2 Mar 2003 steve   » (Master)

The day of surgery arrives

Susan and I showed up at the hospital outpatient area Friday morning at 8:30am. For 15 minutes or so, I signed permission and disclaimer forms. Then we were given a map showing the route to the outpatient waiting area. We sat there watching TV for another 15 minutes. Then, about 9:00am a nurse escorted me to a private room while Susan stayed behind. I had to strip and put on one of those crazy hosptial gowns that were designed to fit some non-human species of creature. I also got a little pair of blue hospital slippers; essentially socks with little diamond-shaped, rubber traction areas stuck on the bottom.

Then I waited. And waited. At one point a phone began ringing loudly. After a little investigation, I discovered the ringing phone to be one of several phones underneath one of the two beds. It rang for a good five minutes. (I've noticed that anywhere you go in a hospital, phones are ringing but no one ever answers them). I went back to waiting.

About 9:40am, a couple of nurses showed up and started in with all sorts of preparations and testing. One of them went through a list of questions about my medical history and had me sign more disclaimers while the other took two blood samples, my blood pressure, temperature, an EKG, and finally a urine sample. Interestingly, neither of them had any idea why I was there or what sort of procedure I was going to get. They gave me a Vioxx tablet (a heavy duty pain killer) and then griped that I drank too much water to swallow it. This progressed into a more general complaint that I wasn't supposed to drink any water for 12 hours prior to surgery. I said I'd been told not to eat any food for 12 hours, but nobody said anything about water. They said water was food and I said it wasn't. I convinced them I hadn't had much water and they eventually dropped the matter and left me alone again.

10 minutes later a nurse showed up with Susan in tow. I gave Susan a bag with my clothes and turned over my glasses to her. Then she was sent to a different waiting area (the "day surgery waiting area"). I was taken to a surgery prep room. The nurse who escorted me there asked what I was in for (I still hadn't run into anyone who knew what sort of surgery I was supposed to have - very reassuring). When I told her I was having sinus surgery, she started telling me how brave I was because sinus surgery was unbelievably painful and she would never let anyone do surgery on her nose because she didn't think she'd be able to bear the pain. Great... I told her it couldn't be too bad if I was getting general anesthesia; I shouldn't feel anything. Yeah, but wait until after you wake up, she said.

Crazy light show

Once in the prep room, the anesthesiologist showed up and started hooking up all sorts of tubes and hardware to my bed. Eventually she stuck a needle in my arm and gave me some sort of drug that she said would relax me. Wow, the drug hit me pretty quick. I don't know if I was any more relaxed but I spent the next 10 minutes or so trying adjust the vertical hold on my vision because my feet and the rest of the room were slowly revolving around my head. Things started getting a bit fuzzy here but the doctor showed up briefly and talked to me while the room rotated. He said he'd done more than 1500 of these procedures and never had any problems. Many of the patients he did were "revisions" - that is, he was correcting screwed up procedures done by other doctors. I asked him how my condition rated among the 1500 or so he'd seen. He said it was definitely going to be one of the more memorable ones he'd done. I lay there a while longer watching a clock precede my feet up the opposite wall and over the top of my head. It was about 10:45am.

The room had slowed from complete revolutions to simply bouncing up and down several feet when two nurses came in, got my bed and rolled it down a series of corridors and through some operating room doors. The anethesiologist was waiting and said, "you may feel a slight burning sensation" as she adjusted something outside my range of vision. I asked something to the effect of, "so this is it, I'm going out now?". I don't recall an answer...but about that time I ceased to exist.

There followed some disjointed memories of lying in a bed with various people standing over me. At one point a nurse was asking if I was feeling okay...someone was asking me if I had any relatives waiting for me at the hospital...it was about 4pm...the doctor was telling me that my sinuses were as totally screwed up as he thought from the CT scans and that they'd sent stuff off to the lab for testing to see if it was baterial or fungal...Susan and someone else were standing over the bed talking about pharamcies and how I was taking a long time to wake up.

Susan apparently decided to go to a nearby pharamcy to pick up some of my drugs while I continued to phase in out of reality. Eventually, she was over my bed again and I seemed to be going through about 15 minute cycles of relative coherence and unconsciousness. During one of my waking cycles, I decided we'd better get out while we could and convinced Susan I was ready to go. I don't remember much after that but we did eventually make it home where I slept for quite a few more hours.

Ending the day in the ER

The good news is that I'd awakened several hours later at home and was not in much pain at all. I felt a bit like someone had punched me in the nose. I also have a vast array of drugs to take. Zyrtec, liquibid, prednesone, augmentin, amoxil, hydrocodone, and some sort of nasal spray. Now for those who haven't been reading my weblog and don't know me, I should preface the following by telling you that I suffered from reflux fairly badly some years ago and have some scarring and strictures in my esophagus that cause it be a bit narrow. My esophagus was dialated to about 6mm and for all practical purposes works fine again. However, I can't swallow things larger than 6mm, obviously.

An 875mg Augmentin is 21mm long, 10mm wide, and 7mm thick. It's a big pill. There is no way it's going to fit down a 6mm esophagus. This would have been perfectly obvious to me any other time so I suppose I was still spaced out from anesthesia. I popped one of those in my mouth and swallowed it. Big mistake. There are two major tight spots - one at the top and one at the sphincter where the esophagus attaches to the stomach. The pill hit the strictures at the top and I knew instantly I was in trouble. After some major gagging, it move passed the top strictures and was now in the middle section of my esophagus. Having something stuck there is both fairly painful and debilitating - your brain sort of shuts off and you get tunnel vision and go into some sort survival mode where all your awarness is focused on trying to swallow.

I told Susan it wasn't going down and wasn't going to come up now that it had passed the halfway mark. And I knew from past experience that the pain was going to be fairly intense when it hit the sphincter. We decided help would be, well, helpful, at this point and Susan called 911. An ambulance showed up fairly quickly and dragged me off to the Irving hospital ER. They had looked at the Augmentin pills at the house and were fairly impressed that anyone could swallow what they termed "those horse pills". Most of the ambulance trip was spent trying to explain that my nose bleed had nothing to do with the problem at hand and that the pill was stuck because of scar tissue from reflux. One of the ambulance guys spent the whole trip trying to figure out how to spell my name.

I then had to explain all the same stuff to the ER staff. This was not the busy ER you see on TV. This was a big empty ER with a lot of bored doctors and nurses hanging around. They didn't really seem to have much of an idea what to do with me other than stand around, watch, and tell each other that I'd swallowed a really big pill.

All this time the pill had been slowly moving down my esophagus and finally hit the sphincter. There were several moments of really intense pain and I had a couple of stomach convulsions and then... nothing. I told them that I thought the pill had made it into my stomach. I asked for some water so I could test my theory by trying to swallow. And, indeed, all was okay again. It tooks us another half hour to get out of the ER and back home. I got a replacement prescription for the Augmentin - they don't have pills small enough to swallow, so I ended up getting a liquid version that tastes pretty nasty instead.

Despite my ER adventure, I've spent the last two days resting and actually feel pretty good now.

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