this will be the story of horace, the gallbladder

So the consultation with the surgeon was relatively short. He was informative and kind of hopeful I'd be more talkative, I think. Good luck with that, but I tried to make him feel he was successful in being reassuring.

So here as is I understand it, provided everything remains status quo.

Surgery will be the last week in August, which he was fine with. They're doing something called SILS - single incision lacroscopic surgery. It apparently is about as minimal as we can get and still call it surgery; they will go in through my belly button only. Recovery time should be one week or so. It can easily be changed to the classic version, but he didn't seem worried that would come up.



Background

My hospital is one of the ones doing this a lot--either they are pioneering it or they are the big experimenters with it (note: they are trainers for it! That seems to be reassuring), as we are a teaching hospital system. He held up a nice colorful chart helpfully showing a gallbladder (beneath the liver! Who knew?) filled with stones (that was educational) with one blocking the duct that leads to this thing that looks like a earthworm without a head (very useful) and how the entire pain thing happened, then explained pretty much the entirety of the procedure. Apparently he does like, five of these a day. Using SILS, even.

Things I Liked

They didn't keep me waiting long. Apparently my weight and blood pressure and pulse are great. Weirdly, while my blood pressure is usually low, my pulse was eighty-five, because they cleverly gave me paperwork to fill out and God knows nothing makes me calmer or happier than someone giving me forms to fill out. So not even kidding; there are reasons I have spreadsheets and three hyperorganized delicious accounts and like to program. They're like goddamn paxil.

I like surgeons that are blase and faintly surprised at worry. I mean, I get it's good to have a compassionate doctor, but this one was relatively young (looking at his page, he's about my age give or take one year by graduation date; he's even hotter in person, which helps), but there's something about a doctor who doesn't even really consider you'll be worried that works for me personally. He was very nice, don't get me wrong, but it was probably telling that my entire question list is "so the general anesthesia; you're sure about this?" and "so a paralytic, huh?" and "so how long again?" (answers; Yes, yes, and thirty minutes, including anesthesia time).

(This is where the blowing up of the stomach with air came up. Ahh, I said, because yes, that does indeed complicate my thoughts on why we don't need general or paralytics.)

He tossed out he does about five of these a day with well-rehearsed casualness, and seemed really unnerved I wasn't more specific. I should have explained it wasn't that I didn't trust him or anything, more that I was fighting back the urge to ask if I could just do this myself, because it's not that I don't trust him or I have any idea what I'm doing (I hadn't even looked up where my gall bladder is, and wow, that's not an easy place to reach), it's that I really don't want general anesthesia a lot.

[I get the human body is not a computer and the gallbladder is not a video card. I mean, I don't, but I'm taking on faith it's a bit more complicated. I'm just saying, I'd let him supervise me, which is more than anyone else would get to do. On a guess, I'd say he would have reacted negatively. Just a guess.]

Finally, catching on that the operation itself didn't do much for me but the entire anesthesia question was coming up a lot, he said my chances of anything at all going wrong are lottery level, which as I have never come close to winning a game of chance, so I loved that part. I explained that I was not going to be like, in the proper calm and rational mood to get to the anesthesia part, and yes, they'll drug me beforehand so I don't care. I'll talk to the anesthesiologist as well, which I remember someone in comments saying would help? Yes, he threw that out there immediately.

I made a list of people that were permitted access to my health information, so besides my family I added svmadelyn and I'll probably add V before I go in. I think I'll feel better immersing myself in the technicalities of HIPAA (please do not say this is sensible; say this is irrational because lottery), because nothing relaxes like me like superanality.

Things I Do Not Like

This entire business.

Thoughts

Usually I like getting things out of the way fast. This is not one of those things, and while you'd think the worry would get to me, to be honest, long-term things like this that are so outside my range of experience tend to get shelved back, whereas if we were talking next week (they did offer, but didn't seem to care if it was later), I'd be incoherent and trying to write my will while crying into my new keyboard. Being committed means basically I'm not going to start thinking about it again in any meaningful way until August 12th, my preop exam, when I'll start to panic about anything I can possibly find to panic about.

I've been obsessively thinking about this since the ultrasound; I have to get my brain off this before it takes up all the space used for like, writing fic and reading porn and um, breathing. I've been stuck in one of these before; it isn't just unproductive. It's boring, and you wouldn't think fits of mindless terror could get to that point, but there is nothing like combining mindless, irrational terror with utter boredom with said thoughts. It takes nothing from the terror, it just adds a new dimension to it. It also thoroughly kills my ability to interact with human beings and sleep.

Personal Anecodote

I'm also starting to react to it with a feeling I can't breathe, which started around the time I had pneumonia a few years ago (second time) and, after some x-rays, I refused to get in the elevator and took the stairs from the first to the third floor and rediscovered the joys of oxygen lines while my tech rehooked everything up with the understanding that the only thing I'd learned was next time to stop at the nearest empty room and get a breath there. These days, I hit a certain level of carefully controlled panic, the not-breathing starts. It's not that I can't; it's not even physical. It's that I believe I can't, and I didn't have my ritalin with me to calm me down and help me refocus, which in retrospect, yes, I should have brought it.

(That was the last time they took me anywhere by wheelchair; to the lung biopsy, they kept me in a bed under covers, cleverly realizing that it would buy them time to distract me from fighting out of hospital corners, getting up, disconnecting my IV, getting my oxygen tubes gathered up in some kind of proto-modernistic necklace, and finding the nearest stairs when an elevator approached. They also kept me on femytol (fematol?), which is magical for the 'not giving a fuck' when I did realize their intentions. I have an instinct for stairs. I may never have been to a place before, but I can find the stairs in under two minutes under stress. If directly confronted with an elevator and pressured to use it, under thirty seconds. If the elevator doors seem to open really slowly, we're talking ten seconds or less. And I can do it without tearing my IV.)

Thoughts, continued

Suffice to say here, I feel at this point I should have apologetically explained to the surgeon that while normally I am a slave to social conformity and an obedient patient, if I'm not drugged, there's a fair to good chance I'll get away, and I'll be really embarrassed and horrified at myself and that won't stop me from cataloging everything they attach to me and how fast I can get it off for a fast run. Claustrophobia is like magic; nothing is impossible when that's your motivator. And I was a sprinter in high school and unsurprisingly, that skill level returns with a vengeance under the power of utter terror.

I also know where all the stairs are here.



Okay, with my fate locked in stone, I have the following things to concentrate on.

1.) scy in Seattle! Hanging out! What to wear to Adam's concert. If anyone wants to give suggestions, feel free. I am all about suggestions.

2.) work. Er, I'll think about that later.

3.) svmadelyn in Chicago! VVC! Hanging out with my friends! Watching vids!

4.) Beach with family.

5.) Tea. Of course.

*blows out breath* I will worry about this again on August 9, when I return from Chicago.

Comments

[scy]

You mean Fentanyl?

[saraht]

Gallbladder surgery is really super-routine these days if you're eligible for laparoscopy. But do your health-care advance directive first anyway.

[foursweatervests]

I always find that the more I worry about things, the better I'm prepared for them, just because I've thought about every possible outcome. Immersing yourself in HIPAA information is definitely a great start, and a great way to sneak in a nap.

[sage]

You are going to feel SO MUCH BETTER afterwards!

*sends best hopes*

[springwoof]

::waves::
I've had the same gallbladder surgery. It really is *nothing*.

And mine wasn't even planned. My gallbladder was evil enough to not warn me anything was wrong (seriously, few if any recognizable symptoms) until suddenly one night at 10pm found me staggering to the bathroom and vomiting until there was no tomorrow. And between bouts, screaming from how much pain I was in.

Long story short, the Spouse finally blackmailed me into going to the ER. Where there was Not Enough Morphine to stop me from almost non-stop screaming. After looking at the X-Ray and Ultrasound, the Dr said, "okay, your gallbladder's coming out right now."

I argued with the man. Wasn't there another way? I really hated to give up any of my original factory equipment. But apparently, there was absolutely no choice at that point, since it was already infected and about to damage my liver. And we didn't want that did we?

The operation itself was really boring and anticlimactic after all the exciting pre-hospital and ER drama. Seriously. It probably could have been outpatient surgery & I could have gone home the next day, except my gallbladder had been infected & they wanted to dump a couple of IVs of antibiotics into me. I sat in a hospital bed for one day and slept, mostly. My belly was sore for a couple of days, but not sore enough for prescription meds.

What you should *really* worry about is changing your diet choices that lead to your gallbladder hating you. Because without your gallbladder, your liver will still make the stones, except they'll have nowhere to go. I was under the illusion that my diet was fine, gallbladder-wise, because I rarely eat fried foods. Unfortunately, nuts and seeds of any kind are also culprits (and basically anything with a seed-like casing, like corn) which need bile to digest--apparently my gallbladder was not up to the task of processing as much bile as necessary to deal with my sunflower seed habit. Also, that whole-grain bread? Not as healthy as advertised for folks with gallbladder issues (again, you need bile to digest & your gallbladder isn't up to the task).

Do some research on gallbladder-and-liver-healthy diets. That's worth more of your energy than worrying about an operation that's truly not a big deal. And I say this as someone who hates doctors and hospitals with a passion. I've had dental visits that were worse than my gallbladder procedure (minus the ER trauma). The scar will be tiny and very boring. After a couple of months, you'll have trouble finding it to show it off.

{hugs}

[lizziebethlj.livejournal.com]

My aunt had this surgery (not sure of the SILS, but gallbladder surgery) and I asked her about it, not having any personal experience with anesthesia. She sent me this link to pass along, she said she found it online when trying to keep calm, and that advice is good. She also said to speak to your anesthesiologist - made her feel much better.

But you have a great month ahead of you - focus on that, too!!!

http://findarticles.com/p/articles/mi_m0NAH/is_n3_v27/ai_n27525371/

PS: I'm still voting for the black jeans with the laces up the sides and the front. Hot. Glambert-worthy.

[aivilo-18.livejournal.com]

What to wear to Adam's concert. If anyone wants to give suggestions, feel free. I am all about suggestions.

I have a black leather gladiator kilt that I bought at a Leather Daddy store in New York that would make you fucking *weep*. Sure, it's meant to be worn by a dude, but it laces up on the sides and looks fucking *nuts* when paired with fishnets.

I'd let you borrow if I wasn't already having babies with it right *now*.

[chrissie-m.livejournal.com]

Oh, totally with you on the anaesthesia thingie. I've had similar surgery and it really isn't a big deal (I didn't even get a little band-aid afterwards), but the thought of being under....

My hospital does surgeries in the deep down basement, which means a long trip down the elevators and through the maze, and the whole time I was fighting the urge to fling myself off the gurney, wearing nothing but the flimsy open nightie, and make a run for it. I didn't go under until I was already in the OR and they were pretty much ready to start; if I had to do it again, I'd ask for a sedative before I left my room and started that trip. So I totally get where you're coming from.

[pi]

Good luck with surgery! It sounds like you, and they, have it pretty well sorted. Perhaps they can figure a way to transport you by way of stairs anyway? If it's going to happen (which hopefully it wont) you might as well have it fully choreographed ahead of time (no idea if that's even probable, but worth asking? They could follow with all the connected bits nessicary? or something?)

Also on a totally different note, I may have mentioned before, but every time you mention you'll be in Seattle this summer it makes me happy. In a (hopefully not to stalkerish) "awesome, Seperis may be in Seattle when I'm in Seattle, which means I might see her on the bus!"....or something. Also, Seattle is of course a wonderful place ergo anyone visiting Seattle is cause for happiness. Of course, I'll probably not be there when you're there, and I wouldn't recognize you on a bus, and you may not be taking public transit, so, moot point. But still, it's my first reaction.

I hope you have a wonderful trip, concert (seconding above on the black with laces of various kinds, and perhaps shiny/metalic bits?), VVC etc... and the surgery (if any surgery can be considered wonderful).

[boggit.livejournal.com]

If it's okay that I ask, why are you so against general anaesthesia? Bad experience or just the whole idea of it?

It doesn't really matter why it freaks you out, because, seriously, LOTTERY CHANCES. They wouldn't let your doctor do five a day if he wasn't good at them. Besides: His hobbies require that he not be accident-prone: Motorcycle touring? Rock climbing? Scuba diving? This guy is good at keeping focused and being safe, when he's taking care of himself or his patients.

I hope you can wrestle your brain back from fixating on this, and keep breathing.

[riazendira.livejournal.com]

I am not at all helpful with regards to surgery... so I will just say good luck :-D And I agree, doctors who react with a chill attitude reassure me too.

As for what to wear, I don't know your requirements for an outfit, but I'd totally wear this: http://www.etsy.com/listing/46093049/lonesome-dove-steampunk-saloon-burlesque With a pair of these: http://www.dressed2play.com/555chheplstp.html Because... why not?

[eleveninches.livejournal.com]

Good luck! I have my fingers crossed! My mother had this procedure a few years ago and it went really well, and she's had no side-effects or anything.

[archaeologist-d.livejournal.com]

I've had gall bladder surgery, the kind where they open you up and you have a long scar and many weeks recovery. It's not pleasant although the drugs were great. I'd have preferred the laproscopic technique (which I know several people who had it and were fine afterwards). I've been in surgery a number of times. They give you something to calm you down before you even get there and before you know it, it's wakeup time in recovery. I had more problems in the room than in the surgery. The darn nurses kept me awake at night (I'm a light sleeper) and I was more than ready to go home by the time they were finished.

However, just make sure they aren't kicking you out early to open up a bed or because the insurance agents are cheap bastards. Once you are home, make sure your family understands just how ornery you might get and you'll be fine!

[cjandre.livejournal.com]

I have no direct experience with surgery like this, but my Mom says it was a breeze when she had hers out. As I try to be encouraging, all I am coming up with is... look forward to the good drugs?

:-)

Deep breaths and focusing on VVC are probably the best things.

On another note, I just realized that Chicago is only a bout a six hour drive from here! I shall have to contemplate VVC for next year!

[phoenix4.livejournal.com]

I so understand the whole "setting it aside" and dealing with it later thing. It's one of my favorite coping mechanisms. I firmly believe in ignoring the panic until it's all over. So I'm good in a crisis, but have horribly embarrassed myself by having a breakdown when everyone else has started to relax.

After having four major surgeries, I encourage the use of pre-op pharmaceuticals. Definitely talk to the anesthetist about getting something to make this easier on you. I just took a lot of deep breaths and did a lot of notthinkingaboutit until they got me in the OR, but in retrospect a little Valium would have really helped with the shaking and racing pulse. (Except for the last - oh please be the last - time when I shattered my right arm and was already on enough Dilaudin to fell a horse.) And I don't even have a thing about elevators.

(The ability to locate stairs would be nice though.)

[mz-bstone.livejournal.com]

I know two people who've had this. Both had quick, normal and full recoveries. Just make sure to cut yourself a little slack for the tiredness that comes after any surgical event.

B