Wednesday, April 13, 2011

living life as opposed to waiting for a life to live

I'm not sure I've talked about this in a semi-public forum so here goes.

Life is for living. There's no tech rehearsal before a final performance and there's no draft before receiving an "A" on your paper.

Rewind to the day after Christmas 2006.

I had what I hoped was life-changing surgery. I had a Roux-en-Y gastric bypass. Why did I do this? I did it for a number of reasons: to be able to breathe again, to be able to walk without losing my breath, to see my friend's little girl grow up and know that I'd be able to perform CPR if necessary because I'd have the lung capacity and the physical strength. And I wanted to live my life, not just kind of exist.

I was not a healthy woman. No, I hadn't developed the co-morbidities that may obese people develop. That was sheer luck combined with a significant financial investment on my part to stave off the inevitable.

I found an amazing surgeon. No, not just good but freaking amazing. And his office and surgical staff were equally amazing. I did all of the pre-op stuff: I had my echocardiogram (I had an enlarged heart and pulmonary hypertension), I did my pulmonary evaluation (I was put on oxygen for any exertion and a CPAP set for 27 in/h20 at night), and my digestive evaluation (yes, put on a proton-pump inhibitor for my GERD). In short, I was a train wreck. Honestly, no matter what my psych evaluation revealed, I was going to be medically necessary patient. Turns out I was a "fair" risk for surgery which was, in all honesty, good enough for Mike to proceed and schedule surgery. I chose to have surgery and fully expected things would be, well, average.

Mike takes the week off before Christmas and heads to Mexico. If you remember, there was a HUGE snowstorm that closed DIA. Oh, yeah, I was SO on the phone with staff asking if Mike had made it back and was going to be able to do surgeries.

I did my pre-op nutrition classes. I did my antibacterial washes. I drank my protein drinks prior to surgery. My extended family called me on Christmas Day to ask if they'd interrupted my holiday feast (lots and lots of LOL). I reported to Rose Medical Center at the god-awful hour of 5:30am for my admission. I manage to drop 11 pounds from my pre-op examination. I put on my gown and stored my personal effects in the plastic bag they provided. Pam kissed me goodbye and sent me off to surgery. They wheeled me into the operating room (cheezits that room is COLD) and gave me my anesthesia and proceeded with the bypass surgery.

I woke up in the recovery room. And I started throwing up almost immediately. Not from anesthesia. Just clotted blood. Please note that most surgery involves giving you paralytics which don't wear off quickly. That means that what usually takes just a single heave (as in to throw up) meant 3-4 semi-coordinated heaves to pull a clot up and out the mouth. While heaving I sounded like a tuberculosis patient on their death bed - lots of heaving, labored breathing, and wheezing. Evidently I hit some sort of magic number of attempts to heave blot clots because the staff decided I may have an abdominal bleed and sent me back to operating room for a endoscopy (scope) to see if I had something that was still bleeding. Someone (a really bright person, to be sure and no this is NOT a snarky statement) had the idea that if there WAS a bleed I'd need to be re-intubated so why not do it prior to the scope? On paper this makes perfect sense. In reality I heaved another massive clot just as they were trying to intubate me. Imagine a giant blood clot blocking not just the trachea (the tube that carries air to the lungs) and the esophagus (the tube to your stomach) at the same time.

You know those magic five minutes? Those minutes to get full air exchange started and know that you've staved off brain damage? I had a fully blocked airway. Nothing in, nothing out. That's what doctors call a full cor. I managed to get BOTH surgical teams into the operating room with each anesthesiologist wondering what was the best for me. Do they stop and try to suction the clot out, or what? Finally Dr. Lee decided to just push the endotrachial tube down into the lung. Yes, this would drop the clot into a lung and no, that lung would not work, but the OTHER one would work and, well, half a set of lungs is better than NO set of lungs and buys time to the go suction the clot out. Great choice on his part. That's indeed what happened. However, those magic five minutes? It took four and a half minutes plus a fair amount of chest compressions to get me stable. Kim, both my friend and director of the bariatric surgery program, got the unenviable task of telling Pam that there was no guarantee that her partner would wake up with the same mental capacities that she left with. You know that scene on TV where the doctor comes out to say everything went fine? Not what happened to Pam. In an effort to give me every opportunity to heal, they drugged me to the gills on Fentanyl. If I WANTED to swat a fly on my nose, there was no way I'd have the ability to do so. It's a short-term equivalent of a medically-induced coma.

I woke up sometime around 3am. Intubated. No one tells you that when you're intubated, they tie your hands down so you can't pull the ET tube out. No problem except for one thing. I was a blind woman and I left my glasses with Pam. I can't see shit. And I'm throwing up again. Around the ET tube. No way to ask for help. Turns out though, if you bite down on your ET tube and cut off the air flow, an alarm goes off. It will get someone's attention albeit slowly. Hey, it's the intensive care ward - everyone's drugged to gills and the telemetry says my heart's still beating.

No surprise to anyone who knows me, I recovered all of my mental faculties. Once Pam gave me back my glasses, I was able to communicate via her PDA. Yes, I can swear quite eloquently via text. Confused the shit out of the intensive care staff when Pam would mention that "Teresa said" this or that. When she showed them what I'd typed on the PDA no one was really worried about permanent brain damage. Yes, I said damn and a bunch of other obscenities about respiratory consults and the definition of "soon" to a great many people while never speaking a word aloud...

So when you wonder why I tax my body, that's the reason. I got a second chance. To quote my anesthesiologist, I'm not wasting this chance. Yes, occasionally my body fights my social schedule. I try to accommodate my body but also be cognizant of the gift I've been given. I have a chance to really live life. And I'll be damned before I abandon or spit in the eye of the chance I've been given.

Hopefully this has given you some insight into why I do what I do and that sometimes I am required (OK, forced) to take mandatory down time to recover. It's me living my life. Living my life with a body that isn't perfect and has limitations. Thanks for listening to me...

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