Monday, September 25, 2006

And So It Begins...

The crippling, mind-numbing, blind panic that overtakes me in anticipation of inevitable surgery, that is. It's really been going on for weeks and months, to a lesser extent, but the Big-Time Crazy usually happens during the final week prior to surgery. It always happens with me. Always. Well, it didn't always, but it definitely has for the last half a dozen or so operations. Where we think this comes from is my having been given, in the past, post-op drugs like Inapsine and Compazine, which have the rare side-effect of basically causing extreme panic attacks--full-blown "fight or flight"--and I'm one of the few lucky ones who hit the jackpot on this "makes you INSANE" side-effect. I've awoken from general anesthesia to find myself literally trying to physically escape the recovery room. That kinda thing'll stick with you, and color any future surgical procedures you might have.

So for now, it's all about the anticipation. Which is not that happy, gonna-have-some-great french-fries-while-Carly-Simon-sings anticipation from the old Heinz ketchup commercials. It's more of the terror-stricken, gonna-die-from-a-slip-of-a-scalpel-or-more-likely-due-to-complications-from-the-anesthesia variety. And then, of course, the surgeon had to toss in that priceless "in case we nick your colon" gem. I really, really, REALLY don't want to do this. I've felt that before, when surgery was approaching, and as irrational as I KNOW it is, in my actual, working BRAIN, this time I look at my daughter's face, and think, "...but I never had this much to LOSE before." Yeah. Makes a lot of sense, right?

Believe me, the real, rational part of me, the part that keeps me from picking up the phone and cancelling the operation, KNOWS that everything's gonna be OK. And the pain right now--the pain is so intense, I wouldn't have believed it possible even 6 months ago. The Methadone keeps it in check, but in no way makes it go away. It just keeps it at a level that allows me to semi-function. And speaking of Methadone, did we all just LOVE that "20/20" episode the other night that featured all the Methadone-related deaths? WHEEEEE! (It actually turned out that the deaths were due to new users taking it incorrectly, not as directed--it's not a "take as needed" pain medication--OR due to the drug being deliberately abused and misused by people who bought it on the street, but THAT wouldn't have been NEARLY as titillating and frightening a teaser as "METHADONE: THE ONE-PILL KILLER," now would it?) I swear, the pain feels very much like a personal message from God, one that reads, explicitly, "This is exactly why you must follow through with this procedure. You've been given an amazing gift in your daughter, which is more than you EVER expected to be blessed with, so now let's get on with the business of clearing this mess out so that you may get on with the life I have planned for you with your family."

So that's what I'm trying to do. But so help me, between now and post-op, I need DISTRACTIONS. Whaddaya got, Internets? Good books? Movies? Music? I could especially use some help with the music, because, since I was, apparently, the last person on the planet without an iPod, my mom actually got me a Nano for my birthday, and Alex gave me the accompanying speaker-port to go with it, also for my birthday (which is next month, but they wanted me to be able to have it for my hospital stay--either that or they don't expect me to pull through and wanted to give me one last birthday present--SEE HOW MY MIND WORKS RIGHT NOW??), and I have not the first clue, out of all the music in the world that I know and love, what I want to fill it up with, because, you know, I can only fit a THOUSAND songs on there, so I have to be choosey. And THEN I realize that it's not only music and video, but also BOOKS that you can download to your iPod! The choices! The choices overwhelm me! HELP! Anyone who knows me can tell you that I would like for every restaurant to offer maybe three entrees, and then it would only take me, say, half an hour to decide what I want to have.

So what I'm saying, is that now is the time for personal recommendations. It just hit me that, since we can burn DVDs/CDs off our DirecTV, and since our DirecTV includes XMRadio, that I have a rich source of programming right there. And then there's all the CDs waiting to be transferred to that nifty little machine...the possibilities are endless, and as usual with technology, I am CLUELESS. But hey, isn't it precious?I've christened mine the "PoodlePod," naturally, and it's as cute as a button, all hot-turquoise and teeny-tiny (and Mom even thought ahead to the extra-tiny ear-buds that would be required for my extra-tiny ears)! If I get really bored next week, I may even try to come up with a few of these, of my own design:
I'm also, currently, embroiled in The Great Epidural Debate. The surgeon and Alex are in favor of me having one, and I am, so far, against the idea. It's not for during the surgery, really, but more for the management of post-op pain. It doesn't have as much of the "numbing" effect, like the ones administered during childbirth, but is more designed to deliver narcotics directly to the affected area. Everyone, at first blush, thinks I'm unreasonable to resist this, but I have my reasons:

* I just don't like the idea of the needle in my spine, thank you. Never have. Didn't want one when Bella was born, either (although I wound up having to have it, when she got "stuck), and I was terrified of it.
* Depending on your anesthetist, just the administration of the epidural can go smoothly, or it can be an absolute nightmare. My sister had a horrible experience, that involved several attempts to "re-seat" the needle, and wound up having "hot spots," whole parts of her body in which the epidural had NO effect.
* The one experience I've had with epidural, when Bella was born, was negative. Pain-wise, I was fine without the epidural, and then after hours of being "stuck" in the same place, to the point that it began to endanger HER, the doctors convinced us to allow the epidural in order to "relax" things...and as it turned out, they were right about that aspect, because once the epidural was in place, I was fully dilated and ready to push within minutes, and my entire active labor lasted about 7 minutes and was just a cakewalk. So in that respect, that it protected my baby girl, I am grateful for the epidural. BUT: If the issue is simply pain management, I don't believe I need it, and the side-effects of the epidural I had during labor were just nightmarish. I shook, vomited, had severe anxiety symptoms, and just felt really horrible--this last being much the same as my sister's experience.
* I simply don't feel that I need the epidural for post-op pain management, and therefore, having it is not worth even the small risk involved with it (you know, the highly unlikely but not impossible, "OOPS! The needle slipped, and you're paralyzed from the waist down now!").
* I think I would rather KNOW how I really feel before I go home, so that I'm more prepared for what I'll have to deal with once I no longer have access to the hospital's pain management system. The surgeon says, "Patients with post-op epidurals feel like they haven't even had surgery." That sounds great at the time, but what about when they unplug it and send you home, which, in the age of HMOs, is going to happen pretty quickly?
* I have had several surgeries. I can tick off eight in my head right now, and I feel like if I really thought about it, I might be missing a couple. About 40% of those have been injury-related, and you know, injuries that require surgeries tend to, um...hurt. I had a two-year period in my life in which I was walking around on a shattered navicular bone (while being told I just had "arthritis" and would have to "toughen up"). I have battled endometriosis for most of my life, and it's been painful. I've had three or four abdominal surgeries already, including one that was extremely invasive, requiring a two-week hospitalization afterward. My point is, I've been hurt. A lot. And in all my vast experience with various types of pain, post-operative pain doesn't really even rate among my personal Top Five (and the one procedure that involved the MOST post-op pain involved a multitude of shattered bones and a bone graft from my hip). So it's just not something I'm terribly concerned about. I think this is the part that my doctor has the hardest time understanding, as far as my resistance to the epidural is concerned.

So, anyway, there's the deal. Has anyone had experience with epidurals for management of post-op pain? What are your experiences, pro or con? Am I being a NUT for resisting the epidural? Listen, I am NOT "tough." If something hurt, or if I was afraid of it hurting, I would be begging for relief, believe me. Post-op pain just doesn't scare me. Maybe it should?

I am overwhelmed with the thought that within a month from now, I will be FINISHED with all the worrying about and fretting over chronic pain management for this particular problem, forever. It blows my mind, frankly. That something I've just accepted as an unpleasant, but intrinsic, part of my life since I was 15 years old, is just going to be...gone. The only thing that keeps me from just rejoicing with abandon at this thought is the fact that in order to accomplish this, I'm being forced to lose any possible hope of ever having another baby. If it was ANY other organ that was causing my pain, and they were taking it out? I would be throwing it a GOODBYE PARTY. But this one? Well, this one I'm kinda gonna miss...at least what it represents. And losing my uterus does represent the loss of much, much more. And so I'm not yet jumping up and down (also, if I did, I'd have to take an extra Methadone) quite yet.

GAH. ENOUGH of that. Hey, look: New Nano!! Fun! And Alex brought me "Phish Food" ice cream last night, which is his ultimate statement of "I'm so sorry you're going through this and I wish there was something I could do to get you out of it, but since I can't, here's some chocolate, and I love you."

25 comments:

  1. My dad had an epidural for pain management after surgery for a an abdominal aortic aneursym. (Makes a hysterectomy look like a hangnail.) He was released from the hospital the day after the epidural was removed and he left ICU...5 days after surgery. He was driving 2 weeks later. I think I would say it was a sucess.

    Enjoy the iPod.

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  2. Ive not had an epidural for post op pain management but i had a terrible epidural during my first child birth. It failed and then left me with pretty much constant back pain in the precise spot where it had impaled my spine for nearly a year - NEARLY A YEAR! And now four years later i still get pain there on occasion!!

    gah!

    just something else to obsess over


    I hope all goes well and that the panic attacks stay at bay.. i get them just because i'm insane and they are really no fun. Post op, just in case would you be able to have Xanax? It's my only salvation once ive run over the edge into full on panic

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  3. You're gonna be fine. You need to realize that. Don't give the Death Merchants any reason to get excited. Sorry, I just had to reference one of the books you and I share in common.

    As for the iPod... hate to break it to you, but video only works on the big iPods with video (the fifth generation), not on Nanos or Shuffles. Sorry to burst your bubble on that one. But you can download a bunch of stand-up comedy audio routines and listen to those on your Nano. Nothing like laughter to cure what ails you.

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  4. I've never heard of an epidural for post-op pain but then again when I had my similar surgery they just injected me with some pain management stuff for a couple days and by the third day I quit asking for it because the damn injections hurt worst than the slice down my gut.

    Know what the worst pain was? That freaking gas pain you get when they pump your abdomen full of air for the surgery. That was really horrible.

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  5. I'm sorry this is going to be long.

    I've never had an epidural. I'm terrified of having a needle stuck in my spine. Not sure ANYTHING could make me agree to having one. I'm in your camp on this, because I've had major surgery, and the pain afterward was NOTHING compared to what I'd had before the surgery. I think doctors who haven't experienced certain ailments themselves seriously underestimate the amount of pain you get used to living with on a daily basis. Honestly, one day after my surgery, I felt like I was on a vacation from pain! In spite of having a 12" incision across my torso, and being minus an organ, PLUS some internal restructuring! It's not that you're tough (you ARE, though), but your pain tolerance has by necessity increased far beyond the norm. Although I haven't had a hysterectomy myself, I have friends who have, and they've been up and around within 12 hours or so. An epidural for post-op seems like overkill to me. Just my two cents.

    I STILL don't have an iPod. So you were the next-to-the-last person on Earth to get one. I'm still waiting. My hopes are now staked on the teeny $79 one.

    What to put on it? Which songs have ALWAYS made you feel good, just to hear them? There's probably a bunch. That's what you need on there. It doesn't mean they have to be upbeat, rah-rah songs. Some of my "feel-good songs" are NOT happy songs, like Linda Ronstadt's "Blue Bayou." I'm going to throw a quick list of my 10 top "feel-good songs" up on Chronic Listaholic, just to inspire you thinking in that direction. I'll post the link here when it's up.

    As for audio books, I have some WONDERFUL ones that I am happy to gift to you. I'm going to email you the descriptions, and you let me know which ones you want. I'll put them up on my website so you can download them onto your Nano easily.

    I absolutely, POSITIVELY believe this surgery is going to be a blessing in disguise. It's a tragic price you've been asked to pay, but you WILL have a full, pain-free life afterward. And Bella will have a happy, healthy ACTIVE mommy. And Alex will have the real you at last.

    One more thing: Phish Food, mmmmm. But Chubby Hubby, EXTRA MMMMMMMM!!!

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  6. I just read Kevin's comment. I have to disagree. NO COMEDY!!! Laughing was the MOST painful thing after my abdominal surgery. Oh, and coughing. YEOUCH.

    Smiling isn't painful, though!

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  7. I don't have anything to offer except to say that the season premiere of "Heroes" is tonight and "Gilmore Girls" tomorrow! (along with the final episode of "House" before hiatus). Oh yeah... and new eps of "How I Met Your Mother" (don't laugh!) and "Studio 60" are up tonight as well. :-)

    And also say that I wants me some methadone now.

    Hang in there. ;-)

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  8. I'm so sorry you're in so much pain. As you said, it's really all about the anesthesiologist. Find a good one, and see what he/she has to say. I had a spinal block for my pregnancy, and it was oodles better than an epidural, IMO.

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  9. Okay, the list is up! Sorry it took so long; life will interfere, despite my best intentions.

    15 Songs That Always Make Me Feel Good

    Anyone who'd like to drop by and add their own "feel-good songs" is welcome, too!

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  10. I was pissed off that I couldn't eat once I got my epidural. That was my only concern. And it had to do with child birth.

    For music. Try Tegan and Sara.

    www.teganandsara.com

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  11. Belinda,
    I'll be praying for you. Not that I think you'll need it for the surgery, but sometimes it is good to know that friends are praying for you, and I can't send ice cream (I've never seen Phish food, but I'll be looking for it now!). I know what you mean about feeling like you have so much to live for that you are afraid of surgery. I had a dvt and wound up in the hospital years ago, pre-Ed, and my life was so uninspiring that I didn't care that much if I died. I banged my bad leg good and hard yesterday and am now frightened of another blood clot forming because I have So Much to live for! Not trying to steal your moment here, but our kids sure do make life precious, don't they?
    I see what you mean about wanting to get a good handle on your pain before you leave the hospital, but I'd want to find out how long your stay in the hospital will be before you turn down that epidural. If you will be there for a week, maybe a few days of extra good pain relief would be nice. Then again, I had fine experiences with my epidurals, which were only for childbirth.

    The poodlepod is darling. I don't know how those things work at all -- it looks kind of small to read a book on, how does that happen? Unless one is there to have a baby, being in the hospital is about as boring a time as I can imagine, so music and books to pass the time sounds like a wonderful gift!

    This is absolutely none of my business at all, but, since you would have liked another baby, is adoption a possibility?

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  12. 1. Talk very sternly to the anesthesiologist. You know what you do, and do not want. You know how you react. Let him know that you know exactly what he is up to... ;-)
    Last June I fell and literally smashed my elbow to bits. When we got to the emergency room, I let the doctors know that I did not want surgery. (I have had three big ones already..a hysterectomy included). LOLROF were they. But, when all was said and done, the surgery went very well. The anesthesiologist called me at home before the surgery and then we talked at length. He also came in before the surgery and I told him again how I reacted before to the surgery.
    2. Trust them all. The alterntive is just too scary. I always imagine that I am a car going in for repairs and they know exactly what to do and we are like so many other autos out there. They are good at what they do!
    (My elbow now has 19 titanium screws and four plates and works almost like the proverbial charm.)
    3. Get a small pillow for you stomach. It helps if you hold it against your stomach when you move in bed, walk, laugh, cough, and go to the bathroom.
    4. For my elbow I got a block in my arm and some sort of anesthesia that made me forget and feel quite wonderful. First time I did not vomit and have a major panic attack when I came aware.
    I agree that the epidural seems like over kill. With the pain meds, and take them regularly, you can manage. Your pain now has prepared you for more pain than a body ought to ever have. Have someone stay with you all night the first night at least. This is really REALLY important. Nursing care is just not as good as it should be. A doctor friend told me that one should not be alone in the hospital right after surgery. You need an advocate. I will be thinking of you and send you good thoughts.

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  13. OH! OH! OH! OH!

    Did someone say that want music and book recommendations?!

    Belinda! Honey, pal, sweetie, babe, sugerlump...why didn't you say so earlier? Don't know what type thing you like, but my top feel good books include Pride and Prejudice by Jane Austen, The Hitchhiker's Guide to the Galaxy by Douglas Adams, The Lion, the Witch and the Wardrobe by C.S. Lewis, Stardust by Neil Gaiman and The Dark is Rising by Susan Cooper. I highly recommend children's books during your recovery - they tend to be well written and have happy endings, which do you better for a quick feel good than ice cream (and it's better for ya too!).

    Music, well, hopefully you'll be getting some of it soon (now I'm kicking myself for not overnighting the rassin-frassin thing). But, in the meanwhile, high on my list of groups to watch are Vaux, Joy Denalane, Gnarls Barkley, Rock Kills Kid, Camera Obscura, Old Crow Medicine Show, The Presets, and Natasha Bedingfield. Let me know if you want more suggestion, I've got opinions aplenty!

    Hang in there, Lady. You hear?

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  14. Oh, and p.s. -

    "Listen to the MUSTN'TS, child,
    Listen to the DON'TS
    Listen to the SHOULDN'TS
    The impossibles, the WON'TS
    Listen to the NEVER HAVES
    Then listen close to me-
    Anything can happen, child,
    ANYTHING can be."

    ~"Listen to the Mustn'ts" by Shel Silverstein

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  15. I've never had an epidural, but I do have a distraction for you. I posted my Butter Chicken recipe!

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  16. IV Zofran is wonderful for post surgery nausea. Request it from the anesthesiologist. It works much better than the other stuff they usually use and doesn't screw your mind up.

    Honestly, I felt so much better AFTER my hysterectomy I was ready to have a damned party. I was so tired of being sick and tired, I got my ass up, and got out of the bed and house ASAP.

    I have a friend who told her husband that her doctor told her she couldn't use her vacuum cleaner for a year. He bought the story. Dumb ass.

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  17. IV Zofran is wonderful for post surgery nausea. Request it from the anesthesiologist. It works much better than the other stuff they usually use and doesn't screw your mind up.

    Honestly, I felt so much better AFTER my hysterectomy I was ready to have a damned party. I was so tired of being sick and tired, I got my ass up, and got out of the bed and house ASAP.

    I have a friend who told her husband that her doctor had instructed her not to use her vacuum cleaner for a year. He bought the story. Dumb ass.

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  18. Knock the video off the list hun, Nanos can't do video. *smile* At least there's a little less you have to choose from.

    I'm one of those weirdoes with psych effects to medications too, so you are not alone there.

    I don't blame you at all for being scared after those other experiences. But hey, they might give you one of those neat girdle thingies after the surgery that're supposed to hold all of your innards in place properly while you heal, and those make great halloween costume additions for the future if you ever want to dress in drag. *chuckle*

    I'm all for you not getting the epidural. Less to worry about before the procedure, and less of a shock afterwards. I had a c-section and the recovery pain (from what I've heard) is similar.

    While I can break a bone and reset it myself without complaining much, I do thnk you have me seriously beat when it comes to pain tolerance, so I'd say you are pretty darned safe to go without it.

    Anyway, with the amount of pain you are in now, the post-op pain will likely be less noticeable as you will be rejoycing over the other, missing pain.

    If you decide you want more children in the future, there's always adoption or becoming a foster parent too.

    I know a woman who has 11 children. She produced two of them herself, the rest are all adopted. She will never have an empty nest. *smile*

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  19. I am wishing you happy distracting thoughts. Rent "the Sopranos" dvds and let yourself go through an entire season.

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  20. Belinda~ Is the epidural an all or nothing deal? For most of the patients we see in our hospital, we always advise them to discuss the epidural before the procedure, make a tentative decision, and then feel free to change their mind later. If you are really uncomfortable after the surgery, I don't see any reason why they couldn't place an epidural then. As long as you are informed about the risks and benefits ( and you are) I would say put off stressing about that aspect for know. Hear them out now and then tell them you'll decide later. Also ask them to medicate you to the gills with anti- nausea's BEFORE they even think about waking you up. i demanded they do that for my abdominal surgery 6 years ago and it was the first time I was not sick. usually, they give you the meds at the first sign of nausea, but by then it's too late.

    One other hint, borrow a Dremel to engrave your initials in the back of your Poodle Pod before bringing it with you to be admitted.

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  21. I am finally back online after 24 hours travel and trying get AOL connected again.

    I will be praying for you during your surgery. I have no experience with pain management, my family tends to be of the "tough it out" type. Just be up front with your doctors and tell them what you want and make sure to be clear with Alex so that he can be an advocate for you.

    Lots of love and prayers will be going out to you.

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  22. Oh, you guys...I can't even stay awake for long enough at one time to respond to all of these, but you are all too wonderful. TOO wonderful. Thank you SO much for all the tips, well-wishes, and prayers. I've had 3 major abdominal surgeries before (they'll actually be opening up the exact same incision for the FOURTH time on Friday), so I've a pretty good idea what to expect afterward, I think. And yes, to cough is HORRIBLE, but they want to make you do it, to make sure your lungs stay clear! Ack!

    And I'm realizing that at least during my hospital time I won't be able to stay awake long enough to read actual books, but I will once I get home.

    But BABY (my laptop) IS going with me, so I'll be recovery-blogging!

    I love you guys.

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  23. My sister in law had a hysterectomy a few months ago, at the age of 29, and she made it through just fine. She was up and around in less than a week, and she feels much better now.

    Don't worry about it Belinda....you'll be fine! Just think of NO PAIN ANYMORE!!

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  24. I realize I am jumping in on this really late, but I had a hysterectomy in May and felt pretty good after it. I am pretty tough (as you sound also) and my doctor was shocked that I was up showering and hobbling around the day after my hysterectomy. As for a needle in my back, I would NEVER let them do that. I can tough it out through pain, but can not stand knowing the needle is there. My first thoughts after my c-sections were "is the needle out yet?" The doctor cutting me open did not bother me, but knowing I had a needle in my back did.

    I'm glad everything is going well now for you!

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