Another day, another surgery

I was in surgery at this time yesterday, and was still on my way home fifteen minutes ago. Peggy is unloading, but I’ve already learned that the doctor wasn’t kidding when he told me not to bend over or lift anything. Here I sit spacey from Vicodin, drowsy from having been too happy and excited to sleep, and wary of even walking across the room quickly—I am dripping blood even now. The words on the screen look to be floating at an indeterminate distance, and I feel as if I last sat at this keyboard in another lifetime.

We drove to Portland a day early so Peggy could shop at the Button Emporium and visit a friend. I awakened that morning with a sore throat, and passed the day in fear that I might be getting sick. I spent most of my time sitting in the van, too sick to want to do anything else even if there had been anything else I wanted to do, and too worried to stay in the motel while Peggy went downtown alone with only her fear of city driving and her insecurity about reading maps to keep her company. I felt too bad even to read Marcus Aurelius’ essays about not letting the things of the world—including my own feelings—get me down. All I could think about was how miserable I felt, and that something—like a cold—might cause me to miss surgery.

I debated whether to tell the doctor if I did have a cold. On the one hand, I wanted to be open, but on the other, I speculated that our litigious society might cause him to err on the safe side and cancel the operation. That night at the motel, I was cold while Peggy was warm. “I’m having chills,” I thought. “Chills mean fever; fever and a sore throat means strep.” I looked in my mouth, but saw no pustules or redness. “No matter, I can’t feel this way and not have a fever,” I told myself; “and I can’t elect not to inform the doctor about a fever.”

My head and ears had ached all day, but since they ache all day every day, I was only surprised by the severity of the pain. I had already filled my prescription for Vicodin, and I took one. It made no discernible difference, but midnight passed, and I was supposed to be NPO.

I lay awake much of the night, scared sick that I might miss my surgery, and feeling blood pummel its way through the arteries in my ears and temples. I thought I saw flashing lights through my closed eyes (signs of a migraine or a cluster headache), but couldn’t be sure. I was sure that neither could hurt any worse than the one I had. My throat looked and felt no worse the next morning; the glands in my neck weren’t swollen; and Peggy assured me that I was too old to have strep. I still thought I had a fever.

When Peggy tried to crank the van, the starter made a pitiful little noise that indicated a dead battery. When I looked under the hood, the siren went off. We knew that the previous owner had an alarm system, but even after eight years of owing the van, we didn’t know that part of it was still there. I couldn’t find the siren, so I left Peggy to save herself and the dogs to freak-out in the van, while I went to the motel office. The motel had no courtesy car, but the manager offered to jump me off or else drive me to the hospital. By the time we got back to the van, the siren had stopped.

As I starting connecting the jumper cables, it started up again. I determined to find it and rip it out bodily if I had to. I finally felt it deep under the hood, alongside a wire that seemed to connect it. I couldn’t be sure of the wire, so I decided to yank the whole damn siren out to verify which wire needed to be pulled. I broke it loose, but couldn’t get it out. Being almost certain that I had the right wire, I pulled on it and quiet ensued. Peggy, mistakenly thinking that the jumper was already connected, turned the key and the van cranked immediately.

“Resistentialism: the belief that inanimate objects purposely thwart you.”
Snow’s Dictionary

The nurse in Day Surgery hooked me up to her all-in-one pulse, blood pressure, oxygen saturation, and temperature unit; and I waited in fear to see how high my fever was. It seemed like the thermometer was taking forever, and the nurse must have thought so too, because she declared it broken and went for a replacement. This one worked instantly, and the number 36.1 C. (or maybe it was 31.6 C.) appeared. I had no idea how high that was, but Peggy said it was a little below normal. My insides leaped with joy, because I knew that the last hurdle was past. As the nurse started my IV, I told her that Peggy was also a nurse and was really good with IVs. She responded by pushing the needle right through a vein—that she had just said she could hit in the dark—and into the bone. I said not to worry, that the pain took my mind off my headache.

The nurse finally left, and Peggy told me one last time that she really didn’t think I should stay awake for the surgery. I looked at her as at one who didn’t know what she was talking about.

The anesthesiologist came in, introduced himself, and said, “Open wide for me now.” “Uh-oh,” I thought. “You can close,” he said in a voice indicating normality. We talked. I told him that I wanted to stay awake during surgery. “Why?” he asked in a disapproving tone. “None of your business if you use that tone,” I thought, but I said, “I don’t like being intubated.” Well, with this kind of surgery, if we have to put you to sleep after it has started, the surgeon will have to stop the procedure while I get you intubated.” I thought it very unlikely that I would have to be put to sleep, and I knew that he knew this, but that he wanted to make things easy on himself by doing them the way he always did.

I was wondering how much trouble he was going to give me when Peggy stepped up to the stretcher and said, “Snow usually does pretty good with this kind of thing.” I was grateful—surprised but grateful. The anesthesiologist gave in: “Alright. People who ask to stay awake usually do okay with it.”

He left and the surgeon, Peter Hwang, arrived. If I hadn’t already known he was coming to a hospital that he rarely works in, I would have figured it out because no one knew how to pronounce his name. He looked a little uncomfortable as he stepped inside my curtained room, like he was worried about invading my space, and this seemed to validate my observation that he is shy. He quickly stepped into his role as a gentle and confident physician, and I had the thought that he is also strong.

When the nurse came to roll me into surgery, I was already high on Demerol, and I enjoyed watching the ceiling tiles undulate as we moved. I’ve yet to be rolled anywhere in a hospital that the stretcher didn’t clank into something, but this trip went better than most—a few bumps but no BANGS. Another nurse was already in the OR, and the first nurse told me to tell the second nurse what I was there for. I counted five people who I had already told this, but I knew it was for a good reason. Peter congratulated me on getting everything right, and I said something about him not chopping off my leg. “Or making you into a woman,” the anesthesiologist joked. “That’s a good one—I wish Peter or I had thought of it,” I told myself.

I don’t remember when the surgery began. I was awake, it’s true, but my IQ had been reduced by 50% and my mental age by 50 years. I knew that my nose was being worked on, but I neither saw nor wondered what tools were used, or whether Peter was looking through a scope or at a TV screen. I also lacked any conception of time, and only realized when I saw a clock on the way out that the operation had taken two hours. I mostly kept my eyes closed during the surgery because of the lights, so I didn’t even know where three of the four people stood. Peter was to my right, and I thought I saw the anesthesiologist off to my left instead of behind me as I expected. I also remember announcing that I had to pee, and a nurse bringing me a urinal from my left side. Peter asked me twice if I was finished before I even started, and I braced myself to hang onto the urinal until I was done.

I remember that I resolved to remember many things, although for the most part, I don’t remember what it was that I resolved to remember. Peter could have been operating on my big toe for all I cared. Once, I heard what sounded like bone being crushed for what seemed like a long time, and I idly wondered what was happening. I concluded that my face had gotten out of alignment and that he was pushing against my right temple and my left cheekbone to mash it into place. “I thought chiropractors were the bone poppers,” I said to myself before I remembered that the skull is all one bone. “Oh, well, whatever…” I was thinking when Peter asked, “Are you okay?” in a tone that I interpreted to mean, “My god, that MUST hurt!” “I’m loose as a duck,” I answered, only to realize that I should have said goose. Then I thought that maybe I had said goose, but I couldn’t remember.

Another time, I told Peter that I had wanted to stay awake so I could feel like a part of the team rather than like a turnip. He said with sincerity that I was a part of the team, and I replied with equal sincerity that he was a good doctor. The anesthesiologist later told me that I was a good patient, and although we had gotten off to a rocky start, he had kept me out of pain, and he seemed to have softened, so I told him that he was a good doctor too.

So far as I knew (and still believe) there was praise and camaraderie all around, even if one of us was at the intelligence level of a dog—or, more accurately since I am human, a child. I managed to recapture one of the attitudes that children and pets deserve to have. Although they can’t always understand why the grown-ups in their lives do something, they should have every reason to trust that it is the right thing to do. Such trust brings out the best in most people, and there are no crimes so abhorrent as those against children and animals.

Staying awake was a good idea, as I knew it would be. Otherwise, I would have had none of these memories—or any memories for that matter other than of waking up in pain from having been intubated. As it was, I was rolled directly out to be with Peggy. Later, I wondered how I had managed to talk so much while my nose was being worked on, and hoped I hadn’t caused a problem.

The surgery has been over for 24 hours. I skipped a dose of Vicodin because I wanted to see how I felt without it; and I can joyfully report that the pain from surgery is only 10% as bad as the pain I experience everyday. My throat pain is also gone—maybe it was psychological.

I won’t forget Peter Hwang. Really gifted doctors can perform feats that are as mysterious as they are wonderful.

15 comments:

Natalie said...

Oh, staying awake is something i could not do! Even after five childbirths,(which is pretty brave) I couldn't.
Did you realise that you used 'Lowell' in your post?
Does that mean we are friends now?

nollyposh said...

Oh Snow i do so love your stories (i laughed out loud during the op scene... Well it felt like a movie!)
i was awake for my mastectomy and don't remember a thing, other than i do remember thinking how wonderfully excited the anesthetist was while teaching a young doc how to put in my spinal block... i felt good about that, you know about my doc being excited about his work, made me feel like i was in good hands... And i too felt fab after-wards, i get so yucky with an anesthetic! and besides they say your recovery post op without anesthetic is much better and i can contest to that (Ps) i think you are brave though, i was a bit nervous when they suggested mine and still feel weird that i might have said something inappropriate while not conscious of myself X:-o!

dana said...

A truly GOOD doctor is so rare, that that's the reason they have a special place in our memories. My surgeon was a known sadist. Unfortunately he was known among his fellow doctors. I didn't find out til too late.

Before my major surgery, he announced that "This patient will not survive this operation and I want all of you as witnesses."

My anesthesiologist leaned close to my ear and said "WE won't let anything happen to you".

Sadly, there was a mix-up with the anesthesia and, although I gave every appearance of being unconscious, I was awake: but unable to lift an eyelid or speak.

Eventually I managed what I thought would be a ROAR of pain, but it only came out as a weak whimper.

The surgeon said I was just reacting to the anesthesia, but a nurse knew better, and injected the proper medication before too much mental and physical damage was done to me.

Prior to EVERY surgery I have EVER had, I too have lived through fear of catching a cold or a sore throat. We aren't being hypochondriacs. We're just looking at the odds of things going "right for a change".

Suzanne said...

The referral is me!!! Hey you! Yup, she matched us. Well she knows something for sure. She know you'd make me laugh my ass off. You're too funny. How you feeling honey? Oh good. Now move over and stop hogging the whole chair. ;)

Snowbrush said...

Natalie said: "Oh, staying awake is something i could not do!"

Lucky you, Anesthesiologists hate it when the patient wants to stay awake, but I would never CHOOSE to sleep no matter what the surgery.

Natalie said: "Did you realise that you used 'Lowell' in your post? Does that mean we are friends now?"

No, it just means I screwed up. Please note that, unlike people who call themselves one name, their blog another name, and then use a photo to represent themselves that has nothing to do with either name; I go by one name only and use a photo that illustrates it. We bloggers could make it a lot easier on one another if we all did that. I AM your friend though, and if you have an email address on your profile page, I will send you my legal name.

Nollyposh said: "still feel weird that i might have said something inappropriate while not conscious of myself"

You could still do that in recovery after a general when you're just starting to wake up. After my last general, I awoke with six nurses looking at me. They immediately walked away, and I still don't know what it was all about. Did I say something "interesting"; did I stop breathing? Beats me.

Dana said: "Before my major surgery, he announced that "This patient will not survive this operation and I want all of you as witnesses.'"

Gee, Dana, I would report that surgeon to his county and state medical board.

Suzanne said: "How you feeling honey? Oh good. Now move over and stop hogging the whole chair. ;)"

Yep, I'll just take off the airway mask, throw the ice pack on the floor, turn-off the heating pad, remove the toothguard, and in my best Bob Barker voice say, "Hello Suzanne, come on down." I've waited 61 years for a girl like you.

CreekHiker said...

What an adventure!

I love the line about the puns rolling off of you... I feel like that sometimes!

All Consuming said...

“Or making you into a woman,” “I’m loose as a duck,” – HAHAHAHA, I really didn’t expect to be laughing at any account of surgery, to be honest I very nearly skipped it, but then decided to go on and I’m glad I did, so very funny in parts and of course I can empathise, though if they try to make me into a woman I’m definitely losing some of my feminine wiles.

It’s nice in a way that it just hasn’t just happened as well. Way back in 2003. Time flies when you’re having fun eh?

Realliveman said...

I had a bout with sleep apnea in my 30's. The whole sleep study thing (the wires kept me awake) but I managed to overcome it.

I feel for you. It's not a fun thing to have.

Realliveman said...

By the way, I really enjoy this blog. I will be back for more!

Marion said...

Well, I'm in total awe. I wish I could do ops with no anaesthetic, but I do believe it would be completely impossible for me to do so. You are very brave...I have to have my wisdom teeth pulled and I am running the other way from it. I could go under full anaesthesia, but I know it takes longer to recover. They have a type of drug now that keeps you awake while the operation is done; you just have no memory of it. That doesn't sound quite right to me either. I'm just the biggest chicken!

I laughed a few times here...again, a very enjoyable post!

Snowbrush said...

Creekhiker said: "I love the line about the puns rolling off of you..."

Thank you. The come out, so then the question is whether--and how--to acknowledge that I'm aware of them.

All Consuming said: "I very nearly skipped it, but then decided to go on and I’m glad I did"

Me too. I thought of you when I posted it, and hoped it would give you a laugh as you approach your own surgery.

Realliveman said: "sleep apnea...I managed to overcome it."

How? I've found no way other than weight loss, but that only works if the problem is weight-related.

Marion said: " They have a type of drug now that keeps you awake while the operation is done; you just have no memory of it. That doesn't sound quite right to me either."

That would be what I had on this and other occasions. Most people first encounter it during a routine colonoscopy. It's not a question of courage, at least in my case. When you have sleep apnea, waking up from a general anesthetic can be among the most painful experiences you've ever had. I am also intensely curious about surgery, and I prefer to know how things are going at the time instead of finding out about them later. I'll also mention that you need to be awake for some surgeries. When I had hernia surgery, I wasn't given the option of being put to sleep.

the walking man said...

16 times i have ridden in that OR rodeo and 15 times I was totally asleep...yes sir you guessed it, I have only 1 surgical regret.

If they need a response from me while they are busy slicing and dicing they can wake me up.

C Woods said...

You made me laugh at the same time I was in pain just thinking about surgery.

Thanks for stopping by my blog. I left a response to your question immediately after your comment.

fiftyodd said...

I love joining a blog to follow and then looking up all the older posts. It is certainly going to take a long time to catch up with yours. Great reads.

Snowbrush said...

Yes, this is indeed old, and I’ve since had three hellacious shoulder surgeries and a couple of lesser surgeries—lesser recovery-wise. Looking at who else commented on this post, I see that at least one is dead—Nollyposh—and that others have given up blogging or left my blog, so there are only three with whom I still have contact. You might like All Consuming’s blog. A few weeks ago, she lost her dog to cancer, and I’m sure your presence would please her immensely, and I think the two of you would hit it off. Creek Hiker is another blogger who I’ve known for years now. She’s Rottweiler lover, and she too lost her dog not too long ago (about two years, I would guess, but that’s hardly a long time when it comes to such grief). The third person with whom I still have contact is Dana, but she gave up blogging.