The surgery that almost wasn’t

About 10 days ago I was scheduled for minor surgery that involved opening up my abdomen.  I had never had this kind of invasive procedure done to me before, so I was rightfully apprehensive. My surgeon, who I will call Dr. B, was a man I had met only once, when I had my diagnosis in his office the week before.  He was a young, good-looking guy with a pleasant personality and a sense of humor.  His fingernails were of normal length, indicating that he was not a nervous nail-biter.  He didn’t shift his weight from side to side as he talked, and he looked me straight in the eyes when he explained what was wrong with me and how he could fix it.  And, he didn’t have that habit of raising his intonation at the end of every sentence making it sound like a question (“The infection rate in such a procedure is about 2%?)  So far, so good.  He passed the DrTom’s Do I Trust This Guy To Open Me Up interview.  We scheduled the surgery.

 

 On the day in question, Management and I went to the hospital where I was admitted, and then quickly led to the prep room.  I undressed completely, put on the blue paper gown they provided, and settled onto the stretcher.  The nurse, who was obviously trying to make me feel calm with her almost-too-jovial demeanor, asked me many questions about allergies, medicines taken, and medical history.  She took my vital signs and threaded an IV line into the back of my hand, which promptly spurted blood all over that side of my bed.   I could tell she was not that experienced in all this, so I found myself trying to reassure her that she did a fine job of inserting the IV, I didn’t feel a thing, isn’t it great that I have large veins, etc.  In general, I overcompensated by appearing passive and bored with what she was doing, as if to indicate that I had abdominal surgery two or three times a day.  It is curious how we sometimes pretend to ignore potential danger in the hope that by not noticing the reality of the situation, that very reality will change for the better.

Within 30 minutes, I was all set to go.  I had prepared myself psychologically as best I could.  After all, I had lived a pretty happy life for 66 years, and if this was going to be the end of it all, I hadn’t done so badly.  As I ran through my list of rationalizations for a worst-case scenario, I realized the time was passing and I was becoming increasingly uncomfortable on the gurney.  I began counting the drops of saline plopping into the line leading to my hand.  I obsessed about the coffee I was not allowed to have that morning.  I began dreading the 3-week recovery period after surgery when I was supposed to “take it easy”.

Three hours later, the head nurse of the unit and her assistant flung back the curtain to my cubicle, and entered my bedside space.  Dr. B has been detained by the surgery scheduled just before mine.  He was already two hours late in finishing, and he could be another 2-3 hours.  There had been an unexpected complication.  Do I wish to wait it out, with no guarantee he would ever get to me that day, or reschedule for another day?  Management and I discussed it a bit.  Dr. B might be tired after his first surgery, and then he works on me.  And I’m not going to go an entire day without coffee.  And I just couldn’t count saline drops any longer.  Nope.  We will reschedule for the following week.

During that evening’s Happy Hour, Management and I discussed the day’s events and the pros and cons of our decision.  One observation we made was that people generally spend more time doing some due diligence on the attorney they choose or their auto mechanic than they do the physician who will be administering their health care.  In my case, I needed some surgery, so my personal physician referred me to Dr. B, whom I had never met or heard of.  I accepted the recommendation unquestioningly.  Management, who was an E.R. nurse for years and then a real estate agent, always pointed out to me how people were much more sensitive about their money than their health care.  They readily gave up their body to perfect strangers for repair in the E.R., but always knew better than their real estate agent about all matters financial associated with the sale or purchase of a house.  They got angry about the latter, but almost never uttered a thought on the former.  Do what you must with my body, but never impugn my checkbook!

A week later I returned to the hospital and repeated the entire procedure again.  This time, Dr. B appeared on time, ready for action.  He had now had another week of  practice in the operating room since we almost met, and that couldn't hurt.  And I had now lived 66 years plus another week, so what the heck.  As the anesthesiologist pushed my gurney through the hallways with Versed (that most wonderful drug of colonoscopy fame) now coursing through my veins, I wondered if I could remain cognizant until I reached the O.R.  I wanted to size-up Dr. B one last time.  But I could not remain alert and, therefore, I did not get to conduct a final appraisal of that somewhat good-looking man with a nice sense of humor who was standing there with a scalpel in his hand.  As the O.R. nurse had told me earlier, "Let's rock 'n' roll".

Senescence sucks: The virtues of Versed (part 4)

(When you see this guy coming, just say "Versed please".

Last week, I had occasion to be given an "ultra short-acting benzodiazepine derivative, which has potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant, and sedative properties"?  Of course, this was done under medical supervision at the hospital.  Don't try this at home.  The occasion was a procedure called an upper GI endoscopy, and it was conducted by the same doc that does my colonoscopy every five years.  Hopefully, he uses different instruments for each procedure; no double-dipping, please.  This most recent procedure involves having the specialist thread a tube with a small camera attached down your throat into the esophagus and into your upper digestive system to reconnoiter, take pictures, or even repair some problems.  This was recommended because of that hiatal hernia that I wrote about earlier. 

The barium swallow that I took several weeks ago was a preliminary look inside the problem area but, as my doc explained, the endoscopy procedure is the "gold standard" for examining that area of the human body.  I may not invest in gold when I trade online, but you can be damn sure I want the gold standard applied to figure out what to do about this hernia.  The doc and I sat in his office as we discussed all this.  It took only five minutes to explain the endoscopy procedure, and we spent 20 minutes talking about cigars, wines, and scotch.  I really like this guy!

Part of the reason the medical discussion went so quickly is because as soon as I learned that the patient is sedated with a drug called Versed, I needed to hear little more.  This is the same drug they used for the colonoscopies, so I was an old pro at this one.  Understand that I have never done recreational drugs in my life (well, there was that one time at the Delta Chi house), but I now go around to cocktail parties, wedding receptions, and bar mitzvahs giving free testimonials about Versed.  What is sad is that my testimonials are more interesting than most conversations at these events, so I always have good attendance in my corner of the room.  There are a few jock-types standing around the hors d'oeuvre table discussing the Yankees, but there are really impressive numbers in my corner where I am discussing my favorite ultra short-acting benzodiazepine derivative.

In short, and I'm obviously being very non-technical, Versed works not only by relaxing and sedating the patient, but it results in total amnesia about the event that occurred while you were under the influence of the drug.  You are completely awake during the procedure, you can answer questions, and you are able to respond to the medical team's directives, but you remember absolutely none of the gagging and swallowing of the tube.  Think about that for a moment.  You realize they are putting 2-3 feet of tubing down your throat while they are doing it, not a very comfortable thought, but when you recover from the drug, you can not remember a single second of the experience from the time they injected the IV drug until you recover. 

Think of all the times in your life you wish you would have been under the influence of Versed.  Your boyfriend breaks up with you.  The next day you feel great, because you don't know you have no boyfriend.  Your boss fires you, the next day you feel great, but you don't know you are unemployed.  The stock market crashes as it did last year, but the next day you feel normal, even though you have no money for retirement.  Wow!

But there are two problems with this antidote for life's miseries.  First, you don't know when these adversities are going to occur, so you would have to be on Versed all the time to gain the benefit.  On your 50th birthday, you wouldn't have any memories until before your 20th, when you began the Versed regimen.  And second, eventually you will realize you don't have a boyfriend, and that you're unemployed and broke.  At that point, you would probably employ Plan B, which is to partake of a more common drug of choice, alcohol.  So Versed is not a long-term solution to life's problems.  But when it comes to someone in a white coat sticking a tube into one of your body's orifices, it is fantastic.  Who needs to remember the details about that?

Plus, I have always adopted the view that life is mostly about creating memories, which you can draw on later in life.  In fact, bad memories may be better than no memories at all.  Memories enrich life, help us realize that our time was not spent for nothing, give us something to discuss over and over, and entertain us when we are alone.  They represent material for sharing with others. But when you see the doc comin at ya with a tube and a camera attached, just say "a benzodiazepine derivative, thank you very much".