Monday, April 11, 2022

No Privacy & Other Fun: Before & After Surgery

Like all planned surgeries, it started days before, with the lists of meds to put a hold on, plans for shifting duties including driving, getting a pre-procedure EKG, don't plan on getting in the pool for 10 days, no deodorant for that side armpit until the incision is healed.  (My apologies to all who need to be on that side of me and down wind.) One thing on the list got me giggling, though: on the day of, take a shower with disinfecting soap, lathering your body twice.

Why a giggle? I mean, makes perfect sense, right?  Wrong. Welcome to Real World Central, folks! Emerging from your super shower, the first thing is toweling off by a non-sterile bath towel. Then there's getting dressed in "clean" clothing that, even if laundered yesterday (it wasn't), got hung up on non-sterile hangers between other non-sterile items in the closet by hands which also weren't sterilized, and which clothes were laid on the non-sterile bed in a stack before going into the closet. Yeah, the bed. On the pillow I use when I toss in that direction in my sleep. Where the dog sleeps whenever she can worm into that spot. Which is pretty much anytime. 

Once donned, the clothing is a barrier - though only in places since the weather is hot now and not all of me is covered - between me and the dog who jumps in my lap the second I sit down. Sometimes even a second before I sit down! Chaos! Toenails!!! Finally my clothing takes that trip with me in the also non-sterile car seat for the 25 minute drive to the hospital, gets included in a hug from Steve in his non-sterile attire, sits on me in the chairs in the non-sterile waiting room. No five second "rule" in any of that.

But hey, I soaped up twice before all that, honest!

 Once called back into the prep area, there is another self-inflicted sterile wipe-down, each towlette assigned one body area before being tossed. Talk about medical waste! The gown I don at least has a looped pair of strings at the neck to hold it on once I'm allegedly clean. Open at the back, with flaps waving in the breeze caused by my slightest motion, Even I with my shoulders can finally grab a section and pull it across for a pretense at privacy. Of course when I get up on the gurney/bed I spend the next hour on, it gets caught under me, doing a pretty great job of pinning me down to the bed. But I'm warm! Unheard of in the surgery area!

All the usual stuff gets done, the usual parade of staff members go through, and even Steve gets a visit. That is cut short both due not only to the uncomfortable chair they put him in, but its distance from me. With both of us in masks, and my head facing up instead of at him unless I muscle myself up, and all the noise around us, we just can't hear each other.

We can hear everybody else, however!

My bed is against the fabric curtain on one side. I clearly hear the irregular beeping of the next patient's heart monitor, mentally diagnosing it based on my own past history. I also hear the swearing, loud groans from pain, begging for food. Of course no food is coming. Finally some anesthesiologist comes in, looks at the EKG, and decides to put in a call for a cardiologist's opinion before embarking on what should be starting in a few minutes. Said cardiologist is naturally busy, so more delay, more grunts, more weird beeping. Once the cardiologist arrives, he puts a full stop to getting the surgery. I hear every word, HIPAA be damned. First the patient next "door" is a she. I can only tell from the pronoun used by staff in consultation, as her voice is in an intermediate range. I know she has diabetes, a recent surgery got infected, the removal of that nasty tissue is why she's back. The staffer describing that is emphatic surgery MUST proceed. The cardiologist pronounces within 5 seconds of looking at her monitor that she is in fact having a heart attack. He's puzzled why she had no chest pain, obviously forgetting that we women get wildly different symptoms from one, a reason they can so often be ignored. A third voice suggests that she needs  more antibiotics, and that she be watched for any progress. This being the agreed upon course, the three walk out. She is left alone, no pain management offered even now that it wouldn't conflict with surgery meds.

Lucky for my tender-hearted husband, he misses most of this, hearing just enough to get the gist.

It's time for my stabbing anyway, taking two people and 4 tries to insert my IV needle in the spot I suggested in the first place, that scar-ridden spot inside the elbow that professional phletbotomists all insist is my very best vein. Too many blood donations in my glory days, I guess. These days the needle wielder just has to push through it. Hard!

Documents get signed, explanations made, my medic alert bracelet removed and put in a case with my glasses, questions asked and answered, and away we roll to the OR.

The table I have to transfer myself onto is at least nicely padded! I still recall how cold the bare stainless table was when I got my tubes tied. I shivered even after I got home again from that one! This OR gets more brownie points for having that padding secured in place, so it doesn't move either with me or away from me as I slowly progress across it to where they want me. I get that weird chemical taste in my mouth...

...And wake up in the recovery room. Well, not awake exactly, but definitely aware again. My shoulder hurts, a deep ache I expected from having my arm hauled up straight for however long it took them to remove a sebaceous cyst from my armpit. It's why I demanded general anesthetic. I can also feel the incision site, but site pain level 2, shoulder 8.  At least they put my arm back down for me so I didn't have to try to do that for myself. 

My new nurse is busy at the computer, but when I say, "Hi", turns and asked me how I was doing and what my pain levels were. Prompt bit of Fentanyl. Shoulder down to 5. Another tiny dose, and it's battling with the incision site for a 2 for the next couple hours, finally fading away with lack of use. 

The rest of me was aware that I was not really all there. I felt like each cell in my body was vibrating. Perhaps twitching. Not pain, just weird. Distracting. I still chatted with my nurse off and on, got a couple spoons of ice, a nice warm blanket over my shoulders, and relaxed. Except for listening to the guy next "door", since of course the walls were curtains. Easier to clean properly, I'm sure, than grout and tile.

He was another diabetic patient, something I found out halfway through his crisis. He'd needed spine surgery. Now he couldn't move his legs, nor feel them except for the lightest dull sense of pressure. While he'd had some issues prior to surgery, both hands and feet, this was new. People came and went, asked questions of the caregiver who came with him as much as of him, poked, prodded , requested imaging, consulted, all taking longer than my full time in recovery. I never heard his outcome. The surgeon never showed while I was there. I have to settle for none-of-my-business and hope he has some improvement in his future.

Steve got rolled in via wheelchair, a match for the one I was getting out of there in. I got dressed, found two overlooked EKG sticky attachments when I pulled up my shorts (Yes, that low), convinced my nurse I could push my chair like a walker instead oh getting pushed in my chair to the bathroom before leaving. Steve signed paperwork for me. I am advised/required not to sign anything or make important decisions (like what's for supper? LOL) for 24 hours. No driving today, nor the usual 8 hours after any Percoset I may need in the next few days. I don't expect to need anything other than possibly something at bedtime since I sleep on my sides, putting pressure on those rotator cuffs. Should I choose that, it would have worn off before anything opened up enough tomorrow to be somewhere to drive to anyway. I got "the speech" for possible addiction to meds, and informed them of my history with them and lack of temptation. No pool walking for 10 days, but do shower. I'm super-glued back together, don't rub or pick at it, etc. 

I need to make followup appointments, one with my surgeon, a second with my primary to discuss lab results.

Now that last is a challenge. First, after getting an actual meal at 2:00, I fell asleep until 4:00. When I went through the documents, now alert enough to take up the challenge to read through and start making calls, everybody was already closed. It should have been just one call but one thing popped out like it was in size 20 font from the page: they listed the wrong primary physician for me. Nobody ever asked if he was still the one. Nobody. They asked about my cardiologist, of course. Steve wouldn't have noticed it was wrong, and they didn't give the paperwork to me when I woke up, legally non compos mentis. The reason it's important is they are having the cyst sent to pathology. Simple standard procedure. My doc won't get it. So most of those phone call attempts were about getting them sent to the right doctor. I finally got the hospital medical records department, voicemail insisting it was open till 8 PM, punch more number choices to get somewhere, ending at this-voicemail-box-is-full. Because of course it was. 

So I'll start again tomorrow.

I am to check out the incision site to look for any weeping or infection indicated by redness or puss. Oh, you weren't eating were you? So before supper I went into the bathroom, and after opening the window to exchange some high 80s air for cooler before bedtime, I disrobed enough to check the incision. Or so I thought. I still had enough pain meds in me to allow me to raise the arm. What I discovered was first, a tangled array of black marker arrows pointing at the site from before surgery, which I knew about, but also a longer black line apparently where she planned her exact initial cut. That's the problem. It's thick enough ink and wide enough to let me know where to look. It's also impossible to see through. So much for that instruction.

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My apologies to all who find the dozens of typos and bad grammar in this post. I started rereading it after posting, and correcting. Just remember, I'm legally non compos mentis! Those 24 hours ain't up yet.



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