T-plus three days

 It feels really surreal. Maybe that's the drugs?

I struggled with "what if I'm doing the wrong thing" all the way up until I was signing the final consent to treatment, gowned and IV'd. Some part of me is still wondering that, but I realize that's because I'm in a new and different kind of pain so my instinct is to mentally downgrade the devil you know, so to speak. (Also say hello to the high res versions of my bone spurs. It looks like they’d been shopping at hot topic for punk spikes.)

Yeah, I'm in pain. It's to be expected really. I have six screws, a titanium plate, and two chunks of cadaver femur embedded in my neck now. (And a bunch of absorbable sutures)

It took three tries for them to seat the first IV, and once I had signed my consent to treatment, I asked for something for the anxiety. I'd been crying behind my mask on and off since arriving two hours early (as directed) and I was exhausted. My last memory was around 1pm, when of a member of the anaesthesia team holding a large slightly yellowed cylinder and tapping it into the hard-won IV port on top of my right hand. The surgery was scheduled for 12:23pm, to last for about 3.5 hours. 

I have some vague recollections of coming out of anaesthesia and talking to one of the surgical team about 18th century gelatin, and carnivorous plants, while they tried to stick a bedpan under me. I was lucid enough to know that wasn't going to work and ask for a catheter, which they were surprised by but assented to ("huh, she didn't even flinch"). I know I called Martin on a phone at some point but I can't remember a word of what I said to him. I woke up a second time in a recovery bed, some time around 9:45pm, visiting hours already over. 

Covid has been surging around the world recently, so it wasn't surprising to me that the promised orthopedic ICU bed didn't materialize immediately as I exited surgery. But hours passed, and more gurney beds with highly-drugged individuals started to collect in that room as no new beds became available. Around 12:30am the nurses came to shut down the recovery ward, so those of us still waiting were rolled back to the capacious pre-op ward, where we'd donned the gowns and IVs and done final signatures before our surgeries.  

So we waited. And waited. And had some jello and crackers, and water, and waited more. And some time around 4am, I started to feel nauseated. I had just undergone a blood draw (because I guess they have to do those every 6 hours or something for monitoring?) in my foot (because, as I found out later, literally every other part of my body that had accessible veins had been tapped) when I started to get tunnel vision and cold sweats. I woke up with a nurse screaming "help help" out into the ward, my toes curled over the bar at the end of my bed, another nurse holding me down as I arched, and a third working a suction tube into my mouth as I vomited and coughed. "Do you know where you are?!" "The hospital?" I coughed and choked as they sat me up, an expelled another liter of fluid (?!?!) before the nausea disappeared. I collapsed into bed as they stripped me and wiped me down, tucked me into a fresh gown and fresh socks and fresh blankets and put an anti-nausea patch behind my left ear. I slept under their watchful eyes, exhausted. 

And that's where I woke up again, about 11am, still not in my ICU bed, but in good spirits. I sat up, I got more blood drawn, they took my vitals, I started to eat again. My surgeon came around to look at me, and over the protests of the nurses got me up out of bed and into a chair to eat. A few minutes after he'd left, satisfied that I was mobile and on the mend, the tunnel vision came back. I had enough time to gasp "I'm blacking out" before it was on me again. I apparently had a vagal seizure that lasted about 8 seconds, scared the crap out of the nurses and the other patient still waiting for a bed, and knocked me off the chair. I got to use this super interesting device called a "Sara Stedy" to get from the floor back onto my bed, and the nurse who'd been looking after me the whole time sent a stream of almost-profanity into my surgeon's voicemail box. A few specialists visited while I was exhaustedly snoozing again, but after some tests we decided it wasn't an epileptic episode, but it could've been due to some of the many drugs they had me on. (My guess was gabapentin, and they said that was possible.) 

After those two episodes I guess I got a priority bump, because around 3pm an ICU bed came free for me and I left the pre-op corner with thanks for the nurse who'd been watching me like a hawk, and the other lady who was rooting for me.  The room was private, which surprised me, and had a great view of the trees of Mount Sutro. And after the loud, dim, busy corner of the pre-op ward, it was heavenly. After that I progressed fairly quickly - able to get out of bed, get to the restroom, and walk a bit with minimal assistance. Martin came to visit me, and I ordered dinner and snoozed a bit, then drifted off to sleep. Two more blood tests later, and an unknown number of shift changes and resident visits, I was ready to go home.

This is only day one home, but I can see this is going to be a long road. I already don't like this cervical collar, and I'm worried that it's also possibly too short for me. My hands, arms, and feet are covered in bruises from failed IV attempts, and I'm still picking ECG pad adhesive off my torso. My neck is bruised and slightly swollen, and I'm afraid to look at what's under the dressings. But I got to have a shower, and I put in my contact lenses, and that makes a huge difference to help me feel human again. I can't brush my own hair yet, and the drugs make me too woozy to walk far on my own, and swallowing is difficult and doesn't feel natural again yet. I'm still coughing up aspirated apple juice phlegm, apparently sleeping in the cervical collar makes me snore, and I've got some allergy/post-nasal drip/sinus infection thing cooking on top of it all. 

But here's to hoping that this pain subsides quickly, and I'm quickly back on my feet and better than I was before. I have a four week LOA from work, so it feels like most of what I need to do is sleep and drink water, and stay away from the surging coronavirus.

Oh, and alllllllll my Christmas shopping. x_x

Self-talk

T-minus three days to surgery. I keep waiting for some Sign(tm) that I'm doing the right thing, and in the absence of such I keep second- and third-guessing myself. I am in enough pain that I have lost the ability to reason about the pain; my brain keeps going back to the following: 1) Did I do enough to try to fix this without surgery? 2) Is my pain really *that* bad? Aren't there people worse off than me here? 3) Since this happened to me, don't I deserve to suffer? 4) What if it goes wrong?

As a mental health exercise, let me break this down for myself and see if it helps.

1) Yes. This first happened in March of 2019 and you toughed it out for a full month before seeking help, then you spent four more months getting back to 99% functionality, all without knowing that this was going to happen again. There were two more levels waiting to go. 

2) Yes, and this is bullshit medical-care-rationing thinking. You are in pain and thus you deserve treatment; you don't need to compare your pain to anyone else to justify getting it. You're having trouble with word-finding, you're having trouble with names, and focus and concentration are beyond you. These are all signs that things aren't going to get better on their own. Sure there are kids starving in Sudan or something, but nothing practical you can do is going to change that, and putting everyone else who suffers before your own care is not actually helping them or you. This is a trauma response. Putting others before yourself here will not make you a better person, win you approval or accolades from a distant theoretical authority.

3) No. This is the body you were granted for this incarnation. Part of the experience you're having is that of watching Time change it. Remember how you felt exactly this way when you got your first crown molar? How ashamed and grief-stricken you were that you couldn't keep your teeth in exactly the state they were when they first cut through your gums? And now it's nothing? You won't ever be the same, but Time was going to ensure that for you anyway. It's just not quite the not-the-same as you'd originally envisioned, and while it's natural given your upbringing to grieve that somewhat, don't let naturalistic fallacy swallow you whole. 

4) Even if it goes wrong, it will help. UCSF is world renowned for their Spine Center, and they're where everyone else goes when some other doctor fucks up their procedure. If Something Happens you'll be under the best possible care to correct it, even if it means more surgery. You're (relatively) young, with no serious underlying health conditions, and should heal quickly. You have a team of professionals on your side, and (gross that I have to write this, thanks 'Murica) the money to pay for their care. You've been in pain for about the same time that they expect you to need to get back to normal; that's more than enough time sacrificed on the altar of needless-pain.

This body is my vessel and I need to heave down occasionally. I will feel joy again, someday.

Real Fear

I am so scared.

After much wrangling with insurance, we're doing a 2-level fusion at UCSF. Anthem wouldn't approve a synthetic disc along with the fusion, so we're doing less to spare my mobility, on the promise they made that if I still have pain they'll approve a disc in a second operation. December 15th is my surgery day. That's a week away. I have an LOA set up with work. I have all the moving parts figured out and scheduling bits in place. And I am scared.

I am so scared I've been randomly breaking down into sobs, for minutes at a time. Hyperventilating, ugly cry, scared. Started turning on music when it happens so I don't freak out the downstairs neighbors. We're at four times today. Nothing like snapping-to and finding you've been sobbing on the kitchen floor in the middle of the day while your lunch cooks to make you doubt your own sanity.

What if I'm doing the wrong thing? What if it doesn't work? There's so much that's out of my hands.

I have never been scared on this animal, bodily level. I'm sitting in here piloting this meat suit through daily tasks while it shakes and sobs and I have to tell it to blink more so I can see what I'm trying to do and I am just... is this still a healthy level of compartmentalization? Am I doing this wrong? Is this breaking me? (Was I broken beforehand and just hadn't quite noticed?)

I'm reading through the pre-surgical instructions and putting them on the calendar and I can't stop crying. 

I can't imagine this hurting less. I am grieving the loss of my, I'll admit to this vanity, my pretty neck and collarbones. I'm scared that on top of this, it won't help - I'll still be in pain (in more, different pain) and will have to get a second surgery anyway. More scarring, more pain, more loss of the OEM parts I had.

And then some part of me recognizes that I am *in* pain right now, and despite my brain's insistence that I'm not in real pain, not really, I actually am, and that's why this (including the random crying jags) is happening and that's why I need this surgery. 

So I took one of my baby tramadol and I am going to go to sleep now.