Tuesday, October 11, 2011

Waking

I'd been warned that I might awaken slowly, bit by bit.  They said I might regain consciousness before I regained any motor functions, even the ability to open my eyes.  Instead, I came to with such clarity that I noticed that was not what had happened even as I said, "Hi Mom."

There had been no guarantee that I would recognize her, or anyone, or that I'd be able to speak, or even that I'd ever wake up again.  My next words, to my father, "Am I dead?"  That, in relation to some conversations I'd had with him before the surgery, addressing the questions in my, "Who am I?" post; I was not questioning whether I was in some sort of afterlife but whether I was still the same person.  I probably could have phrased the question better but hey, I just woke up from major brain surgery and was drugged out of my mind.

After the brief greeting I was wheeled off to the ICU.  I felt surprisingly good, all things considered.  My pain was so minor that the dryness of my throat was a greater discomfort; even drinking water would have made me vomit at that point and they had stuck a tube down my throat during the surgery, so I had to make do with the occasional tiny wet sponge to suck on.  It wasn't until the third or so that I realized I was allowed to suck on it instead of just holding it in my mouth.  Again, brain surgery, drugs.

It was actually quite remarkable how little pain I felt during the entire ordeal.  It stands to reason, of course.  There are very few sensory nerves inside the skull, and those in my scalp had largely been severed, leaving much of the top of my head numb.  What little pain I did feel was quickly controlled, and by the second day of my stay I didn't need anything for the pain at all.  During my entire recovery after that point, I never even needed a Tylenol.  What I did feel were strange sensations on my scalp and across my suture.  At first it felt like a wet dripping, which I mistook for blood.  A close examination revealed no bleeding at all.  For weeks after I would feel strange twinges from time to time.  Also an itch.  Intermittent but completely impossible to satisfy, as it was located on part of my scalp so numb I couldn't even feel my own touch.  But again, I'm getting ahead of myself.

Even with the drugs in my system and the fatigue from my surgery, I could not sleep in the ICU.  My nurse was constantly checking on me - which is to be expected - and my oxygen tubes kept slipping out, and I wasn't sure if I was supposed to have one or both in.  Maybe they didn't want me getting THAT much oxygen, I reasoned.  They frequently checked on a drain inserted into my head, a thin tube with a suction bulb on the end, which steadily drew a thick red fluid from my incision, lighter in color than blood.

As they wheeled my bed to the MRI, I felt kinesthetic shifts throughout my body.  I felt like they were wheeling me down a slope, and when they stopped I felt as though they were slowly pulling me backwards.  At one point I felt as though I was rising into the air, though looking around I could easily tell I was stationary.  Most of all I felt very heavy, which was an effect of the morphine.  That seemed to be all morphine would do to me: make me feel heavy and numb the pain.  No hallucinations or highs, or anything so interesting.  By that point every person I met would ask me for my name and birthday, and most would also run through a series of basic neurological tests to assess my condition.  It became so routine that one nurse would simply say, "tell me a story."

This is where things started to get kind of bad, and before I go on I want to make a few things very clear.  First of all, I feel that my doctors and most of my nurses did an excellent job caring for me, and I know that staying in a hospital is never fun.  Secondly, I have a great deal of sympathy for my fellow patients and wish them all the best of luck.  Third, I think that there's a point at which it becomes totally reasonable for a brain surgery patient to want some goddamn sleep and to hell with the doctors, nurses, and other patients.

They brought me to my hospital room, to let me rest.  At least, that was the theory.  The room had a nice view of the city and was really quite comfortable, except that it was a "semi-private" room, meaning I shared it with another patient and had all the privacy of a thin curtain.  For some reason they'd designed that particular room so that the patient farthest from the door (my new roommate) had to pass directly through the other patient's (my) area to get to his own bed.  My roommate, another young man who had been at the hospital for more than a month due to a spinal tumor, had several family members over and seemed to be having a small party.  They left entire food trays along my windowsill to be picked up by hospital staff, while talking loudly about how good the food was.  They blasted Christian rock constantly, even when none of them (patient included) were in the room.  For my benefit, you see.  My parents informed them that we are not a Christian family, to which they replied, "that's OK, Jesus will take care of you anyway."  Very kind people, very sweet and thoughtful, but they seemed deathly afraid of silence and would not shut up.  It was around the point that I heard my roommate on the phone saying, "we can't fit more than a dozen people in here so not everyone can come at once," that I thought maybe the situation was worth addressing.  My mother got me transferred to another room.  The next day, my former roommate had a party in his room, the entire day.

My next roommate seemed better.  I'd prefer not to identify another human being as a disease but as that's all I really knew about the man, I'm going to call him Mr. Liver.  Mr. Liver was suffering from liver failure.  Jaundiced and bloated, he didn't have much time left.  His family was there to see him and they were quiet and polite.  They seemed to be trying to get Mr. Liver to hospice care but were unable, as the hospital was short-staffed due to the upcoming July 4th holiday.  Either way, his family was courteous, he didn't seem too bad and my heart really went out to him as I knew he didn't have much longer.

He also peed all over the shared bathroom several times, and seemed incapable of speaking lower than a shout.

At the time that wasn't a big concern to me as I was still attached to a catheter.  They had me stand and try walking with the aid of my IV stand - less than a day after brain surgery and they already had me doing laps - and it was a little dizzying at first but I did manage it.  It made me very aware of how weak the surgery had made me; my gait had changed significantly, and while I never felt unsteady I did feel unsure of my footing at times, and had to walk very deliberately and carefully.

Once they determined that I could walk, they removed the catheter.  That experience was more socially unpleasant than physically, as my penis (and anus) were somewhat numbed from the anesthesia, or perhaps from the surgery itself.  Sensation would slowly return over the next two or so weeks, to my great relief, but at no point did I lack control of my bowels and bladder.  The problem was that I was still hooked up to a saline drip, which meant I needed to go to the bathroom every hour or two, yet for liability reasons they refused to let me get out of bed without help.  Unfortunately the nurses would rarely come immediately after their summons.

The nurses wanted to keep track of our urine so we each had separate containers, and my nurse (who herself was very kind and skilled) was rather horrified when she saw that my urine had apparently turned nearly black.  My roommate didn't take the time to read the labels on the containers. 

As visiting hours drew to a close I was less than thrilled with my circumstances but found them tolerable, even though at that point it had been about twenty hours since I'd last slept.

Thus began one of the worst nights of my life.

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