What did you do with your summer vacation?

As I mentioned in my last post I spent a little time in the middle of June outside of the hospital, but it was only a few days. Between June 8th and July 5th I basically spent every waking hour in the hospital or laying on the couch recovering from what had been promised to be a simple surgery. Now I am on the slow heal with a vacuum pump attached to my stomach as a large abscess heals in my gut.

Prior to my surgery I had made the claim that the big problem I have with allopathic medicine isn't necessarily the techniques but the fact that once they (the practitioners) have you in their grasp they hold on tight. Once you get healed you really are just establishing a relationship with the providers of this healing. A relationship that never ends and can demand more in more.

My current situation is the obvious case in point. Twenty years ago I had an emergency repair done to my spleen and kidney. As a result I earned a mainline incision along the middle of my belly that over time weakened (herniated). My simple surgery was a repair of the herniation from that twenty year old operation.



Three days after my simple hernia repair surgery they (meaning I) discovered that my GI system had actually frozen due to the shock and as a result everything I had consumed during those 3 days had to be brought back up the hard way (technical term: Ileas). Three to four days later after some meaningful time with a tube down my throat and anxious anticipation for signs of a fucking fart they let me back out of the hospital. That was when I made my last post.

Things seemed to be going swimmingly for a day or two. Sleeping on the couch on a bit of a ramp and kind of passing the days in a bit of a media consuming daze. The problem is I didn't start improving and I was having a strange belly pressure. By day three the pressure was not funny any more, and really had to be called significant distention.

"Ok, I can suck it up" is a bit of a mantra so I figured it was something I could just man up and deal with until sitting up for a meal and my friend noticing that I was leaking clear ooze. A race to the emergency room later (even I know when the time to man up is over and it's time to cry like a baby) and the pronouncement was dire (if a bit understated). I had contracted a little bit of a life threatening infection and if they didn't cut me open pretty quickly that could be the end of the Aragorn! experiment. Terror ensued and I woke up in the surgery recovery room.

A little sidebar about anesthesia. As someone who has had a half dozen trips through the surgical process in the past month I have learned a little bit about general and local anesthesia. For starters, and this pains me to say as a sXe person, but they are a lot more pleasant than would imagine them being. The transition from being a living, joking person to being a slab of meat on the table is faster and less humiliating than I would imagine. The worst part of it, by far, is the waking up. General anesthesia fucks you up. The transition back from wherever it takes you is hard. Your head lolls about, you drool and babble incoherently. You see shapes and colors (which perhaps is partially due to them robbing you of your glasses during the process) but little else. The staff running around are nice to the idiot but usually are taking care of people who are actually in distress. Your little lack of bearings doesn't rate to the actually sick people hanging out all around you. Fair enough, give it an hour and you are ready to be wheeled back to your room to phase back into three dimensions.

Local is much smoother. I wouldn't want to be placed immediately into an action movie after a little local surgery but there is nothing like the transporter room effect of total checkout-check-in like general. Add to that I didn't experience the drama of the actual surgery room any more coherently under local than I did under general and I strongly vote for a future of local anesthesia. Oh, I don't get to vote? Shit.

Back to the main story. After the surgery I didn't really come back until the surgical rounds of the next morning. I became well acquainted with the hospital processes during the next period. Every four hours a vitals (blood pressure, oxygen levels, heart rate, and temperature) check. Every shift change a nurse would come in, introduce themselves and right their name on the dry erase board. Every morning between five am and 6 am one of the front line surgical staff (Hierarchy: Surgeon, Resident, Intern) would come in and confirm with me the plan for the day (we are going to wait today and perhaps change your WoundVac ™) and then an hour or two later the entire team would swing by my room for rounds.

My guess is that I was pretty fun for the surgical staff. I was at a central hospital in Oakland where the bulk of the people who passed through surgery were old, very sick, and not particularly articulate. I, naturally, am jovial and as educated, in my way, as the surgical staff so most days was pleasant pop culture and sarcastic banter with the group unless a Surgeon was in the mix. Surgeons, as you can imagine, talk down from somewhere close to mount Olympus even when they have no fucking idea what they are talking about (which is the definition of watching someone recover from an infection you caused) but I had a good time coming up with nicknames for their behavior. There was Imperious, (creepy) Man pat, and the No-bullshit women in the Surgeon pool. The residents were far more numerous in their disposition with the only highlight being Manscape (as far as nicknames). I'm not sure they would be as pleased with their nicknames as I am...

The first morning of my lengthy hospital stay was mostly interesting because one of the surgery team actually looked at me and said "I have never seen anything like what we pulled out of you before." To whit they actually pulled over two liters of infected material out of my abdomen before they could pull out the material they used to repair my hernia in the first place. The abscess this left in my gut was probably the size of a grapefruit. All that was left was carpet bombing me with antibiotics until such time as my natural flora had been razed to the ground and allowing the giant hole in my abdomen to shrink to a manageable size (what size is this exactly?).

This took about 17 days. During this time I lost my humor about the whole situation.

Part of the Kafkaesque ritual of my leaving the hospital is worth retelling just for the insanity of it. Hospital technology has made a tremendous leap since my first surgery (almost 20 years ago when I was stapled shut. Ouch!). Significant wounds like mine are now literally patched with a kind of sponge that is taped in place and then put under vacuum (125 mg Hg for the nerds in the house). The product that provides this is called a WoundVac ™. The VAC is about the size and weight of a heavy small suitcase and gurgles and mutters along as it pulls muck out of you and maintains the pressure. They appear (I still have a VAC on) to use this device until you are damn well closed but there is no way I would be able to carry around one of the hospital units at home so the process began (once the idea of me actually leaving was on the table) to get me a unit to bring home. My 'case worker' (HMO speak for bureaucrat who wants you out and wants to bill you) informed me that there would be a significant 'co-pay' for the ability to go home (with a VAC) OR I could go to a nursing home in my general neighborhood and get VACed for free. They then informed me that they were going to disconnect me from the VAC, wrap me in gauze, and within 48 hours a nurse would arrive and attach me back to my portable VAC (called an ActiVAC ™, aren't they cute?). The surgeons then told me that they didn't want me to be off the VAC under any circumstances so an impasse was created. On the one hand the cold hand of the hospital wanted me out, were going to charge me for the privelage, and didn't particularly care that it wasn't in my medical interest to leave on their terms. On the other were the reasonable surgical staff (note that the actual Surgeons did not get involved in this problem, probably due to the legal issues and their imperious nature) who wanted me to leave the hospital with a portable VAC in place.

Of course the hospital doesn't seem to HAVE any portable VAC's in house so the actual portable VAC had to be delivered by some roving medical delivery service to my home. The solution to the impasse could finally be reached. Upon delivery the ActiVAC ™ was raced to the hospital and the surgical staff, under cloak of night and fear of rebuke, attached the actiVAC to my body and then, finally, sent me home.

I'll save the later parts of this story for another time but suffice it to say that my time under the knife, or away from the hospital, did not end after my 17 day sojourn. It probably is still not over nearly six weeks after my initial, simple, surgical operation to repair a hernia. On the plus side I can say that I have lost over 20 pounds on the starving vegan hospital diet and have material from the recently dead tucked away inside of me waiting for its chance to launch us into a bad B-movie. Those are good things, right?

• Posted: 17/07/09 08:21PM
• Category: Personal

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