Wednesday, December 17, 2008
A Day in the O.R. with Dawn
I have decided my new motto is going to be, "This is the day the Lord has made, I will have some fun in it." Pre-surgery holding areas do not lend themselves to entertainment or distraction of any kind, giving you plenty of time to invent new life mottos. The idea is you're there to recite a brief medical history to the anesthesiologist as he reads the same thing off your chart, get an IV of Ringer's started, and head to the OR. So I had a unique view of life behind-the-scenes in my cubicle positioned as one spoke off the center hub of the surgical unit. I could see other patients coming and going - patients (all of them my parents' age or older) who needed help dragging their IV poles and holding their gown-backs closed paraded by me to the only bathroom adjacent. Most of them were here for cataract surgery, a procedure I have begun to regard fondly for the straightforward operation it is. I watched them leave for surgery, come back from surgery, and leave for home while I waited for my surgeon to come. The workspace was filled with staff in blue scrubs, talking on the phone, looking at pictures of each other's children on computer screens - a mix of work and play so early in the day.
One way I deal with the stress of medical procedures is to learn as much about the people taking care of me as I can. Becky, who prepped me, was a 35-year veteran of the nursing force. (These are always the people you're happiest to have insert your IV.) She told me the IV would all be worth it when I finally got, what she called the "Don't Give a Damn Drug." I laughed. I asked questions and found out she has two daughters - one who teaches Spanish Immersion to 2nd graders in Minnetonka. She's engaged to be married in August and Becky is looking forward to grandchildren. Her younger daughter lives in Milwaukee and works for a low-end retailer who's doing so well, she will get a big Christmas bonus. My anesthesiologist Dr. Bryan came in next. I asked him, "So, is that your first name or your last name?" He looked puzzled. I said, "Do they call you Bryan Bryan?" He said, "You can call me Roy." When he heard I was from Fergus Falls, Roy asked me if I had ever sat on the otter and I found out that he has 4 children - three who played hockey here and a daughter who will graduate in the spring and who's looking at schools in California where it's warmer. He hopes she'll go to Bethel. All the technical things checked off the list, Becky and Roy left to take care of other patients and I went back to leaning around the curtain, gown agape, watching the goings-on in the hallway, hoping to reel in another victim for conversation.
I am continually struck by how young medical people are and they grow increasingly juvenile with each passing year. Some of the interns I've seen look like they don't shave yet and their voices still crack. On this morning, one youngster toddled by bearing a tray of pastries that looked like it could feed Paul Bunyan and his friends. My stomach growled politely, unaccustomed to being denied sustenance at this hour. One lady at the desk who was making appointment reminder calls took a big bite out of what looked like a chocolate donut and wiped her mouth on a napkin.
"Are you SERIOUSLY going to eat in front of people who've had nothing by mouth after midnight?" I called out from my cell. She looked up and laughed. She had the toddler bring the tray to me and let me pick out what I wanted - an apple fritter - which they sealed in a Ziploc and marked with one of the name stickers from my chart, for me to eat after surgery.
I was the first to see Dr. G blow in from the outside still wearing her winter coat. "HI!" I yelled, waving with my free arm, "It's me, your favorite patient!" She smiled and came to my room first apologizing, then complaining about the closed roads. (She's from Florida and these winters have got to make her crazy.) I love Dr. G and just seeing her cute face made me feel more relaxed. That, and the sure and certain knowledge of the labeled apple fritter in the next room. Jinna, the nurse anesthetist, joined us and we talked some more about my past procedures. Jinna commented on my colorful history and summarized by saying, "You poor thing..." That was a mistake on her part. I immediately felt impoverished. Poor me. That's right. I am here for SURGERY. Dr. G leaned over me to put numbing drops in my eye and I yelped in pain. "What WAS that?" I gasped. "Dawn, the same numbing drops you have put in your eyes all the time," she held up the bottle for me to see. Dr. G told Jinna, "She is just SO done. All these surgeries, all at inconvenient times - when her grandchild was due to be born, when her daughter was graduating. Numb her really good - make her comfortable." My eyes burned with tears that she remembered all these details about ME. I am one of hundreds of patients she sees all over the world. I stared hard at a watercolor beach scene on the wall until the tears reabsorbed.
Dr. G emptied a tube of numbing gel into my eye, put a permanent marker check above my left eye and I was wheeled into the OR. I looked around at all the bright lights and trays. A new girl, Deb, came in to drape my face and strap me down with tape and velcro and heated flannel blankets. Dr. G asked someone to turn the radio from Christmas music to country and we got started. Throughout the hour-long surgery, I felt a lot of pressure, an occasional rinse of cold liquid, and some pain. Several times I told them that I maybe needed some more "Don't Give a Damn Drug" in my arm, as it didn't seem to be working. I was giving a damn. Dr. G just said, "Well, I think we'll numb you up with another block," and gave me more in my eye. From under my drapes, there was nothing to see. I asked if a guy could still breathe good under all that paper and someone said, "That's why you have oxygen in your nose, remember?" Oh, yeah. My surgery eye was all doped up and all I could see from that eye was dark and light and vague awareness of people moving. To make the time pass, since the IV drug wasn't apparently going to help with that, I talked. I conducted a full-on interview with Dr. G, asking about her daughter's college plans, her mother's visit from California. I gave her advice about her aging cat who's drinking a lot of water - since I am almost a veterinarian. Then I asked her about everyone else in the room - who they were and what they were doing. She patiently explained, working the whole time with her scalpel and sutures. There was some discussion about electronic medical records and Dr. G had them look up the size shunt she put in my right eye in April. "You don't remember, do you?" she asked. I told her I thought it was a ten and a half. I asked if eyes bleed a lot when you cut them and Dr G said, "Some do. Yours isn't." I said, "Good." I told her that I made Christmas cookies and brought for her. She said, "Really?! That's GREAT! I think I'm the only Jewish person I know who puts up three Christmas trees." I said, "Well, these are Hanukkah cookies, actually. The gingerguys have little hats on their heads." She laughed again. You'd think we were two friends talking over a pedicure. I remembered I was having eye surgery when she asked, "What were your pressures the last time they were checked?" And I said, "Maybe in the low 30s." She said, "Well, judging from how hard your eye is, I'd say it was at least 50 today. Your old trab has completely closed. I'm going to put in a tube now and release some of the pressure." Audible exclamations signaled the eruption of an ocular geyser. Dr. G told me when she was finishing up with the sewing on on the donor skin. I told her I was a little creeped out by the donor skin. She told me what part of the eye it came from and that it was a good gift, really, as the person who gave it didn't need it any more. Unfortunately finishing up took longer than she expected because she had to redo one part of the stitching three times when she couldn't get it to lay flat. I patiently waited for her because no one gave me any other options. Then, it was over. I got a good rinsing, more gel, and lots of bandages. Then I was off to recovery and my apple fritter and my smiling husband. When I left, an hour later, the nurse who helped me to the car thanked me for being such a fun patient.
After the block wore off, I had a miserable afternoon and evening, but felt better yesterday when I went in for my post-op. Dr. G was delighted with her cookies and exclaimed over the little yarmulkes on the gingerbread. I really AM her favorite now, I think. She also was very happy with her work under my eyelid and my lower pressures and explained to me why she operated with so little anesthesia. "Every time Jinna gave you more, you stopped breathing. So, I'd lift your chin up and have her back off a bit. I wanted to use the local as long as you would tolerate it. I didn't care if you talked the whole time. I didn't want to intubate you." I apologized for my chattiness and thanked her for not intubating. She said, "Hey, every patient on that table is ME. I do what I would want done for myself." Is she not great?
So, I am home today, not bending or lifting and trying to not make dramatic movements of my eyes as I am wont to do - it hurts. Some kind souls plowed out our driveway and brought over two meals. I have Stephie home to wait on me. We plan to watch a lot of TV and pet the cats. Thank you SO much for all your words of encouragement and prayers. I can't even tell you how much it means. Now....I'm off to rest...and have some fun in this day.