Quick Note

I have a blog post about my hospitalization half written, and then I realized I needed a nap.

And, that nap hasn't really ended yet. I'm resting, healing, and doing nothing. I'm fine but don't have a lot of energy so am piddling around these days. What is sucky about being home like this is all those projects you wanted to start - you don't have the energy. As soon as I go back to work, then I'll be mad I didn't start the projects.

Anyway, I'll try to finish that post soon, as I want anybody who has even the smallest possibility of getting this surgery to know what it's like.

But, one thing it's like is being tired.

See ya soon!

I Left My Lobe in San Francisco: Liver Resection Story. Surgery

I went feet first through double-doors which automatically opened and closed behind me, like a Disneyland B-Ticket Ride; "Mickey's Hospital World." My gurney rumbled down a hallway, one decorated the length of the corridor with dozens of white coats hanging from knobs. It reminded me of Hell's Kitchen with all the chef's coats skewered on meat hooks and flames wiping away the picture of the cook who'd been eliminated. We flew past Disney's Hall of Coats and then on the left hand side we encountered a line of physicians behind glass scrubbing for their upcoming surgeries. I went through another set of wacky double-doors, and there I was - in the operating room.

And, I have to say, it looked exactly like the operating rooms you see on TV. Everything was gleaming and expansive. Overhead were shining mirrored lights, cabinets glowing with drugs, instruments sparkling on tables, doctors gloved and ready.....

...okay, no it didn't.

It looked like my office storage room, before I make my TAs clean it each year.

Over to the right was my surgeon standing behind a jumbled pile of boxes near a whiteboard, talking to another doctor. There was an x-ray on the lightbox which I thought could be mine but then I saw somebody else's name on it. There were nurses moving around, again behind what appeared to be open boxes, maybe from Amazon or the Home Shopping Network. There was stuff piled in corners, and the shelves were haphazard - it looked pretty ordinary, and kind of like they put an operating room in the middle of a cellar.

The Anesthesiologist explained that they were going to put the epidural in first, and alarmed me by saying this was one of the most painful surgeries they do but the epidural would help. He asked me to sit up and bend forward over the gurney railing, which I did. As all pregnant women know, an epidural is a small tube inserted directly into your spinal canal that drips medicine in to give you pain relief. As they struggled to get the tube in the right place, I became frustrated, because I could hear my surgeon talking about my very own personal operation with his colleague, and it sounded like he was discussing odds and new theory and what was best and giving a lesson on ablation, and I really wanted to hear that. But, the tube wasn't going in properly and the anesthesiology team kept talking to me, each other, and everyone else, so I couldn't hear my surgeon's very interesting conversation.

Tube finally in my spine, they moved me from the gurney to the operating table. They were serious when they said they hoped I had the temperpedic one. (I didn't). I didn't think I'd care very much although I thought a temperpedic operating table an interesting idea. I reminded them about my frozen shoulder, and they said my arm would be down by my side and not to worry. They gave me a hat to put on and then said they would give me medicine to put me to sleep now. They put a mask over my face and I breathed in the plastic scent for quite a while, looking around, blinking now and then.

Nothing.

I began to wonder if I was going to go to sleep, or if, like Michael Jackson, I was immune and was going to have to grab the bottle of propofol and take a slug myself. Had they asked me to count down from 10 (for you surgery newbies, they never do), I would have done so easily - and than then what?

We'll never know because I'm no Jackson, and I did go out.

And, ladies and gentlemen, had I not survived the surgery, those would have been my last thoughts on this earth: Michael Jackson, Propofol, and WTF - when am I going out?

Not exactly profound.

Then they did the operation

I woke up to chaos. It's pretty fuzzy, but I was in the same place I'd been in the morning, which is PACU (Post-Anesthesia Care Unit). It was about 1:30 and I was told I was fine and the operation had gone well. This was the first time they asked me that pain scale question I hate so much, but when your pain is a 10 it's not so hard to answer.

I was in terrible pain, and I know I drifted in and out as they tried to get a handle on it. I don't remember everything they did but they kept shooting me up with drugs, and I don't think my epidural was working, or it wasn't turned on, for quite a while, or maybe that's my imagination.

I have to say that the nurses in that area were quite kind. I shared a nurse with one other person, and she took good care of me. I was unable to move, really think or do much but suffer for the longest time.

Eventually, they got a handle on it and asked me if I wanted my husband. I said I did, but she forgot to call him and I didn't have the knowledge of time passing to remind her. I think this happened a few times until she finally remembered, and by then it was about 7:30. That's a long time to make family wait. I realized they they didn't want my family to see me until the pain was under control, but she shouldn't have forgotten. My sister finally called up and said they wanted to see me now, and that's when the nurse remembered and allowed him to come see me.

As I recovered I also got to see the rest of my family, which was nice, and which I'm sure helped. I was happy to be alive, although considering the pain, not ecstatic. I found out from my husband that the surgeon was very happy with the results he got. He'd told my husband that they had taken all of the left lobe of the liver. They couldn't take the cancerous part of the right lobe because it was too deep and would have been dangerous, but that the remaining tumor was extremely small so they used the microwave ablation tool to burn it off with a 2 inch margin, and he was extremely pleased and felt things had gone as well as possible.

I realized, despite the pain, that I was now cancer-free.

I don't have cancer.

I eventually found out I had to stay in PACU until I told them my pain was down to a five, so the next time they asked, that's what I told them. I was ready to get out of there, I was the only patient who'd been there that long.

That pain scale is all subjective anyway; hell, maybe it was even was a five.

Now that they'd decided to move me to a room the nurse got on the phone with the reservation desk and turned to me and asked me if I'd requested a private room. I said I'd had. Indeed, I'd called a week ago and made that request. I'd been told repeatedly that it was unlikely I'd get one, so I was extremely happy to find that I was, indeed, assigned a private room.

Even in my pain and drug-fueled fog, I was thrilled at that. Nobody else's farts, foul smells, complaints, groans, visitors or endless TV would interfere with my own suffering and healing. I would get to be alone, except for my family.

I couldn't have been happier.


Until I saw the room.....

I Left My Lobe in San Francisco: Liver Resection Story. Pre-Op

October 3rd, 2011. Picture morning in a movie: an alarm clock goes off. The screen is dark but gradually sounds fade in - the drip of the coffee pot, the padding of feet across carpet. Then, eyes blink open and shut, and open again. You see that you are in a darkened hotel room, and somebody is whispering, "Ann, it's time to get up."

5:00 a.m. It's about the time I get up to go to work, but on work days I am allowed coffee and the snooze button. I don't get coffee this morning, or even water, so in my groggy mind, I have no business being awake.

I'd been told to take a shower and use some packets of Hibiclens I'd been given to ritually purify myself before the Gods of Surgery descend upon me. I seriously hate a first-thing-in-the-morning shower-without-coffee, but I did as I was told. I don't know why I expected the Hibiclens to smell like hibiscus - it didn't.

I got out of the shower and put on Juicy Couture sweats. They were the same ones I bought for my mastectomy two years ago, so they are not quite in the best shape but this is not my first hospital rodeo, and I know nobody cares what I have on, not to mention whatever it is will taken off immediately anyway.

We wake my son up. He is surprisingly perky for that hour of the day, and off we go to the hospital.

We drive around in the black of a San Francisco night. It wasn't foggy, fortunately. We could see streetlights and lovely architecture and an emptiness that is rare in that city. I rested my head against the window for a bit. Suddenly, a booming voice cuts into my doze, "We're lost."

What? What do you mean we're lost?

My husband has made a wrong turn somewhere and can't find the hospital. And, we have to be there in five minutes. I get upset at him for never wanting to use a GPS (which we've lent to my son anyway) and then I get a text from my older son, "Where are you? We are all here."

Great. I'm going to be late for my own liver resection.

I grab my iPhone and try to use location services to get a read on where we are but my husband is frustrated, is driving aimlessly, and won't slow down. (This is a man who I have to beg to at least up it to go the speed limit). I yell at him to stop the car, we need an address, and then I see a cross street, tell my son where we are, and his girlfriend finds it on her phone and gives us directions to the hospital. I text them to let everybody know we are on the way, and we arrive within 10 minutes of our appointment time.

Not late at all in my book.

My husband drops me off to park the car and my son and I run in. The hospital staff sees me and immediately whisks me to the pre-op area, I don't even get to see the surgical waiting room where the rest of my family is. I wave as I'm hauled off, and since two people are allowed to go with me, both of my boys go.

Upon arrival in pre-op, they ask me my name and birthdate for the first of what turns out to be 4,327 times.

They give me a big yellow bag for my clothes and give me a thin, ratty hospital gown, and yellow socks that mean I'm a fall risk, and close the curtains. The boys wait outside while I get undressed and get into the bed. I complain of the cold, so they bring me those nice warm blankets, straight out of the heater, and I sit and chat with my boys.

My husband shows up eventually and since only two people are allowed to be with me, my younger son goes down to be with his aunt. They do some pre-op stuff - IVs, wrist bands, but not much. I meet my doctors and am told I'll get an epidural for pain control, and ask if I have any questions.

I never do. The only one I want to know, "Will this cure me" is one that nobody can answer.

It was at this point that I realized that perhaps the Magnesium Citrate had not yet released its grip on my bowels. Fortunately, the bathroom was right in front of me so I availed myself of it several times, while hoping this would not create a situation on the operating table. What if it did? Did they have a way to stop it? I know they'd be putting a foley catheter in, did they have something for that end too? Would the anesthesia drugs stop that sort of action? They had to know this was possible, right? Surely I'm not the only person in the world that had a 7 hour laxitive delay?

I decided it was in my best interests not to think about it.

It was now 7:00 a.m. and the area was a hub of activity. Patients being wheeled in, nurses, PAs, doctors arriving, histories being taken, people stating their name and birth dates, charts being flipped open, families coming and going. It was loud and crowded and a lot like Starbucks at 10:00 a.m. break time. One by one, people were wheeled out to their operations, doctors disappeared, nurses disappeared. It was 7:30 - my surgery time - and I was left all alone - just me and my husband and son.

The cleaning staff came in and picked up dropped linens, mopped floors, tidied everything for the next round of surgeries.

Then there was silence.

I began to wonder - have I been forgotten? Is my surgery cancelled? Is this a passive/aggressive way of punishing me for being late?

Eventually, somebody walked by and we asked them to find out what is going on. A few minutes later my nurse came in and said that they were waiting on a piece of equipment to arrive from Mt. Zion hospital and didn't want to start without it.

I had flashbacks to when my implant for reconstruction hadn't been ordered and I never did get my surgery. What part was missing? I'd met my Super Surgeon so it wasn't him. I'd met the anesthesiology team, so it wasn't them. The only thing I could think of was that it was part of the microwave ablation tool that my doctor likes to use.

What if they couldn't find it, like my old implant? What if it was broken? What if the operation was called off? Would I have to choose another date, more time off work, more hotel time, more money spent? It's unthinkable.

Somebody needs to come and take me to the OR, STAT.

At 8:15, they told us that it would be another hour. I was getting really hungry by that point, and my sister texted me and offered to drive it from Mt. Zion herself. But, their Currier was faster than expected, because it was only about ten minutes later when they said it was time to go.

Back when my older son (now 25) was 8, he had a life threatening seizure of unknown cause. He seized for 45 minutes. He stopped breathing and had to be taken by ambulance to the nearest hospital. He was on artificial ventilation for 24 hours and in the hospital for a week. That was, without a doubt, the absolute worst week of my entire life and that includes everything that has happened to me to date and trust me, my life, even aside from cancer, has not been an easy one.

Nothing compares to your child being critically ill, and there is nothing I wouldn't have done for him at that point. But, what can a mother do? You stay by their side and you comfort them as best you can, in a way you think will help them. At one point, as he was coming off the breathing tube, I said to him, "If you get better I'll get you any video game you want."

It was time to take me to the OR, and as they did, my big, burly, curly-haired, 25 year old son bent down, gave me a kiss, and said, "If you survive this, I'll give you any game you want." That made me laugh, and cry a bit, and I kissed all of my family and went through the doors to the operating room.


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I Left My Lobe in San Francisco: Liver Resection

I know many of you want all the details of my liver resection, so I am going to break the description into different sections. That way, nobody is stuck at their computer for an hour, including me, since sitting up isn't that easy yet.

Sunday, October 2nd. Magnesium Citrate. We were packed and ready to go to UCSF - after much angst, my liver wedge resection is on! I had everything important - iPhone, iPad, extra pillows for the car ride home and, of course, Paul Frank Monkey pajama pants.

Add a liberal dose of nervousness, and I had everything necessary for a successful surgery.

I had been told to do some bowel prep beginning at noon and at that point, only eat liquid meals: soup, jamba juice, "anything you can put in a blender." Then, stop all input at midnight. The bowel prep consisted of taking one 10 ounce bottle of magnesium citrate, and then waiting to explode. No enemas, thank goodness.

Clearly, timing is everything, but I'd never done this before so had no idea how to manage said time. I thought maybe I could take the laxative at home and then drive two hours to SF - by then it should have taken effect, right? But after querying everybody I know, the consensus was that it worked too quickly. It would be rather embarrassing if we'd had to stop on the Golden Gate so I could hang my butt over the railing, and I've no doubt the thought of my skinny ass dangling into the breeze might cause enough despair to spur on a suicide or two.

Best plan seemed to be an early check in at our hotel and do it all there, so that's what I arranged.

We arrived a little before 1:00 and went to our room at the Cow Hollow Motor Inn. It was nothing fancy but everybody who worked there was truly nice, plus it was clean, servicable and located next to amenenties, and was only 20 minutes from the hospital. I gave them a link because it was Fleet Week and also the Oracle World convention was in town - and this was the only hotel I called that hadn't quadrupled their rates into the $400.00 range.

As soon as we got in I downed most of the calcium citrate. It was unpleasant tasting but I wouldn't say it was disgusting; more like salty soda. While waiting for my bowels to turn into rocket fuel, I amused myself by reading the Poop Report.

Yes, folks, there really is a website for everything.

I quickly started to feel very sick. I mean, queasy as all get out. Hot, cold, hot again. Nauseated and weak. But, there was no rumbling in my bowels and no signs of lift-off. I still had a couple of ounces left in the bottle but I knew if I drank it I'd puke everywhere, so I hoped what I had in me was enough.

I suggested my husband and son go grab lunch and I was okay to stay in the room. They went across the street to a diner and I waited.

And waited.

And waited.

My older son and his girlfriend showed up and I was still resting on the bed. We chatted a while and I sent them out to find their father.

It was now 3:00, my nausea was dying down but still - nothing.

Everyone came back and my sister showed up. My plan was to play cards or rest with my family in between trips to the bathroom - but I wasn't tripping into the bathroom. I began to get very concerned that nothing at all would happen and my poor doctors would get an unexpected surprise when they cut me open. "What the hell is that?" "Looks like she didn't do her bowel prep, doctor." "Goddamn it, surgery is off."

I imagine I'd have to explain it when they saw me - me coming out from anesthesia, a bunch of masked faces looking down at me. "Doctor, I promise I drank the laxitive. No, I don't know what happened, maybe I'm just poop-resistant."

Worse, I started thinking that the process would begin at midnight and I'd get no sleep at all and I'd still be running to the bathroom when I was in pre-op.

Now it was dinnertime. I wasn't going to go out, because I was fearful I'd get stuck somewhere. I was no longer nauseated though, so I drank the remaining two ounces in the bottle, hoping that would start the brown waterworks. I asked my family to bring me some miso soup and go enjoy themselves. I surfed the net and read about laxitives (which seemed to work instantly on everybody but me) and waited.

And waited.

And waited.

My family came back from their Japanese meal, with two bowls of miso soup. I drained the tofu and seaweed out of it (solids) and sipped the broth.

And, suddenly, it happened.

A rumbling. A rolling. And, a running to the bathroom.

Ahhh...it worked, seven hours later. The trick is to mix a little magnesium citrate with red miso.

The family watched Storage Wars while I ran to the bathroom every 15 minutes. Then every 30 minutes. Then every hour.

It wasn't violent and it wasn't rocket fuel but it got me squeaky clean, so there was at least one unpleasant conversation with the doctors I got to skip.

By 11:00, I could safely sleep without thinking I'd make a mess, so we shut everything down and nodded off. 6:00 a.m. was just a few hours away.


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Updates While in the Hospital

I know you people are expecting me to post immediately out of anesthesia - and trust me, I would if I could.

I doubt I'll have the strength for a couple of days, but I hear that the nursing staff makes you get up and walk the very next day, so who knows? Maybe posting will be easy.

I think the best way for me to update you immediately is via twitter. I can use my iPhone for that so it's light and easy. If you haven't subscribed you can do so @butdocihatepink. If you don't want to subscribe - and really, I might be the most uninteresting tweeter in a world of tweeters so I don't blame you - there is a box to the right where my tweets are inlined, so you can just load this page and see how I am. Excuse any potential typos; as iPhone owners know, the device likes to change mistakes into weird words.

It doesn't mean I've thrown a clot.

....cue ominious music... If you don't hear from me in a week, I imagine the news is not very good. My family has instructions to, at some point, update this blog if I can't. When that will happen is up to them.

Dear Criminals: If you are planning on robbing me thinking the house will be empty, think again. I have a big, burly, 25 year old male house-sitter staying here with my dog and cat. It's good to have older children with scary looking friends.

Now, I have to go finish my laundry. Thank you for all the well-wishes, both emailed and posted. I do appreciate each and every thought, even if I can't respond to them all.


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