Not So Standard Operating Procedure

“It went beautifully Joy. I’m going to go talk to Lynn now.”

I’m peacefully foggy but recognize my surgeon despite his cap and mask and I realize the surgery–the event that my entire life has been pointed at, on hold for, for the past 18 months, is over. I feel a goofy grin spread over my face. It dawns on me that I’m wearing a paper hat. I wondered if they were short-staffed in the cafeteria.

In recovery, with a nurse admonishing me to breath deeply and cough, the events of the morning fall into order. The fistful of pills I had to down with a thimble of water. The space age inflatable blanket, powered by what it looked like a cross between a rental floor cleaner and R2D2, that wrapped me in a weightless cocoon of warm air. The catheter hooked into the back of my hand, through which a whole lot of drugs travelled into my bloodstream. The tiny bit of dread that made me ask Dr. Eva, as she checked my airways in the event of an emergency intubation, if I was going to hear or see anything—I had opted for a spinal and “cocktail” instead of a knock-out to the core general anesthetic—a choice that had friends calling me the bravest person they knew. Still, I knew some heavy equipment would be used to attach the new joint to my leg bones and the last thing I wanted to hear was workshop sounds.

“No way,” she grinned. “We let you see what’s going on and next thing you know, you’ll be wanting to give all your friends new knees at home. We couldn’t risk letting you cut into our business that way.”

I liked this woman. She had kind eyes and I could tell she was going to light me up good.

Once we got into the operating room, the team asked me to crawl over on to the operating table and I did just that. I rolled over and crawled across the table, exposing all that wasn’t covered by my tiny little gown to those assembled. “No, no, sweetheart,” someone said, “We need you on your back.” The sedatives must have been working because I was rather amused that I’d mooned the room. I also vaguely remember being held up by someone, whom I may or may not have been hugging back. Took me a day or two to connect that encounter with the faint bruise on my lower back from the spinal.

Yes, I was that out of it. Gratefully I still couldn’t feel anything below my waist. And I would continue to slug back a cupful of pills every few hours and ignore the morning ritual of a heparin shot to the stomach. During my stay, I didn’t mention the hallucinations the pain pills were creating, neither the multitude of cats I thought were walking around my room, nor the fact that a gift basket brought by a friend kept turning into a Carmen Miranda-like figure. I wiggled my toes every hour as prescribed. I gained the appreciation of the nurses because I wasn’t afraid of needles (we’re a small group apparently) and I didn’t flinch, whine or ask unnecessary questions. Even when the interest in my health moved north. Around dinnertime on the day following my surgery, a porter showed up to take me to x-ray. I had already been there in the morning to check my leg, but this time they did some chest shots.

That’s the beauty of heavy post-op drugs.  I knew something was wrong—but I could’t work up the effort to ask about it.

The following day, one of my surgeon’s residents showed up to explain that my blood oxygen factor was too low and my heart beat too fast—and there was a slight effusion (scary doctor talk for a bit of fluid) on my lung. That explained the chest x-ray. There was a fear that I’d developed a blood clot, which could be really dangerous. An ECG later, I learn I’m scheduled for a CT scan sometime later that day. That’s when the real adventure begins.

CT scans are wider than MRI machines, so I avoided the claustrophobic sense of panic I was expecting. But despite the technician’s warning, I wasn’t prepared for the effects of the dye they shot into my veins through yet another new catheter on my arm. A smoky, metal taste exploded in the back of my throat, I went hot all over and an intense headache crept in immediately. By the time I got back to my room, I was shaky, my blood oxygen was way too low and my blood pressure was scary high. I could feel my heart bumping in my chest. My night nurse, funny and refreshingly heavy on the profanity, told me I was having a mild allergic reaction to the CT dye. The doctor on call was called. The only thing to be done was flush the dye from my system.

For the next three hours—the duration of the final episode of Survivor I was watching on my iPad—I alternated between sips of water and watered-down Coke, using a spare gown to swing my stapled up knee to the floor so I could steer my walker and my overfilled bladder into the bathroom. Eight trips later, past midnight—and just after the winner of the series was announced—my vitals were in an acceptable range. As my nurse tucked me in and made sure my call button was handy, he leaned over and whispered, “Now go the f#*% to sleep.”

I did. And just after my sort of French toast arrived in the morning, another resident showed up to tell me all the tests had cleared. The problem was that a small portion of my lungs had collapsed just a little during surgery—a fairly common event if you aren’t intubated and something that would work itself out with enough deep breaths. I’m surprised he bothered to tell me the good news—at first I didn’t realize he was a doctor and asked him to help me clean up the dirty cups and mess that had accumulated on my tray. Good sport that he was, he followed me and my flapping gown to the garbage pail outside the room.

He also decided it was safe to release me.

“You tend to run a little hot,” he said. “You’re in fine health, but your vitals are just a touch higher than most people.” I smiled. One of those times I’d have preferred to be struck with the status quo.

A wheelchair ride down to the car, a cup of good MacDonald’s coffee from the drive-thru and a shower later, I was wearing my own pjs and lying on my own couch, drinking a decent Coke. Plenty of pills and pain and physiotherapy were still ahead. Along with the same operation on my right leg, to be scheduled once my left fully healed—but now I knew what to expect.

Thanks to all the tests, all that we had learned and all the mysteries that had been dispelled, the second time around would be standard operating procedure.

 

 

 

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