Thursday, July 1st, 2010 07:52 pm
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![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
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.
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.
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