Surgery
Weather: Starting to get crisp.
Music: Elvis Costello. The old stuff. Throw-back to ACL 2004
I severely underestimated the amount of pain that would be involved.
Going into the abdominal hernia surgery, I didn’t know what to expect. I wasn’t nervous. There was some consternation about COVID protocols, but I’ve learned to trust my providers. That said, I’d never been on the other side of the knife.
I’d taken part in abdominal surgeries countless times before. During PA school, I even did an abdominal surgery rotation(!). The three things I learned had little to do with surgery: 1) Save your back. Don’t hunch over a patient! 2) The vas deferens feels like an al dente noodle. During every male hernia surgery, Dr. Clarke would grasp the patient’s vas deferens and have the students gently touch it. “It feels like an al dente noodle, doesn’t it?” Every time. 3) I hate working in the OR!
The hernia first popped up back in 2014. I was living in Dublin and started working towards removing the flab. Sit-ups before work. Every day. 20, 25, 30… slowly raising the stakes. As the blubber melted, the protrusion appeared. Not painful, just mildly prominent. Over the years, the sit-ups gave way to planks, but the hernia had nowhere to go but out. During the 2017 Polar Bear swim, it made it’s introduction to pictures. By the 2020 Polar Bear swim, it crowded out the shot.
I’d put off the surgery for 6 years. It was more of a vanity project than anything. It wasn’t like an inguinal hernia that could get strangulated and cause life-threatening damage. It didn’t cause any pain, except for when I ate too much or fiddled with it. It was just unsightly; it looked I was incubating an Alien baby. It was time to abort the Alien.
I don’t recall being nervous before the surgery. There was some consternation related to COVID, but I had faith in my colleagues. It’s all I could do. And then… it was over.
I regained consciousness somewhere in the bowels of Mount Sinai. As I woke up, I ran through the myeloma patient list with the attending nurse. She was not too concerned that the labs for patient XXX hadn’t yet returned. I was wheeled to another floor. There I could eat (graham crackers) and drink (apple juice) for the first time in 18 hours. “How’s your pain?” the nurse asked. It was already starting to gnaw at my insides. “Four,” I replied. It was more than a four, but my brain couldn’t comprehend the numerical scale of pain.
It was time to go home. I tried to walk the 15 blocks to the train, but reassessed that plan after a block. We would Lyft it; my first Lyft ride in the time of COVID. I gave Lori an N95 and put on mine. As we got in the car, I thought about rolling down the window. By the time we reached the Battery Tunnel, I was able to tie that thought into a muscle action.
Now it became a game of pain control. That first night, I maneuvered myself into the bed. As I laid back and pulled my legs onto the bed, it felt like my insides were ripping apart. It produced an uncontrollable, guttural moan. I tried to lie on my chest/side. Searing pain. I could feel one of the internal stitches pressing against my visceral organs. I didn’t have the energy to roll onto my back; the pain sucked me dry. I was stuck. “Lori, you have to help me. Roll me over. No really, with all your strength. I can’t do this. It hurts…” She picked up my shoulder and helped me get on my back. It must have been terrifying for her; I’ve always had a bit of a stiff upper lip when it comes to pain. This was next level.
For the rest of the weekend, it was percocet, ice, acetaminophen, ibuprofen, stillness. Unfortunately, my bowels also participated in the stillness. First it was bladder retention related to the paralytic effects of the drugs. I was up and down trying to empty a bladder that would never empty. Each trip to the bathroom brought a searing rip through my insides. Then it was my intestines; 50+ hours of post-operative paralytic ileus. That means I didn’t poop for 50+ hours. I didn’t pass gas for 50+ hours. I was suspended in a state of misery. The first fart felt like the most rewarding achievement I’d ever accomplished.
By this point, post-op day 5, the pain is fairly well controlled. I can go to the grocery store. I can do laundry. Bowel movements are tricky; muscles that would normally be associated with pushing are currently associated with pain. I’m still not sleeping on my side, but I feel that’s the next domino to fall. Work tomorrow. Beef and Guinness stew tonight. All with the help of Lori.
Damn, this hurts.