Surgery #2 - May 21, 2008

Hello everybody! Thanks for your prayers, good thoughts, and support. This Surgery #2 should have been the same as Surgery #1, but there were a few odd differences to describe.

We were earlier in the schedule for this second surgery. I asked several folks how the sequencing was determined, and nobody really knew. Anyway, we were told to report to the hospital at 9AM for a 10:30AM surgery time. Departing at 8:50 put us at the tail end of the Salt Lake City rush hour. Utah does not have LA traffic or Boston traffic, but there are a couple of natural bottlenecks (mountains in the way) that make it really slow during the classic morning/afternoon rush. Thank the Sierra Club for preventing additional or wider roads, adding to the time, cost and misery of any fix. And Utah weather in May is always entertaining. In the 90s Monday and Tuesday, today was 45, overcast, and rainy. We got to the hospital and checked in at 9:10.

In registration I played 20 questions got processed in. This time they did not require payment up front, which was good - they still owe me $26 from last time! We went to the Ambulatory Care Center, where they showed us to a semi-private cubby, similar to last time, but with much higher traffic in the hall and outside the window. We were very pleased to find that we had the same outpatient nurse again, the most excellent Vicki. I was gowned and temped and BPd and resting comfortably in no time. Used the hypnosis deep breathing relaxation technique from last time the night before and this morning, so my BP was pretty close to normal. Better relaxation and having been through it all just six weeks before combined to dramatically reduce the stress. Kathryn and I watched TLC network's "What Not to Wear" from 10-11, and I was wheeled upstairs at 11:15 - already they were 45 minutes late. Brad, the orderly that took me up, was an enormous guy - like a college football lineman. He and I joked about how he was the guy they used for troublemakers and I must be one.

After 15 minutes or so Michelle, the pre-op nurse came in and introduced herself. A petite blonde, about 50, she was there to check paperwork and start the IV. I gave her the standard warning about being a "hard stick," so she took her time and made sure everything went smoothly - and so it did. We talked for a few minutes about a variety of topics - Michelle has a great, reassuring bedside manner. I asked why I didn't have a pre-op nurse before, and she said sometimes they move folks in and out before she can finish rounds. She moved on to work the others and left me alone for what seemed like half an hour. You are surrounded by curtains and can see nothing outside. With no watch, reading materials, TV, Blackberry, or other toys, there was absolutely nothing to do at all, except to eavesdrop. There were only two other patients in pre-op, both women, both having some female parts removed. The lady next to me was very nervous, and Michelle spent a lot of time reassuring her. I could tell that it helped a lot.

I had been told that my anesthesiologist would be Dr. Petersen this time. She came in and grabbed the gurney, taking me over to the operating room. Older than Michelle and strictly business, she told me all the standard stuff about breathing tubes, IV, etc. I asked if we would do a countdown, because we didn't last time. "We can if you want," she replied, smiling for the first time. "Just surprise me." I answered. She left me in the hallway - something to do with the OR not being ready. Several people passed by, going about their business, and most ignored me - not making eye contact. This is pretty normal behavior - surgeons and staff need to emotionally distance themselves from patients to do their best work. Keith, the OR nurse, came by for 20 questions and introduced himself - he was the same guy I had before. Dr. Hopkins also came by, fresh from two weeks in Paris. He was still in sticker shock at the unfavorable exchange rate ($1.55 per Euro) and high prices, but admitted the food was amazing. He also reassured me he would take a different approach on local paralysis to guarantee no repeat of the unpleasant events last time. A few minutes later I was on the table. Keith and another nurse joked and got me situated - apparently we were waiting for Dr. Petersen. She and Dr. Hopkins were still working with the previous patient and family in recovery - not a very good sign, for him. I was pretty relaxed and happy, and Dr. Petersen came in and pumped something into the IV that made me feel warm.

Two seconds later I was scooting into a bed in the recovery room. Dr. Hopkins was there and spoke to me about prognosis - no visible regrowth in the area, but two new very small (1mm) growths removed. He called them "implants" and said they were probably a result of not doing chemo last time. We were doing it this time, and I could feel the burning. This was a good sign, as it meant no bladder puncture this time! They were using Mytomycin and there was a pretty strong urge to pee, even though the catheter was in, because it was clamped off to hold in the chemo treatment. I talked with Millie, the recovery room nurse, who was the same one who had taken care of me last time. She said I looked familiar, and looked up on the computer to be sure. Indeed same as last time. She did not remember my getting cranky with her last time, so that was good. Dr. Hopkins came in again and showed me photos of the two "implants" he removed. (No snickering - you in the back. You know who you are!) He asked if I remembered his first visit, and this time I did.

Millie and I talked a bit. She noted that my BP was too high and my heart rate was irregular, and she said I was not behaving. I assured her once she unclamped the tube that it would all dial in. She checked her watch and looked concerned. Grabbing Dr. Petersen for a consult, the advice was to wait. Millie took mercy and opened the floodgates 5 minutes early (55 min instead of the full hour). Soon my vitals were back in line and I was "behaving."

Ten minutes later I was back with Kathryn and nurse Vicki in Ambulatory Care. We were all happy, feeling good, and ready to roll. But I had more IV to absorb, and other vitals to be monitored. Best news of all was that I could get the hated tube out on Friday, and it was not necessary to go to the Doc's office to do it. Kathryn was not eager to become a nurse, but she's tough and would do well when the time came. I asked if Friday meant 12:01AM, and they told me more like 8AM. Oh, well... And Kyle, the helpful CNA, had come on duty, and I thanked him for his very practical help last time. So we made a day of it, hitting the tail end of rush hour back North, and Kathryn battled the post-work crowd in Target to get the prescriptions filled. Got home at 6:30PM and began the comedy of post-operative recovery, to be detailed in the next blog entry.