Saturday, December 8, 2007

The Surgery

Here I am during the traction the day before surgery. Note
the tongs attached to the big pins in my head, and I am
surrounded by an innovative CT machine so that the
procedure was done not only under flouroscopy but CT,
as well.

My Tethered Cord surgery was scheduled for 7:30 the next morning. I can't remember being awakened but I do remember two women pushing me on my hospital bed into the "netherlands" of the operating room area. It had to be quite early, yet there were many people here and there and the gals pushing my bed were saying hi to friends. This area that is off-bounds to non-medical personnel looked almost factory-like. No borders or pictures on the walls here. And if my "guessing" was right, there are several operating rooms in that area.

They pushed me up to two big double doors, pushed a button from the outside which would cause the doors to swing open, and then they moved the bed up beside the operating table.

The anesthesiologist greeted me with a big smile. He was Jamaican, a strong-looking, large guy with a big, toothy grin. I remembered him from the Invasive Cervical Traction the day before. He looked at the hospital bracelets encircling my right wrist, including the orange one that declares I am allergic to Sudafed. He asked me my birthday to be sure it corroborated the bracelets. He told me that I would need to be intubated awake, and I remember slightly wondering how ugly that would be. Someone injected something into my IV line and I was told that I would feel sleepy soon. I noticed one of the nurses as she unbundled stainless steel instruments, big ones, from a folded up, white towel. Another man came in and said something to me, but soon....

I woke up in ICU. I can't recall now if I was in a great lot of pain, I don't think so. But I was SOOOO dry. A nurse brought a little pan of ice chips to me and I gobbled them down and they brought a lot of relief.

My sister told me later that both neurosurgeons went to speak to her in the waiting room, telling her that my surgery had lasted 7.5 hours (usually, these tethered cord surgeries are 2.5 to 3 hours long). The reason for the great length, they said, was the fact that I had a LOT of tissue that was paper thin and needed to be carefully dissected in order to detether my cord.

One surgeon said to my sister that if I should choose to come back for the craniocervical fusion, it would help me a lot, and "dare we say it, but perhaps she could ride again. Others have." The other surgeon remarked, "Wouldn't that be a wonderful thing. Horses were her life."

It pleases me now to think that these surgeons were talking about me while they worked so diligently to cut away the paper-thin tissue that was holding the end of my cord down so tightly and sucking my brainstem and cerebellum into the spinal canal. To think that the doctorwho knows me better was filling in the other surgeon on how I was hurt, what happened and why, and that "horses were her life."

The following days are hard for me to pinpoint what happened when. At some point, I was rolled up to the neurosurgery "floor." My sister was there a lot. I think I remember one morning waking up and the room was dark and my sister was sitting there alone in the dark, waiting for me to wake up. That really touched me, although I probably couldn't express it.

As I wrote before, I had not seen my sister in six years, and it would have been nice to think of these days as a time to visit and catch up. But I don't remember any of that going on. I hardly remember her being there at all. She did bring me a Starbuck's latte that I requested. I remember it as delicious, but she tells me now that later, I complained about it being lousy.

In the bed next to me was a woman, but I have no recollection of what was wrong with her. I do remember on Thursday, which was Thanksgiving but I had no understanding of that, many members of her family came to help her celebrate the day. All I knew was that it was very noisy. Maybe they came on Wednesday too because it seemed they were there very late. But again, my perception of everything was skewed because I was using that pain pump as often as possible. It helped with the pain, but it also triggered hallucinations, crankiness and who knows what else.

That night, I heard intermittent clicking and I imagined that the woman next to me, her sons were playing with cap guns out in the hall. I pressed the button for the nurse and when she came, I angrily asked if there were boys in the hall with cap guns. She said no, then said, "Maybe it is the closing of the binders you are hearing." Later on, I noticed that in the middle of the night, the nurses must go through all the charts for all the patients, which are kept in binders. That sound happened every night and later on, in a more lucid state of mind, I noticed how they did sound like toy cap guns.

One night, I hallucinated that the TVs up on the wall were buffalo. Below them were two clocks which in the dark, became feed pans, one under each of the buffalo's noses. I imagined that I had to ready them for a fundraising auction.

On top of the closet to the left was a basket of flowers that my sister brought to me, with a mylar balloon with the words, "Get Well Soon." In the dark, these became the head of a Massai warrior, bedecked with feathers around his throat. I also imagined that I was not really at a hospital. I felt I was in a room that had been tacked on, shed-fashion, to the back of a factory where they were laundrying money. I feared this very much, that I wasn't really in a hospital, because that hallucination was very real to me.

Eventually, the med that was causing the visions and dreams was taken away from me. That was the last day my sister was going to be there. How I wish I could have those hours back and be able to really TALK to her, but I was in such a state that I couldn't. Or if I could, I don't remember it.

Speaking about not remembering...about the awake intubation, I found out later that they give you a drug that causes you to forget events during the time the drug is active, and thus I have no recollection of that process which I hear is very difficult and even terrorizing. It IS an odd sort of feeling though, to know your psyche and body went through something so terrifying as awake intubation...I HAD to be aware of it at the time, but I just don't remember it. It's strange to think about.

The morning after my rough night, a PA came in to assess my situation and noticed that my IV port was ripped off. He asked, "Who took that off?" and I said that I had. He asked why. I remember trying to think of something to say besides the truth, but in the end, just said, without apology, "I thought it was a bracelet and I wanted it off." He seemed to understand that it was all just a part of the hallucinations and did not scold me for ripping it out.

On Friday night, my sister bid me goodbye with tears and hugs. She had brought me a lot of snacks to leave there. I felt so alone with her gone. Yet I was so thankful that she chose, at the last minute, to come down to help me. I know now without a doubt that no one should go through a surgery and hospital stay without a clear-headed advocate to be with you. I hate to think how things would have gone if my sister had not been there. She truly saved my life and I will be forever thankful.

The day after she left, I was moved to a room up by the nurses' station. My mother tells me she talked to me on the phone and I told her that I was really hurting and needed the nurse, but no one was coming to help me. She said she hung up and called the nurses' station (my mom worked as a unit secretary at a nurses' station in her local hospital for many years) and asked why no one was helping her daughter. Way to go, Mom!


Anonymous said...

my goodness Mac , boy hope you are doing better .

Caroline said...

what an amazing story. I sure appreciate you sharing how it was for you. It gives all of us that have upcoming surgery some insight into what it will be like.

I had conscious sedation before for an upper GI. The doctor performing it came and talked to me beforehand and then I was given the drug. I don't remember the actual procedure of the flexible tube going down my throat into my stomach(Thank God!) but apparantly I was so chatty with the doctor that they had trouble even doing it :). I don't remember any of it but if makes me laugh that I was flirting with a cute doc and have no memory of it.

How is the recovery process going? I hope you are feeling better everyday.

hugs to you,

Zoe said...

Hi sweetie,
This is a sobering post~
(I'm sure you're with me in thinking- "I'm just glad it's over!")
(Large SigH)

It is incredibly wonderful that you're able to share so much about your experience though. Many people will be blessed by this!!

I have horrid memories of my heart surgery in 06' and never really understood that parts of it must have been like yours- ~hallucinations~ (grimacing face- I hate to even think about it)

How I thank God you were in the best hands possible for your surgery- esPecially with the complications that came up! Dearest "mac"
I'm glad you are home safe and sound, healing and sharing again.

(((((((you))))))))))))) from zoe