Hospital: Surgery and post-surgery

This article is part two of a three-part series on my hospital experiences. Part one is called A day in the life, and part three is Recovery at home. When we last left our hero, he (that is to say "I") had been in the hospital for over 5 weeks and was getting pretty tired of being there.

24 Hours Notice

For the entire month of February, Gail and I kept asking the doctors what would be happening next, mainly to try to figure out when I could go home. They told me I'd eventually be getting my gallbladder out, but they couldn't tell me whether that would be days, weeks, or months away. The most common answer to any of these types of questions was "We'll just have to wait and see". At one point near the end of my stay, a nurse told me that I had been very patient through this whole thing (I guess I was a patient patient HA HA HA) but the truth is that I had no real choice. All I had heard for five weeks was "wait and see", so my options were (1) be patient or (2) go insane. At the beginning of March my stomach seemed to be growing larger and more uncomfortable. The doctor said that a pancreatic pseudocyst was forming, and all of the dead tissue from my pancreas was collecting there, as well as blood and other fluids and stuff. On March 15th I was told that they wanted to do surgery tomorrow to remove my gallbladder and drain the pseudocyst. By this point, I was getting quite uncomfortable so I welcomed this news. Not to mention that this was the first step in actually solving the problem – all the ultrasounds, CT scans, and X-rays were just for diagnosing it.

The surgery began around 4:20pm on March 16th and went for a couple of hours, followed by about three hours in recovery. They wheeled me down to the operating room in a stretcher and Gail stayed with me as long as they would let her. But eventually they told her she had to go to the waiting room and they wheeled me into the OR. They hooked my IV up to the anaesthetic, and then the anaesthesiologist put a mask over my face and said "You'll be under in ten seconds". I didn't make it to five. The next thing I knew, I was waking up in the recovery room several hours later. Gail, my parents, and my sister were all in the waiting room the whole time and they all remember the exact moment that Dr. Pace walked in after the surgery. He wasn't smiling. They all stood up and walked over to him. He took Gail's hands in his and the first thing he said was "It was a mess in there. <pause> But he's going to be OK." The pause only lasted a second or two, but they all remember what they were thinking during that time. Gail thought "Oh God, either he's dead or the surgery didn't go well". My sister figured that both Gail and my mom would collapse and she was trying to decide which one to catch. Perhaps if Dr. Pace had reversed the order of those two statements, some momentary anxiety might have been avoided.

I had figured I'd be mentally out of commission (i.e. either sleeping or awake but incoherent) the rest of that day and part of the next day, but once I woke up in recovery I was pretty much alert. I remember being wheeled back to my room and when I saw everyone, I attempted to be as upbeat and chipper as possible to convince everyone that I was OK. I didn't think about the fact that I'd already been out of surgery for a few hours, and everyone else knew far more than I did about how it went. My gallbladder was removed, and most of the pseudocyst was drained. I almost fell over when Gail told me that four litres of "stuff" was taken out. Four freaking litres. They couldn't simply remove the pseudocyst because it was physically attached to my pancreas and as far as I know, it's still there.

Tubes, Staples, and a Pain in the Ass

I lifted my gown the next morning to see that my abdomen was covered with bandages, and I had two drains in – a "J2" tube and a T-tube. I don't remember what the J2 tube was for, but it was basically a little plastic bulb. The T-tube went from my common bile duct out through my abdomen into a bag to drain off the excess bile that would normally have been stored in my now-absent gallbladder. The J2 was only there for ten days, while the T-tube was there for several weeks, even after I was discharged. I also had yet another tube up my nose which went to my stomach but this time rather than pushing nutrients into my stomach, it was pulling stuff out. This was, again, to make sure my stomach stayed empty to let the pancreas rest. When I had the bandages changed the next day, I saw the actual incision for the first time – a long nasty-looking cut with staples holding it closed. The staples (all 43 of them) were removed on March 29. My sister Trudy had had abdominal surgery a couple of years before, and she told me that the staples were similar to your standard paper staples, but longer and had little hooks on the ends to make sure they didn't come out. When the nurse came to take the staples out, she couldn't figure out why I was so nervous about it. I kept asking how this was going to work and she showed me the tool she was going to use to do it, but I was still nervous. Eventually I asked about the hooks on the ends of the staples, and she had no idea what I was talking about. Turns out that the staples I got did not have hooks, so they just looked like three sides of a square. The tool would bend the middle one, forcing the other two up (making the whole thing look like a capital M) and straight out. No pain, no discomfort, and the whole thing was done in maybe 15 minutes. I was ready to call Trudy and yell at her for scaring me but she assured me that her staples did have hooks, and by the end of our conversation, she was ready to call her doctor and yell at him.

About a week after surgery, I had a CT scan that showed that there was a collection of fluid in my pelvis. The doctor said that they were going to put another drain in, but it might be uncomfortable. The best way to do this would be to go through my buttocks. So they inserted the drain by putting a needle straight through the middle of my right butt cheek. This was done in the CT scan room – I lay on my left side in the CT scan machine. They took a scan then started to insert the drain. Every now and again they'd stop, take another scan to see where they were, and then continue. After my surgery, I was given a pain pump, which was a machine on an IV pole that dispensed a measured amount of painkiller whenever I pressed a button, so I could control how much I was getting. Of course, there were some rules – pressing the button more than once every five minutes would do nothing and if I pressed it more than some number of times in an hour, it would lock out and have to be reset by a nurse. During the insertion of this drain, I forgot about the second rule, so I stared at the clock and pressed the button precisely every five minutes. About halfway through the procedure I hit the second limit (though I didn't realize it) and so all button pushes after that did nothing. This meant that I was getting no additional painkiller for half of this procedure. As a result, this was the most painful thing that happened to me during my entire hospital stay. The fact that the radiologist hit my sciatic nerve twice didn't help. Once they were done, they padded the hell out of my butt so I could still sit down comfortably, and I had another bag to pin to my gown. But this one didn't drain much at all – a few mL a day - and Dr. Pace (who was on vacation when it was put in; another doctor made the decision to do it) told me later that it was either put in the wrong place or entirely unnecessary. Great.

On March 29, Dr. Pace told me after yet another CT scan (I had a ton of those) that there was still a gallstone in my common bile duct, and it was likely the one that caused all the problems in the first place. There were three ways to get rid of that stone: (1) put a scope down my throat, (2) put a scope in through the T-tube, or (3) as a last resort, more surgery. Two days later, I had an ERCP (endoscopic retrograde cholangiopancreatography) – this was option 1 above. He couldn't remove the stone, so he put a little cut in the bile duct so that the stone would fall through into my intestine where I would eventually pass it. The next day I had an X-ray, and the technician said that the stone was still there, but Dr. Pace said this wasn't too surprising and that I shouldn't worry about it.

Get Out Of Here

By this point, I was really ready to go home. Dr. Pace had acknowledged this, saying that I had "hospitalitis" and he would try to get me home as soon as he could. He had also mentioned the possibility of going home temporarily – he could give me a "day pass" so I could go home in the morning as long as I was back in the evening. They had been preparing me for discharge as well – the J2 tube was gone, the T-tube was still there but clamped, I no longer had anything up my nose, and even my IV had been removed. I assumed that the one remaining gallstone would have to be gone before I could be discharged, so when the tech told me it was still there, I was quite disappointed. This was April 1st, the day before Good Friday. I figured the X-ray techs would all be gone for the Easter long weekend, so I wouldn't be able to have another one until Tuesday, which meant I wasn't going home until at least then. First thing the next morning, Dr. Pace came into my room with some surprising news. "It seems you have been given some incorrect information", he said. "The stone is gone". In my mind, I jumped up and did some cartwheels around the room. In reality, it was likely nothing much more than a little fist pump and a muttered "Yes!" before Dr. Pace asked the Dumb Question of the Day: "Do you want to go home today?" I decided that "Duh!", although correct, wouldn't be an appropriate answer, so I just said "Sure!" and he went off to begin the discharge paperwork. I called Gail and asked her the second Dumb Question of the Day: "If it's not too much trouble, would you mind coming to the hospital to pick me up?" She was happy enough because she thought I'd gotten a day pass, but when I told her I was being discharged, she almost dropped the phone. She and the boys were in the van within minutes. It was exactly eight weeks after I was admitted.

After getting some prescriptions and arranging for a home care nurse, I got dressed in something other than a hospital gown for the first time in two months. Bending over to put on and tie my shoes was a challenge and I almost asked Gail to do it for me, but I persevered and did it myself. I remember the feeling of walking out the front door of the hospital – it was as if I'd been released from prison. Gail asked if I wanted her to bring the van around so I wouldn't have to climb the four stairs into the parking garage (it had also been two months since I did stairs) but I decided if I could tie my shoes, I could climb four stairs. The van ride home seemed quite bumpy – for the next few weeks, any bump we hit while I was in the van caused discomfort or pain in my belly. But by 2:00pm I was home, and we had my parents, my sister, and Gail's parents over for dinner that night. They probably had barbecued burgers and potato salad and stuff like that for dinner, while I had a small bowl of soup that I couldn't finish. But that night I slept in my own bed, with my family less than 45 minutes away, and it was fabulous.

Coming up next, the series finale: Recovery at home.