Past encounters with medical procedures gives me some idea of what to expect from the overall surgical experience that I'm facing. I really hate that sensation when you first come partially awake after the effects of general anesthesia. A female voice is calling your name in this somewhat insistent, annoying fashion. It sounds like she's talking from the other end of a 100 foot tunnel. Then eventually you wake up enough to realize that it's over and then you can take stock of whatever they've done to you. This time what will be done to me seems a lot more significant than taking out my tonsils or inserting implants to fix the ravaging effects of breast feeding three children.
Mostly I'm worried that I'll wake up with the epidural still in effect and not being able to feel my legs and then panic. I'm hoping that I remember enough to know that it's nothing to worry about. But I worry that I'll worry. If that makes any sense.
On Wednesday I went to the hospital for my pre-op appointment. The first phase consisted of a chirpy guy named Andrew going over my financial history. Poor Andrew was trying very hard to be bright and upbeat, but he was really just freaking me out because he was talking really fast and I was trying mightily to keep my breathing under control so I didn't hyperventilate. At the end he informed me that my estimated out-of-pocket was going to be $948. I told him that I wasn't paying anything until I got an itemized bill because that figure came from the bundled payment for the DRG that had been assigned to my procedure. He blinked and said "I'll just put here that the patient is requesting to be billed". I smiled. Point for me.
The second phase involved me going upstairs to the surgical ward to do the medical half of the preparation. A lovely nurse came out and greeted me and took me back. This is the type of nurse that I hope I get on my surgery day. Late 50s to early 60s so she'd seen it all and nothing would rattle her. If she was aware that I was nervous, she chose to comfort me with her brisk, efficient and professional manner. She cooed over my blood pressure (104/56 -- which is actually HIGH for me, I told you I was nervous) and a pulse rate of 60. Then we went over medical history, previous surgeries, any health conditions. All this did serve to assure me that I really am pretty much the ideal surgical patient. I'm unlikely to go into cardiac arrest on the table or need a blood transfusion. Both of which, I'm sure, would mean that my out-of-pocket would end up being a lot higher than $948.
It struck me how every part of the medical establishment is designed to make the patient the "thing" and in control of the people who will be taking care of you. Not that they don't try extremely hard to treat you like a person. They really do. But it's unavoidable that at some point, I'll be an unconscious "patient" that needs to be operated on. How a surgeon can view a patient otherwise is beyond me. I mean, he's going to cut up my pelvis. If he spends too much time thinking about me as a person, I'm sure that process becomes a lot harder. At least it would for me. If I was a surgeon, I wouldn't even want to meet my patients. Maybe I'd have made a better ME than a surgeon. At least when you're an ME, your patients don't come back and complain about your bedside manner.
Ok, so there's the waking up part, which is going to suck. I hate being "in recovery" and away from my family with nobody for company except the nurse at the other end of the 100-foot tunnel. But at some point they are going to transfer me to a room and then I can be back with the people I love. Weird that I won't be leaving the hospital. That's a first for me. Every other surgical procedure I've had done was as an out-patient. So at some point they cut me loose and let me go home. This time, my home away from home will be a hospital bed on the 6th floor. I wonder if there will be other PAO patients up there or if I'll have to share the hallways with 70 year old hip replacement patients.
I've read a lot of blogs and posts on discussion groups and adjectives like "tough", "grueling", "hard" are what people use to describe the first two weeks. So I imagine, given that I'll improve every day that the adjectives to describe the first two days would be things like "major suck ass" or "I can't remember because I've blocked it out". When discussing my surgical options with Dr. Peters, I said that I was aware that the recovery from a PAO was going to be a bit more difficult than a hip replacement. His surgical fellow chimed in with "oh, recovery from a hip replacement is a cake walk compared to a PAO..... a cake walk". Well, that's encouraging. Maybe they were playing good doctor bad doctor, I'm not really sure.
So the PAO recovery will be long and I'll have quite a challenge ahead of me. The difficulty is that I'm still not sure what that challenge will entail. And I won't until I get there. I hate that. I want to know everything there is to know now. It's not the pain that scares me, really. I can deal with pain. At least I have in the past. I've given birth to 4 children with no medication at all. But that pain was different, really. It was pain with a purpose. I could define it as "what's necessary to get the baby out" and look at the end result rather than focus on what was going on at the time. I had a goal in mind. And what adorable, gorgeous, perfect little babies they all were. It's hard to get as gooey about a hip, right? I can't dress it up in cute clothes and nobody is going to throw me a "hip shower" and buy me presents. So what should my definition of this pain be? Maybe its "what I have to go through to not be in constant pain any more". Or "what I have to go through to get back to doing yoga the way I used to".
Whatever comes, I can handle it. I know this. But that is small comfort in the wee hours of the night when I wake up from a deep sleep with images of what is to come. Just 5 more nights to get through. Then it will be about coming back. And I will be back. Of this I am certain.
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