Monday, October 10, 2011

Surgery

I don't remember much from the day of the surgery.  Maybe due to my nerves, maybe because there wasn't much to remember on that day.  Maybe because those were the freshest memories I had at the time of the surgery; the ones, I'd been told, I'd be most likely to lose. 

I think it was around 10AM.  I went straight from the hotel to the hospital.  They brought me to a small corner of a crowded room and had me sit on a tiny bed surrounded by machines, separated from the clamor by a thin curtain.  I could see the city through what little of the window remained exposed, the venetian blinds nearly all the way down.  I had to remove all of my clothing and put on a hospital gown, and socks with a rubberized texture on either side.  My clothing went into a long, dark-blue bag with a zipper running down the front.  I couldn't help but notice how much it resembled a body bag.  A nurse gave me a few final tests to make sure I was ready for surgery.  Blood pressure, that sort of thing. 

Then I was in a hospital bed, being wheeled through the hospital by a kind nurse and orderly.  We chatted during my trip.  Light conversation, jokes, my defenses of choice.

In the operating room I met my nurses.  One of them went by one name only.  "Like Cher?," I asked.  They laughed at that.  I can still remember their eyes.  Their faces and heads were covered of course, but I could see their eyes.  They warned me that I would feel a pinch, and they started inserting the IVs.  Three of them, judging by memory and by the three tiny scars I now carry, one on the back of either hand and one on my right wrist, for the arterial IV.   I remember staring up at the fluorescent lighting in the ceiling, focusing on how I felt, trying to watch the anesthetics overtake me.  If I succeeded, I do not remember.

The operating room was state-of-the-art, specifically designed for treating gliomas.  During the operation I would be resting on a bed attached to an arm so that they could rotate me into an MRI right there in the room, and check on their progress in the middle of the operation, without even closing my head up.  I was told that my head would be secured using some sort of gel, which I believe since I was picking the stuff out of my hair for weeks to come.  Based on my own research and from watching a web seminar given by Dr. Brain in the days following my surgery, I now also believe some sort of vice-like device was used to hold my head still, as evidenced by three scars on my head, one behind the left temple, one behind the left ear, and one behind the right ear.  They never mentioned these to me, nor did they provide sutures.  The first we learned of them was from my mother washing my hair and exclaiming, "there's a hole in your head!"  A rather reddish, angry hole, to be precise.  They have now healed, but I doubt the hair will ever regrow. 

From what I understand, I was under for about nine and a half hours.  Only about five of those involved surgery; the first four and a half had me waiting for the doctor, something to which I have become quite accustomed though I do wish they'd have the courtesy to knock me out every time.  Five hours is about average for a surgery of the sort, and while I apparently bled a surprising amount, there were no complications.  Even so, they had no idea how it would turn out until I actually woke up.  After the operation, Dr. Brain met with my parents to tell them how it went and to again try to prepare them for all possible outcomes. 

The incision is in something of a hook shape, staring beside my left ear, right up my sideburn, then curving around just behind the hairline until it reaches the very center of my forehead, stopping right at the hairline.  It was sutured with 45 staples, which now sit in a small jar on my shelf.  A small piece of my skull was removed, then later replaced with a series of four titanium plates.  "Plate" is a generous term, as they're really just small tabs used to connect pairs of screws.  I can feel them under my skin.  The tumor contained a few cysts that had to be drained before resection, thereby changing the shape of the mass, which again shows the value of the in-OR MRI.  Dr. Brain was able to remove 98% of the mass, but did not operate on the right hemisphere or the corpus callosum, nor did he attempt to scrape any lingering cells from a pair of large blood vessels that the tumor had been pressing against (possibly the cause of my migraines).  The mass was preserved and frozen so that it could be analyzed for a pathology report, which would tell us precisely what we were dealing with and inform us as to how we should proceed.  I would later donate the leftovers to the cancer center for research purposes. 

Given the amount of brain that had been removed, the painkillers in my system and the lingering anesthetics, I remember waking up surprisingly well.  In particular, I remember being surprised that I immediately knew where I was, why I was there, who was around me, and that for all intents and purposes I felt pretty much normal.

Which was really very fortunate, because my hospital stay was so bad it literally lead to an investigation.

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