A Diva Moment

Surgery day – Part 2 February 14, 2014

One day surgery is for the birds. Seriously. I get that it’s less expensive to do a one day surgery, but let’s be realistic here. Sometimes you need just a little extra time to recover and to be able to get up out of the bed and to your car. I mean, really, would it have killed them to give me a few more hours? But I’m getting ahead of myself.

Let’s see, where were we? Oh yes, bored and waiting. At around 11:30, the nurse came in and said she wanted to get me started on some IV fluids prior to the surgery. She hooked up the IV bag to my hep lock and discovered that the fluid wasn’t going in. “I’m going to have to flush it.” I had an idea what this meant, but didn’t really have a good handle on the implications. She came back with a syringe which she attached to one of the ports on the line. She sucked up about 5-10 ml of fluid, and then pushed it back into the line. Seems simple enough, right? Well, imagine a giant bolus of fluid being shoved forcefully into your vein through a tiny hole. Nope, not comfortable at all!

“Ouch!” No comment at all from the nurse. I didn’t get any warning, “This could hurt a bit.”, nor did I get an apology. “Oooh, sorry, I should have warned you.” I kinda wanted to smack her upside the head to see how she liked that, but thought that wouldn’t win me any points. So I just gave her a dirty look and let it be.

Several minutes later the anesthesiologist rushed in, sat down and started filling out some paperwork, gave a brief explanation of the anesthesia, and then said, “You don’t have any medical issues, do you?” Okay, let’s just stop for a moment. Has NOONE read my chart? Good grief! I’M ALLERGIC TO LIDOCAINE. IT MAKES MY THROAT SWELL UP. Seriously. Why is this not front and center in my chart and why do I have to tell this to every. single. healthcare professional. I encounter? So annoying! Anyway, I told him about my allergy and of course, he was surprised. (Insert giant eyeroll.) He then mentioned something about intubation. This is when I realized once and for all that in healthcare, you HAVE to advocate for yourself every step of the way. The fact that I’d already talked to the surgeon, the surgeon’s nurse, the pre-op people and another anesthesiologist about NOT being intubated definitely didn’t mean that the message got to the man on the ground. I had to politely request that they use an LMA instead of intubation. The doctor seemed totally shocked that I was asking. The look he gave me was like, “How in the world do you know about LMA’s?” He asked why I felt I needed one.
Me: Well, my vocal cords pay the bills, so I have a vested interest in keeping them unharmed.
Doc: Oh, I see. (He said the same thing the other anesthesiologist had said.) I can’t guarantee that we can use it. Blah Blah Blah.

Fine, whatever, just don’t screw up my cords! He then handed me a consent form to sign. Again, I surprised him by flipping it over and actually reading the form. I’m guessing that most people don’t bother to read or ask questions, and he kinda seemed annoyed at having to explain things to me. Sorry dude, I’m gonna make you earn your pay!

I signed the form and he rushed out. A few minutes later, the nurse came back in followed by another nurse who introduced herself as Margo who would be getting me ready for surgery. She wanted me to get in the bed. Up until now, Rick had been laying in the bed and I’d been sitting in the chair . . . .it was just more comfortable for both of us that way. I asked if I could hop in the bed at the last minute since the bed made my back hurt. Margo seemed a little surprised and unsettled, but she agreed. (Are you seeing a theme here? Apparently, I’m a surprising patient! hahaha) She asked if I had any questions, and of course, I did.

“What happens if a person has to pee during the surgery? Or do people not feel the need to pee while under anesthesia?” Yep, that’s me, asking the ever-important questions! =) Margo said that sometimes patients pee on themselves, but they have chucks and other pads underneath to deal with that. For longer surgeries, they will use a catheter. Since my surgery was less than 3 hours, I didn’t need a catheter (AKA infection waiting to happen). At this point, the one day surgery nurse piped up and asked if I need to use the bathroom. After alot of waffling, we decided I might as well go since I wasn’t yet laying in bed. As I was leaving the room, I passed a lady that looked awfully familiar. When I came back, I realized that it was Gina, who attends my church and who teaches my middletons Sabbath School class. I asked if she was on my case . . .sadly, she wasn’t. But she hung around to help wheel me to the surgery room.

So I got in bed, gave the hubs a hug, and we were off! I chit-chatted with Margo and Gina as we moved to the surgical area. Margo opened a door and then, there it was: the operating room.

Time suddenly stopped.

My hearing suddenly failed me.

I looked around at the instruments, the giant lights over the operating table, the brightness of the lights, the sterility of the room and it hit me.

Panic.

Sheer panic.

I wanted to reach out and grab Gina’s arm so that she wouldn’t leave me. Either I had a panicked look on my face or it was Divine Providence, or maybe both. In any case, a few seconds after panic hit, Gina said, “Would you like me to stay with you until you are under?” “Yes, that would be lovely!”

And then, the panic disappeared.

She leaned in and said, “If I had to choose any nurse, Margo would be it.” I don’t know if she was just saying that to make me feel better, or if it was true. I guess it didn’t really matter since it had the effect of making me feel better.

They wheeled me next to the operating table and it was my turn to be surprised. The table was SO NARROW! Maybe 2 feet wide, at the most. I asked Gina what happened with patients that were, uh, large. She said they “get held in more.” I had no idea what that meant until a few minutes later. I scooted over onto the table which was not at all hard like I had imagined. It was soft and cushy, kinda like memory foam. It was nice. I laid down with my head in a donut type thing, and then Gina strapped a belt over my legs to keep me from rolling off. And then, I understood her “held in” comment. The bigger you are, the more the belt holds you in/on the bed. I can’t imagine that would be comfortable!

Anyway, I laid down, got strapped in, then Gina and Margo put compression stockings on my legs. They actually felt really nice, like little massages for my calves. The purpose is to keep the blood moving during surgery so that you don’t end up with DVT, deep vein thrombosis, a blood clot in the legs. While they were working on that, Jenny, the nurse anesthetist was getting me ready to be knocked out. At least I’m assuming she was a nurse anesthetist. If she was a doctor, I’m sure she would have said, “Hi, I’m Dr. S and I’ll be getting you ready for anesthesia.” I found it interesting that a)I wasn’t dealing with the doctor that had just talked to me 15 minutes before and b)I was dealing with a nurse anesthetist. If you’ll recall, my surgeon had said that some of the nurse anesthetists were okay while others weren’t. I’m going to make the assumption that he was okay with Jenny. I have to believe that is true because if it isn’t, then he was just lying to me when he said he would request a doctor to be on my case if he saw that a nurse was assigned. I have to believe he was telling the truth, otherwise, how could I trust him on all of the other more important things?

The other thing that was interesting was the difference in how the nurses handled my body. Gina and Margo were pretty gentle when moving my legs and covering me up, etc. Jenny, on the other hand, not so much. I kinda felt like I was a slab of meat that she was flopping around, not exactly the most gentle treatment I’d received. I got this thought about 2/3 of the way into my brain before the mask was put on my face and then I was knocked out. I came to several hours later and heard someone calling my name very loudly saying something about, “You’re going to rip out your IV!” I felt a firm hand pushing my arm down. I opened my eyes and saw a female nurse standing on my left and a male healthcare tech standing at the foot of the bed. I must’ve fallen back asleep at that point because the next thing I remember I was back in one day surgery and I saw DH coming into the room. I asked what time it was: 4:15. Whoa! Four hours of my life disappeared just like that, and I didn’t even notice! Kind of creepy, actually.

DH informed me that the surgery had gone well and they had removed 3 lymph nodes. Two were sentinel nodes, and the third was a smaller node that was suspicious. We won’t know anything for sure until my follow-up appointment with the surgeon on Tuesday. That’s when we’ll find out the exact size and pathology of the tumors and whether or not the nodes are cancerous. All of this waiting around for results is killing me! Fortunately this time, I’ve spent much of the time sleeping and relaxing, so it’s been a less stressful and seemingly shorter wait.

But back to my recovery. Ah, the recovery. What a disaster! Morphine is some hard-core stuff! Apparently it made me kinda wild in recovery. Oops! It also made me extremely sleepy, weak and dizzy. I got back to one day surgery at about 4ish. The nurse, Sue, came in and gave me some pain medicine and the tech brought me some cranberry juice and applesauce, even though I’d requested pudding. (He later corrected his error and brought the pudding.) DH fed me the pudding, helped me with the juice, and then ate my applesauce. About 5ish, another nurse came in since Sue was on break. It became pretty clear that her name was nurse Ratched. “Okay, we are going to get you up with your legs dangling along the bed, get you to take some deep breaths, get that IV out and get you out of here!” Uh, she clearly had no idea how terrible I was feeling. Whenever I opened my eyes, the world was just pulsating and I couldn’t focus on anything. My arms and legs felt like lead and I didn’t have a single iota of strength. I didn’t see how sitting up and dangling my legs was going to be at all possible.

Nurse Ratched comes next to me, puts the railing down and tells me to sit up so I could dangle and take deep breaths. “Can’t I just take my deep breaths in this position?” I frankly don’t remember what she said, but I was thinking, “Give me a break! I’m a professional singer. I can get a good, deep breath in pretty much any position. I DON’T need to have my legs dangling!” I’m sure she said something argumentative and I calmly but firmly said that I wasn’t ready. She grabbed my covers, pulled them off of me and ordered me to sit up. With my eyes closed, I petulantly and firmly grabbed the blankets, yanked them back up and said, “I’M. NOT. READY!” and set my jaw. She wisely gave up and walked out.

Me: 1
Nurse Ratchet: 0

I heard her saying to the tech, “Go in there in 5 minutes to remove her IV.” Five minutes later the tech came in and said, “Are you ready to try and sit up?” He was so calming and gentle, such a difference from crazy nurse Ratched! I thanked him for “. . being so gentle and quiet. The previous person was just awful!” DH helped me sit up and my hand flew to my mouth as I was sure I was about to upchuck. (I’m telling you, morphine is some evil stuff! I think the sweet pudding didn’t help matters any, either.) The tech went to inform the nurse of my nausea and she came in and gave me some zofran. At this point, they must’ve realized that I wasn’t going anywhere fast, so they just sort of left us alone. At least that’s how I remember it. DH was helping me get dressed, but it took a VERY. LONG. TIME. I couldn’t stay awake to save my life. I felt like an elderly person with narcolepsy! At one point, I asked for a drink. DH put the straw in my mouth, and then after a bit, I realized that I had fallen asleep with the straw in my mouth and I hadn’t even taken a drink. So hilariously pathetic!

I eventually managed to be clothed, Sue, the nice nurse, came in and removed my IV, and we were ready to go home. Oh, at some point, nurse Ratched came in and gave discharge instructions to DH, which I only sort of heard and definitely didn’t internalize. DH helped me up to sit in a chair while he went off to get the car and the nurse called for transport to take me to the front entrance of the hospital. I found it interesting that they left me sitting in the chair unattended. I totally fell asleep in the chair and noticed my mouth was hanging wide open when the transporter arrived. I could easily have fallen out of the chair. I’m not sure why they didn’t let me stay in the bed. Furthermore, I have no idea what the rush was to get me out. I arrived at one day surgery at 4 and I was heading home shortly after 6pm. Would it have killed them to let me rest a bit and get me home at say 9 or 10pm? I mean, that’s still the same day, right? So as I said, one day surgery is totally for the birds!

The transporter was probably the best one I had all day. He went over all of the bumps VERY slowly and there were no herky jerky movements. I should have taken note of his name to send him a commendation. Oh well. So DH drove me home since I clearly was in no shape to be doing much of anything. My pain was really no biggie, I was just soooo out of it! When I walked into the house, the babes were all lined up, freshly showered with their jammies on. So darn cute! I gave them quick hugs, got in bed, took some medicine, drank some water and then zonked out until about 1am, when I woke up and realized I was hungry and needed some more pain meds. I felt leagues better, though. The world was no longer pulsating, I didn’t feel impossibly weak or dead tired.

The two days since the surgery have been filled with many hours of sleep. It’s been nice. I’m having to force myself to just take it easy and to allow people to do things for me. I really feel mostly fine, just a little tired. I’m so used to going through my day feeling tired that this is normal for me. But, I know I need to rest, so I just disappear into my room to rest throughout the day. I’m no longer taking pain meds, which is great. I’m hoping that by tomorrow I won’t feel as tired and my head won’t feel as weird. But if it does, that’s okay, I’ll just keep on taking it easy.

And on a final note. No amount of talking can prepare you for gurgling boobs. No, really. I knew that there would be liquid filling in the gaps, and I knew there might be sloshing. I wasn’t, however, prepared for it to sound like a gurgling stomach! It’s hilarious and weird all at once! Apparently, there is never a dull moment with breast cancer!