July 22, 2003
Hey there. I’m back. I really planned to return before this. I was going to go in Wednesday morning and proceed in an orderly fashion through the milestones in the “Before your Gynecology Surgery…” handout. I’d be home on Friday and back at the keyboard no later than Saturday, typing up my story. Well, it didn’t quite work out that way.
The adventure started out well enough. All along, I’d been told we had to arrive two hours before surgery, which meant 5:30 in the morning. Man oh man, that’s just nutty. Tuesday afternoon, someone from the hospital called to confirm my appointment and emphasized that we needed to be there at 6:30. Really? 6:30? I didn’t quite trust this change, so I called the operating room number listed in the “Before and After Your Operation” booklet and confirmed it. Sure enough, we’d get an extra hour of sleep. It’s pretty pitiful when being told you have to be somewhere at 6:30 in the morning is good news.
We got to the hospital around 6:25 and found the doors to the ambulatory surgery unit didn’t even open until 6:30. Man, I would have been so pissed if we’d shown up at 5:30 and had to wait an hour. Considering I wasn’t able to have any breakfast or diet Coke or pain reliever, I was in pretty good spirits. I got checked in and gowned and Mr. Karen came back to sit with me while everyone involved with the surgery came to introduce themselves– my doctor, his residents, the nurses, and two anesthesiology people. I wasn’t loving the head anesthesiologist. She kept saying things like, “Are you worried? You look anxious.” I did not find this reassuring, and thought she should either give me Demerol to help me be less anxious or shut up about it already. Of course I was worried, and that seemed like a perfectly reasonable way to be under the circumstances.
There was a bit of confusion during this prep time. I’d understood I was going to get general anesthesia for the surgery with patient controlled analgesia via an IV pump afterward, but that wasn’t in my record for some reason, so discussions ensued about whether it would be better to go with a spinal with a booster after surgery to cover the first 24 hours of pain relief, which is what my doctor usually has his patients do. Given that I’d never had any of these drugs before, and the one used in the spinal can cause nausea and itching and would be in my system for a whole day even if I had a bad reaction, unlike the morphine pump, which could be pulled if it didn’t agree with me, I said I wanted to go with the general and the pump. My doctor and the head anesthesiologist were fine with that. When the other anesthesiologist was prepping me, he started talking about how I might hear voices during the operation, and feel some tugging and pressure. What? I looked over at Mr. Karen to make sure I was hearing this right– this guy was talking about a spinal, wasn’t he? He was. He had not gotten the word about the whole I don’t want to be aware of anything plan. I objected and he went off to get clarification and came back and apologized for confusing me. I was just glad we got that straightened out. And once he knew the plan, he executed it perfectly– I remember nothing between Mr. Karen kissing me goodbye before they made him go out to the waiting room and when I woke up in the recovery room.
I was feeling pretty good in recovery. I didn’t feel much pain, and I wasn’t as loopy and out of as I’d expected to be. I remember taking the oxygen mask off and peering around the room to see where I was, which attracted the attention of my nurse. I thought I’d overheard her talking quilting with some of the other staff, so I asked, and that wasn’t just something I imagined. She even had some blocks from the quilt she was working and asked if I’d like to see them. Of course I did! How cool is it that I’d get a quilting nurse who had show and tell? Very cool. They were nice blocks, too, with a fish fabric and lots of bright colors in the pattern. The nurse seemed apologetic that they couldn’t find Mr. Karen in the waiting room even though they went to look twice, but I wasn’t worried. We’d be told more than once that he couldn’t come back to recovery, so I expected he’d gone to meet me in my room, which is exactly where he was when I got wheeled up there.
He’d talked to my doctor and the surgery had gone well, exactly as planned. He fed me ice chips and I tried to stay awake, with only some success. So far, I was on track with the handout. The catheter gave me a little bit of trouble; I felt like I had to pee even with it in, but a suppository to calm my bladder took care of that. Soon it was time to tackle the last milestone for the day: sit and stand at bedside. A nurse and an aide came in to help me up. Rolling onto my side and sitting up wasn’t too bad; I was a little stiff, but I had the magic of morphine to dull the pain. Then they stood me up, and the next thing I knew, I was lying sideways on the bed, looking up into people’s faces. It took me a few seconds to realize I’d passed out. Wow, another new experience. I’d never fainted before. I couldn’t figure out why everyone was asking me about my head, did my head feel okay. Evidently, I’d hit the rolling table that goes over the bed when I crashed and made quite a noise as I did so, but I had no idea. It took a little while to convince them that my head was fine. Well, as fine as someone who can’t stand up’s head could be.
I think dinner came next. Perhaps clear fluids would perk me up enough to get that standing action going. The chicken broth portion of the meal went well, but the grape juice didn’t want to stay down. Man. Throwing up was not on the handout. At some point, it was decided that they needed to get my blood pressure lying down, sitting up, and standing to get a better idea what was going on. Steps one and two went fine. Step three, not so fine. I’m not sure how many people were there helping me stand, but all of them seemed to be talking at once, telling me to keep my eyes open and focus on something on the wall, and I’m thinking (saying?) my eyes are open, I can see the calendar, and then I’m back on the bed again. This goes into my record as a second faint, but I think I should get some credit for at least hearing them talking to me as I was falling over. I’m not sure I was up long enough for them to get a blood pressure.
Evidently passing out twice in one night is a good way to get extra attention from the medical staff. I don’t remember in what order things happened, but at one point I was getting my vitals checked every fifteen minutes and having blood drawn to be run down to lab and being visited by doctors called in from I don’t know where and getting a bedside ultrasound to check my abdomen. I added even more interest to the evening when I threw up all the water and fruit punch I’d had in between tests just as a new nurse was introducing herself. Hi, welcome to being my caregiver. Eventually, it was determined that I was stable, that I didn’t need to be taken back to surgery, and I got a few hours of uninterrupted sleep between the last vitals check and the first resident showing up at first light.
Strange as it seem, I flattered that the residents found my case baffling. “We’ll talk about you in rounds this morning,” one said, and I was glad to have sparked some interest. By having problems after a surgery that went so well, I felt special. Hey, you got to look for the bright side. After the residents had come and gone, my doctor showed up. He was baffled, too, about how I could have lost so much blood when the surgery had gone according to the textbook and I was completely dry when they closed me up. But lose blood I had. He confirmed that the loss had stabilized, and said I could wait for my body to replace the loss or I could have a transfusion. Man. I hadn’t donated my own blood ahead of time because so few women need it with a hysterectomy, and at least one study shows that the women who did self-donate were more likely to need to be transfused than those who didn’t. I knew Mr. Karen had some concerns about my getting blood, so I put off a decision until I could talk to him and he could talk to the doctor. Still, from the start, I was thinking I’d get the blood. I didn’t want to drag around for weeks and weeks. I wanted to do what I could to get better sooner. I called Mr. Karen as soon as the doctor left; I felt bad about waking him up, but felt better just hearing his voice and knowing he’d soon be with me.
By mid-morning Thursday, I’d decided to get the transfusion. It took most of the day to get two units in. A nurse sat with me the first ten minutes of each unit to watch for any problems; fortunately, there weren’t any. It was strange to look at the blood dripping into my arm and think that it had been in someone else’s body. There was a little ick factor there. I’ve given blood, but never really thought about where it ended up. I wondered about the people who’d given the units I was getting and thanked them, wherever and whoever they were, for doing it. By the time the second unit was almost in, I was feeling restless for the first time. I wanted to get out of bed. I felt so much better already; I just knew I could get that whole standing up action going this time. As it turned out, not only could I stand up, I could shuffle down the hall, so Mr. Karen and I took a few turns around the floor. Being able to walk with just the IV pole for support meant I could get the catheter out, only about a half day behind schedule. I was on the mend. Since I was still on IV fluids as well as drinking water and juice, I was blowing the urine output targets out of the water, so to speak, so I got lots of practice getting out of bed and going to the toilet, which was equipped with a little basin so they could keep track of my production. Rather than hitting the call button every time I filled up the basin, I’d just empty it and write down the numbers to tell the nurse the next time I saw her. I’m so self-sufficient, aren’t I?
Friday morning the IV’s came out. Switching to pain pills rather than the morphine pump was one of the things I needed to do before I could go home. It was a little rough– I had no appetite, so I didn’t eat enough before the first vicodin and motrin doses and ended up feeling really nauseated until I could choke down enough crackers to settle my stomach a bit. I hadn’t realized how great it was to be able to get morphine on demand until it wasn’t there any more. I found myself watching the clock and counting the time until I could ask for more vicodin. The other thing I needed to do before I could go home was pass gas. All along, the people listening to my abdomen had been complimenting me on my bowel sounds– can I put that on my resume?– but the actual gas passing took a little while. I was just glad they took my word for it, that I didn’t have to fart in someone’s face to get that checked off on my chart. Being IV free meant it was easier to get around, so Mr. Karen and I ventured off the floor for our walks on Friday. I even went outside. I was surprised at how I didn’t care how crappy I looked, even in the public areas of the hospital. Yeah, so I’ve got greasy hair and no makeup and am wearing a gown that clashes with my robe, no problem. It was rather liberating.
By Saturday morning, I was ready to go home. A doctor I don’t remember ever seeing before stopped by to see how I was doing– maybe he was one of the ones who was there Wednesday night– and gave me his stamp of approval. My doctor came a little a later and reviewed the restrictions I’d have and said he’d get my discharge paperwork going. Excellent. I was dressed (well, if you consider clothes that could just as well be pajamas dressed, though I was wearing underwear and a bra for the first time since I’d come in on Wednesday) and ready to go when the nurse came in with the papers for me to sign. Mr. Karen and I had to watch a discharge video and then we could leave. I could have walked out by myself, but procedure said I had to be wheeled, so I had to wait a few minutes before a chair and an aide to push it was available.
Since I’ve been home, I’ve been doing a lot of napping. Even after the transfusions, I’m now anemic, and I don’t think that’s helping. I don’t have the attention span yet to watch DVD’s, and sitting up straight is still uncomfortable, so there’s been only a tiny bit of computer time and no sewing in my schedule so far . But I’m on the mend. I’ll get there.
A year ago, I was looking through boxes in the basement. Won’t be doing that again for a while, what with the not being able to lift anything that’s even slightly heavy right now.