duskpeterson: (bookshelves)
[personal profile] duskpeterson
A warning for potentially squicky medical details.

From an e-mail overnight to a friend:

There are various restrictions on my physical activities (I can't walk down the stairs to the kitchen without Jo/e [Noakes]'s escort, for example), and I plan to sleep a lot during the next few days (I sure wasn't given much opportunity to sleep at the hospital), but I was told by one of my surgeons' resident doctors that, with the physical-restrictions caveat kept in mind, I could otherwise resume daily activities. ("Does this mean [Dusk] can watch the fiftieth anniversary show of 'Doctor Who'?" Jo/e asked the doctor eagerly. The answer was yes.) I tweeted, and am writing this letter, because there are *no* restrictions on my mental activities - I was wrong in thinking that it would be like after my concussion, when I wasn't supposed to do anything for a fortnight except lie in bed in a dark room, listening to soft music.

The operation was so short that my parents missed the chance to talk with my surgeons afterwards, because they'd gone away to have dinner at one of the hospital cafeterias; they'd been told beforehand that the operation would take one-and-a-half to two hours. Instead, one of my surgeons (Dr. B) swiftly drained a scalp lesion and stapled it up, and then my neurosurgeon (Dr. Q) cut out the portion of the skull that had my lytic lesion. (The lesion had already caused damage to the skull, so he'd have had to patch that area up even if he wasn't taking out the lesion.) He cemented titanium mesh in place of the stuff he'd taken out and stapled up the wound. The whole operation, from first incision to closure, lasted a grand total of twenty-two minutes, according to the timing of the reports that Jo/e received in the waiting room. I think my surgeons should receive a reward for "most efficient work done in the least amount of time."

I won't know what the lesion was till the biopsy is done on it, but Dr. Q said the lesion didn't *look* suspicious.

I had excellent care in the hospital, particularly in terms of their handling of my dry eyes. The gel the anesthesist put on my eyes for the period of the surgery was terrific, and the minute I got out of the OR, a nurse was on hand with my eyedrops. The nurses in my hospital room let me self-administer my eye medicine, which was *such* a relief - I'd been afraid they'd take away the medicine I brought and only give me the official dosage for my drops and gel, which would have been much too little for that type of low-humidity situation.

(At my local hospital, they forgot to give me my eyedrops altogether after I had my seizure. Fortunately, Jo/e had brought to the hospital my emergency pack of eyedrops, so I didn't undergo the agonies I would otherwise would have experienced. I'd be tempted to write a Hidden Dungeon scene in which a prisoner with severe dry eye is tortured by being deprived of his medicine . . . except that doctors didn't have treatment for severe dry eye in Victorian times, so I'm sure the prisoner was dead long before he would have been arrested.)

The few minutes I remember in the operation room were quite interesting, if a little daunting in the seconds leading up to the surgery. I mean, first of all, we arrived at this big solid door that was *locked*, as though I was about to be wheeled into a radioactive room. And the operating room itself was straight out of science fiction: bright from lights set into circular pods that hovered in the air, attached only by slender stalks from the ceiling. The operating table that stood immediately under the lights - way off to the side of the giant room - was a stark slab of metal, with only a thin pad on it to give a veneer of comfort. (The very nice OR nurse asked me whether I was comfortable, and she gave me extra padding for my hip when I requested it, as well as the extra blankets I wanted, because I chill easily.) At first I felt like Elsdon, more interested in the machinery than in its upcoming effect on me.

But then the anesthesist covered my mouth and nose with a mask - I knew he was just giving me pure oxygen, but I also knew, from what he'd told me beforehand, that he was giving me the oxygen because the anesthetic tube was actually going to block me from breathing for a few moments before the anesthetic was turned on. And just around then, the nurse turned up with this big black strap in her hands, and told me cheerfully that she was going to tie me down, and I'm thinking, "This is beginning to feel like Elsdon's rack," and the anesthesist said, "I'm giving you the sedation now," and I was *out*.


Do you know what I did either during the surgery or during the not-quite-awake period immediately after the surgery? I plotted. I'm not sure *what* I plotted, but my first waking thought was, "I *never* stop telling myself stories." Then I realized that, hey, I was still alive, which definitely seemed like a bonus, especially since everyone around me was talking in calm voices, so it didn't sound like they were worried about me. And I was able to squeeze my anesthesist's hand and wriggle my toes at his instruction, which seemed like a good sign. I think it was then that he removed the anesthetic tube from my throat, but I don't remember that very clearly. I was sleepy and too unaware of what was going on around me to fully follow the conversations, but inside I was completely mentally alert from the moment I woke up. I was still under the assumption that I must keep my mental state as calm as possible if I was to fully recover, so I just dwelt on the glory of being alive, and looked at pretty patterns on my eyelids, which I later realized must have been inspired by the patterns that appear within the eyes themselves.

I was shaking like crazy right after the surgery, which worried me a bit, but as I suspected, it was simply because I was cold. My first spoken word after the operation was "Shaking," and the OR nurse quickly put warm blankets on me, which resolved matters for a while, till I got cold again and had to request more blankets. That happened in the so-called recovery room, which was really too bright and loud to be a very helpful place to recover, but someone had told me after the operation that it would "probably be best for you to sleep." So I followed his advice and succeeded in half-dozing in the recovery room, a lot longer than I thought at the time I had - several hours, apparently.

My worst discomfort came from the fact that I was completely parched after the surgery, and it was several hours before I was allowed more than a few trickles of water in my mouth and throat. I was so dry that I could barely speak, much less swallow, but when I was finally assigned to a hospital room, I managed to convey that this was a big problem, and after checking Dr. Q's written instructions, the nurse gave me a cup of ice water. Heaven.

I had a few bouts of minor nausea, and so I stuck to pureed food the first evening, but otherwise I had no ill effects from the anesthesia, which I had been really worried about beforehand, because of my breathing problems. My throat was a little sore from the effects of the tube for the first few hours, but it doesn't hurt now, except when I eat something dry.

As for the wounds in my head, right after surgery the pain only felt like a 5 on the 1-to-10 scale, which initially made me think, "Hey, I don't need pain medicine - I've hurt worse." I mean, when I first got dry eye in 2001, before I was diagnosed and began being treated, I spent three months having continuous, migraine-strength headaches (an 8 on a 1-to-10 scale) *while I was on extra-strength Tylenol 24 hours a day*. But the nurse who was tending me right after the operation encouraged me to take the pain meds, so I said, "Okay," and the meds were indeed helpful at that point.

A few hours later, I managed to achieve fame by becoming "the patient who refused pain meds six hours after skull surgery." I thought the pain was so little at that point - just a 2 on the 1-to-10 scale - because I was *still* on pain meds, and that the nurse in my hospital room was just asking me if I wanted the dosage ramped up. I've experienced worse pain in my hip from walking too long. It wasn't till the next day, when my latest nurse was quizzing me about my highly unusual behavior, that I realized I wasn't on any pain meds at all by that point in the previous evening. Nor did I need any pain medicine for the rest of my visit at the hospital, though I kept being offered it. (My nurse that day thought I had a high tolerance for pain, till she stuck me with a needle and discovered otherwise.)

Now the pain in my head is down to a 1 - about the same as my hip on an average day. I was given a prescription for a pain reliever in case Tylenol didn't do the trick, and I dutifully picked it up from the pharmacy on the way home, but unless the pain gets worse, I'm not even going to need Tylenol.

I wasn't put into the critical-care unit after I left the recovery room, since the lesion was attached to my brain but not actually in it - my neurosurgeon didn't have to invade the brain itself. So except during the operation and the recovery-room time, and when I was getting into my hospital gown in pre-op, Jo/e was with me the whole time; the hospital very considerately places a reclining chair and fold-out sofa in the regular hospital rooms for the sake of family members who want to sleep there overnight. Jo/e was quite helpful, not only in terms of doing little things for me when my nurses and techs were busy elsewhere, but also for the moral support he provided.

My parents stayed with me during the four hours I was waiting in pre-op. (Dr. Q visited me there, said, "I don't expect anything to go wrong during the surgery," and proceeded with a smile to tell a grisly story about a surgery gone wrong. As my father put it afterwards, "Doctors have dark senses of humor.") However, my parents left to drive home before I reached the hospital room - they'd been up for over twelve hours, and my father was afraid he'd fall asleep at the wheel if they stayed till 11 p.m., when I was predicted to arrive. (I actually arrived at the room at 9:30 p.m., not long after they left.) I surprised them the next morning with a phone call, and they drove us home from the hospital.

Date: 2013-11-24 03:40 am (UTC)
sphinxfictorian: Sherlock played by Benedict Cumberbatch in S1 Ep 1 Study in Pink (Sherlock)
From: [personal profile] sphinxfictorian
So glad you came through so quickly and well, my dear! Very efficient surgeons indeed, and encouraging words from Dr. Q, it sounds like.

And you got to watch Doctor Who! Yay!! What did you think? I loved it. It had a few weirdnesses, but it gave me a real thrill! And to make my day complete, my online friends have posted the Sherlock trailer that the BBC ran right after it. You can probably find it, if you haven't seen it, online somewhere.

Anyway, my dear, I am so happy you made it through. Keep us in the loop about what that lesion turns out to be (horrid thing!).

Hugs to you and Jo/e and greetings to your esteemed parents!

thanks for the details

Date: 2013-11-24 09:54 pm (UTC)
From: (Anonymous)
Great to hear the pain is manageable. Hope it continues that way! From the sounds of things you have lots of inspiration to write about. If not directly because it is too modern, at least you must be intrigued by how primitive it must have been at the turn of last century.
A.B. Gayle

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