Tuesday, May 13, 2008

Zach 1, Appendix 0

I woke up on Monday morning and had a typical breakfast. Nutrigrain waffles, turkey bacon, grape-cranberry juice, and a banana. I packed my lunch and afternoon snack, also typical. I brushed my teeth and told my wife that I loved her, which is typically typical.

Over the past three months I’ve had a few medical procedures. The goal of these procedures was to figure out why, every five weeks or so, I would have a 12-hour period of what I unfondly called “the crud.” The crud started as nausea followed by stomach pain and discomfort. The discomfort would transition gradually to my lower right abdomen. Eating was generally a bad idea. Doing anything other than sitting semi-upright on our love seat was less than fun. Between 12 and 24 hours later, the crud would disappear.

When I got the crud on my birthday, I decided to act. My primary doctor recommended a Gastroenterologist, a Doctor Luis Galvez. The first suggested test was an Upper GI. In this test, I got to put on a cute little gown, drink some radioactive fluid that tasted like chalk, and sit on a table while the radiologist took pictures of my esophagus down to my intestines. Nothing abnormal was found.

Test number two was a CT scan of my abdomen and bowel, which I think used to be called a CAT scan. For this test, I got to drink about a quart of the same chalky substance, this time berry flavored. Again I put on the gown. The radiologist put an IV into my left hand. I got to lie down on my back as a recorded voice in the machine told me when to hold my breath. This test showed no abnormalities. Test number three was an x-ray of my RLQ (right lower quadrant of the abdomen) and bowel. What I thought was a single x-ray became a half-day ordeal. I consumed a quart of banana-flavored barium and got really depressed reading the first 200 pages of She’s Come Undone between x-rays. The book depressed me partly because it was depressing, and other partly due to me not having breakfast. For these tests, you’re not supposed to eat for 12 hours beforehand.

I had three sets of x-rays, with 30 minute breaks, and one final set with a doctor, who again told me nothing was wrong.

I wondered if all this radioactive chalk had killed the crud. I hadn’t suffered in ten weeks, more than twice the usual time. After a Saturday afternoon birthday party, I decided to clean out some leftover meat loaf. Nearly immediately after finishing off a too-large hunk of the stuff I felt it.

It started like bad gas but transitioned to the familiar nauseated feeling. I woke up at 3 a.m. feeling crappy and spent the rest of the night sleeping on the love seat. I can’t get comfortable lying down with the crud. On Sunday I recovered. My right abdomen was a bit swollen and sore. It was a good thing that I had a doctor’s appointment on Monday. He could examine me when I had symptoms, as they were good at hiding.

Dr. Galvez showed only slightly more expression than usual when I mentioned my side. When he tapped on my left side, the sound was hollower than the right side. When he pressed in, the pain was sharp.

He suggested another CT scan, with an immediate follow up at his office. Great. My work day was in the crapper. I had a big project and plenty of little things to do. I called my boss and he hopefully asked when I would be in. I didn’t commit.

It was during this time, as the nurse tried to get me an appointment with the downstairs radiology department for the scan, that I knew this wasn’t going to be a good thing. Whatever was happening to me was coming to a head.

I went downstairs and filled out some paperwork. During my paperwork filling out, I had some banana flavored barium. I assume on the third CT scan that you get to choose your flavor.

CT scans are like airport security. It’s different every time. I got to squeeze a little football to awaken my veins. The veinologist poked me in the right forearm. I’ve had IVs in every vein on my right and left arm.

For this scan, I did not have to put on the gown. I had to lower my pants to my knees. The radiologist put the IV in my right forearm. I’ve had IVs in every vein on my right and left arm.

I had to repeat a few stories yesterday. Story one was what I had for breakfast. This was of critical importance since everything that happened to me yesterday usually happened to someone who did not eat for 12 hours. The fact that I had bacon, even the healthy turkey kind, made it worse.

Story two was story of the crud. That story didn’t interest too many of the medical professionals. Story three was the staph story. I need to have a teleprompter for that one, or a 3x5 card. It’s hard to distill an epic near-death story like my near-death coma back surgery followed by antibiotics that made me anemic tale. I told that one at least six times.

The scan ended and I pulled my pants back up. It’s hard to feel glamorous even when you don’t have to wear the gown. I went upstairs and was waved behind the door at Dr. Galvez’s office. Yes, I had become a VIP. Dr. Galvez shook my hand rather formally before telling me that I had appendicitis, which meant that I was in for surgery. I had to pause for a minute. Galvez called every doctor on his cell phone (it was lunch time) while I wondered who I was supposed to call. I called the wife and the boss, yes, in that order.

It was hard to tell Alison to join me, since I didn’t know exactly where I was going. The nurse directed me to the surgeon’s office. I filled out my second set of paperwork. Before I could go into detail about my adventure with staph, I saw the surgeon. He didn’t look like McDreamy or McSteamy. He made it simple. We’re going to get this thing out as soon as possible, he told me. Finish the paperwork and go to the main hospital.

I like to multitask. One of my favorite things is being in the kitchen, making dinner, while simultaneously reading ESPN.com, doing a load of laundry, emptying the dishwasher, and possibly talking to my mom on the phone. This was a different kind of multitasking. I was talking to the woman who was scheduling my surgery, talking to Alison on the phone, trying to tell her where I was going when I didn’t exactly know myself, filling out the paperwork, and chatting with the surgeon.

Instead of taking the elevator down one floor, I took the stairs and ended up walking out some kind of service exit where there was no sidewalk to avoid the oncoming traffic. Since the doctor was probably canceling an afternoon of golf, he wasn’t able to give me any clue as to how long this surgery would put me out of commission. Alison looked it up online and told me two to four weeks.

I went to the outpatient front desk, even though I knew that I would be staying overnight. The gal at the desk wanted to know about story number two. I got a plastic wristband and filled out paperwork set number three. While I did so, I talked to Alison again, now that I knew where I was going to be, and the attendant. I mentioned my idea about having one’s medical information on a card so I wouldn’t have to hurriedly scrawl it down three times at the same medial institution where I have been at least two dozen times.

They brought me back to pre-op before Alison showed up. The nurses promised that she would be able to find me. She did. Within five minutes, three different women asked me the same personal questions, including my breakfast saga. The bacon was the killer. My surgery was bumped to four o’clock. An IV went into my left hand, although the stuff they gave me to numb the area hurt more than the actual needle. I finished She’s Come Undone. My review: She sure did. Alison let me listen to a Bill Maher podcast. Arlen Specter said that the President gave him a bad handshake because he was afraid of catching Specter’s cancer. We played rummy and Alison let me win.

Once the pre-op area was completely clear of other patients, it was time for me to go. The sides went up on my bed and the nurse carted me a few feet forward. Actually I think it was the anesthesiologist, since she kept repeating that my nurse wasn’t available. It was at this point that I got nervous. I wondered what would happen if I tried really hard to stay awake when I got my sleepy medicine. I thought about the highly miniscule chance of me dying on the table. Nothing like a worst-case scenario to get the blood pumping.

I’ve had surgery twice, and neither time was I awake by the time I got to the OR. During my quality time with staph, I don’t remember anything 36 hours prior to surgery. When I had a pilonodal cyst removed, I remember being on the cart heading for the OR, but that was it.

They moved me to a second bed, which made the single bed I slept on during my freshman year of college look positively spacious. The room was freezing. I had warm blanket wrapped around me. A nurse injected something painful which was not the sleepy medicine. I asked why it was so cold. One of the docs or nurses said that the operating lights were really hot. I would rather the surgeon be comfortable than me. Probably two minutes later I was out.

I had flashes of dreams, mostly involving people in scrubs moving about, and then I woke up. My stomach was in intense pain. There’s a little chart in the pre-op room that shows smiley faces turning to frowns. That’s the pain scale. It goes from one to ten. I woke up at a nine. I told one of the nurses that it really hurt. She gave me morphine, and then it was like I wasn’t there. I got an oxygen mask and tried to breathe normally as I waited for the serrated knife to be removed from my gut. The pain subsided slightly. It was about six in the evening. Around 6:30 an orderly carted me to my room. Alison joined me.

How can I continue without talking about the booties. The booties must be a relatively new medical invention. They are made of cloth and Velcro and are for circulation. You feel kind of a tingly sensation moving up and down the booties which are strapped from your knee to ankle. They are a major distraction when you’re trying to sleep, as if being in a hospital isn’t enough, and they are a hindrance when it’s time to go to the bathroom.

The pain dropped steadily for the next couple of hours. When it got back up to an eight, the nurse told me that I had to request pain medicine. Yes, thanks. I had an injection of Demerol followed by a pill an hour later. Zachy likey. We switched between Terminator 2 and Major League for the following two hours. There was one nurse for the IV and another who took the blood pressure and temperature. In a hospital, you have a specific job.

OK kiddies, the next part is not for the squeamish. It was time to go to the bathroom. This was a multi-step process. Alison had to unplug the booties. Then I had to sit up and swing my legs off the bed. You don’t realize how much you use your core muscles until they are in a lot of pain. Just getting to a standing position was tough. I walked like an old man to the bathroom while Alison pushed the IV cart.

The first time I went to pee, it took about twenty minutes to get the flow started. When it did, it was like a hotel shower. I could tell when I needed to pee, but it was really hard to tell when I was done. Also, the process was so painful that I figured it might be better for me to wet the bed.

We slept poorly until around 3 a.m., when the overnight nurse checked on me. Between three and 5:45 a.m. we slept better. In the morning our third nurse told me that once the surgeon checked in on me, I could go home. When the surgeon showed up, no one knew.

I finally got to check out my new scars. I have to say they were somewhat disappointing. There are two small holes on the left side of my abdomen and a half-inch one at the bottom of my belly button. The process was laparoscopic, which means they put little cameras in me and kind of suctioned out the appendix.

The doctor showed up around nine, and after that it was a rush to get me out of there. Alison got my clothes and I barely had my underwear on before the nurse had my exit paperwork. An old orderly carted me out and it was time for freedom.

Moments when you knew that it was Zach having surgery:

Zach was more worried about Alison getting his mom’s nut roll out of his car than any other important items.

When Alison talked to Zach’s parents the night of the surgery, Zach woke up long enough to loudly remind OBL (Zach’s dad) that he lost to him in fantasy baseball last week.

Zach was nearly as worried about notifying his company kickball team of his absence than his actual absence from work.

After getting crap for eating bacon for breakfast the previous morning, what was part of Zach’s hospital-provided breakfast? Bacon. And Zach ate it all.

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