On Last Week’s Surgery and this Week’s Surgery

Last Friday (April 8), I had a posterior capsulotomy. This is a laser procedure in which a hole is cut through a cloudy, post cataract surgery lens in order to allow the cloudiness to dissipate. So far, I’m not seeing any great improvement in vision, but the resultant floaters are driving me nuts. They are large and appear to move more rapidly than ordinary floaters. Depending upon where I am looking and how distant they appear, I mistake them for gnats near my face, roaches on countertops, and spiders on walls and floors. Yesterday, I sidestepped what I mistook for a mouse crossing my path. I am told that the floaters will “probably” get better.

Later this week, I’m to have a transurethral resection of the prostate, which is the name of a surgical procedure that’s performed through the penis in order to reduce the size of an enlarged prostate. Death is unlikely (one man in a thousand), but incontinence afflicts ten out of a hundred, five of them long-term or permanently.

I’m up to twenty-plus surgeries depending upon what one counts as a surgery (is a posterior capsulotomy a surgery?), but instead of growing accustomed to them, I dread them increasingly because: (1) the risks worry me more; (2) the care I receive is often impersonal and sometimes egregiously callous or glaringly incompetent; (3) Whether they’re minor or major, somewhere along the line of the many people and departments that are necessary to make a surgery possible, mistakes happen, always; (4) The older I get, the more slowly I heal; (5) I have to be at the hospital hours before I usually get out of bed, and surgery is a crummy way to start the day; (6) I chafe under the limits imposed upon me during convalescence (I’m not supposed to lift more than ten pounds for six weeks following this surgery, which is nothing compared to the limits imposed after rotator cuff repairs and major joint replacements).

I try to reconcile myself to the things I fear or dislike by remembering that, if things go well, my life will be better for having had the surgery, and that I should be grateful to have access to medical care that is denied to most of the world’s people. In the 1950s, I saw my impoverished grandmother go blind in both eyes for want of cataract surgery, and after five hernia repairs, I know something of how miserable and limiting hernias are (I try to put myself in the shoes of a poor laborer whose family will starve if he can’t perform heavy labor, but who is sure to die a horrible death from bowel strangulation if he continues to work). 

A hundred years ago, the average American man died at age 59; today it’s 76, and without modern medicine, I would already be dead. I remind myself of such things, but counting ones blessings can make a person feel bad about himself for complaining at all. By way of comparison, if you try to reconcile yourself to having a toothache by telling yourself that your problem is nothing compared to dodging missiles in Ukraine, not only will your tooth hurt as much, you will hate yourself for being a whiner and a wimp.

 

Update: My speech difficulty being worse in the morning, Peggy  called the hospital an hour ago to ask why we haven’t heard from the anesthesia department (they invariably schedule pre-op tests and a consultation a few days prior to surgery). She was told that the hospital doesn’t have me on its surgery schedule (perhaps the doctor’s office never contacted them). Upon learning this, Peggy immediately called the doctor’s office, but it’s nearly impossible to get them on the phone, and they take hours to call back. I have also called them, but I have no idea if the urgency in my voice will inspire them to act.

So it is that mistakes always, always, always happen, and the patient can never, ever sit-back and trust that what is supposed to be done will be done in the way that it should be done. Instead, the patient can but hope that the mistakes will be temporarily frustrating rather than life-altering or fatal. In this case, if there’s no operating room available, the surgery will have to be postponed, and because I was getting in early due to another patient’s cancellation, I could end up waiting months.

10 comments:

Anonymous said...

Correct. You can never assume, and when you are really old and alone with slower thinking...well, what happens then. The TERP surgery was life changing for someone I know, even if the recovery was painful.

angela said...

“Probably” go away. I don’t like the odd implied in that sentence
I do hope you get in sooner rather than later. Waiting is really the worst as your imagination goes wild
Well mine does
Will be sending you all the good vibes for a speedy and full recovery

Strayer said...

Oh no, that's terrible, Snow, that they fouled up and didn't put you on the surgery schedule. I had an eye injury, from a head whacking fall, that caused terrible numbers of floaters along with flashing lights in one eye. I was told by the emergency eye doctor it was viscous fluid sac tear and that nobody needs their viscous fluid. After another visit a month later, I'm told I'll see the biggest floater maybe for the rest of my life and possibly also the string of lights at the outer edge of my vision in that eye, when I blink, forever too. And yeah I swat at what I think are knats or spiders before I realize, oops that just my floater. I don't try to contact my doctor either. Takes forever and ever on hold, then you only get a reception who says she'll have an assistant call back and that may or may not (most likely not) happen.

kylie said...

all i can say is, if the mistake has happened now, it's at the less important stages. I tell myself these kinds of things all the time, as though having dealt with one mistake, no more are possible.

I hope the floaters stop and i hope the prostate surgery is aboundingly successful.

My mum was in hospital last week, complaining that the strawberry jam on her breakfast toast was not the kind of jam she likes at breakfast time. I never thought she was a princess but she absolutely is. All of that is apropos of nothing, I'm just mind blowingly frustrated with her and this is just the beginning

Elephant's Child said...

Good luck.
I hope that the mistakes ARE just temporarily frustrating, but feel for you.

PhilipH said...

Very sorry about the after-effects of your eye surgery. How disappointing. Cataracts are usually 100% perfect but you've been a tad unlucky with yours. Hope the ruddy floaters soon disappear.

Your prostate surgery is obviously worrying you. I have become used to the enlargement of this troublesome gland over the last 30 years, trying to deal with it by buying Saw Palmetto over the counter. My GP agreed that it help but it was minimal. There are other more expensive such medicines without prescription but I doubt they are truly beneficial.

I fully understand your concern; who wouldn't. Surgery always creates concerns. About 15 years ago I had difficulty swallowing food. It just stuck in my throat. Saw my Scottish GP who said I'd need an x-ray to confirm his guess: a pharyngeal pouch. He was spot on, as the x-ray showed.

He said I'd need a throat operation. Sounded very dodgy to me. I asked him if this would involve cutting into my throat; he said 'probably'and I was very disturbed.

Anyway, I went to see the surgeon at Edinburgh Royal Infirmary and he explained that he could "sew up" the pouch without cutting anything! But I'd have to have full anaesthesia and understand the risks of this and also to WAIT until they had a couple more patients with the same problem. This was because the machinery for this job had to be hired, and it was an expensive bit of kit.

Eventually I was called to attend for the procedure. I went in on the Monday and back home on Tuesday. The surgeon called to my hospital bed on the Tuesday morning to ask how I felt. I said ok, just a bit of a sore throat. "Well, that's to be expected. Did you enjoy your breakfast?" he asked. I said I didn't want it. "You cannot leave here until you've eaten something, Mr. Harfleet. 'Nurse, bring him a round of dry toast and make sure he eats it!' and now I'll tell you that we stitched up the pouch by firing some 300 or more titanium staples around it, so eat your toast and then you can go home."

And so it all went very well. All my doubts and fears gone. This will be your experience too, Snowy dear friend. Best wishes, Philip

Strayer said...

Did you get your surgery Snow? Are you back home and Ok? I hope it helps. My brother has that and just lives with it, the enlarged prostate. At least so far he's lived with it. If your surgery helps, I'll suggest he look into it.

Snowbrush said...

"when you are really old and alone with slower thinking...well, what happens then"

Old men have the highest rate of suicide, so that's one thing that happens. If I didn't have Peggy and the cats to live for, I don't know if I would take that option, but it would be on my mind a lot as I watch my mind and body deteriorate ever more rapidly. Combined with the many physical and mental limitations that accompany aging, is the fact that old people are patronized, and their lives seen as a costly burden. During Covid, the gloves came off of any pretense that the lives of the elderly were valued, with many young people openly saying that because old people and the chronically ill contribute nothing and are a drain on the economy, there should be no shutdowns, no mask mandates, and no vaccine requirements imposed in order to protect people that society would be better off without. When the news broke that black people are also at heightened risk of death from Covid, the same attitude surfaced to a smaller extent regarding them, the difference being that one can better get away with showing contempt for the lives of the elderly.

"The TERP surgery was life changing for someone I know, even if the recovery was painful."

Before agreeing to the surgery, I went to my internist (who is also 73, and who I've been seeing since 1990), to ask  what he would do, and he said he would go for it. I often ask doctors who propose surgery as a possible option what they would do if they were I. I like to think they are honest, but I can never completely get the thought out of my mind that they have a financial incentive in being dishonest, and that even if they are honorable, that incentive might sway them away from the best interest of a given patient. This is why I like to take the matter up with my internist.

"'Probably' go away. I don’t like the odd implied in that sentence."

I'm optimistic that they will. In fact, I already fancy that I'm seeing a small improvement. Last night, I got to wondering just how many floaters I had, but I found it hard to count them because the darn things won't stand still.

"Oh no, that's terrible, Snow, that they fouled up and didn't put you on the surgery schedule."

The problem has been fixed, and I'm on schedule for tomorrow (Thursday).

Snowbrush said...

"I was told by the emergency eye doctor it was viscous fluid sac tear and that nobody needs their viscous fluid."

I haven't had a torn vitreous, but I had a detached one that occurred for no known reason (I discovered it upon waking one morning). I don't remember what the symptoms were or how I was treated, but when I described the problem to whoever answered the phone, she got me in to see an ophthalmologist within a couple of hours. If an ER doctor told me that no one needs vitreous fluid, I would to to an ophthalmologist because because I seriously doubt that our eyes would have evolved to have vitreous fluid if we didn't need it.

"And yeah I swat at what I think are knats or spiders before I realize, oops that just my floater."

It's tough to suddenly be unable to know if what I'm seeing really exists, but I'm sure that, if necessary, I can get used to it. I've heard that there's a surgery to remove floaters that are troublesome due to their size or their numbers, but I know nothing about it.

"My mum was in hospital last week, complaining that the strawberry jam on her breakfast toast was not the kind of jam she likes at breakfast time."

I know something of what it's like to be frustrated with an increasingly irrational parent. Maybe, in this instance, she's displacing her fear of big things that she can't cope with onto small things that she can. Then again, maybe she's to the point that jelly really is the biggest problem on her horizon. When my formerly independent father saw his ability to do for himself diminishing to the point that he could no longer live alone, he went through a period of saying the words, "I don't have to beg" to anyone who offered him something. For example, if someone offered him a cup of coffee--he would say, "I don't have to beg." Sometimes, they wouldn't even need to offer him anything. For example, if a person said, "How do you like this weather we're having, he would come out with, "I don't have to beg." People of understanding accepted this while others ran from it. Fortunately, once Peggy and I moved him from Mississippi to Oregon to live with us, he immediately stopped doing it because he felt loved, wanted, and in control.

"Thank you, Doll (I don't why I just called you Doll, only that it seemed right). The surgery is on as planned, so I went to the hospital for my Covid test and to see where I will have to go on Thursday.

"Well, that's impossible... to dodge a missile."

I was speaking metaphorically.

"Your prostate surgery is obviously worrying you."

Very much so. I plan to say the card you sent to the hospital to cheer me. I've used saw palmetto for years, but lately have been on a prescription drug called Tamsulosin (which is not at all expensive). Without the surgery, the problem is likely to get worse; with the surgery, it might return.

"About 15 years ago I had difficulty swallowing food. It just stuck in my throat. Saw my Scottish GP who said I'd need an x-ray to confirm his guess: a pharyngeal pouch."

Peggy has a friend who had the problem and who also did fine with the surgery.

"Did you get your surgery Snow? Are you back home and Ok?"

Thank you so much for asking. I'm sure you saw the above, but I'll again say it's on for tomorrow (Thursday). I might never know why I wasn't on the schedule, but am guessing that the man who cancelled hadn't been taken off, and so they just did what should have been done already, which was to slip me into his time slot.

Creekhiker said...

Hope you are better Snow!