Appendix to Appendicitis

I’ll presume you’ve read my previous post, which is how I got … well, to this post. If you haven’t read the previous one, you should — this is kind of Part 2.

We’ll wait…

Now when we last chatted, you left me lying on a bed in Rockyview General Hospital’s Day Surgery ward, waiting for my turn for an emergency operation. (The term “emergency” being highly subjective, of course. One person’s emergency is another person’s “hurry up and wait”.) The assessment had been long done, the papers were signed, and all I had to do was … well, lie there.

You’re probably wondering how I wrote that entry while waiting. It wasn’t easy. I was on a lot of morphine. It took me a while so it didn’t sound totally incoherent. (I’m leaving it in its morphine-addled state for posterity.) As for the mechanism of how I wrote it — thank the wonders of modern technology. An iPhone 4 with the WordPress app, and access to the hospital’s WiFi (courtesy of my wonderful wife, Alex, who happens to work there). The rest you’ve already read.

Somewhere around 14:15, Alex finally appeared (she’d planned to be there earlier, but chaos reigned once again around the house), early for her evening shift so she could come by and check on me. I had just been given my instructions to drop the trousers as the call to go to the OR would come “any minute”, so I had to be pants-less.

I didn’t have the apprehension I had for my first surgery, which was just over a year ago for my hernia. I was terrified of that one. Having had that experience, I was less worried for this one, though I still wasn’t really looking forward to it. So when they came for me a few minutes after Alex appeared, I wasn’t sweating bullets … although in hindsight, that could have also been due to the morphine.

I should also note that until writing this blog entry (which is just before I posted it; I don’t normally write blogs over long periods of time), I didn’t really understand how much danger I was in. I downplayed the appendicitis a lot more than I should have. It’s a serious thing, and treating it lightly in any way can quite easily lead to death. Point of note, there.

I waited for only a moment in the OR holding area before the nurse appeared to wheel me around to OR 12, where I was met by the anesthesiologist, and eventually the surgeon. The standard “what’s your name, birthdate, and what procedure are you having done” questions were posed (it’s a sanity check more than anything else), before I was brought into the OR itself. OR 12 is a lot smaller than the OR I’d been in before, and looked less TV-friendly. I repeated the answers again to the two other nurses in the room, adding “my appendix hates me, and I’m not particularly fond of it at the moment, either” before scootching over onto the surgical table.

The last thing I remember clearly was asking the anesthesiologist if I was getting the same drugs I got the last surgery (she seemed to have the record handy), since I knew those drugs wouldn’t, y’know, kill me or anything. Also, I’d found the recovery to be fairly easy. She replied that while the base drug was the same, the actual mix was usually left to the preferences of the individual.

An aside… I’m trying to understand this whole “preference” thing. I’ve never really understood how the medical industry has such a wide variance in the execution of a medical practice. Different drugs because of a personal opinion, even when documentation shows otherwise; or Doctor A doing a procedure totally different than Doctor B, even if the result is the same. Are standards that loose? I know this is kind of a rhetorical question, because the same nonsense exists in my field — standards are at best guidelines, and open to interpretation. Anyway…

I fought recovery tooth and nail. I simply couldn’t snap out of it. Whatever drugs that anesthesiologist used are going down in my books as “awful, not to be repeated”. I had to be on an oxygen supply for three hours before anyone would let me take that idiotic hose off my nose. My belly was sore, but the pain in the lower right quadrant was (thankfully) gone. About a half hour after gaining most of my consciousness, I was wheeled up to Unit 83 to begin my stay.

The reason for the stay is due to the seriousness of appendicitis. The appendix, depending on whom you ask, is a leftover (but still somewhat functional) part of your digestive tract, meaning that it’s still got some really nasty stuff in it. While functioning normally, it’s not usually a problem. But when something goes wrong … it goes wrong in a really, really bad way. Most of the problem is that its in an area with a (literal, but being used mostly for effect) shitload of bacteria. And they just love it when things get necrotic, like when appendicitis sets in. Leave it too long, and the appendix starts to fill with pus, bursts, and then you’ve got a major problem on your hand — lots of bad stuff now floating around in the most sensitive part of your body.

Antibiotics are a key part of this fight. I’d already started to receive them as part of treatment and preparation, but I was to stay on them (and am still taking them) as part of the cleanup. While some appendicitis cases are cleaned up entirely with antibiotics, surgery is still a very common practice. But even with removal, there’s usually some nastiness left behind.

By about 18:00, I was feeling somewhat stable again. News had been light on the surgery, and all I had known was that the appendectomy had gone well, and that the offending piece was “pus-y”. I was in a room with a older woman going through a very rough bout of recent diabetes diagnosis, migraines, and what appeared to be a rebellious intestine. For all that I was in discomfort, she easily put me in my place.

An hour later, I was already doing my first post-operative walkabout, having felt that lying down for the better part of two days was already too much. It had gone far better than I had expected, and was glad to see that my abdominal muscles had been left largely unaffected. (Incidentally, if you’re ever offered a choice between a laparoscopy vs. a regular surgery, get the laparoscopy. The holes hurt, yes, but the recovery is mind-bogglingly easier.)

Then came the sponge bath. This was unexpected, and not particularly desired, either. The reason is the iodine wash, which isn’t even really iodine — it’s an orange-coloured antiseptic whose name I’ve forgotten — apparently becomes itchy if left on too long. I didn’t remember this from last year, but I’d also been discharged the same day, and washed myself. Staying at the hospital, this puts the responsibility in the hands of the Nurse’s Assistant.

This was Divya, a nice young woman who announced herself as she drew the curtain around my bed, explaining what she had to do. I suddenly felt rather sad that this had to be part of her job, to remove the antiseptic, to have to deal with people’s private parts and various injuries. How numb must you become to such things? And also, a recognition that I had pretty much shed any remaining humility as this was done, for I (apparently) no longer had anything to hide.

By 20:00, I was eating. Toast, mind you, and dry at that. But it was food. I’d sufficed off of saline drips for nearly 24 hours, and enough was enough. Just a little earlier, I’d been fortunate to receive some ice chips; the sound I made from that first spoonful was so orgasmic that every nurse who came in related the story to me. It was honest, though — my mouth felt absolutely awful, and having something in my mouth, especially some form of liquid, was the most gratifying sensation.

I had refused morphine since coming out of surgery (not for any sort of “heroism” — the last batch had made me feel like my beard was made of electricity, and it totally buggers up my sense of time), so I had to struggle to get to sleep on my own, along with assistance from my old friend, Tylenol 3.

But rest came fitfully, at best. Aside from having my blood pressure taken regularly, I also had to get up to go to the bathroom fairly often (that stupid pee bottle didn’t agree with me one bit), and I couldn’t seem to get just warm enough to get restful (seriously, why are hospitals cold?). I finally “woke up” for the day at 6:30 — the time Choo Choo normally comes in to wake me up — and gave up trying to get any more rest.

The surgeon, Dr. Artan Reso, came in that morning and gave me the real shpeal on what had happened. Terms like “perforated” and “muscousy” had been tossed around the night before. Dr. Reso was more specific: perforated, no; but it had been very close to bursting. So close, it sounded, that I was a lucky man to have it removed when I did. Had it burst, very likely I would still be in the hospital, very likely fighting for my life. He seemed oddly cheerful about the whole thing, almost like an Albanian Dr. Julius Hibbert…

Apparently due to my recovery rate, and the ever-present need for beds, I was to be discharged. But before I was kicked to the curb, I got a highly appreciated breakfast, a visit from the two surgical residents I’d seen the day before, and my friend Dan, who arrived about 15 minutes before Alex appeared with the kids.

What I currently have to show for all of this are three holes in my belly. The largest is my belly button (where the camera was inserted), one about ten centimetres to the left, and third about six centimetres below the belly button. The dressings are clear transparent plastic, and adhere so tightly that it looks sort of like I’ve been shot three times, and the bleeding is just starting. It’s mildly creepy. (Monkey’s since asked that I not lift my shirt again. I can’t blame her.)

The pain is easier than my hernia, no question. That one was hell to sit upright with. This is much easier, but I’m still getting wicked sharp pains. Lying down is still, by far, the easiest thing to do.

And so recovery goes on. Sadly, this also impacts a few things: work (my boss actually called my wife, ordering me away from my phone and my computer — no lie!), being Monkey’s soccer coach (there’s three of us, but I still feel bad about it), any form of exercise (I’m doing laps around our new kitchen island, but … well, it’s boring), and my appetite is pretty low (okay, not really a bad thing, I might lose a couple of pounds from all this). But life should return to normal soon enough.

Y’know, if by “normal”, I mean “randomly chaotic”. Which I do.

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