Stepping Out

By Wednesday, 8 days after the operation, I was ready to expand my horizons. I started going for walks. It was Liz's influence. She more or less challenged me to get out of the house. She took me for a walk, all the way to the end of the block. I was wearing my scrubs and holding my splint pillow over my tummy, but I was walking outside, even outside the yard. It was both a major expansion of my horizons and a reminder that I was a convalescent. I made it to the stop sign and back, but it was work. When I got back, I settled onto the couch. My plan was not to move more than necessary for as long as I could manage it. I was pretty wiped out.

I was, at that point, still taking the Percocet exactly on schedule. I did make it to the end of the six hours each time, but I didn't go more than ten minutes past. Walking around the house was becoming routine, but I hadn't left the yard on my own, and without Liz's encouragement, I may not have for a few more days. Once again, I found myself caught in this place, between thinking I was really making progress and the limitations on what I could do, or was willing even to try, because of the pain when I made any real effort. I knew I could manage walking to the bathroom and back. I knew I could stand taking a shower. It was weird to recognize that those felt like real accomplishments. How much of our lives is based on illusion and perception?

I had received a few emails from colleagues at work. Most were just expressing hopes for my rapid recovery and return, but one of my colleagues, Cyndie, who was covering one of my classes, sent me an email asking about a few questions on the exam I had shared with her. She was polite and professional, but the message on the questions she asked about was, What the Hell are you thinking? Well, on the two most obvious problem questions, I explained that I had edited the question, but forgot, somehow, to update the key. That's what the problem was. I think that may have been the truth, as I don't usually use the test bank key to make the keys for my exams. I just read the test, and type in the answers before I scan the forms. But once in a while I screw it all up, and put the wrong answer in the key. Fortunately, most of the time when that happens, everyone misses the question, and I notice the error when I check it. I do check questions that most of the class miss. That got me wondering again when I might get back to work.

And then I remembered my walk. If I could barely get to the end of the block and back, I couldn't stay on my feet to proctor an exam, much less give a ninety minute lecture, and teach a lab or two or three in the same day. I was still dreaming of getting back to work after a couple of weeks, but here I was, over a week out from the operation, and just walking half a block. Maybe Dr. Paddy was right. Maybe recovery from major surgery would take a bit of time. And I would just have to learn to deal with that.

The best I could do was keep taking a few steps more every time I went out.

A New Normal

I woke up Tuesday, and got up to the bathroom. I didn't go straight back to the couch. I wandered into the kitchen, and stood looking at the stove for a few minutes, wondering if I could make my own breakfast. Before the operation, I would get up nearly every morning and make some eggs, veggie bacon, and usually coffee for Liz and me. I just wondered if I was ready to start again. I decided I wasn't.

I went back to the couch, and started reading. I was waiting for Liz and Sharon to get up. And waiting for time for my next Percocet. I timed everything I did around when the pain meds were due. I could take longer walks, or even shower or something, in the first hour or two after I took the pill. I avoided any unnecessary motion in the last hour before the next pill. But I was just starting to wonder if I could stretch that, or challenge that approach. Maybe I could shower right before the next pill was due.

I didn't shower on Tuesday. As it turned out, I didn't shower Wednesday, either.

I guess the biggest variation from the dull routine was that I took a nap on our bed on Tuesday. I could get comfortable if I arranged the pillows right, but I couldn't lay on either side. I wasn't a good nap. I wasn't ready to sleep in our bed yet. When I woke from a bit of dozing, which was the best I managed, I went back to the couch. I settled in there for the rest of the day. And the night. And most of the next day, too.

I think Wednesday, I took a walk outside. I walked down to the end of the driveway. I was getting more ambitious as I sat on the couch, reading, but ambition quickly melted in the face of motion. A walk to the end of the hall and back still felt like an accomplishment, though I did manage to spend more time on my feet. I could stand at the window, for example, and watch birds and squirrels. That was something. And eventually, I figured, I would get back to regular showers, and maybe wear something besides scrubs and t-shirts. Someday. But not yet.

Learning About Schedules

Monday morning, I felt pretty good. Liz made me a couple of fried eggs with veggie bacon for breakfast, and Sharon made me a bowl of oatmeal. That was a good start to the day.

I took a shower. I didn't take the splint pillow into the shower with me, so it was rather a long time standing up without support. I washed my hair, face, arms, and various other parts, avoiding the abdomen. After I rinsed off, I turned off the water, and grabbed my towel. I carefully dabbed the water off around the staples. I was pretty tired by the time I was done and dressed again, but I had a feeling of accomplishment.

Meaning to carry on doing things that mattered, I called the doctor's office to schedule my staple removal. I asked for an appointment in a week, meaning 21 April, thirteen days after the operation. Usually, staples are left in for a week to ten days, but the doctor, on discharge, had suggested I go in that Monday. The office, however, said there were no appointments that day. The earliest I could get in was 28 April. Three weeks after the operation, with staples still in.

"But that would mean I would have the staples in for three weeks," I explained. "Do you think the doctor would want that?"

There was a pause. Not along pause, but noticeable. I don't know how much medical education the person answering the phone had, but I hoped enough to know my question wasn't absurd.

"Well, sir, I can't schedule you for any earlier, as there are no appointments available. You can call next Monday morning to see if there are any cancellations, or if the doctor wants to work you in," she said.

"Okay," I replied, slowly, stretching the word out to show that it meant something else. Like, if that's the best you can do, I'll have to make my own arrangements. I know people, people who know how to remove staples. Maybe I'll just take my business elsewhere.

It is true; I know people who can remove staples. But I wasn't going to call them. I knew Dr. Paddy was on vacation, so I decided I would wait, and call the next Monday morning. And when I called, I would make a fuss until I got in that day, because I wasn't waiting three weeks. That's what I was thinking. I doubt that came across in the way I pronounced, Okay.

I had kind of expected that Dr. Paddy's office would anticipate a patient needing an appointment to get staples out after surgery. I mean, that's what Dr. Paddy does. He cuts people open, takes out what needs removed, and staples them shut. Then, after a week or two, he has the staples taken out. So, you schedule an operation, and you pencil in a time for removing the staples. But I guess not.

The rest of the day was about like the day before. I sat on the couch reading, I ate what someone brought me for lunch, which was leftovers, I took a nap in the afternoon, and I read some more. Until about 5 pm, when I asked Liz if she wanted to watch TV. I doubt that that marks a point of progress in my recovery. Maybe it did, because I hadn't wanted to watch TV Saturday or Sunday. Maybe turning on a show was too much commitment before Monday, but that evening, I was ready. I could manage a whole episode of Star Trek. Then we watched Haven. Then X-Files. And finally, Poirot. Yes, about four hours of TV. But around 9 pm, I took another Percocet, and said I wanted to sleep. I was at my limit for TV endurance. Until the next evening.

Resting, drinking lots of water, walking some, eating healthy food, and not too much, and resting. That was my life that day. The other stuff was all extra, and helped to pass the time. And now, I need some more rest.

Defining Progress

I was glad to be home. I spent the first two days just sitting on the couch, reading, and eating when meals were brought. I didn't even turn the TV on. I took my pain pills  on schedule, and I kept my splint pillow on my tummy almost all the time, including when sitting and reading. It was much better than being in the hospital, because I wasn't constantly being disturbed by nurses or noises from the hall, but otherwise it wasn't much different. More comfortable, calmer, quieter, more consistent, but still the same. Lie still and convalesce. How could I know if I was actually getting better?

I called my mom when I got home. She had tried to call me in the hospital, but I didn't talk on the phone at all in the hospital, not even to Liz. I had texted a few times, but that was all. Liz had called Mom once or twice to report on my progress. But Mom had tried to call me, and I hadn't answered. Mom rarely calls. I think she has social phobia worse than I do, which really is saying something. So I called her, first thing, after I got home. I told her I was doing well, and everything was under control. Because I was doing well, and everything was under control. But at that point, there was still enough pain to keep me mostly focused no enduring. It hurt too much to let boredom set it.

By Monday, things were changing a little. I finished The Handmaid's Tale, and had to start another book. I picked up one Liz suggested. She had put it on the coffee table in front of me. So there I was, thinking about something besides enduring the pain or taking care of bodily functions. Not a truly momentous occasion, but still, a sign of progress. Someday, it seemed, I would be thinking about normal things again. It was nice to know.

A Day at Home

I was awake when Liz got home from Pleasure with Payne, the fundraiser for Columbus Dance Theatre. I heard some of her stories. She was talking to her mother, Sharon, in the dining room. I was still lying on the couch, but I had recently taken another Percocet. The show did go on, but Catherine Payne had some troubles. She misremembered the way she had practiced some of the songs, and played variations on them, even getting the wrong song once. That made it a challenge for the dancers, who had to adapt. It may have been the influence of the pain Ms. Payne was in. I hear she skipped her pain meds, in an attempt to keep her head clear. She may also have been suffering from a concussion. I'm guessing there may be some follow-up to that accident.

I don't think Liz came to talk to me. She thought I was asleep, and I was trying to be. I did sleep on the couch, but I had to get up every couple of hours, all through the night, to pee. I had a lot of extra fluid on me. I weighed myself soon after I got home. Despite having no food Tuesday, a couple of sips of broth on Wednesday, and a frozen lemonade on Thursday, before eating most of the hospital meals Friday, I had gained five pounds since leaving for the hospital Tuesday morning.

I noted that I did not have a bowel movement Saturday. My last one was Friday, early morning. The med I had been given to help my gut move had been stopped after Thursday morning, but I was still on the pain meds. Between not eating, and taking narcotics, it seemed I had slowed my gut mobility. Or stopped it. I ate Friday and Saturday. Saturday, I even had solid food. But eh servings were small.

I was awake between 2 and 3 am, so I took my next Percocet as scheduled. I noticed that walking to the bathroom when it was near time for the next pill hurt more than right after the med. I tried to challenge myself to hold out on the pain medicine, see if I could stand to be without it for a while. I made it 10 minutes. Yeah, I'm a wimp. I hate pain.

So the first day home, I sat on the couch and read, I ate when meals were brought, I slept after every pill, and I walked to the bathroom a lot more often than seemed reasonable. It wasn't much different from being in the hospital, except it was completely different, and I was ecstatically happy to be home. But at that point, it was hard to visualize full recovery. The most ambitious thing I did was walk past the bathroom, all the way to the bedroom, just to take a look at it. That took its toll. What if I never got better than that, and had to walk with a pillow pressed against my tummy for the rest of my life? That would make it hard to gesture during lectures.

Change of Venue

Saturday morning, I woke early. I lay there, waiting. But I wasn't expecting anything soon. I wish I could have slept in, because I knew I wouldn't get to leave until around mid day, but I guess the excitement got to me.

My breakfast was still full liquids. Blended oatmeal and stuff. I skipped the yogurt again.

My vital signs were fine, but my BP was creeping up a little. I had been restarted on my ACE inhibitor on Friday, I think. The nurse came in and talked about my discharge, but she said there were no orders for it yet. She said she didn't know when the doctor would be coming. So I waited.

I got up to the chair for a few minutes a couple of times. I didn't need the bathroom. I noticed that, but didn't think anything of it.

Liz came just before noon, and the doctor still hadn't come by. It was getting hard to be patient. Liz tried to help by reading to me some more.

Just about noon, the doctor came. He was from Dr. Paddy's group. He checked me over a little, listening to my tummy and looking at the incisions. He said he thought I was ready to go. He told me to call for an appointment to have my staples removed a week from Monday, and said I shouldn't lift more than 10 pounds. Then he left to look over the orders from Dr. Singh, written the day before.

I had to wait a bit more, because Dr. Lindsey had to read over the discharge orders, and sign off on them, and then the nurse had to look them over and prepare my discharge instructions.

Finally, around 1 the nurse came in with a few pages of instructions. We discussed my diet, because the instructions say to stay on the diet you had at discharge, which was still full liquids. The nurse suggested I advance to a regular diet as tolerated. She told me to use a pillow to splint my tummy, and to try to keep increasing my activity. She told me what to expect, and when to call the doctor. It all seemed simple and straightforward. I was going home.

Liz had brought some clothes. She brought my bathrobe, some scrub pants, a t-shirt, and a pair of slippers. The scrub pants, normally quite loose on my, just barely fit around my belly. The t-shirt was okay, but also seemed a little snug. I was happy about the slippers. Bending all the way over to tie shoes would have hurt.

The nurse took me down in a wheel chair, and we waited at the curb while Liz got the car. Getting into the car took some effort, and hurt, but I settled in. Liz had the seat reclined, which meant I had to lean back. I couldn't really lean sideways and then lift my feet, as I did getting in and out of bed. But once I was settled, it was comfortable.

Liz drove home as carefully as she could. I did feel some bumps. We got home about an hour before my next Percocet was due. I began to worry about that, even before I got into the house.

Climbing out of the car was easier than getting in. I could use my arms to pull better. I walked slowly into the house. Sharon was all smiles as I shuffled through the kitchen. Nala barked once in greeting, and wagged her tail.

Liz had put blankets and pillows on the couch, set up so I would be at the end that let me see the TV. I settled on the couch, covered myself with a blanket, and pressed a pillow to my tummy. Compared to the hospital bed, this was heaven.

By then, though, I had to pee. I found, after I got home, that I had to pee about every two hours, even through the night for the first couple of days. That first trip down the hall to the bathroom reminded me that I was still in the early stage of recovery from the operation. I set the pillow down, and lowered myself carefully to sit on the toilet, then picked up the pillow and pressed it too my tummy again. Peeing had become entirely passive; I would think about relaxing and letting it go, but didn't try to increase abdominal pressure. It was working fairly well, but it did take a little time.

When I got back to the couch, I was tired, and ready to try to nap.

Liz went to the pharmacy to get my pain meds. She got back half an hour before the pill was due. I was glad. I was beginning to feel the pain return.

After I took the Percocet, I picked up my book. I found it easy to read, then. I read two hundred pages before the end of that day. I pretty much read for the rest of the day, stopping briefly to eat a meal brought to me on the couch. Liz had to go the Pleasure with Payne that evening. Sharon stayed home with me. I just read, except for those regular trips to the bathroom.

It was good to be home, but I was still weak, slow, and absolutely dependent on the Percocet. I was worried about eating too much or the wrong food. I didn't try any salad. I ate cooked veggies and pasta. Real food, with real flavor, and it went down fine. It was very good to be home.

Anticipation

Friday morning, I woke feeling better than I expected, as I had to get up to the bathroom twice during the night, and for an hour in the middle of the night I found the bed unbearably uncomfortable. I even got up, just to stand beside the bed for a few minutes. But the pain med button got me through the wee small hours well enough. And I knew change was coming.

Fairly early that morning, I was visited by Dr. Paddy's fellow, Dr. Singh. He was a pleasant young doctor, enthusiastic about life, it seemed, and very energetic. He made me want to get up and, well, not dance exactly, as I knew that wasn't advisable in my condition, but maybe walk a little faster than I had been.

He asked me about how things were going. I told him about my successes at various elimination processes, and my three walks the day before.

"Good," he said. "Excellent. We should think about getting you home tomorrow. Or maybe even late today if there is any reason to."

Wow.

I was still on a clear liquid diet, because my first BM was after the doctors' visits on Thursday, but Dr. Singh wrote the orders to advance my diet to full liquids, and then, assuming I tolerated those, to a regular diet. He also ordered the stopping of IV pain meds, and other IV meds, switching everything to po (by mouth). If I could eat real food and get by on pain pills, I could leave the hospital.

My breakfast was brought right after Dr. Singh left, so it was still clear liquids. I ate most of it. Then, just after I finished, another breakfast tray was brought, this time full liquids. I really wasn't that hungry, having eaten most of the clear liquid breakfast, but I ate the blended oatmeal, just to prove I could.

Soon after that, the nurse for the day came in, and told me about the change in pain meds. I was being switched to Percocet. This was Taylor, the same nurse I had on Thursday. That mattered, I think, in events later in the day.

I had been given Percocet once before, a long time ago. It was after I had my wisdom teeth removed, I think. This is how I remember that. I was living in Indian Springs, Nevada, which is an hour away from Las Vegas, and I started having pain on the drive home, as the anesthesia wore off. I took a Percocet. A few minutes later, I got dizzy, and then nauseous. I was so sick, I couldn't stand it. I blamed the Percocet, so I never took another.

And now I was going to be taking Percocet for my post-op pain. I almost spoke up, but I decided it might be wise to try a pill, and see how I did. An hour or so later, when Taylor brought me my first Percocet, I took it.

After fifteen or twenty minutes, I was getting a little drowsy, and I was certainly feeling no pain. I did not, however, feel any nausea. So for thirty years, I had been blaming my episode of nausea after my oral surgery on Percocet when it was probably caused by the withdrawal of the anesthesia. After all, on this occasion, I also had nausea some hours after withdrawal from anesthesia, which it never occurred to me to blame on the pain meds. Good thing, too, because I needed those pain meds. They got me through three days of misery. Percocet, it turns out, is my friend.

So for the most part, I was just biding time, and doing what I could to prove I was ready to leave the hospital. I felt so much better that day than I had even the day before, it was hard to remember how miserable I had been on Tuesday and Wednesday. Maybe we need to invent a dissociative drug that will let the nurses and other hospital professionals lead patients through the first few days of post-op recovery without conscious awareness on the part of the patients. It would make recovery much less miserable if we didn't have to actually experience it.

At lunch, I ate almost all of the my full-liquid food tray. Hospital food sucks, but one can choke it down if the incentive is right. Getting the hell out of there was enough for me. No reflection on the nurses and PCA's, who were wonderful, and helped me get through all that misery, but I was longing for the comfort of the couch at home by then.

After lunch, I made a trip to the bathroom. The IV had been disconnected. I was not getting IV fluids anymore. I noticed the tape around the IV was a bit loose, and I pressed it all back down in place as well as I could, but when I got up, I pressed my hands over the sorest spots on my tummy. Than meant I turned my hand up sideways. And the whole IV fell off, onto the floor.

The PCA noticed, and picked it up. He placed it on the bedside cart. I made it to the bathroom, completed my elimination processes, and went back to bed. The PCA said he would tell the nurse about the IV.

Taylor came in a few minutes later, and looked at my hand.

"Well, we knew it wouldn't last forever," she said, philosophically. She just sort of looked at my hand for a minute or two, thinking. "Maybe I can get the doctor to write an order letting us leave it out, since you're leaving soon anyway."

I don't know if another nurse, one who hadn't gone through the struggle to get that IV in place the day before, would have taken that route. I was a little afraid she would try to place another new IV. But we were both hoping I wouldn't need one. I was not on IV fluids, and had no IV meds, so the IV was only there in case of unexpected changes. In an emergency, and new IV could be put in. Only, let's not have an emergency.

Friday afternoon, feeling like I had been given license to behave like a patient about to be released, I started getting myself up to the chair, and going to the bathroom to pee on my own. I didn't have any problems with it, and I didn't get caught by the nurse or PCA. I spent half an hour or so in the chair. I tried to read my book at one point, but I still found I was concentrating on my abdominal wall, and couldn't focus on the words. But I was ready to go home.

I had expected a regular food tray for dinner, but I got full liquids. Potato soup, which turned out to be very tasty, along with chocolate pudding and some sherbet. I didn't drink the carton of milk.

I noticed Friday afternoon that my tummy wasn't rumbling like it had been the previous day or two. I had a BM that morning, but now my tummy seemed rather quiet. My kidneys were still working, though my fluid intake was all oral now. I can say I felt, not normal, but at least human again.

One nice thing about the switch to oral meds was that the pulse ox was removed from the right index finger. The skin on that finger was all swollen and wrinkled, like it had been in the bathtub for much too long. Three days. My left had was still a bit swollen from the IV problem the day before. So neither of my hands looked or felt at all normal. But I could tell they were going to recover.

Liz stopped by briefly on Friday. She was dealing with Dress Rehearsal for Pleasure with Payne, a fundraising dance recital by Columbus Dance Theatre, for which she had provided the costumes. And there was a lot to deal with. One of the company dancers got hurt the day before, so she had to outfit his replacement, who was a good six inches taller, at least. And Ms. Payne, the cabaret singer providing the music, fell of the edge of the stage, hitting her head and braking an ankle, perhaps changing the whole meaning, and spelling, of the title of the show. But show biz is show biz, and the show would go on. So Liz got there a little later than planned, and stayed long enough to hear my progress report. She immediately began planning for my transport home. Then she read me a chapter of Shadows as I settled in for the evening.

I told Liz to plan to come around mid day on Saturday, as I didn't expect things to happen too quickly in the morning. I welcomed the drowsiness of the Percocet, and dreamed of relaxing on the couch with a flannel quilt and the remote for NetFlix, and other heavenly visions. I was going to survive the hospital ordeal.

The Value of Continuity

After my second walk on Thursday, the PCA, Regina, changed the linens on the bed while I sat in the chair. Then she helped me back in be. Unfortunately, she never plugged the IV pole back in.

We took the IV pole with us on my walk, so it ran on batteries. I don't know how long the battery charge on the IV lasts, but some time Thursday afternoon, it stopped working. And some time after that, I noticed it. It didn't beep. I would have noticed that sooner.

Once I saw that the IV wasn't working, I pushed the call button, and reported the problem. My nurse arrived a few minutes later.

She fiddled a little with the IV, and plugged it in. Then she just restarted it. She looked at my hand, and asked about pain. There wasn't any pain in my hand. So she said we would hope for the best, and left it as it was.

A bit later, maybe half an hour, I noticed that my left hand felt tight and swollen. So I pushed the call button again. By the time the nurse got there, my hand was almost round. I could only bend my fingers a little. The IV clearly wasn't going into the vein. Something went wrong when the IV was left off for too long.

The nurse tried to place a new IV in my right hand. Actually, she didn't have much trouble with that. I saw the ultrasound wand she used to locate the veins, and it was remarkable, showing every little vein all over the back of my hand. She pushed in the needle, and advanced the catheter, and I had a new IV.

Unfortunately, the tape she placed over the IV didn't stick very well. The first IV had been placed before the operation on Tuesday, and the tape was still firmly attached until the IV had to be removed because it stopped flowing. But the new one just didn't take. The nurse added more tape, eventually trying at least three different kinds, to get it attached well enough to hold it in place. But something about the way I was sweating and all the oils on my skin was interfering with the tape.

For the rest of the day Thursday, the IV in my right hand kept working, but I had to keep pressing the tape down again, and hold the hand still as much as possible. I also held my left hand up a lot, hoping the swelling would go down. As I settled in to sleep Thursday night, there wasn't any noticeable change, but I wasn't in any pain, except when I coughed or moved too fast. And I was able to get up to go to the bathroom. Only with assistance, mostly with someone watching, in case something happened. But I could begin to see that normal life would return. It was a distant vision at that point, but I was pretty sure I wouldn't be in that same, miserable state forever.

But I had a terrible time sleeping that night.

Put One Foot in Front of the Other

Some 36 hours after the operation, I could say that my gut was working, as I had farted twice and had lots of rumbling in my tummy. I was also peeing about every couple of hours. Unfortunately, the abdominal wall block I got from the anesthesiologist before the operation had worn off, so my tummy hurt more and more every time I moved. I even noticed it with the incentive spirometer. The first day, I could bring the thing up to 2000 mL without much problem. By Thursday morning, it hurt to get to 1500.

I still had no appetite for breakfast that morning. Dr. Paddy came in early, before breakfast, and asked how I was doing. I told him about my progress, and he seemed pleased. He talked about advancing my diet,which seemed absurd to me, as I wasn't eating anything. He listened to my abdominal, and seemed very pleased with the rumbling. He was leaving later that morning, and would be gone for a week, but had other doctors covering for him. He talked about getting me home in a few days.

 I wanted to leave. Not because I felt ready, but because I was tired of the hospital bed. And the noise. The bed was uncomfortable. I think it made me sweat. Maybe it was the plastic cover on the mattress and pillow. I also hated not being able to move because of those damned inflatable wraps on my calves. I wanted to either be asleep all the time, or have someone there helping me do something else. I was restless and uncomfortable, just trying to lie in bed and do nothing. I couldn't read. I couldn't really sit still and concentrate. But I couldn't sleep all the time, either. It was a little like restless leg syndrome, something I think I've had all my life, but this was my whole body. I would get this irresistible urge to move, but all I could do was tighten my muscles for a few seconds, and then relax them. I couldn't toss and turn, because it hurt my belly too much. I couldn't get out of bed without help. I was sweaty and oily, and felt disgustingly dirty. I wanted it all to end.

Late in the morning, I got to take another walk. The nurse took me around. She said the PCA would take me around again later. Something to look forward to.

I was not on oxygen by then. Someone from respiratory came in to check on me. She looked at the nasal cannula and the connection on the wall.

"Hm," she said.  "They have this hooked up, but it's turned off. Your sats are fine. How about we just take this off now?"

I had no argument. Another step toward normal: I was breathing room air.

The PCA came in around lunch time. She checked my vital signs. She put the cuff on my right arm, which is the side the pulse ox was on, so when the cuff inflated, the alarm went off. I hated all those alarms. They were loud and really annoying. Regina ignored them.

After I told her I had no interest in lunch, she suggested a walk. She unhooked the pulse ox, and it screamed at us again, and she just let it scream. The others had always turned the alarms off. Not Regina. She just didn't care. Funny that no one else came to see what was the matter.

I made the walk, and Regina sat me in the chair while she changed the bed. I wasn't very comfortable in the chair. I had decided before the walk not to push the pain med button. That may have been a mistake. I was really ready for the bed when she finished making it. I climbed on, and settled onto the fresh sheet, and pushed the med button as soon as I found it. I think I was asleep in five minutes.

I knew that day that I was getting better. I was strong enough to complain, and too think about all the things I couldn't do, which I hadn't thought of at all the day before. I was progressing as fast as could be hoped. But waiting it out was not fun. I hated life all that day.

After my second walk and afternoon nap, the nurse came in, and asked how I was doing. I don't remember what I said. But she asked a few specific questions.

"How would you rate your pain currently?" About a 2/10, unless I move.

"Have you had a bowel movement, or passed any gas?"

Well, yes, I had passed a little gas. Oh, and, um, I just noticed something. I still feel all this rumbling, but it doesn't feel like gas moving down to the exit. I, um, think I have diarrhea. I had just noticed that.

"You mean now? Have you passed any?"

No. It just feels like liquid trying to escape. Can I get to the toilet?

So, she helped me to the toilet. I sat there, trying to relax. I still couldn't do anything to increase abdominal pressure. Cutting open your belly is a way to learn just how active things like moving your bowels or peeing really are normally. But all that fluid in my gut wanted out, and after a couple of minutes, I had no need to push. It gushed out. It was as bad as during the prep.

I sat, letting it all happen, and waited a few minutes after, in case another bout should appear. Then I had to wipe. I had an IV in one hand, and a pulse ox on a finger of the other. And wiping meant bending one way or the other so I could reach that far down. Pain. Lots of pain. I even thought about asking the nurse to wipe me, but I managed it. Then I pulled the string on the wall, which called the nurse back in to help me back to bed.

So my bowels were moving. Not pleasant. Thin liquid, despite all the narcotics. But it meant my gut was working, or at least moving, if not doing what it should have been doing. After that, I felt empty. Completely drained. I took another nap when I got back to bed.

Then I had another trip to the toilet before my third walk for the day. It was a long, miserable, painful day in which I made every goal I had. Due to that day's events, my diet was advanced for the next day, and there was real talk about when I might go home. It was only just barely worth it.

Clearing the Air

That day after the surgery was slow, tedious, painful, miserable, and unavoidable. I would have loved to be completely sedated through the whole thing, and have woken up several days later. But the doctors and nurses wanted me to breathe and walk. That is supposed to help with the whole recovery thing.

I did use the incentive spirometer several times a day. It wasn't bad. I could take a breath in, getting as much air as I could into my lungs. How much depended on the position I was in. More when lying down or standing, less sitting in bed. More pressure on my tummy, I guess. I also managed two walks around the floor that Wednesday. I kept the splint blanket tight against my tummy the whole way, and I just swallowed the pain. When I got back to my room, I collapsed into bed, and more or less didn't move. I think I drifted into sleep both times.

Having thrown up twice Wednesday morning, I just skipped meals for the rest of the day. I sipped a little water because my mouth got dry. I was really worried that my stomach wasn't emptying at all. The doctor had added another IV med to help with nausea and stomach mobility, but I had no way to know if it was working. The rest of my gut was still rumbling, but that was all.

Until the wee small hours of Thursday morning. Then, when I sat up to try to pee again, I felt a bubble shift downward in my gut, right to the end of the tube. I have never wanted to fart so bad in my life, but I couldn't. Adding any pressure hurt too much. So I sat and waited. And nothing happened.

Oh, except I did manage to pee. The second time I peed after the catheter was removed, it took about five minutes waiting, and actually three tries with the urinal. the third time, it took two tries, and less than five minutes. I was getting good at it. I had to. That IV was still running pretty fast. I was being fulled to the gills with fluids, and now I had to get them out myself. But each time, it got a little easier.

Later in the morning, with my fourth time urinating, I felt another bubble move down. I didn't try to push. I sat forward, using external pressure. And there it went. A tiny pop, and something came out.

Who would ever have thought that passing gas would be worthy of celebration? But that meant my gut was, indeed, working. Hallelujah!

Go with the Flow

I don't remember everything that happened those first 24 hours after the operation. I know Liz was in the room when I woke up, at least when I remember waking up. She told me later that I said a couple of things right off. I don't remember them at all. I said, first off, "You're gorgeous." Then, when she told me about the open operation, I said something like, "Damn, that sucks." She stayed through the evening, and has reminded me that I did get out of bed around 7 or 8. I sat in the chair, next to the bed, for a few minutes. I didn't do anything. I just sat. I kind of remember that. It took all of my concentration to keep from moaning in pain. Or begging to be put back into bed, and out of my misery.

Liz cam back the next morning. She got there shortly after my second throw up. She talked about the coming show she was costuming, and the last minute problems she was fixing. She read to me some more. She also helped shift my blankets and my position in the bed. I was glad she was there, because it gave me some comfort. But I hated being so weak with her there. I didn't want to give in to the pain with her there. But I really wanted oblivion. I did let myself drift off to sleep a couple of times while she was there that day.

I knew that time was a major factor in the whole process, and I just had to wait out the healing. In the abstract, that doesn't seem so bad, but moment by moment, it isn't easy. You can keep telling yourself it's going to get better, but that doesn't help for the next five minutes, when it's going to take more like five days to mean much. Aside from the constant reminder that she cared about me, the best thing Liz did for me was provide some distraction. Trying to follow her stories, which were about people I know, kept me from obsessing on my condition. When I couldn't sleep, that was the best I could hope for.

By late that afternoon, the urge to pee was becoming desperate. I had tried, in that I got down the urinal, at least four times. And the nurses had noticed that I wasn't peeing. The nurse for that day, Amy, came in around 5, and asked about the need to pee. I explained. Yes, I really need to pee. But I can't get the flow started. I can't push, because any abdominal pressure hurts like hell, and that stops any possible parasympathetic response, being overwhelmed by the fight-or-flight response from the sympathetic output due to the pain. No, I didn't use those terms, but I understood the phenomenon.

"Well," she began to explain, "We need to know if your kidneys are working, and if it is just a problem with your bladder."

"My bladder is full," I replied.

"We have to be sure," she said. "So I want to do a bladder scan."

Terrific. She was going to get an ultrasound probe, and press on my lower abdomen. Maybe that would squeeze some urine out, and I would just wet the bed.

The goop she put on the probe was cold, and she didn't have to push much at all, because my bladder was stretched to the limit. She quoted some number, which was more than half a liter.

"Well, if you can't empty your bladder yourself, we might have to do something."

I know exactly what she meant to do. Straight cath. Stick another tube into my dick, just long enough to drain the urine, and the pull it back out. It didn't sound pleasant, but probably better than not peeing for a few more hours. But I had a suggestion first.

"Maybe I should try standing up, and peeing that way," I said. Get gravity to help a bit. Be in a normal position for peeing. I mean, it just doesn't feel right to sit on a bed and pee, even if you have something to catch the urine between your legs.

"Do you think you can stand up for that?" she asked.

Sure. I'm willing to try quite a bit to avoid having a tube shoved up my dick.

So she helped me stand, and I held the urinal under my dick. And she turned on the water in the sink. And then she left. Liz sat across the room, saying encouraging things. I stood there, hoping.

At first, nothing happened. I pulled on my dick, hoping to coax a little urine through the sphincter. After about five minutes, which felt like an eternity, I began to worry it wouldn't work. I tried bearing down, which hurt all across my abdomen. Then I pulled again. And I felt something, like a drop shifting forward. So I pulled again, and I pushed again, and I shifted my feet a little, and I thought about Niagara Falls, and I glanced at the sink. And the urge to pee increased. And another drop trickled forward. And the urge to pee shifted forward, and an actual drop of urine leaked out the end.

That almost felt like victory, and I figured that getting the flow started was the hardest part, so I concentrated on relaxing and think about water flowing. The Falls again. And the Mississippi River. And the Amazon, and Fos de Iguazu, and lake Erie. And slowly, painfully slowly, urine began to trickle forward. Just a few drops at first, and then a tine stream. And, finally, I felt like I was actually peeing.

By the time the flow stopped, I was completely exhausted, but I had done it. I had actually peed. I got more than 750 mL of urine. The nurse came back in just about when I finished. She had stopped by a couple of times while I stood there trying. It may have taken 15 minutes total. The nurse took the urinal and emptied it into the toilet, and turned off the faucet at the sink. She helped me back into  bed, and I pushed the pain med button immediately. I felt like I had finished a hard day's work. My reward was a couple of hours sleep. As I settled in, Liz came over, and kissed me on the forehead.

"Good work," she said.

Worries

I hadn't been in the hospital 24 hours yet, and I was worried I might never get out. I pretty much quit drinking water, and skipped my lunch, because it seemed like nothing was getting out of my stomach.

That included the medicine that was supposed to help make my gut work. I had never heard of this drug, enterig, or something like that. I asked the nurse about it, and she read me what the label said. Something about blocking the opiate receptors on smooth muscle. Most pain meds, at least strong ones, are forms of opiates, and they have some major side effects. One of those is slowing gut mobility. Some opiates are used to treat diarrhea. But now there is a drug that protects the gut from the side effect, but doesn't interfere with the pain blocking of the opiates. That sounds really cool.

But I took the pill by mouth, so it got to my stomach. It wouldn't be absorbed much if it didn't get out, and into the intestine. All signs were that nothing was getting out of my stomach, except the wrong way. What if my gut just stopped working all together? I saw that once. A man who had had an aneurysm repair, and then had an ileus, meaning his gut just stopped moving. His abdomen was tight as a drum, and sounded like one when you tapped it. There were no sounds of gurgling when you listened. The doctors were trying all kinds of ways to decrease the pressure, but nothing was working. He'd been there more than a week since his operation, and things were just getting worse. I was beginning to picture myself in the same condition.

And then the nurse started messing with another system. Dr. Paddy had ordered that my catheter be removed. The nurse explained the process, which I understood. The catheter was a tube stuck into my urethra, all the way into my bladder. Once in the bladder, some fluid was injected into a tube in the tube to inflate a balloon at the end of the the catheter to keep it from slipping back out of the bladder. The main catheter tube went to a bag, which collected all the urine that came down into the bladder. A catheter like that is put in during surgery so the bladder doesn't fill up and get in the way. Or maybe so the patient doesn't pee all over everything. Anyway, the catheter was still in. But now it was supposed to be removed.

Here's the thing, from my point of view. Pulling that tube out of my dick would hurt. It probably hurt more putting it in, but I was sedated for that, and didn't remember it. I was in enough pain.

And what happens once the catheter is gone? My kidneys seemed to be working fine, and I was getting lots of fluids from the IV, so I would have to pee. The nurses and PCA's were regularly emptying the bag at the end of the catheter. I was making plenty of urine. Without the catheter, I would have to pee into something, and walking to the bathroom scared me. So I resisted.

But the nurse showed me a portable urinal, which was a sort of pitcher, something I could pee into in the bed. And she reminded me that without the catheter, it would be easier to walk, which I was supposed to do some time that day.

I gave in, and let her take out the catheter. She used a syringe to deflate the balloon. All I could see was the plunger on the syringe pulling back. I didn't  feel anything. Then she slowly withdrew the tube. At first, I just felt some tugging. Then it started to sting like crazy. But then it was out. That actually felt better. I realized I had been aware, sort of, of the pressure of the catheter in my urethra all along. It bothered me a little, but so much less than the pain in my tummy that I ignored it. Now it was gone, and once the stinging  stopped, I felt better. That was the first step back toward normal.

A couple of hours later, though, I found I wanted to pee. The urge was building. I grabbed the urinal, and tried to figure the best position for it, so I could pee into it, and not leak onto the sheets or mattress. I pulled the end of my dick out, and pushed it into the opening of the urinal, and I felt the need to pee. But I couldn't push. Even thinking about pushing hurt. Hurt a lot. So I couldn't do anything. I tried, and waited for about ten minutes. Finally, I gave up, shifted my dick back down out of the urinal, and covered myself with the hospital gown. I closed the urinal, and put it back on the bedside rail. And I began to worry that, because of all the pain in my tummy, I wouldn't be able to pee.

At that point, I knew, I had IV fluids and sips of water going in, and so far as I could tell, nothing coming out. Except sweat. I would sometimes break into sweat. Maybe it was pain. Maybe it was fear. Maybe it was just hot in that hospital bed. But for a few minutes, I was dripping sweat.

During that afternoon, I tried three more times to pee, with the same result. I felt the need, but couldn't make the urine flow. I was beginning to worry. So was my nurse. Maybe this whole operation was a bad idea.

The Morning After

I woke around 7:30, which means I slept for about two hours, maybe a little less. I pressed the pain button, and waited.

Someone came in with a tray of food. Well, clear liquids. Chicken broth, fruit juice, coffee. I thought I should try to make some effort, so I sipped the broth. Very salty. I sipped some water to wash it down. That was enough effort. I pushed the tray away.

Dr. Paddy came in, all smiles. He told me about the problems with the robot. Too much scar tissue from my appendectomy, apparently around the whole right side of the colon. I guess the operation took about 4 hours. Dr. Paddy listened to my belly, and seemed pleased with the bowel sounds. He asked about bowel movements or passing gas. No to both. I was feeling some rumbling, once in a while, but that was all. He said not to worry about eating if I wasn't hungry.

Maybe and hour later, a woman came in, and introduced herself as a nurse practitioner from Dr. Paddy's office. She listed to my bowel sounds, and pronounced them quiet and minimal. Then she ripped off the dressing. Ouch. She didn't seem to even try to be gentle. She noticed some seeping from the incision, and said she would order a light dressing over the large one, and then she left.

After another hour, I noticed that there was seeping blood, or pinkish stuff, on the sheet and hospital gown. And I got a sudden rush of nausea, and tossed my breakfast into the waiting basin. A lot more fluid came up than I had swallowed.

I pushed my call button, and told them I had thrown up again. I tried to settle in for another rest. I don't think I'd have made it to noon without that pain button.

First Night Activities

I faded in and out of consciousness through the first few hours of the night. Someone would come in every couple of hours, either the nurse to give me meds, mostly by IV, or the PCA to take vital signs. I always looked at the blood pressure, which was on the low side, around 104/60. My temperature was normal. The nurse also looked at my belly, listened for bowel sounds and said encouraging things about them. Like there were some. She also listened to my lungs, which I guess were also okay.

Around 5 or 6 in he morning, the nurse asked me if  I could get up to the chair. She wanted to change my bed and help me bathe. I said yes. She helped me to the side of the bed. Roll over a bit. Shift your legs off the edge. Lift your trunk with your arms. Try not to use your abdominal muscles. We managed it, but it hurt. And I moved very slowly. It's hard to lift with your arms while holding a folded blanket tight against your tummy.

Once she got me to the chair, which was right beside the bed, she placed a bathing bowl, or whatever, in front of me, dipped a washcloth into the warm water, and handed it to me.

Once she was done, she asked if I felt I could stay in the chair for a while. I got the feeling it would make her happy if I tried, so I said I would. I would much rather have got back to bed, punched my pain button, and zonked out for a couple of days. But I sat.

I thought about trying to read. Liz had left me a novel. I was reading, The Handmaid's Tale, by Margaret Atwood. During the five days I was there, I think I managed maybe ten pages. That first morning, I didn't even try. It seemed to take all my concentration just to think about picking up the book. I never got so far as to reach for it.

After maybe fifteen minutes, I started to feel a little off. Not pain. More like coming nausea. I held out as long as I could, which wasn't two whole minutes, and I pushed my call button.

"Can I help you?" came a voice from the button thing, or a speaker on the bed. I have trouble with direction of sounds.

"I'm feeling a little nauseated. I think I need to get back in bed," I said.

"Okay, I'll tell your nurse."

Having done something, I felt a little better. That lasted about a minute. Then the nausea came back. I deliberately breathed in deep and slowly, fighting back the nausea. But in about five minutes, and still before anyone came, the nausea suddenly jumped me, and I spouted all over the floor. It looked, and tasted, like water, splashing on the floor, and on my slippers, and some on my hospital gown.

I felt better. No more pressure in my stomach.

After another five minutes, the nurse came in.

"Feeling a little nausea?" she asked.

"I threw up," I explained.

"Oh," she said. She called the PCA. Between them, they changed my gown again, mopped the floor, and got me a new pair of slippers, which they placed on my tray for when I might need them. They helped me back into the bed.


"Sit back, and as far up the bed as you can," the nurse instructed. "Now lean toward the top of the bed, and lift your legs to the side. Okay, now roll onto your back."

As soon as I was settled on my back, I pushed the pain med button, and held my splint blanket against my tummy, waiting for sleep to come back. At that point, I decided that if I had known what the recovery would be like, I would have taken my chances with the cancer.

Where I Woke

I woke up in a hospital room. I don't know what time it was. I think Liz was there, and I met a nurse and a PCA. I think my nurse was named Erica. I don't remember the PCA's name. He was large.

I was in pain. It hurt to move. It hurt to breathe. It hurt not to move. I had some nausea. I wasn't sure I was awake. I got the idea that the surgery had taken longer than expected, and the robot didn't work. I had a huge incision, stapled shut. I guess it was already evening shift, but I don't know what time it was. It seemed noisy and busy. I just wanted to shut down again, and wake up when everything was right.

There was a little button clipped to my hospital gown, which I was told I could push for pain relief. I figured out eventually that pushing it gave me a dose of a pain med. It was pretty powerful stuff. A couple of pushes, and I could sleep through anything. Of course, the pain meds were timed, so I could only push the button every ten or fifteen minutes.

I had a tube across my face, with prongs up my nose for oxygen. I guess, when I would fall asleep, my oxygen would drop, without the supplement. There was a sensor with a glowing red light on my right index finger to keep track of my oxygen.

I also had a catheter, which didn't bother me much, as I couldn't move anyway. And I had things wrapped around my calves, which would take turns inflating and deflating. For the first day, I didn't mind that. They got annoying later.

There was a board on the wall across from the foot of the bed. It had my name on it, Patient's preferred name, and places for the nurse's name, PCA's name, diet (clear liquids), goals, and other stuff. Under activity, it said, "Up to chair today. Walk tomorrow." Getting up to a chair seemed like a much to ambitious goal. Just staying conscious seemed like a lot of effort. And not worth it.

There was a tray at the side of the bed. It had a couple of things on it. A small pitcher of water and a cup with a straw. And a plastic tube thing with a mouthpiece. An incentive spirometer. I knew that after an operation, a patient is supposed to walk and breathe. The incentive spirometer has a tube above the mouthpiece with a bit of plastic that would rise when you inhaled through mouthpiece. You're supposed to breathe in fast enough to bring the bit of plastic above the first arrow, and keep it below the second. Then another tube to the side has a piston that rises with continued airflow, measuring the volume in the breath. I was told to try for 1000 mL.

I snatched up the spirometer, and took a breath. I got it up over 1500 mL. Breathing didn't hurt that much, and I knew it was supposed to be good for me. I took a second breath, and got it to 2000 mL. Then I coughed. Coughing is also encouraged. It helps open the airways. Coughing hurt like hell. I put the spirometer back down.

I took a few sips of water. I was feeling a little thirsty, and my mouth was dry. And my throat hurt some. I figured that was probably from the tube down my throat during surgery. I talked with squeak. I couldn't make my voice sound normal.

Damn, I thought. This sucks.

I pushed the pain button, lay my head down, waited a few minutes, and pushed the button again. Then I drifted back to sleep.

Cutting Out

The truth of the matter is that for several days after the operation, I was in no condition to write about it, but I think I'll pretend that the missing week doesn't exist, and write about my experiences as they were happening in order from last week.

So, Monday afternoon and evening, I suffered through the prep, cleansing my bowel until my (frequent) bowel movements were mostly water, with some yellowish gunk. I drank a lot of water, a bottle of Gatorade, and a couple wine glasses of white cranberry juice. The first time I went through the prep for a colonscopy, I was weak and tired, and felt totally drained. I could walk only slowly and barely keep my mind focused on what I had to do. Liz led me through the procedure, at least as far as getting me to the care of the nurses. This time wasn't bad at all. I felt fine, just a little hungry, but fit and strong. I got up around 7, because of the whole bathroom thing, and I chose some loose-fitting clothes to wear to the hospital. I almost made breakfast for Liz.

Li got up closer to 8:30, and was fixing her breakfast when I got a phone call from the hospital, asking if I could come in an hour early, in case the OR was ready early. I said I'd have to ask my ride, and told Liz what was being asked. She nodded, and I said, "Yes, I could be there at 9:45."

After I rang off, I told Liz it meant we had to leave in twenty minutes, and she wasn't dressed yet. She kind of rushed through the rest of her breakfast, gathered a few things in a bag, and off we went.

I drove. Liz joked about making me drive to my own execution, but I'd just as soon drive as sit thinking, so I didn't mind. I knew where the parking lot was anyway. We got to the hospital at 9:35, and up to the on time.

I registered,which didn't take long. Handed the receptionist or clerk or whatever her title might be my insurance card and driver's license. I still had the blood type form from the pre-op testing. We went on to the next space, and waited a few minutes before I was called back.

I was handed off to a nurse, who took me back into the pre-op area, where I'd had the pre-op testing the week before. She weighed me (158 lbs dressed), and took me to a bed with my name on it. I stripped, and put on the hospital gown and slippers, and got onto the bed to wait. The nurse came back in a few minutes, and asked me, again, who I was and why I was there. She seemed impressed that I could tell her exactly what the procedure was. Robot-assisted right hemicolectomy for sessile polyps. I told her I teach anatomy and physiology to nurses, which is true. It's easier to just use the right terms that to make something up that gets the point across.

After assuring herself I was the right patient, for the second or third time, she asked about my medications, doses and timing, and when was my last dose for each, and then allergies. Once, more than a decade ago, I got an ingrown hair on the back of a finger, and I kept picking at it. After a couple of days, the finger started turning red, and then I got red streaks going up the back of my hand. A resident started me on an antibiotic, which didn't seem to help much. Three days later, I had a fever of 102 F, and threw up in the morning. My finger and hand looked worse. So a doctor stopped my antibiotic, and started me on another, and told me to go home to bed. I did. I took the new antibiotic, and I felt much better the next day. After a week, though, and before I had finished the course of the drug, I got a fine, red rash from my head to my feet. So, maybe I'm allergic to that antibiotic. Because of that rash, every time I go somewhere for a medical procedure I have to have a red band put on my wrist with the name of that antibiotic on it. For the rest of my life.

Then the nurse put in an IV on the back of my left hand. It burned a little when she put it in, but she taped it down efficiently, and the fluid she flushed through it flowed smoothly, and it didn't get in the way. She hung an IV bag, but I couldn't tell if she started a fluid drip.

Liz was brought back to my space. She commented on the kind of people you see in a waiting room at a hospital, which shows why the nurse was impressed that I knew the right name for the part of me the surgeon was cutting out. I guess a lot of people don't know their butts from page 8. Liz got out her Kindle, and started reading to me. Shadows, by Robin McKinley. Lots of weird stuff in that book. I'm enjoying it. While she read, and I concentrated on remaining calm, I farted noisily a few times. I told Liz I was practicing, as farting after surgery is considered an important accomplishment. She smiled indulgently.

A few minutes later, a doctor came in. He was an anesthesiologist. Not the one for the surgery, but an extra, offering something else that might help.

"I can give you a transverse abdominal block, which can help with abdominal wall pain," he explained. I'd never heard of that, but it makes sense. Use a local anesthetic to block the pain fibers in the belly wall, and you don't feel any pain there.

The procedure uses an ultrasound to find the nerve. A drug is injected around the nerves on the two sides of the abdominal wall, and the whole front is numb. It only took a few minutes. I don't know how much it helped, but it seems like a good idea. Before he did it, the anesthesiologist had me sign consent forms, because he gave me a small dose of versed or something like that for pain caused by the numbing process, which meant I couldn't really sign legal forms anymore. So I signed permission forms for his procedure and for anesthesia during the operation. That doctor would be Dr. Sleeper. How appropriate for an anesthesiologist.

Liz cam back, and we waited. She read as long as she could, and still we waited. I think it ended up, I was taken back for the operation at the original scheduled time, so rushing to get there early was kind of wasted effort, but maybe it bought some good will. In the end, a nurse came in, said it was time, and took me away. I don't remember arriving in the OR, so I must have got some drugs before we left. That's all I remember from before the operation. Quiet, calm, steady professionalism. And everyone impressed by my use of technical language. Is it really that unusual? I did see Dr. Paddy (Ananthan Padmanabhan) and Dr. Sleeper before I was taken back, but only briefly. I don't mind giving up control when I'm not responsible for the outcome.

The Morning

I leave for the hospital in about two hours. I managed to get all the prep solution down, and things ran through pretty fast. I had to get up a few times during the night, and I don't think I slept at all. This morning, my tummy is still rumbling, but I've only been passing gas. My last BM was very liquid, and just a pale yellow, so I guess I'm pretty cleaned out. I'm also hungry and feeling a little weak. And thirsty. No more water, even, since midnight.

Liz insists on staying with me at the hospital. I will be in the pre-op room for a couple of hours, and then the operation is supposed to last about three hours. After that I will be in the PACU until I'm ready to be moved into a room. So Liz won't have much to do for most of the day. I suggested she drop me off, and then come back in the evening. She argued that if the positions were reversed, I'd stay to wait for her operation. She's right; I would. But that doesn't make it smart. I'll be in the hands of the doctors and nurses, and there's nothing she can do until I'm in a regular room. But humans aren't always logical. Hardly ever.

I wish I could have slept last night. It would have made the time go faster. Liz is still asleep, but I expect she'll wake up soon. It's light out, and the birds are chirping. Besides, she gets to eat breakfast.

I didn't worry over the operation during the night. It was more over the need to get to the bathroom, and all that noise from my tummy. Now, I just want to get it all over. I look forward to trying to get out of bed and walk a few steps. Waiting, with nothing to do, kinda sucks.

Rumblings

After a small and healthy dinner last night, well, okay, a grilled chicken breast, carrots and broccoli, and a salad, not in that order, and I didn't eat any of the tomatoes in the salad, I went on the clear liquid diet plan. So, just drank juice in the evening. White cranberry.

I didn't sleep well last night. Maybe I am worried about the surgery. Maybe I'm worried about school. Anyway, I slept some, and got up around 7 this morning. I had a cup of chicken broth for breakfast. I went to school, and I had no lunch. I wasn't really very hungry. Another sign of nerves.

I got a few things together for my class today, and I checked the lab and email and puttered around to pass the time before lecture. I gave the lecture, even though I won't be there for the class for at least a couple of weeks. I told the students that. I didn't say why I wouldn't be there. I said I had something I had to deal with. I don't know how long I will be out. There is another faculty member with a planned surgery, a partial colectomy I think. Hers is in late April. She was told she would be out 5-6 weeks. Maybe I'm being optimistic, saying I might be back by Week 4. I don't know.

I had a few drinks of water at work. I drink from the drinking fountain. Some of the students, after they take microbiology, won't touch the fountain, but I'm not afraid of it. Besides, bottled water is not a sound environmental practice.

I started my final prep, SuPrep, when I got home. It was hard to get the whole pint of stuff down, and I keep getting these sort of waves of shudders when I think about it. I did drink the two pints of water after. My tummy is rumbling. A lot. I've visited the toilet three times, so far. I'm not sure when I should drink the second batch. I'm not supposed to have anything by mouth after about midnight, and I don't really want to stay up all night emptying my bowel. Maybe I'll do the second batch around 9.

I seem to be walking through this with a sense of fatalism. Maybe I'm just confident in my doctor. Maybe I don't care if I die. Maybe I just do what I'm told, because I know the polyp needs to go, and there's no sense in worrying over what might happen. It might not happen, too, and everything will be fine. And by tomorrow evening, I'll be ambling down the hall with a pillow pressed over my tummy, and taking a few deep breaths. Meanwhile, there's got to be something to see on NetFlix.

First Steps

I think my dietary changes and such are supposed to begin tomorrow, officially, but I've decided to start today. Nothing red or purple in my diet, not alcohol, and my last coffee was at breakfast this morning. Tomorrow, I think I'm supposed to be on clear liquids after breakfast, but I'll start that at breakfast. I had a couple of home brews last night, but won't tonight. I bought some white cranberry juice to sub for wine and beer.

Sharon asked if I would be willing to grill chicken breasts for dinner. I said yes. Do probably grilled chicken and salad for my last meal of real food until my gut comes back online after the operation.

Back when I was in school, I was sent to get a history and physical on a patient in the post-op ward. His belly was swollen. He had had an operation for an abdominal aortic aneurysm, and had a post-op ileus, so gases produced by the bacteria in his gut kept accumulating. You could tap on his belly, and it sounded like a drum. That could happen to me. Then I wouldn't be allowed to eat, or even drink, except sips to wet my mouth, until things started moving again. Not a happy prospect. I really hope I never stop farting.

I should take a walk today. I've spent most of the week sitting down. I've read a few books, and spent a lot of time on the computer, and hours every day watching stuff on NetFlix. I haven't been moving much. That's bad. I think the nurses will want me to walk the day after surgery, maybe even the same evening. So I could use the practice. It's good for us to move our bodies. I just haven't had anywhere to go. Or any desire to do anything. Maybe I'm scared, and trying not to show it.

So, plans for today: Drink lots of water, and maybe some juice or tea. Eat a healthy dinner, and possibly a healthy lunch before that. I already ate eggs, fried potatoes, and veggie bacon for breakfast. And a cup of coffee. My usual coffee, with cocoa, brown sugar, and half and half. Eggs fried sunny side up. Yummy breakfast. I slept in, so breakfast began around 9:30, and I finished the coffee around 11. So I don't need lunch, but I might nibble something anyway.

Continuing the plans. Laundry. It is Sunday, and I do laundry on Sunday, so I'll do that today. Take a walk, somewhere. And I will probably read, and watch TV in the evening. Yesterday, the evening began at 4. We watched X-Files, Star Trek, Haven, and Poirot. We took a break from watching when Sharon went grocery shopping, for an hour of intimacy. I have to wonder when I'll be able to do that again.

I'm having major surgery. So many things could happen. I could get an ileus, and not pass gas or be able to eat for days. The connection between the small and large intestine could not take, and I'd have a colostomy (or ileostomy) for a while (or forever). I could have serious abdominal pain, and never have sex again. Hell, I could die.

Or everything could go as planned and predicted, and I'll be up walking the halls by Tuesday evening, farting and pooping by Wednesday evening, and home on Thursday or Friday. I could be back to work in two weeks, grilling steak and drinking a bottle of Cabernet, and fucking my brains out before our anniversary. That is, if Liz is willing. I kind of wish I knew how it would all work out, but only if it is going to be good, and not too unpleasant along the way. If it's going to be bad, I'd rather not know ahead of time, and just live with it as it comes.

Time for the next batch of laundry. And maybe I'll take that walk.

Biding Time

I've made arrangements for my work to be covered while I'm indisposed. I worry that it might cause trouble for some of the students. I don't do well w.ith transitions, so I know what that can be like, but I should be taking over my own classes in a few weeks. Maybe I should take the whole quarter off. Maybe that would be easier for some of the students. Or maybe I should get back to work as soon as I can, after a week or two. I can't really take the quarter off. I don't have sick leave, and the short term disability will only pay as long as the doctor will sign off. Besides, STD only pays 60%.

I read the policy about time off. I want to rewrite it. I mean, the policy says something about working 40 hours a week. So can't I get credit for days missed when I work 50 or 60 hours in a week? Not what the policy says. It says, very clearly, that days missed must be made up during the next break. If not made up then, your pay is cut. There is no flexibility.

I can understand that. My dad was a school teacher, and talked about benefits, like sick leave. Teachers had a certain number of days. Some just used them, sick or not, each year. Days off, maybe for mental health. Others, like Dad, didn't use them, and stored them up over the years. When you retired, you could get paid for them, maybe half rate or something. I think Dad actually used a whole year of sick leave at the end of his career, after he had his stroke. But if you give employees sick leave, they use it.

With our benefits, it pretty much takes an emergency to get us away from work. Maybe that's better for the school. Lower rate of missing work. Kind of bad for morale, though, especially when we have to work over the break to make up missed days, even though we work more than the 40 required hours pretty much every week. I'd like to just tell Them (Powers-That-Be, bosses, whoever makes the policies), let me teach my classes and figure out my own schedule, and just pay me for getting the job done. Filling out two sets of forms, and paying my doctor to fill out his part, just so my job will be waiting when I get back is annoying. Makes me wonder if I shouldn't look for a better job.

I won't, though. Not right now. I've got this operation coming up, and the paper work is all done. Now, maybe I'm focusing on benefits, or detriments, and effects on students and stuff, so I won't obsess over the possible outcomes of the operation. And even that is just a distraction from my other distractions, books and TV. I know what could happen. I know it's likely everything will be fine. I know there's not much I can do, one way or the other.

I came up with another distraction for this evening. I asked a friend to dinner. She's a teacher I met a few years ago, not at my current school, but the one before. Then she came to my current school, and taught there for 3 years. She left a year ago, for health reasons. She was supposed to have an operation, but it has been delayed. I figure she will have some perspective on my situation, and it made an excuse to go out somewhere.

I'm not worried about the operation, but I could be if I tried. And I don't have much else to think about. That's kind of weird. I guess usually at this point, I would be thinking about classes next week, but when I'll only be there for a day, there isn't much to do to prepare. So I'm really glad there are lots of books I want to read.

Cleansing

I took some home brew to a bar last night, and spent most of the evening with recent graduates. They said they liked my beer. I had one, too, and I liked it. The pizza was also good.

One of the youngsters was on a "cleanse," so she didn't have a beer herself, but did take a sip. Her cleanse consists of dietary restrictions and some supplements. She is attempting to gain better control of her condition, hoping that she can find a diet plan that will allow her to avoid flare-ups and stop getting medical treatments. I hope she succeeds, but I don't think it will work. If diet could control Crohn's disease, I think someone would have figured that out by now.

But I could be wrong. Science hasn't solved all our problems. Science has given us new kinds of foods, like the modern wheat types that are mostly grown in America. But I read a book, Wheat Belly, that says this new wheat is bad for us. It was developed for bigger crops not for better nutrition. Those claims are also made by science. Science is not a united source of information, but a bunch of guys (mostly) trying to outdo each other in learning new stuff, and proving each other wrong as often as discovering something cool. A lot could be learned from studying diet choices, if anyone would pay for the research, but as there isn't much money to be made in the end if they just say, "Buy local organic," no one will want to pay for it. Return on investment is too distant from the field, being mostly in lower health care costs. Yeah, I've also read Michael Pollan.

I have cleanse coming up, but it is a bit more direct. Got to get all we can out of my colon before the operation. That won't be much fun. I picked up the cleanse kit yesterday, which is why I'm thinking about it. It's the same one I had for the colonoscopy, so I know what I'm in for. Nothing red, maybe starting Sunday, and clear liquids only on Monday, before the gut mobilizer Monday evening. I bought some white cranberry juice, just on a whim, so I could have something I like to drink.

Maybe when this is over, I'll start paying attention to my diet. I'll stop eating things that might cause cancer. I hear soaking meat in beer before grilling decreases the risk of cancer. I don't think that means that drinking the beer would also decrease the risk. Too bad.

Preparing for the Worst

When I went in for my doctor's visits, including for the colonoscopy, I was asked each time if I have a Living Will or other health care documents. I don't. But I wonder if I should.

I'm not very fit, because I don't exercise much. I have high blood pressure, or did before I started the meds. I have partially controlled depression, including chronic anhedonia. Sort of the opposite of a hedonist; I don't want to do anything. I do things, and I have fun, at least sometimes, but here I am, on "vacation" from work, and I sit in a chair and read, or stare at the computer screen. I watch a lot of TV in the evening. There just isn't anything I want to do. So, what's the point of continuing? Don't get depression; it sucks.

I could have the doctor make me DNR when I go in for surgery. The odds are (always in my favor), I won't code. I looked up the odds on what would happen if I did. Overall survival to discharge is about 17%, for all comers in hospital codes. White people in good hospitals with few major health problems do a little better. Half of those who make it to discharge go home. Neurological damage looked surprisingly uncommon in the reports I saw, but maybe a quarter have some loss of other function. The conclusion of one paper was that people who code have bad outcomes, which they do. 85% die, and another 8 or 9% go to a nursing home. Scary.

But what would I do in a nursing home? I suppose I'd sit in a chair and read books, or stare at something. Maybe not a laptop, depending what was damaged to send me there, and the in-house theft rate, but not that much different from my wonderful break from work. Maybe people would visit me. Maybe not. Maybe I wouldn't even notice.

I don't think I'll do anything, like make a Living Will. I can't decide what I should do, and, like with pretty much everything else, I don't want to do it. I'm not against having a Living Will; I just don't have a drive to take care of it. So I'll do what I'm told, and answer what I'm asked, and keep plodding on without any advanced directives. Just too lazy (code word) to get it done. Besides, the odds are, it won't matter. How often does the worst happen?