to finish I was there *maybe* 4 hours. I had both feet done at the same time. I'd pump right before going back for surgery and as soon as you're reasonably coherent after.

I'd call a lactation consultant about the pump/dump. Stuff is all over the place about anesthesia and meds.

Diapers-can you do that on a bed?

Depending on your setup-could you ask for a wheelchair instead of crutches? Logistically it might make things easier.

We have a two story house, and some narrow doorways...but maybe crutches for upstairs and wheelchair for downstairs? I'll have to think about that a little more, but it's a great suggestion.

ETA: rbp KNEE SCOOTER!!! Do you think I could hold the baby with one arms and push the knee scooter with the other??

[Deleted]

Knee scooter + baby carrier?

[rbp]

Sept 22, 2014 20:57:02 GMT -5 VillainV said:

Sept 22, 2014 20:52:13 GMT -5 arch01 said:

I had bunion surgery a few years ago and start to finish I was there *maybe* 4 hours. I had both feet done at the same time. I'd pump right before going back for surgery and as soon as you're reasonably coherent after.

I'd call a lactation consultant about the pump/dump. Stuff is all over the place about anesthesia and meds.

Diapers-can you do that on a bed?

Depending on your setup-could you ask for a wheelchair instead of crutches? Logistically it might make things easier.

We have a two story house, and some narrow doorways...but maybe crutches for upstairs and wheelchair for downstairs? I'll have to think about that a little more, but it's a great suggestion.

ETA: rbp KNEE SCOOTER!!! Do you think I could hold the baby with one arms and push the knee scooter with the other??

I think you'd be fine wearing the baby! I scooted around at nine months pregnant, which isn't *that* different from wearing a baby. Lol

[fortmyersbride]

I never advise pumping and dumping. Like pp said, by the time you are awake and alert enough to hold a baby to BF, the concentration of anesthetics or analgesics in your milk is negligible. Sorry I don't have time to post a more official source, but here's the gist of it:
www.anesthesiaweb.org/breastfeeding.php

I would not BF while taking codeine though, due to it's variable metabolism to more active forms of opioid.

Depending on your surgery, and your surgeon and/or anesthesiologist's preferences, it may be possible to avoid general anesthesia and have a spinal, epidural, or peripheral nerve block. Like I said, I wouldn't pump and dump just because you had general anesthesia. However the recovery can be a bit faster (less sedation, nausea, etc) if a nerve block is an option for you. Of course, discuss all of this with your particular medical team.

[lolo]

@ashleyscott, did you have a surgery or have info on a resource about medicines and pumping/dumping? My mind thinks you might.

[arch01]

Sept 22, 2014 20:57:02 GMT -5 VillainV said:

Sept 22, 2014 20:52:13 GMT -5 arch01 said:

I had bunion surgery a few years ago and start to finish I was there *maybe* 4 hours. I had both feet done at the same time. I'd pump right before going back for surgery and as soon as you're reasonably coherent after.

I'd call a lactation consultant about the pump/dump. Stuff is all over the place about anesthesia and meds.

Diapers-can you do that on a bed?

Depending on your setup-could you ask for a wheelchair instead of crutches? Logistically it might make things easier.

We have a two story house, and some narrow doorways...but maybe crutches for upstairs and wheelchair for downstairs? I'll have to think about that a little more, but it's a great suggestion.

ETA: rbp KNEE SCOOTER!!! Do you think I could hold the baby with one arms and push the knee scooter with the other??

The knee scooter is an even better idea-good baby wearing time and you can get around!

[simpsongal]

You may recall, I had pretty major shoulder surgery last month (J was a little under 7 months old at the time). I've got 2 months in the sling and then 3-4 months of physical therapy (I'm so sick of this stupid sling). I semi-feel your pain on the feet, I have a bad bunion that got worse with pregnancy. To address some of your surgery-related fears:


1. General anesthesia/pain meds and breast-feeding:  My pedi and surgeon all recommended I P&D for 24 hours. Anesthesioogist said 12 is fine.  When I had my MRI with contrast they said the official rec is like 6-12 hours but they said to do 24 to be extra cautious.

Ultimately, I P&Ded 48 hours b/c I was on quite a bit of percocet after the general wore off. Honestly, probably wasn't necessary b/c they give percocet to c section moms.  Personally, I would do 24 though just b/c the surgery will probably be in the early morning, so P&Ded until the next morning (when supply is highest).


2. Am I even going to be able to pump on the day of the surgery? I won't find out until the day before what time they need me to show up.  I had to be at the hospital at 6am (I BFed J a little before but he was sleepy and we were in a rush)- I got into pre op around 6:45am for a 7:30am surgery.  I was pumping while they put the IV in me and got me all ready.  Of course, it was hard to get a good let down under the circumstances, but I got like 6 ounces out, which made me comfortable enough to make until about 3pm (by the time I got home and settled to pump again).

2. General care and feeding of a 6-month old while on crutches. I'll be on crutches for 3 weeks, completely non weight-bearing. My H is super-helpful, and C can spend the day in day care. But I guess this means H will have to bring him to me in bed for MOTN feedings? We still don't have furniture (it's enroute from the UK) , so we're changing his diapers and getting him dressed on an old blanket on the floor....which means I won't be able to do this either. 
Yup, your DH will have to help a lot.  I'm guessing your surgery will be a lot like mine re: pain - it's worst the first couple days.  Sleeping stinks, that's when pain tends to be highest.  If you're on percocet TAKE COLACE.  I've managed to do almost everything with 1 arm.  It's actually a good time for surgery b/c your LO is sturdy enough to "wrangle" but not so big that he's really tough to handle.