Friday, June 4, 2010

Surgical History: Part 1

The surgery approaches, and I'm starting to feel my nerves come unglued. I need this surgery. I need at least two more after that. But trying to prepare for it...? It's making me crazier than usual.

I keep flashing back to previous surgeries, and think about all the "wonderful" things that happened with those. Mind you, I've had an abnormal amount of operations in my life. And it started before I was even forming complete memories.

1: Double hernia - I was two years old. There was a little bit of other work done, but far too personal to mention. Suffice to say that I have no real memory of the procedure, but do have a matching set of scars that managed to never fade over the decades of my life.

2: Excision of a post-auricular inclusion cyst, left side - I was about 16, and kept getting a cyst behind my left ear. It would grow, become infected, burst, heal, and seem to be okay...then repeat. What makes this interesting is that I was hospitalized for diabetes trouble, and my endocrinologist was on vacation. He left another doctor in charge, and then HE went on vacation. This left me in the care of the third-string doctor, and I'd been in the hospital for 10 days with no sign that my blood sugars were coming under enough control to send me home. I told the nurses about the cyst, and they supposedly told the doctor. He'd dismissed it, and this led him to make do something stupid. I was in my room, reading, when the doctor came in...

Doctor: Rob, we've been trying everything, and we can't get your diabetes under control.
Me: I've noticed.
Doctor: Yeah. The thing is, the only possible answer is that you're cheating on your diet. I want to know what you're eating, besides what's on your meal trays.
Me: I'm...cheating.
Doctor: It's the only answer.
Me: Well... (I started acting ashamed) ...I have to admit, I have had soft pretzels with mustard.
Doctor: (pulling out pen and paper) Okay. Where are you getting them. Who's bringing you soft pretzels with mustard?
Me: (I held up the book I was reading, "Soft Pretzels with Mustard," by David Brenner.)
Doctor: (Stormed out of my room.)

My nurse came in and said that was pretty rude on my part, to which I said it was rude of him to accuse me of cheating. Especially since I'd been complaining about an infection behind my ear. The nurse brought this back to the doctor, a surgeon was brought up, he examined it, prescribed antibiotics, and told me to call his office once I was discharged. Wouldn't you know it? The antibiotics brought the infection under control, which brought my diabetes under control, and I was sent home.

As it happens, the surgeon was the same guy who'd operated on Stu's leg when he was around age five, so my parents trusted him. He operated on the back of my ear under general anesthesia, and all seemed to be well.

3: FULL excision of a post-auricular inclusion cyst, left side - All SEEMED to be well. It wasn't. By age 17, the cyst was back, bringing fresh infections with it. This time, however, the doc wasn't going to take any chances. He cut out the entire area where the cyst could grow and that was the end of that.

4: Arthroscopy of the left knee - Things like this happen when someone tries to put a Volvo in your leg. I was 18. Nothing was found during the exploratory surgery, so my knee troubles were only exacerbated by having my knee filled with medical fluids and equipment. I honestly had no idea a knee could be increased to that size!

5: Excision of a post-auricular inclusion cyst, RIGHT side - I was 19, and this was like a bad film sequel. Cyst 3: Revenge of the Cyst! There was no reason to believe that it would behave the same way as the one on the left side, so the doc opted to just remove the cyst. Less cutting. That, however, led to...

6: FULL excision of a post-auricular inclusion cyst, right side - Cyst 4: The Final Revenge of the Cyst that Strikes Back...of the Dead! Why the doc chose to attempt this while I was under "twilight anesthesia" is beyond me. I suppose he was hoping I wouldn't have to be put all the way under. But the infection was much larger than any of the others before it, and he wanted to get it all. Eventually, in my barely conscious state, I was trying to pull away while he was cutting. I was also crying. I BARELY remember this. What I recall rather clearly was the doc saying, "Okay. Put him all the way out." And that, thankfully, was the end of that...

Except for a little bit just before the surgery. I had my gallows laugh going strong, so it didn't take much to get me laughing harder. I was in the operating room, and blankets were being placed on me. My legs were also being strapped down so I wouldn't attempt anything silly, like rolling over. One of the surgery staff was making me laugh with the occasional joke. But what sent me over the edge with laughter was, (and this was just as they were sedating me), "Okay...We're taking off a leg, right?" I laughed my way right into near-unconsciousness.

6: Arthroscopy of the left knee with a lateral release - Oh, this one was fun. Whatever damage that had been done to my left knee when I'd been hit by a car had finally caught up to me by age 20. When my leg was relaxed, I had a patellar tilt, meaning that my patella wasn't resting in the groove formed by the tibia and femur, but drifting upward on one side. When I would bend my knee, the connective tendon called the "lateral retinaculum" would tighten up so much that it would cause me to experience a "lateral riding patella." My kneecap was resting on the end of the femur, with bone-to-bone contact. If you're wincing at the idea, imagine how it felt.

I had this surgery in Manhattan, and the surgeon chose a new kind of anesthesia. Well, new for me. He was going to use epidural anesthesia, as well as the traditional stuff. And the only thing I knew about it was that I'd feel nothing from the waist down.

Silly me, but I thought that would be just during the surgery, not afterward. It's a scary thing when you can't feel or move your limbs. This tiny taste made me empathize with those who suffer permanent damage of this sort. I would pinch my thigh as hard as possible and there was nothing. Absolutely nothing. And no matter how hard I concentrated, I couldn't get my legs to move.

But there was no going home until I could move my legs...and use the bathroom. (Yes, that last was actually a requirement.) So I kept at it, trying to move my legs, and my good one...made some kind of uncontrolled spasm that I was willing to chalk up as a success. Movement = recovery. I let this minor success go to me head. So when the nurses came along and asked if I wanted to try and stand, I was SURE I'd be able to do so. They got me over the side of the stretcher, my feet touched the floor, (to which I was encouraged by feeling the floor), they helped me to stand...and were there, thankfully, to catch me as my legs immediately began to fold up. It would be a couple of hours after that when I was able to actually stand on my own.

Then came their second criteria. I was fairly sure I had to go. There was pressure on my bladder and everything. But when I was escorted to the bathroom, I would swear to this day that the task took me 15 minutes to complete. Complete it I did, though, and I was sent home.

Amazingly enough, I was able to get around after both leg surgeries. That is, I could limp from room to room in my house. Long distances required the crutches they gave me. Even after the second operation, which involved more cutting, I was doing "laps" around the block on the crutches about a week afterward.

Oh, to have that kind of recovery rate back!

Oh...Before I leave this one, I was recently reminded of a "happy" little event after this surgery.

My brothers and I shared a phone line, and I had hobbled upstairs to use the bathroom when the phone began ringing. Somehow, my brain forgot that I'd just had surgery. And so it was that I attempted to run down the stairs. As I said, I was getting around pretty well. But moving swiftly for any reason was out of the question. My attempt at running turned into a rather painful stumble down the stairs. I made it to the phone, desperately trying to hold back the tears of agony, and answered. What made scenario even better was the fact that the person calling was looking for Barry. I hung up on whoever it was and called my doctor to make sure I hadn't done something horrible to myself.

7: Emergency appendectomy - I was 29 and living with Robin. She'd made steak and potatoes the night before, and I thought the pain in my stomach was some kind of revenge from a heavy meal. It'd never happened before, but there was always the chance. I took some over-the-counter meds we had for upset stomachs and went back to bed...only to awaken the next morning, unable to extend my right leg completely. I was bent at a right angle at the waist, barely able to walk, and Robin said we had to get me to a hospital immediately.

So what did I do first? Why, I called my insurance company to find out which hospital would be covered. When I got someone on the line, they were stunned that I'd pause in the middle of an emergency like this to make such a call. "It doesn't matter where you go for an emergency; we'll cover it." The rep probably hung disconnected the call, muttering how stupid said call was.

Now for the REAL fun. This all occurred at the triage station.

Nurse: Have you been running a fever?
Me: Not that I know of.
Nurse: (checked my temp, which came back at 102 F) I'd call that a fever.
Me: I guess the pain is covering the feeling of a fever.
Nurse: How about nausea? Any vomiting?
Me: Nope.
(I promptly got sick, the nurse getting a basin to me just in time.)
Me: Please don't list anymore symptoms. I seem to be getting them as you say them.

I don't remember that much afterward. On a scale of one to ten, my pain was an 11. They took some blood and gave me something through my IV. Robin later reported that my white count was WAY up. I was scheduled for emergency surgery that afternoon, and the doc said that had they waited any longer, my appendix would have burst.

Silly me, I thought I would only need a few days of recovery. They did the surgery laproscopically, meaning that they only put a few tiny holes in me to take the infected organ out. So I reported to work, and walked around my office while bent at a right angle at the waist the whole time. My supervisor called me into his office around lunch and told me to go home...and stay there for the next week. "We have sick days for a reason."

Y'know, I'm going to cut this off here. I've done plenty of writing for the time being, and there are a few more adventures to talk about. But the count is already at seven. Oh, how I wish I was one of those people who could say, "I've never been in the hospital." *sigh*

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