Surgery went well ~ Back home to detox & heal

A journey of a thousand miles begins with a single step.
Lao-Tzu

It’s Wednesday morning, and happily, I’m back at home, feeling relieved that this next step is behind me. The surgery went well—no cancer in the lymph nodes (and they had to remove two, since two seemed to be sharing sentinel node duty), and no other surprises or complications--and it seems as if time will continue to heal my wounds and eventually lift me out of this over-medicated state of feeling not at all like myself. I am sore—mostly in the chest region, under my left arm, and shoulders and back, both of which have never responded well to so much bed rest—but Vicodin is taking the edge off, and making me feel a little woozy, clumsy, and spaced out. I’m wrapped in a tight layer of bandages and compression tape, and am finding it hard to breathe deeply. Turning or twisting or activating any of the core muscles on my left side brings about instant ouch, but it’s gotten better. I’m still feeling wiped out, there’s still a lot of strange medicine coursing through my veins, and I just took off the scopolamine patch (an anti-nausea patch you wear behind your ear), and am feeling some symptoms of withdrawal—a bit of nausea, dizziness, blurry vision, and yes, the floor is pitching, as if I were still trying to find my sea legs on the anesthesia boat, rollicking on the waves of nausea. My throat is irritated all over again from the breathing tube, which has also left me with an ulcerated fat lip, and I’ve been hacking up a bit of phlegm. Lovely, I know, I know. I am sorry I am being so graphic. But that’s what it is. Think of it like a wicked bad hangover, the worst you’ve ever had, from a 10-hour long happy hour in the hospital, endless cocktails of meds, intense over-stimulation, and no time to sleep or eat. So—apologies ahead of time if my thoughts are not as clearly articulated as I would like them to be. I am aware of an area of hollowness under the bandage on the left side, whereas the right side feels like my usual filled out self. My girl is gone, alas, but I’m on my way. On my way, no looking back. Things are better today than they were yesterday, and they'll be better tomorrow. If I didn't believe that, I couldn't get through this day, or look to tomorrow.

On Sunday night, we stayed at the Marriott in Newton, and when we arrived at our rooms and walked out onto the balcony, which looked over the Charles River, a huge white swan swam over to us, and immediately started to trawl for food on the bottom of the river along the edge closest to us. We were reminded of watching pink flamingos on a few of the Galápagos Islands, flamingos that would gather food the same way, leaving visible trails along the bottom. It seemed a good omen.

Despite my best efforts to get a good night’s sleep before the surgery, it proved an impossible task. It’s not that I was horribly anxious, but I was filled with much anticipation—similar to what I used to feel on Christmas Eve, or before a ski race, when I was a kid, and butterflies would find their way into my belly, my breathing would become shallow, and my mind would fill with spinning thoughts. As well, my stomach was feeling the pinch, and at some point in the wee hours of the morning, I realized I had just gotten my period. After months of dealing with irregular cycles, my menses decides to regulate itself this month almost perfectly with the full moon, day 28. What great timing! (nearly as wonderful as getting my period at the start of my honeymoon, having to arrange one of the Antigua islanders to buy me some tampons in the village, and picking them up later that night from "Alex" at the bar, who had wrapped the box in a brown paper bag. "Got anything for me?" ) I added it to my list of things I would need to talk to the nurses about in pre-op. Make sure you position my neck so it's straight, and one other thing, too: Sorry, but you’re going to have to put one of those big fat pads under my butt, too.

My mother drove me to NWH, which was about five minutes away. Jim would come with the boys later, after I had checked in, and had been taken to Nuclear Medicine for my injection of dye directly into the left breast, which would then illuminate the sentinel node(s) for biopsy. I checked in to pre-op, was asked my name and birthdate about ten times by ten different people, met the usual array of anesthesiologist, nurses, and med students, and signed a bunch of documents to ensure that I would not sue anyone in case something went wrong. The anesthesiologist told me I looked nervous (“Wouldn’t you be?” I believe was my response, difficult patient that I am) and asked me if I wanted a little something to help me relax. Drug pushers, all of them. “No,” I told him, “I need to ride this out.” With all the over-medicating that is done in hospitals, and the amount of medicine that has been prescribed for me and offered to me these past weeks by different doctors, I have grown concerned about the potentially dangerous combination of drugs in my system—and the possibility of the Heath Ledger-effect, mixing anti-depressants with sleep aides and pain killers. With that on my mind, I figured that I would try to minimize all the narcotics in my system. Why anyone would actually seek out this feeling of being drugged and clumsy and out of it is beyond me.

I met with Dr. Pitts in pre-op, and she seemed eager and awake—all good things for such an early start. Dr. Specht was running late (and I love this, truly: she had a parent-teacher conference that morning) and it was okay with me—and I do believe I was waiting for her in the Nuclear Medicine room when all that groovy Juju found me. The anxiety that I had felt just walking into the pre-op room—where doctors and nurses buzzed about, patients were being wheeled in left and right, and where my little gurney bed sat, awaiting my body and warm blankets—had dissipated, and as I sat waiting for Dr. Specht, I changed into my johnnies and special no-slip socks and felt a calmness about the morning that would made me believe I had nothing to fear, and that every little thing was going to be all right. So thank you to all who were able to get up early and breathe with me. I honestly felt you with me, and it made a huge difference.

Dr. Specht finished the injection quickly and efficiently before escorting us all back to pre-op, which was surprisingly quiet. I climbed into the gurney and under warm blankets, said hasta la vista, baby to my family, and just minutes before being wheeled into the OR, caught a glimpse of a familiar face: Mark Rounds, a fellow Exie, walking about and looking very surgeon-like (he heads up the hospital’s plastic surgery and eye, ear, nose and throat divisions). I called to him, and after a brief hello, he promised to come up to see me later in the day. I figure—some of that Juju materialized in the form of a familiar face, and again, I was put at ease, cradled in the knowledge that I was going to be well taken care of.

As soon as the sleepy-meds hit me through the IV, I was out. Out. No resistance whatsoever. The waves rolled in and out, the sand was soft and warm under my feet. I was putty. And after not sleeping much the night before, I knew I would not, could not resist (not with a bat or a cat, a tree or a knee), and feeling the avalanche of fatigue wrestle me no more, I surrendered quickly, and that’s the last I remember.

I came-to several hours later (though it felt like seconds) in post-op, surrounded by curtains, a few nurses who kept coming in to see if I slipped back into my trance, and the loud snores of the guy next to me, who had just had a hip replacement done For a split second, I thought perhaps I was home, but soon the buzz of the hospital sharpened, and I knew that I wasn’t hearing the mating calls of crickets or spring peepers, the dog barking, or Jim snoring, but rather the squeak of the gurney wheels, the hushed voices of the nurses and docs, and my neighbor, snoring away in his bliss.

That first hour felt a bit like trying to wake up and wrap your head around the past hours after a truly horrible night of partying, (and please, don't let anyone tell me you have no idea what I'm talking about) and you just want to close your eyes and go back to sleep, but there’s a big chunk of time missing from your memory, and you’re trying desperately to piece together what happened, and your mouth is all glommy, cottony yuck, your tongue is stuck to the roof of your mouth, your body feels deeply bruised, beaten up, and fatigued, your vision is blurry, and the ceiling is moving in and out and all about, making it impossible for your head is search for possible explanations as to just where am I and how did I get here? Just what did I do last night? The classic post-rugby match Sunday morning wake up call. But I’m so much older now. And it hurts much worse. Much.

I tried to shut out the dancing ceiling, closing my eyes to try to snatch some sleep here and there, each time keeping them open them a little longer, and hoping that the ceiling would stop moving about like a pulsating, sweaty crowd-filled, disco floor. Eventually, I was able to suck some cranberry juice through a straw, the snoring bionic guy next to me finally woke up and ceased his rumbles, and I was given some pain meds, which thrust me deeper into a Narcotic Narnia, where Mr. Tumnus came with his friend to wheel me to my room before saying good luck and good bye to me in their native tongue, and Hobbiton nurses offered me tea in the form of IV meds and cookies in the form of drier than desert saltine crackers that I could simply not get down. Which way to the wardrobe?

Gradually, bit by bit, throughout that first afternoon, I experienced and shed some of the effects of the anesthesia drugs; watched, for the first time, my drain be emptied, a dark red; felt the rush of anti-nausea meds in my IV (just when I was about to urp); and praised and cursed the trappings and workings of modern American medicine. I used the bathroom for the first time, but with all systems slowed by the drugs, it was a pitiful task, and later that night, my nurse Laurie—who would prove to be an amazing care taker—would have check my output with a bladder scan, and then drain the rest with a catheter (my first, amazing how it worked). Sometime in the expanse of hospital time that afternoon, my head slowly stopped whirling about, I took my first (assisted) steps to the bathroom (ouch!), and I was able to greet my first visitors: my mother, Jim and the boys—it was great to see everyone, my three little birds. Dinner came and went, uneaten, on my tray. The only things I could successfully chew and swallow, given the acute dryness of my desert mouth, were jello and apple sauce. At some point, Dominick and Luke went with Jim to grab themselves dinner and buy some edibles for me from the nearby Whole Foods: goat’s milk yogurt, rite rounds crackers, and chicken vegetable soup. My step-mother, Martha, arrived for a visit, and it was great to have her there for a bit before she and my mother left to get dinner together. Jim and the boys returned with food (hurrah!), and they all helped me get washed up and ready to ah, sleep? Is it possible to actually sleep in a hospital? Gawd, it was like another big party gone wrong.

By this time, I had a roommate, a woman a little older than I, who was discussing her surgery and aches and pains with her partner. Luke overheard her mention that they had “shaved off all her pubic hair,” and at once became convinced that she had had a sex-change operation. Actually, it was only a hysterectomy, not nearly as interesting, I suppose, as a sex-change. I suppose Luke might have had it on his mind, given that one of the last SSAT words he’s practiced and learned was androgyny.

Jim and the boys said good night, and I began to think there might be a way for me to sleep—but my neighbor’s guests arrived, including her three year old nephew in his fire truck, which he proceeded to ride back and forth from hallway, past my bed, and to the end of his aunt’s. Vrooom, vroom. Both my neighbor and her partner were coughing constantly. Up and down to the bathroom. Lights off and on. Nurses arrived every 30 minutes to take vitals, administer more drugs, wake me up, ask me if I had been passing gas ( I felt like a newborn—have you eaten, peed, pooped, slept?). I tried to sleep, but only dozed in between disruptions. When my father and his new wife Mimi arrived, they brought a lovely little bouquet of daffodils and baby breath—from one of their wedding bouquets the week before—and a beautifully colored ceramic lizard from Mexico, their honeymooning spot. It was nice to see them, and have the lizard to cheer me up, and a touch of spring in the room, which had, in its dire darkness and endless stream of white coats, managed to block out all sense of a world outside, and made it difficult to remember that the sun was out there, somewhere, that healing was possible, and that sleep would come. Or not.

My night nurse, Laurie, was stellar—attentive, caring, and funny. She took good care of me that first night. I was so grateful for her for helping me get through that first night—with its softer buzz and shadowy silences, the endless awakenings and disruptions, the manic nature of the midnight brigade of fears, pain, and strangeness. I was glad to see the morning sun start to liven up the room; night over, I could finally begin my heal-about, my plan to recapture my good health. Juanita tried to convince me to order a lot of food for breakfast and lunch, but I doubted that was part of the plan. Hospital food, I've realized, is designed to make it much more difficult for you to do all the things you're supposed to be able to do after surgery before they send you home: pass gas, pee, have the first celebratory bowel movement. But there's hardly any good fiber in the food, and more than that, it's loaded with all the refined sugars and flours and crap that keeps you blocked up. So not only do the meds have to fix problems caused by other meds, they also have to fix problems brought on by all that colon-jamming food. Oy.

Dr. Specht and Dr. Pitts both arrived at about the same time, just as I was coming to, and quickly checked me out. They again confirmed that there was no cancer in the lymph nodes—very good news—and that the surgery went very well. Dr. Pitts left with me with a brief sheet of instructions: no heavy lifting over 5 lbs., no stretching, no showering until 24 hours after the drain is removed, etc. She recommended deep breathing and walking to keep my lungs healthy and fully-expanded and exercised: use the breathing exercise machine twice every hour, keep an eye on the color of the fluid coming through the vein (it’s a beautiful magenta now, yellow mixing with the dark red blood of yesterday), and take it easy. I’ll be checking in with her in about two weeks, as well as the oncologists, who will by then have reviewed my final pathology, and agreed on a treatment plan.

The morning at NWH was zoo-y. I saw my new morning nurse only a few times; she was busy. There was paperwork to fill out, instructions on measuring and emptying the drain to be understood, a big bag of bandages, ace and otherwise, to be sent home with me for the visiting nurse, etc. I enjoyed a few more visitors: Jean and Kate arrived at about the same time, and I was happy to see them, to be able to sit on the bed upright, talk and laugh a bit with some old friends. My mother came over mid-morning, and Jim and the boys showed up after their Monopoly game was done. I was moving a little better, going to the bathroom by my self, and even walking some laps around the floor with all the other IV-toting gimpies and gumpies. At a certain point, the nurse came in with final discharge instructions, I got dressed (with more care, I realized, than I had ever had to use before), and packed up all my cool hospital stuff (the best: disposable cotton stretchy underpants!)

The trip home went fairly quickly, if not for the potholes that sent little spasms of pain through my chest, waking me up every now and then. The dog went bazooks when we arrived, jumping up on the car while we were still moving down the driveway, and yelling at me “Where have you been? Why are you walking so funny? What’s the matter with you? I must lick your face, must lick your face, bone? Did somebody say bone? Where? Give it to me, give it to me. Throw me the ball, the ball, a stick, a Frisbee, something.” If I could just bottle some of that energy…

Back to today. It's afternoon now, and the visiting nurse—a great woman named Sarah—has come and gone, changed my dressing, checked my vitals, and promised she’ll be back again tomorrow. It was very reassuring to have her here and to know that I'll be checked again tomorrow, and won't have to change my own dressing yet. I am so grateful that I did not have to remove the original bandages myself. It was hard enough seeing the wound out of the corner of my eye—sensing the hollowness, the concavity, the sunken nature of my chest on that side—much less getting an eyeful of the whole she-bang. Tomorrow, I’ll steel myself and look a little bit longer. Bit by bit is all I can handle. I know it’s going to be a bit of a visual shock to see the incision, the flatness, the total and complete absence of my left breast, the no-going-back—so I have to get used to the idea slowly. This is me now. Cancer is gone, gone! But I’ve lost a girl, and can’t grow a new one back. I have to put my faith in the expanders, the saline, the silicone implant, Dr. Pitts. The sureness that my body will know how to heal, that my liver will rebound after all these narcotics, that my digestive system will re-establish balance after round three of antibiotics, that my strength will return, my vision will sharpen up, my body will be reclaimed, up and out of the ashes, a phoenix rising. Spring is on the way, too, and I am grateful that I am able to go through my own re-awakening of sorts during the re-awakening of the earth; my own rebirth will echo that of the natural world around me, and soon, I’ll be rejoicing in the symphonies of spring peepers and wood frogs, crickets and coyotes, birds and budding trees. Life abounds, burgeons, blossoms, bringing forth new growth, blessings and native wisdom. For all I am grateful.

I hope that wherever you are, you are delighting in the beginnings of springtime, aflush and aglow with color and warmth, promise and wanderlust. Be well, stay well. And thank you.

LOVE
Liz