Monday, May 9, 2011

Surgery Day.

The day finally arrived.  The get-this-crap-out-of-my-abdomen day.

And it started early--shortly after 4 am.  Tim and I got up around then, got our stuff (including a sleeping Rowan) together, and headed toward Indy.  We stopped in Judah so my mom could follow us (we drove two cars in case I would have had to spend the night, that way she could have brought Rowan home).  I was really, really tired.

Why?  I didn't go to bed until 12:30.  I was up working on a meta-analysis that I've been working on with a writing group at IU, and we're hoping to get the manuscript out in a few weeks.  I had to finish my portion.  I did (and I actually really enjoyed the work, I was just tired), then packed a bag for Rowan for the next day and went to bed.

Rowan woke up at 2:00, so I had to get up to feed him.  I was back in bed by 2:15, but couldn't sleep.  The last time I saw the clock, it was 3:30.  The alarm went off at 4:00.  Oh, well.  At least I'd be sleeping most of the morning.

We arrived at the surgery center at Community North around 7:00.  I checked in and then, within five minutes, they were calling me back.  At this point, Tim, mom, and Rowan couldn't go with me, but they would be able to soon.  The nurse explained to me that she is a nurse and would be taking care of me today (I find it so strange when a nurse tells me what he/she does...because I totally know).  She weighed me and took me into the pre-op room, where she asked me the standard health history questions.  She took my blood pressure and my pulse, which was 44.  It was then that I had to break the news to her that I'm a runner.

And I finally outed myself as a nurse, too.  Conveniently...right before she started the IV.  She did so successfully, hung the IV antibiotics, and the next thing I knew mom, Tim, and Rowan were in my room.  That's when I started to get a little nervous.  I always worry about general anesthesia, and part of me was still worried they wouldn't find anything.  We talked for a while, and the anesthesiologist came in and introduced himself.  He told me he'd be using Propofol to put me to sleep.  As an ex-neuro trauma ICU nurse, I have administered a LOT of Propofol (it's also the "Michael Jackson" drug) and I know how effective/fast-acting it is.  He also promised me some Zofran to combat any post-anesthesia nausea.

Then Dr. Jones came in.  I felt at ease just seeing her.  I again pointed out all the areas where I have pain.  She smiled and said "I'll look around everywhere, don't worry."

And then it was time.  I hugged and kissed my family and walked back to the surgical suite.  Word had gotten around that I'm a nurse.  The intra-operative nurses asked me what kind of nursing I do.  When they found out I taught, they asked me all about that.  It put me at ease as I was getting situated on the table.  I saw the anesthesiologist again and knew that if I had anything to say I better say it quick--he had Propofol in hand!

I looked to my left and saw the white liquid (Propofol is white) about two inches from my arm.  "Uh oh," I said to the anesthesiologist, "It's coming."  "Yep!  Good night!"  I quickly said, "Oh, I'm starting to feel it."  And then I remember saying "What kind of music are you playing in here today?" (it is very common for surgeons to play music while they work.  I heard the nurse say, "I don't know--I think..." and then I woke up in the recovery room.

I woke up at a mildly inopportune time--when they were attempting to extubate me (removing the breathing tube).  This is not very comfortable.  I guess I moved around too much, because I heard the nurse say "I just pushed 100 of Fentanyl."  That's a lot, especially for someone my size and who has no tolerance to Fentanyl.  Before I knew it, the tube was out and my throat hurt a LOT.  The nurse then said "I gave her some Labetalol because her pressure was 158.  And 50 more of Fentanyl."

So, with all the Fentanyl in me, I felt like I was in a dream.  My eyes weighed a ton.  I knew I had just had surgery, but I was in NO pain. None.  So I started wondering if they had actually done it.  I heard myself say a single word:  "Husband."  No one answered, so I said it again:  "Husband."  So interesting to be on the patient side of things, because patients do these things all the time when you're trying to manage their blood pressure, etc.  The nurse came to me and said "Your husband will be here soon, he's in the waiting room."  I heard myself continue to say "husband," though I knew it was futile.  But I really wanted Tim.  She then told me she had just given me a little morphine and was going to give me an injection of Dilaudid.  I wanted to protest, but in my drugged up state couldn't do it.  I felt the injection in my upper arm.

I tried to calculate how many narcotics I had been given (at least those that I even knew about).  150 mcg of Fentanyl, an unknown dose of IV morphine, and an unknown dose of IM Dilaudid.  That's a LOT for me.

The next thing I remember, I had Tim by my side.  I was back in my original room.  I still felt like I was in a dream.  It felt weird...kind of nice, actually.  I'm pretty sure I was stoned (I wouldn't know because I never have been before).  I asked him what Dr. Jones had done, and he told me.  But I didn't understand a word he said.  So I kept asking.  And I kept not really understanding.

I was too messed up to know what had been done to me.  I just kept going in and out of consciousness.  Occasionally, I would hear Rowan babbling in the background.  It was so bizarre, like a dream.

Finally, after I sobered up a little, Tim told me again what Dr. Jones had found.  She had not found any active adhesions--nothing attached to anything else.  But she saw a large area of scar tissue over the surface of the liver....right beneath where I told her my most painful area is on the right.  And on the left, there was a very abnormal area on the peritoneum (the abdominal wall...not the muscle, but the abdominal cavity).  She thought it looked like it might be endometriosis (which I had previously been told it was IMPOSSIBLE for me to have in that area).  The area was in the exact spot where I have the left-sided pain...lower than on the right side.

So what did she do?  Well, first of all, she took some biopsies of the abnormal tissue.  That was mostly for the left side--it will tell for sure if it is endometriosis (and from searching at pics online and looking at my picture, I'm pretty sure it is) or something else.  She scraped off the scar tissue from the liver.  Why was there scar tissue there in the first place?  My liver was infected, of course.  Not just infected, but chronically infected, which resulted in quite a bit of damage to the outer hepatic tissues.  As they've healed, they've formed scar tissue.  She mentioned to me (when she came in later) that it is possible that the liver was, at one time, adhered to the abdominal wall, but that it, at some point, broke free.  That may be why I've been feeling relatively better.  Anyway--she got rid of the scar tissue and then worked on the endometriosis (or whatever it is), removing as much of it as she could and cauterizing it.

She also looked around the rest of my abdomen and pelvis and didn't see anything else needing attention.  But she had succeeded in finding two GLARING abnormalities that were situated exactly in the areas of pain.  And she took pictures so that I can show all the (male) doctors that it is NOT MUSCULAR!

If the one biopsy does turn out to indeed be endometriosis, I'll have to consult an OBGYN (not any of those I've seen up to this point, as they dismissed me...other than the NP, but she couldn't treat this).  A hysterectomy would likely be in order to prevent the endometriosis from recurring.  Fine by me!

They told me I could leave, but they had me so sedated that I couldn't get up.  I slept it off a little more and finally felt like I could walk a little.  They wheeled me to the car.  I slept the entire way home.  Tim helped me to the couch, where I passed out cold again.  I still wasn't having any abdominal pain--this is because she gave me an abdominal nerve block.  If you ever have abdominal surgery--ask for one!!  For almost 8 hours, I had no pain.  I do have some now, but it's not too bad.  Taking pain medicine (but Lord knows I don't need much after that narcotic buffet) and resting.

I'm glad the surgery is over and that I have physical evidence (pictures) that prove that there are internal abnormalities where I am having this severe pain.  I asked her when I could run again, and she told me to wait until I saw her next (next week).  I mentioned I have Dances with Dirt this weekend, and she said I could do it if I feel like it.  She did tell me, though, to be aware that the liver surface may be sore because she removed that tissue from it--it will take a while to heal.  As of now, I'm planning to do Dances...I might give one of my relay legs to Wes, though, so I won't be running too much.

1 comment:

  1. Wendy- Ive been following your blog for awhile and never commented but i have to say!... 1. Youre a huuuge running inspiration :) i finished my 2nd mini this year 2. Im so glad you finally found an answer to your pain!!! And I know and love Dr. Jones!!! I worked with her in the OR at St.Vincent when she was there.. She is wonderful! I hope she helps you find relief!
    -Sarah Steinke