The Cancer Diaries, Part 11

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Three Stooges, nyuck, nyuck, nyuckAnaesthetic must be one of the most remarkable inventions of the 20th century. While various forms of anaesthesia have been used since the ancient Egyptians (with varying degrees of effectiveness), it really wasn’t perfected  until the last century. It’s difficult to imagine the horrors of surgery before it became commonly used and as effective as it is today.

Here I was, lying on a table in the operating room, Thursday morning, being covered with a warm blanket by one nurse, while another nurse held a mask over my face to breathe from, and a third prepared to administer my anesthetic via the IV drip (that spelling is for my American readers). The latter nurse said, “In the next thirty seconds you’re going to drift off to sleep…” And then I did. Lights out, like flipping a switch.

Sleep. Mercifully deep and absolute. No dreams, no tossing and turning. No having to get up to pee three or five times. No pushing the cat or dog off my legs. Don’t feel a thing as I am poked and prodded internally. Just sleep.

And then I awoke. Just like that: bang the shutters of the eyelids popped open and I was awake. No slow rise to consciousness, no lingering dream state. No memories either, just a sort of ellipsis between the operating table and the recovery room. And just like that, my surgery was over. Amazing stuff, anaesthetic. Where was I? Ah, yes, my latest surgery.

I know there are readers in the world, as well as many other good people in it, who are no readers at all, who find themselves ill at ease, unless they are let into the whole secret from first to last, of everything which concerns you.

That’s from Chapter IV of Laurence Sternes’ delightful 18th-century novel, The Life and Opinions of Tristram Shandy, Gentleman, more commonly simply referred to as Tristam Shandy. I’m reading it right now, among other books, and this bit amused me. He continues, apologetically, 

It is in pure compliance with this humour of theirs, and from a backwardness in my nature to disappoint any one soul living, that I have been so very particular already. … [I] therefore must beg pardon for going on a little farther in the same way: For which cause, right glad I am, that I have begun the history of myself in the way I have done; and that I am able to go on, tracing everything in it, as Horace says, ab Ovo.

From the egg, that Latin bit from Horace’s Ars Poetica; means from the beginning. So to follow in Shandy’s (or rather Sterne’s) literary footsteps I must go back a bit and explain for those who have not read the previous ten pieces on my cancer, why I was on the operating table again. Put it all in perspective, as it were. I do recommend you read the previous entries, however, to get a more robust story than this precis.

Back in the late winter, my PSA test came back alarmingly high and suggested prostate cancer. Like a fire alarm suggests a blaze.

This was confirmed by a subsequent biopsy. After which followed surgery to remove the offending organ, but which also failed to entirely remove the cancerous cells. A couple of weeks followed with a catheter and a urine bag and an infection.

Further treatment was mandated but I had to wait while I endured the subsequent weeks of slow recovery. But just as I was feeling right again, to complicate matters, my urine flow diminished to an annoying slow dribble during the last few weeks following surgery. 

The urologist was concerned. He performed a cystoscopy: basically sticking a camera on a tube into my urethra to look for the problem: an unpleasant and undignified but not terribly painful procedure. He found a small stricture where he had sewn my urethra back onto my bladder during the prostate removal. Scar tissue from the long-dissolved sutures, I suppose, had constricted the passage. He needed to operate again, to fix it by zapping part of it with a laser so it would relax. Like an elastic band returning to its normal state, I suppose.

Fast forward to now. The surgery was quickly scheduled. We drove to the distant hospital early in the morning. After leaving Susan waiting in the car in the parking lot (with her book and iPad to keep her occupied), I dutifully appeared at the hospital entrance two hours ahead of time. After screening, I waded through the viscous-but-necessary bureaucracy, and began the preparations necessary to get into the operating room. I had to change into the gown, (removing even my underwear but keeping my socks), have blood samples taken, an IV inserted into my hand, and then to sit and wait. And wait.

Note to others: you should bring your own clothing bag, something with pockets to put things in for easy access. I have a small, soft overnight bag with external pockets that hold my phone, my health card, books, and my glasses. The side pockets are large enough to hold my shoes, too (wear slip-ons if you have them). I also bring a couple of plastic bags to put the underwear in, and anything else (shoes if they don’t fit the side pockets). And bring a book. Or two.

I was bemused by the number of people who sat in the waiting rooms staring at their phones instead of bringing a book or at least a magazine. Sad, really. It was mostly people my age and older who brought something to read, while younger people had just their phones (or failing that, desultory glances at the TV tuned to some mindless show; most phone-addicted people ignored the set, however). People with only phones to stare at have the look of Dante-esque abandoned souls, clinging on their technology like some of his damned clinging to a raft of shit in a burning sewer. There was the muted sound of tap, tap, tap on their virtual keypads as they tried to find a connection in their digital life. People who used to walk down the street talking aloud were called village idiots not long ago. Now they’re just on the phone.

I was prompted to wonder if reading books will become a lost art in a few generations, like writing in cursive. I had brought four books (the top four in the pile on the left) so I could read a bit of fiction and nonfiction. And it was a good thing, too, because my surgery was delayed by an hour. I was able to read several chapters in all four books, although a few times I wished I had brought the Sterne I was reading instead of the Stevens which I had not begun. 

some of the current reading listBe that as it may, I awoke post-surgery and was able to read for about an hour before I was released into Susan’s care for her to drive home. I found the nurses and volunteers at RVH friendly, chatty, and engaging. We chatted about books and reading, too. Conversation is important, maybe as important as anaesthetic to the patient.

The human connection makes it all more bearable; the welcome, the small talk, the jokes, the little chats while you’re on the beds are all important to patient health. Face it: surgery is stressful no matter what the procedure. There are machines, strangers, cold rooms, inexplicable devices, and the dry formality of paperwork — all of which contribute to a sense of isolation and separateness. The nurses, support staff, and volunteers help humanize the experience. make it less threatening, less impersonal.

I am not afraid of any procedure — in fact, I can be annoyingly curious to know what’s happening — but having someone to talk with at times before and after makes me less anxious, more comfortable. And at RVH, they certainly made me feel relaxed simply by taking the time to chat for a few moments, rather than rushing off to do their jobs.

I awoke in recovery room one, still covered by the blanket, with a daytime urine bag strapped to my right leg. I would have to change that once I got home because (as the euphemism goes), I dress left. Not that there’s much to dress these days, but decades of pointing one way makes it feel odd to point the other.

In room one nurses check your vitals and figure out if I’m okay and came through everything reasonably well. Apparently I passed this test, and my clothing bag was placed on my bed. I was left to read for a few minutes. I may have been there longer than I can remember, but a side-effect of anaesthesia is that memories don’t coagulate well in the first few minutes after waking up. I had been told I would remain there for 30 minutes, but I honestly can’t remember.

Eventually, I was wheeled into the second recovery room where the first thing a nurse asked me was if I wanted a banana popsicle. Not really being a popsicle aficionado, I declined but asked why banana. It was all they had left, she said.  Strange; I didn’t pursue that line, however. We chatted a bit, speaking about books and reading. When she went to tend to other patients, I read some more. Other nurses and helpers dropped by, some just saying a few polite words; others chatty. It made the recovery much more bearable.

Although lying there reading was pleasant, I couldn’t stay. After a short time, I was helped up and the drapes pulled shut so I could change back into street clothes. Susan was called to bring the car around, and I was wheeled to the entrance by a young volunteer. Also friendly and chatty. Susan took my bag, said thanks to the volunteer, and drove me home.

Anyway, here I am again. Typing at a computer with another damned catheter in my penis, and a urine bag strapped to my leg, checking it through my pants’ leg to see if it’s filling. Sigh. Have I mentioned how much I dislike catheters? Not just wearing them, but having them removed. Well, this one comes out Monday morning, and I have to take it out myself. That’s probably a post in itself. I was sent home with a small booklet on care and removal (something not provided last time, but should have been). Not really looking forward to that. And I’m a bit worried because I’ve expressed a small amount of blood from my penis, suggesting there’s an unhealed wound in there (can’t call the doctor’s office to ask: it’s the weekend).

I am becoming somewhat of a pro in the daily routine of changing bags, draining them, cleaning them, strapping them to my leg, applying Polysporin. I have to sleep on my left side so the urine drains at night, though, and that gets uncomfortable at times. I fidget and toss instead of sleeping. And sitting on anything too solid can be uncomfortable because doing so presses on the catheter. However, I still worry about a UTI (urinary tract infection) because I’ve had one the last two times I wore a catheter.

And on top of everything, I’m constipated; it has been for me an unpleasant side-effect of surgery both times. My body groans and aches from the stoppage. That just adds to the general misery. It will end, I hope, after a gentle laxative coaxes it along. (UPDATE: Whew. That passed. Literally. it was becoming g painful and costing me sleep. It left with a little help from RestoraLAX…)

Once I have the catheter removed next week (hooray!) and the doctor feels I’ve recovered sufficiently, I can move on to other treatments. Radiation, perhaps hormonal. I don’t know yet. I’ll await the call from the doctor’s office about how we proceed. Stay tuned.

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