Thursday, January 17, 2013

The Big Day

The day before surgery, my parents came down from Boston. They had planned to be in the area for Christmas anyway, so just moved up their travel a few days. I called the hospital surgery hotline to find out what time to arrive the next morning, expecting it to be dark-o-clock (also know as the ass-crack of dawn); I was told 10 AM. Great, more time to sit around worrying the next day! I expected to be a nervous wreck that evening, as past experience led me to believe that I would be spending my time going over endless "what if" scenarios in my head. But I was strangely calm. Then, the big day came...

...and to my great surprise, I was still fine! I'd had some trouble getting to sleep the night before, but not from nerves. It was more like the excitement on Christmas Eve when you just want to get to sleep sooner, so that you can wake up sooner and it will be Christmas. This feeling lasted through the morning as I counted down the minutes until we could leave for the hospital.

I believe 2 main elements helped greatly with keeping my mood in a positive place. First, having the transjugular liver biopsy several weeks prior had given me a glimpse into what an operating suite looked like, and what to expect with the feeling of sedation. For that procedure I had been half awake; being put all the way under would be a breeze by comparison! The second helpful item was my lists. I had a list of what to bring to the hospital that I had revised several times over the last couple weeks. I also had a list of instructions for things I would need help with at the hospital, including important things to remember. Both of these were electronically shared with my mother, who I had named as Head Care Agent and Walking Drill Sergeant. Knowing that someone else knew about what I felt was important, and what to do in case something major happened helped me stay calm. Giving up control was pleasantly soothing.

This is the list of instructions I gave my mother to be in charge of:

At the Hospital
- MUST HAVE pain meds before JP drain comes out!
- Short walks 5-6 times/day
- Don't mess with me
- Don't try to make me laugh if you feel awkward...
- If I complain about something, write down the time and issue, and ask me what # on the pain scale (1-10) for when doc/nurse comes in. Same for if I have a question.

Before Leaving Hospital
- Instructions for taking home meds (lexapro, chewable vitamins)
- Make sure I take everything I brought

Just In Case
- No heroics - don't want to be long term vegetable
- Cats to someone trustworthy, preferably who one of us knows

(Left a short list of names and number to call after I came out of surgery OK)

After arriving and getting checked in with the intake coordinator, I got my sexy on. One gown open to the back with another on top open to the front, plus non-skid slippers and a surgical hat/hairnet later, I looked amazing. I was taken to a holding area with reclining chairs where I waited for about an hour. During that time, a nurse came to review paperwork and ask final questions to make sure I was eligible and safe for surgery. My mum came back to keep me company - we played cards and looked through my patient binder. I was getting bored and antsy, and temporarily lifted my "no pictures at the hospital" rule for the gems below:

Stay tuned for the follow up fashion show in my next post!

Eventually I was told to get into a gurney bed and was wheeled down the hall to the elevator. On the way, we both realized that I was probably going up to the surgery prep area, so my mum quickly grabbed my dad and sister. Have you ever ridden in an elevator while lying down? It is a strange feeling, to be sure.

When we got upstairs my entourage was directed to the waiting area and I went into the torture chamber. That is not the official title for the prep area, but it might as well have been - it took 3 people 9 attempts to place 2 IVs. Only 1 got finished during the time I was awake and they waited until I was "light's out" to deal with the other one, as I think all involved were tired of trying to shove a needle into my already small veins which were even tinier from having no liquids for the 12 hours before. The anesthesiologist and my surgeon both made appearances to go over a few formalities and then, before I knew it, I was being wheeled down the hall to the operating room.

As we paused outside the door, I asked if the instruments inside were covered, since I knew that seeing them would send me into panic mode. I was assured that I wouldn't see them. As we entered, I glanced to my left and saw a nurse laying everything out. This was the first time to feel anxiety, and it came on quickly. Luckily, the next thing I knew my bed was next to the operating table and I was being given instructions - transfer surfaces, move up/right to get in the proper position, state my name and date of birth. The various staff were quickly getting everything into position, and I found that in the flurry of activity, I could only focus on what was being said directly to me, which helped me keep my mind off  anything stressful or unpleasant. Someone gave me an IV dose of Versed and as it washed over me, one of the anesthesia staff placed a mask over my mouth and nose. The last thing I remember was looking up at the huge medical lamp and thinking how thoughtful it was that they hadn't turned it on yet, because it would have been annoying to have that shining in my eyes.

After what seemed like only an instant in time, I awoke in the recovery area. A nurse was nearby, and came over to ask what my pain was on a scale of 1-10. I guessed at about 4, and she assured me that I would go to my room soon, where they would give me a pain pump. Around this time I asked her if I made it out ok and realized in the same instant that if I could feel pain, I must be.

I was alive.

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