Sunday Funday

Day 7

September 8, 2024

“No surgery is without risk.”

Papa

Granny told me that Papa would say this anytime someone went into surgery. Whether it was getting tonsils out or something more serious—Papa was the worrier.

My papa was the best man on Earth and I miss him so much. I know how upset he would have been about all of this and how much he would have prayed and been by my side. One of his famous sayings was, “Don’t do anything stupid!” He also had my older cousin walk me 1/4 mile home at age 17 and always reminded me to “hold the rail” and to “zip up my coat.” He was always my protector and even though he wasn’t here anymore, I knew that he was with me from the moment I stepped out of bed on September 3, 2024.

He woke me up, led my path, cleared the ER, helped me get an MRI (which was nothing short of a miracle at the ER—insurance made this nearly impossible), opened up the operating room, put me in the steady heads of a skilled spinal surgeon, and watched over me until I came out of spinal surgery unscathed.

If any single one of these events didn’t happen the way they did, I would surely be paralyzed. I read many stories of the lawsuits people won over Cauda Equina Syndrome. Paralyzed and incontinent after being going to the ER and being turned away. Not only was Cauda Equina Syndrome life-threatening, it was like a ticking time-bomb in your body. I had only hours to spare, probably somewhere around 12.

Thank you sweet Papa. ❤️ For being there and helping watching over me.

I looked up some stats. Surgery wasn’t that risky in and of itself. When the health of the patient was compromised or it was on a particularly sensitive structure such as the head, heart, or lungs, it increased in risk, but not significantly. People often equate anesthesia with risk, but I’ve never actually thought about it.

Nothing had crossed my mind before my first sinus surgery until I was asked to sign a waiver that stated I understood the risks of the surgery, among these being that it could cause a spinal fluid leak, brain cavity perforation, or visual problems. In that moment, I thanked God I was in Boston. I signed the form and didn’t give it another thought.

The worst part of surgery for me was post-op. I absolutely hate throwing up. I remember prior to my sinus surgery I spoke to the nurse about my concerns. She nonchalantly replied, “Well, they like you to get the blood out of your system so they don’t do much for that.” Great, I thought. After that surgery I vomited blood in recovery for almost three hours. Non-stop. So when it was time for my second sinus surgery I brought it up again and the anesthesiologist told me that if you throw up a little blood it’s positive, but it is not okay that I was ever that ill. She put a patch behind my ear, managed my meds, and I barely got sick.

While researching about the dangers of anesthesia, I came across something called PONV, or Post-operative Nausea and Vomiting. It is one of the most common side effects of anesthesia and occurs in 30% of all patients. In adults the predictive list factors are as follows:

female gender—check

non-smoker—check

history of PONV or motion sickness—check, check

surgery duration >60 minutes—check

use of post-operative opioids—check

Guess it wasn’t shocking that I threw up post-op. Although I wasn’t cognizant enough to go over this with the surgical team because of extreme pain and the level of opioids that have given me—it must have been in my chart. I found the sticky tab behind my ear three days later. The technical name is a scopolamine patch. Scopolamine is in a class of medications called antimuscarinics and it works by blocking the effects of acetylcholine (a natural substance) on the central nervous system. Basically, it calms the stomach and bowels, and helps patients avoid the horrors of PONV.

I remember waking up disoriented, seeing Jess and Jay, talking for a few minutes (no idea about what), and then the nurse telling them that they had to leave because visiting hours were over. I had probably been in post-op for less than 30 minutes. My sister stated that she was not okay with this, that she hadn’t spoken to the surgeon, and at this point they were still unaware of what surgery I had even undergone. The nurse was sympathetic, let them stay late, and found the surgeon. After Jess left later on, I looked at Jay. “I’m going to throw up. You need to find something.” And then 20 seconds later, “Hurry!”

The nurse overhead and flung a sort-of pitcher into my lap with zero seconds to spare. I threw up about six times in a row profusely, and then it was over as fast as it began.

From my experience—if you’re going to worry about the risks of surgery on an anesthesia-basis, it makes way more sense to panic over PONV than spontaneous death during the procedure—but that’s just me. Papa, was a worrier. For some reason, despite being a “small stuff sweater,” I never really worried about surgery.

When I saw my surgeon Dr. Pieters the next day, I told him that I didn’t remember him. “Really?” he responded, “You were talking a lot. I’ve never seen someone so happy their way in to emergency surgery before!”

I clarified, “Well, I remember the 1/3 story, Dr. Lambert reminded me, but I don’t really remember your face.”

Prior to surgery, Dr. Pieters had told me, “People think that a herniated disc is always caused by something strenuous, but the reality is that 1/3 of the time it’s during activity, 1/3 of the time it’s when you’re relaxing just watching tv, and 1/3 of the time it happens while you’re sleeping.”

He laughed. I continued, “Well, they gave me SO much medication, I guess it didn’t work in time for the MRI but I guess it was beneficial pre-op.”

I remembered more now. On my way into surgery it was all a blur. Hectic, doctors throwing a hospital gown at me, reviewing the procedure, shoving my belongings in plastic bags, asking me medical questions, marking my back with a sharpie, slapping a patch on my ear…it was crazy. Just before going in, they asked me to sign a waiver. I had to agree to the risks of the surgeon accidentally severing my nerves or cutting open the thecal sac. My signature provided my consent to paralyze me or kill me. That the benefit was worth the risk. And it was—-because waiting was certain paralysis and incontinence, and I’m not sure that felt easier than death right now. My response at the time was, “Yeah, I’m used to signing these. They make me sign one for sinus surgery about puncturing my brain.”

I’m sure my nonchalance about potentially dying or being paralyzed was slightly foreign to them. But as I said, I’ve never thought much about these risks, and at this time, I was desperate. With the horrendous pain and startling paralysis creeping down my legs, they couldn’t cut me open soon enough. I didn’t have the ability to think past this moment.

After the surgery, Dr. Pieters said to Jessica, “The surgery went well, and neither of the major risks were a problem.”

Step 1: I wasn’t killed or paralyzed.

Today I was finally reunited with my sweet angel Kennedy. She looked inches taller in just a week. So much older. So independent, almost like she grew overnight. I knew it wasn’t really true, but that is the nature of 2 year olds in general. The difference between ages 2 and 3 is stark, and it isn’t crazy to notice differences day to day. At least that’s how it felt in this moment. She crawled up on the bed and we snuggled. We had an awesome visit but it was challenging because I couldn’t explain why I couldn’t carry her, go on a walk, chase her, or do any of the things I normally did. Other people had to strap her shoes on, bring her potty, fix her hair, pour her milk, wash her face, all the little “mommy jobs” that you don’t realize you love until they’re gone. She didn’t want to leave me so I turned it into a game about waving through the window and she did okay. My brave little peanut.

Got some hugs from my big, brave boy too. Can’t believe how old and grown up he is now. Such a sweetheart and such a good older brother. ❤️

There are hard times every day. Sometimes not more than a few seconds, or a minute, sometimes an entire hour. My family and friends have been the biggest support and the reason those seconds never creep into hours or days. They just couldn’t. It is impossible to go dark when you are surrounded by so much love. And I love all of you so much.

P.S. I walked across the kitchen with no walker today. Still can’t feel my foot but I’m getting better balancing with one dead foot I guess. ☺️