Surgery day & Post Op Day 1

February 1, 2005
Surgery Day
Stress Level; Low, Calm and Resolved To Get On With The Process

I got up this morning with an amazing sense of calm. The whole pre-op process from yesterday got me a bit tired. Jen and I got up earlier this morning before sunrise and we watched the colorful sunrise together before going back to bed. I did not sleep all that well but managed to get rested enough until we finally got out of bed at just after 8:00 AM. I took my last pre-op meds this morning completing the pre-op process. One last shower before getting dressed to head over to the Greenbaum Surgery Center Where I will be for the next several days.

This will be the last time I get to listen to Loreena McKennitt for a while too.

10:00 AM, we arrived at the Greenbaum Surgery Center and signed in with the receptionist. A few minutes later, the other receptionist called me to the desk to verify my Identification and information. I did this with my passport and Driver’s license. She noticed my long hair and we started to chat about owning long hair, it turns out she is a fan of long hair. She asked me to check my information on the ID tags, it all looked fine and this was passed on to Jen, one of the

intake nurses. She escorted me into a room where she took my vitals and once again verify my personal information. She also commented on my longhair and asked how long I have been growing it, I told her about 11 years. I noticed they had a computer on the net, and told her where there is a picture of me. I typed in the URL and she liked the picture on that web page. I asked nurse Jen to braid my hair and get me two hair caps. She went off and got two hair campo and she braided my hair as I sat down in a chair. I learned how to deal with my hair from a previous surgery. It was the only thing we found that worked the first time and still the best solution for my hair. Nurse Jen asked what my height was, I told her 5’ 7” and she handed me a gown to change into then left the room for me to change. Everything that has happened so far is nearly identical to the first time I had surgery. Once I had changed, with a knock on the door, a different nurse took over, Dana. We finished gathering up my clothes and patient information, then she escorted me to bed# 11. I got on the bed and Dana proceeded to install an IV into my left arm. The first try did not work, it might have hit a vein valve. On the second try she tried my left hand, I don’t know what the reason was, but that failed too. All this has taken about 30 Minutes and I was on the verge of crying over what was happening. I have not had this much difficulty getting an IV installed in the past. Dana asked another nurse to get this done I don’t remember her name, but she got the IV installed on her first try. The only problem with this IV was the location, it was on my wrist and that prevented me from typing until it was removed.

Once the IV was installed, I asked the nurse to get Jen to come in. Jen has been waiting for a while and was getting worried. We greeted each other with a kiss and she sat down and held my hand as we waited for Dr. Meltzer and the anesthesiologist to visit. Dana gave me a pill, I don’t remember exactly what the name was, but it was used to lower my BP for surgery and then an injection of anti- coagulant to reduce the possibility of blood clots during surgery. In short time, Dr. Meltzer came in to chat for a little while. I told him years ago when your uncle mentioned you that performed this procedure regularly, I would have never guessed that would be one of your patients back then. He smiled and we chatted about the events to come. He had just finished surgery on his VAG patient this morning. I will be his second VAG patient for today. He went off to have lunch made by his wife before we got started. The anesthesiologist came in to see me and asked if I have had general anesthesia before, yes, I have. I told him it was done with a combination of drugs Propfol, Fentynal and Gas. I was also given some Anzemet to prevent nausea. I was certain of being intubated; it’s the norm for this type of general anesthesia. He told me these are pretty much the same meds they will use today. Knowing that I have not had a reaction to these specific meds does make me feel better. As he went off to get some meds, OR nurse Cindy came in and told me she will be my OR nurse for today. I gave Jen a hug and Kiss, told her I love you and she mirrored the same words to me. When the anesthesiologist came back, he injected a sedative into my IV line and I floated off into sleepy land as they wheeled me into the OR. The last thing I remember hearing, “Is she gone? Yes.” I don’t’ remember anything more after that.

The surgery team;

Dr. Toby Meltzer, surgeon

Dr. E? , anesthesiologist

Michael, Dr. Meltzer’s surgery assistant

Cindy, surgery nurse

??? Operating room tech

Surgery Day, Feb. 1, 2005, 12:40PM into OR, 1:00PM start of surgery ended at 4:15 PM.

I remember very little of my time in Post Anesthesia Care Unit. I had no problems with nausea, recovery time and etc. The only thing I remember during that time was a nurse calling my name and I responded. She removed my O2 mask and they began to wheel me upstairs to room 16. The ride in the bed was totally disorienting, I sort of remember going straight, turning, then into a elevator and finally into my room. Jen was waiting for me there and was worried why I was taking so long in the PACU. The wait brought back memories of what happened to Jen’s mom in December of 2004. I finally arrived to room 16 around 6:00PM. I sat up when Jen came over, gave her a big hug told her I love you and thank you. Jen and I chatted about stuff for a while before we watched a bit of TV together. I ate some Jell-O, soup, and crackers. This was the first meal I had since my liquid diet day on Jan 31 and basically dumping everything down the potty from my digestive tract as part of the prep for surgery. I asked Jen what Dr. Meltzer told her about my surgery. She told me that Prep took 20 minutes, and the procedure started at 1:00PM and took 3 hours and 15 minutes. This was less than his typical 4 hours for this procedure.

Event at this time, my sense of relief was incredible. It felt like a huge burden has been removed from life and will not be back. I was honestly surprise at how I felt so early post-op.

My nurse for the night was Katie, she is the nursing supervisor, but was filling in for another nursing staff member that nigh.

I was tethered to my bed by an IV, vitals monitoring, urine catheter, two blood drains from my sutured together labia, calf compression stocking to reduce the possibility of DVT and a ice pack on surgical site. I also had Patient Controlled Anesthesia control button. This controls an extra dose of pain meds (meperidine) depending on my needs in addition to the timed program dosage. The pain level as not that high so I that I used the PCA much over the next 12 hours. With all this stuff hanging from me, I was not going anywhere for a while.

I did not sleep well that first night due to all that racket coming from the IV pump, DVT compression device, vitals monitoring device. I was in a state of semi sleep. I felt OK, but I was tired from the events of the day.

Karen a nursing assistant came in several times during the night to check up on me. That made getting any real sleep difficult. Jen stayed with me in our room that night to make sure I was OK. Back in October 2004, I slept in that same recliner and I can tell you, it’s not comfortable to sleep on, it’s lumpy, and hard.

Katie came in at 7:00 AM to take me off the PCA. She asked me if I wanted another hit, I told her, Na. Katie told me some patients like being on the PCA, it’s not surprising since meperidine is a narcotic similar to morphine.

Post-op Day 1, Feb. 2, 2005

This was basically a bed rest day. Charlotte was my nurse for the day. She was Jen’s nurse when we were here in October. Other than trying to get comfy in bed and dealing with all the drainage from the surgical site, dealing with ice bag, and Charlotte changing my IV meds of IV fluids, IV antibiotics and etc, it was a pretty uneventful day.

Janet from Dr. Meltzer’s office came in to do a quick exam and check on me to see how I was doing.

This is the same day I was switched to oral pain meds. I have taken perocet the last time I had surgery and worked OK for me the last time, so I chose the same med again knowing it would be OK. I tend to try not taking any meds if I can. In the case of the pain meds, I should have taken them more often today than I did. It would have made things a bit eaiser.

There was another problem that I’m concerned about, I was not circumcised, those who I have spoken to about this had a hyper sensitive clitoris, sure enough this might well be the case for me. It’s a good and bad thing.

About 1:00 PM Dr. Meltzer and his surgical assistant Michael came by to see how I was doing. We talked a bit about my surgery. He told me that the procedure took 3 hr & 15 min, less time than usual. Everything went well and nothing out of the ordinary. My blood loss was less than 100cc during this procedure. I was a bit surprised that so little blood was lost over a bit more than three hours of surgery. When I asked Dr. Meltzer about this, he told me since I was a well trained aerobic athlete, you can easily allow the patients blood pressure to be in the 80 / 50 range. This means you bleed a lot less during surgery and the vascular system can tolerate this well. Jen had loss a similar amount of blood during this same procedure. Blood loss has an effect on overall recovery.

I was feeling icky from all the stuff that has happened over the past few days, so Jen gave me a body wipe down with some wipes similar to baby diaper wipes, that felt nice when we were done.

The nurses would come in once ever so often to take my vitals, when they do this during the night, it can get annoying.

We had dinner together in my room and Jen stayed the night again to make sure I was going to be OK.

I called a few friends to chat and returned a few phone calls. I got some pain meds from my nurse took them and went to bed.

The level and quality of care Dr. Meltzer’s patients recieves is nothing short of special in today’s world of HMO’s and mass production health care. In some ways, many of Dr. Meltzer’s patients and staff is like an extended family. Dr. Meltzer has stopped by every day to spend time with his patients and see how they are doing. He would ride his bike on weekends and stop by Greenbaum to check on his patients to see if they were doing OK, answer any questions or deal with problems that might come up. He would change from his bike clothes and put on his scrubs to do rounds. How many doctors do you know who spends time with his patients in this way?

:)