30 Day invisible illness challenge: Day 27

Day Twenty Seven

What's it like having a pelvic laparoscopy? 

Surgery is scary

I modified today's question, because surgery is almost inevitable if you have endometriosis. Hell, you can't even get diagnosed with the disease until you go under the knife. Nowadays, endometriosis can be treated with a pelvic laparoscopy. Laparoscopy refers to the use of a laparoscope to perform the procedure. This is leaps and bounds from the old use of a pelvic laparoptomy, where the patient receives a large incision, or "open surgery". Pelvic laparoscopies are "minimally invasive" the surgery is performed with usually two to four tiny "keyhole" incisions.

Still, surgery is surgery and there are many risks involved in pelvic laps. In a pelvic lap, you're put under general anesthetic, which has its own associated risks. To me, surgery is terrifying, and I am so thankful for minimally invasive surgery. I have had two pelvic laps, and I found them to be very painful. After my second surgery, I awoke in the recovery room in so much pain. I remember there was a sassy nurse that told me I was maxed out on morphine, but I was still so sore. I was pleased to have lost consciousness. The pain killers I take on a daily basis (like T4s and Tramadol) are "heavier duty" than the ones I was given in the hospital (I was given T3's which have half the amount of codeine than T4's) so in-hospital recovery from surgery #2 was paaaiiiiiiinfulllll. I couldn't imagine the pain following open surgery. 

A pelvic laparoscopy. No fun, but better than a laparoptomy.

I want to share with you guys what it was like to have surgery for endometriosis. It's kind of exciting, in a horrifying potentially life threatening kind of way. 

Before surgery, you have to fill out some forms. Mostly consent forms. Surgery, even the minimally invasive ones, have risks. Pelvic laparoscopies have a mortality of about 0.05%, according to surgery.com. Those are some good numbers. Though hemorrhaging is always a big risk in surgery. 

Before you go in for an op, your surgeon explains all the risks. They also talk about recovery, and what to expect. In all honesty, I get a bit overwhelmed at this point. In August 2013, my boyfriend took me to the Foothills Hospital for my 2nd surgery. I was in a ridiculous hospital gown and I met with my specialist (who was performing the surgery) pre-op. He put a hand to my knee, and we went over the procedure. Again, so scary, and so overwhelming.  

Surgeons always ask if you have any questions, and this is me, every time: 

As I said before, surgery is scary to me, and there are a lot of things that make me nervous. First and foremost, my biggest fear about surgery is "anesthesia awareness". What is this? Let the mayoclinic explain. 

Estimates vary, but about 1 or 2 people in every 1,000 may wake up briefly while receiving general anesthesia. The person usually doesn't feel pain, but is aware of his or her surroundings.
In very rare situations, some people experience excruciating pain in spite of general anesthesia. In this situation, because of muscle relaxants given prior to surgery, people aren't able to move or speak or make others aware of their distress. Some people may develop long-term psychological problems, similar to post-traumatic stress disorder.

This is terrifying to me, and it was on my mind before both surgeries. It's on my mind now, and I don't even have my next surgery booked yet. To me, this is more terrifying than not waking up at all. 

So surgery. What's it like? 

When you're admitted to the hospital, you have to do a blood and urine test. They're testing for pregnancy, etc. You can't eat or drink for about 12 hours prior to the procedure, so you're hungry and thirsty, and it's hard to provide a urine sample at that point.Then they put a stack of fancy hospital bracelets on your wrist, and you're taken to day surgery. Then you get even fancier when you put on the backless hospital gown. 

so fancy.

You're put into a bed, then a porter takes you to pre op. I got lucky and had a flaming gay porter take me to pre op for my first surgery. He was awesome, and we chatted flamboyantly about hospital stuff or whatever.

For my first op, the experience was a bit terrifying. Pre Op was a dismal room with sick patients laying beds waiting for their surgery. Everybody is terrified. You answer so many questions in this room. All the staff asks you the same question repeatedly: what are you having surgery for. And it's not because they're clueless-- even the surgeon asks you this. It's to make sure you're in for the right op, and to make sure you know what's going on. 

The operating room is the worst part. Operating "theaters" are extremely cold. It's like being in a meat locker (ok, not a meat locker, but it's so cold in operating rooms). There's always a lot of staff in there too. For my first surgery, I had to get out of the hospital bed and get on this super narrow stainless steel table. Above you are these huge lights, and all around you is strange and unfamiliar equipment. 

For my first surgery in 2011, the surgery prep was done by this wonderful granny nurse. She was old and so kind. She made me feel a bit less nervous. She put electrodes on my chest then she put an IV line in my wrist, and then the surgeons and doctors started coming in and milling about. I find operating rooms to be terribly scary. The metal table was cold, I had needles in my arms and electrodes on my bare skin. And then the granny nurse (bless her heart) put an oxygen mask on my face. She explained that it was just oxygen and I should relax. I cry before I go under. Both times, and even during my ear surgery as a child. Going under is scary and I dislike it. You're in a big, cold, scary room with beeping machines and doctors in masks are milling about. Then, a mask is on your face. The anesthesiologist injects a drug in your IV line, and for a moment, a very brief moment, you feel yourself slipping away.

After surgery #1 I awoke in the recovery room like a wild animal.  I awoke to a nurse trying to put disposable underwear on me. I kicked fiercely, trying to kick her. She got angry (I suppose I can see why) and said she just wanted to get some underwear on me. I passed out. I'm always in and out of consciousness in the recovery room, and never remember getting to day surgery. I pass in and out of consciousness there, until family arrives. After my second surgery, I awoke in the recovery room with a number of doctors looking down on me. The intern that had screwed up my IV line pre op was there, and doctors were saying "Danielle, we need you to breathe." I was confused. "Danielle, we need some big deep breaths from you." My legs were wrapped in these odd devices that squeezed and released, like blood pressure cuffs. I think they're used to prevent clotting in your legs post surgery. Again, "Danielle, breathe. She's not breathing." I remember thinking what are you talking about? I'm fine. I fell out of consciousness and awoke later to the recovery room staff talking about the Honey Badger youtube video. They were laughing and it felt like a dream. I saw one of my customers from the pet shop, who I had helped just the night before! He was part of the recovery room staff. We smiled at each other and he asked how I was feeling. He called me the Pet Store Girl (the name stuck, by the way).  

Waking up in the recovery room and seeing doctors surrounding you, fussing over you, telling you to breathe...

I remember feeling just awful after my first surgery. I had been in surgery for a little over 4 hours. It was a long operation. The tennis ball sized endometrioma I had in my left ovary had ruptured during surgery, so it took a lot of suction to clean the blood out of my pelvis. The surgeon didn't touch the endometriosis in my pelvis (which she described as being extensive) and I've been told that her not doing anything to treat my endo while I was in surgery is medical negligence.

When I come out of surgery, I drift in and out of consciousness for a couple hours. Then I wake up in day surgery, and it's time to investigate the damage. It's like inspecting yourself after a horrible accident. You take inventory of yourself and assess the damage. After both surgeries I had a tender, bloated tummy. In surgery they inflate your abdomen with Carbon Dioxide. The inflation makes room for the surgical tools and gives the surgeon a good look at your insides. After both operations my tummy was not only bloated, but bleeding. The incisions bled through the steri strips, gauze, and hospital gown. Not a pretty sight, considering the iodine stains your tummy yellow and there's usually bruising around the incisions.

After op #1, I vomited when I tried sitting up in bed. I was on constant heavy pain killers and I grew faint and sore when I was sitting up or on my feet. My father took me for a "shuffle" around day surgery. I leaned heavily on my IV line and I was pale and green in the face after a round. I had to stay overnight after that surgery. And let me tell you, overnight stays in hospitals suck. I had a grouchy nurse that night, and I was waking up every hour or so. Op #2 wasn't so bad, and I was anxious to leave the hospital as soon as possible. 

I discovered that I get a sore throat after surgery, and it's actually very common post op. When you're under general anesthesia, they insert a tube down your throat. The tube is called an endotracheal tube and it's necessary for the patient's breathing during surgery. They insert the tube before surgery, when you're deeply sedated. 

It's a really flattering look.

One thing that I learned that's kind of freaky cool is that your eyes are taped during surgery. My eyes were taped shut!? Why is that? It's to protect your eyes from drying out, and to protect them from any damage. Even in the case of a pelvic lap, there's a lot going on around your face. When you're in surgery, you're given some serious muscle relaxants. When you're paralyzed like that, you won't blink and your eyes will fall open. 

I feel you, bruh.

Surgery is weird. Right before you go under, you're suddenly so aware of how vulnerable you are. You look at your anesthesiologist and think oh christ my life is literally in your hands. Don't fuck up. You know that you're naked and vulnerable on a little table, tubes in your throat, eyes taped shut, and your vitals on a beeping screen. It's..... scary, to say the least.

My Stupid Surgery Album 

My bloody incisions are healing a couple days post surgery, 2011.

Post-op in 2013. I was really high on morphine. Like, blitzed.

Yeah, my boyfriend gave me a hickey right before surgery. The doctors found that a bit funny.

I had only 3 incisions for my 2013 op. I had 4 for my first.

My bloated, bruised, and tender tummy post op 2013. The X shaped scar is still very visible.

For some reason, I got a lot of bruising around my incisions in 2013.

Now, I have 7 surgical scars on my tummy. I'll be having a third operation soon, but the surgeon mentioned reusing old entry sites, so hopefully I won't get any new scars. Surgery is very scary, but it's worth it. 

The operating room, named “Theater 612”, is cold. I lie on the narrow bed, staring up at the large, bright lights meant to illuminate me; the patient. The only sounds I am aware of, in my state of fear, is the air-conditioning and my own pounding heart. I feel a lump rise in my throat as a nurse comes to my side and takes my blood pressure. It is so cold in this room. I am self-conscious because my breasts are pointy beneath this thin hospital gown and my hair is standing on end.  I can’t bring myself to further explore this room with my eyes. I stare at the enormous lights, far too bright, and focused on calming my pounding heart. Another nurse, an older woman, is by my side and warns me that “this will be a bit cold.” I don’t watch as electrodes are placed on my chest. I’m sure she can feel my heart pounding wildly. How can she not? I’m sure all my arteries will burst, my heart is beating so hard.

The electrodes are secure on my chest, and a young man is at my side and tells me he’s here to insert my IV. I watch as a long, thin needle is pushed onto the top of my hand. The pressure is painful and I roll my eyes to the side in an attempt to avoid tears leaking from my eyes. He withdraws the needle, and slips it instead into my wrist. This is more comfortable, and I am calm as he tapes the tubes to my arm. My surgeon stands at the foot of the steel bed, a tired smile passes over his face. He puts his hand on my cold foot, gives it a squeeze, and asks if I’m ready.

“Take good care of me” I say, my chin trembling pathetically. He smiles under his gruff grey mustache. I notice the deep lines in his weathered face and I try to relax.

“Of course” he says, and then the anesthesiologist puts a mask over my face.

“Breathe deeply” she says, and tears leak from my eyes. My surgeon is now holding my hand, and I give it a squeeze. Deep breath in, concentrated oxygen, and now I’m light headed. I squeeze his hand, I think of my boyfriend, of riding my horse, I think this will be over soon. My head is light. I’m dizzy. I’m floating.