Surgery

I didn't have this on my bingo card. So Monday night I'm out hiking in the mountains. And just after turning around to go back down I start to get this ache in my lower abdomen. And I'm lamenting that I did not bring any toilet paper. It had occurred to me before I left the house, but I'd just gone number 2... And I'm wondering if I will make it home. And when I do, I sit on the pot and... Nothing. Okay... So we watch some TV, and the ache in my lower abdomen is somewhat intense, but I'm chalking it up to the fish I ate for dinner. Felice has got a new meal delivery service, and although the halibut was tasty, it smelled very fishy, and that can be an indicator of a problem. But I'd just eaten the fish, could it already be in my lower intestines? Didn't think so. But, Sunday evening I'd eaten a bunch of stuff from Gelson's poke bar. I love the squid especially. And Sunday night, I had some stomach discomfort, so this must be it, right? So I'm waiting for it to pass. Drink some Metamucil. But almost nothing comes out. So then I think about alleviating the pain, what would work. And my research really didn't come up with anything. So normally I read at night after Felice goes to bed, but I couldn't focus, I'm lying on the couch doomscrolling on my iPad, believing that I just have to wait it out. All things must pass, right? Eventually, long past 2 AM, I get in the bed. I mean I'm tired, but I'm in pain. To the point where I think I'll take some Tylenol. Which I do and then promptly vomit. Thank god I made it to the porcelain goddess. Okay, maybe it is the fish. Which started to come up in chunks. But I felt no better. I might have slept the better part of an hour, but basically, even though I spent some time in bed, I could not fully relax and chalk up some Z's. I was just in too much pain. And all my research online told me it was diverticulitis. Which I've never had, but... And now it's closing in on 9 AM the next morning and I decide to text my doctor. I hear back from his office promptly, they tell me there's nothing they can do for me and I need to go to the emergency room to get a CT scan. God, I had to work myself up to even contact my doctor, now I'm supposed to go to the ER? Normally I wouldn't. Unless you were bleeding profusely, my mother wouldn't take you to the doctor, never mind the hospital, and is there anything worse than going to the ER, where you sit forever? But my doc said to do it, and I trust him implicitly, and obviously something was going on. I told Felice to take me to UCLA in Westwood. Now I could go to a smaller joint and wait less, but if any action needed to be taken, I wanted to go where they had all the pros. And their system is pretty good there. You check in promptly, and then you sit and wait for triage, in a room so cold thank god I brought both a vest and a sweatshirt. And triage came about half an hour later, around 10:30, and this woman was compassionate, which surprised me, because usually they're punching the clock, they've seen it all (probably fakers, that's what my mother would say), and I was given a heat pad for my pain and then... Sit there long enough and they come with your very own blood pressure cuff. I don't know why these things can no longer be shared, but I was told to keep it with me and... Let me see now, all told I was in the ER FOR THIRTEEN HOURS! A personal best, or worst... First I fell asleep for 90 minutes, probably due to the anti-nausea pill the triage person gave to me. And I was worried about not hearing my name, but she told me she'd put down a description of the clothes I was wearing and they'd find me. The better part of three hours in, a doctor came out and found me, wanted an explanation. I just showed him the e-mail I sent to my internist and this guy then said he was pretty sure it was diverticulitis. Now... That CT scan didn't happen until around 6 PM. In between, I kept getting my vitals checked, I peed a bit (worried that I'd miss my name being called, which did not happen), and read this book of the person I was supposed to be doing a podcast with the following morning. And then I doomscrolled... It's like being in suspended animation. You're just killing time. You don't want to answer e-mail, get involved, you're on your own trip, you want to focus, at least to the degree you can. And I'm there so long that the pain starts to reduce. And then I go for the CT scan...after I get my blood drawn and a port installed in my arm...and then go back to sit down. And sit. And sit... Finally, around 9:15 PM, a doctor finds me. Takes me into this side room, not part of the main complex... The main complex, the inner sanctum, it's like "The Pitt" on steroids. There's a virtual town of people at desks in the process of directing traffic. And there are bodies everywhere. And it seems like we have to walk to a different time zone for the CT scan and... By time I'm talking to the doctor, I feel guilty. Obviously I'm okay and am wasting their time. But that's not what my internist thought. Turns out if you have diverticulitis you need to get antibiotics. So it was good I didn't leave, that I was playing it out. But when my internist heard I was at UCLA, he went bonkers and said THAT'S THE WORST! He thought I was at St. John's. Or a smaller joint. He was chuckling, saying you only go to UCLA if you're experiencing serious trauma, in a car accident, if you're bleeding and... I sit down with this guy who looks like a college student who tells me... It's a kidney stone. That's hard to fathom. I've had a plethora of kidney stones. And the pain has always been in my flank, not my lower left abdomen, like in this case. But he's assuring me. But then, BUT THEN! He says there's an infection and they've got to do surgery. WHAT? Oh, I have the option to go home to wait for the stone to pass, which was what I'd planned on, but if I did that and there was a blockage, I'd die within a couple of hours. Well, that scared me straight. Yup, the stone is 6mm (why they use the metric system in medicine and not the rest of America...it's so much simpler). And it was blocking urine. And if that infection got backed up by the kidney... All hell would break loose. So it was like that Dirty Harry movie. Did I feel lucky? Not that lucky. I'm all in. Forget about the cost, my health comes first, and then... This doc says he's got to call his boss. But before we break up the convo he tells me I need to be admitted, and the surgery will be the next morning, unless I started to feel bad, and if so they'd run in and do it in the middle of the night. Meaning, I couldn't drink or eat anything. Well, I hadn't eaten since 9:30 the night before. An energy bar. As for fluids, I'd had a hard time keeping them down, but I did hit the water fountain a few times on my way back from the bathroom, but I did not consume much. So how long is this gonna take? The doc won't be positive, he won't lie. And hours go by, a nurse practitioner comes by and checks me out and I think I'm good to go, but he tells me to wait and... Then a nurse needs to take a detailed inventory of my belongings. Down to my sweatshirt and my cash and credit cards. Their systems are pretty good. But really, if something is stolen are they going to admit it? Finally, just before midnight, a guy comes by...there are a slew of these people, sans CV, essentially pushers, who wheel you around. But I said I could walk. And I'm already envisioning my room, and mentally relaxing. Thinking about taking a shower. And then, they take me into this mini-ER and say THIS IS YOUR BED! You've got to be kidding me. There's a row of these. About five. These plastic mattresses surrounded by curtains. Plastic. This is going to be comfortable. And the new nurse, she has a very heavy accent and is wearing a mask and I just can't hear her. Ultimately she wants me to get into a gown. But it's too damn cold to wear a gown, I'll sleep in the clothing I'm in! Then I say I have to go to the bathroom and she says...IN THOSE SOCKS? I mean the bathroom isn't even ten feet away. And she wants me to wait while she gets me the hospital socks, with those little treads. I just push myself ahead, it was URGENT! And after returning there are two nurses, tag-teaming me, asking questions simultaneously. And this nurse with the heavy accent...she's asking question after question about whether I've thought of killing myself. Then she starts going through the inventory of my belongings again. BUT I'VE ALREADY FILLED OUT THE FORM WITH THE NURSE IN THE ER! But she's still asking the questions. Telling me they're not responsible if any of my stuff is stolen. And I've been there fourteen hours already, with nothing to eat or drink, I'm at my limit. And she backs off and tells me I'm going to be woken up at 4 AM to have my blood drawn. And then someone comes and draws my blood right then! So obviously she was confused. The other nurse... She's hooking me up to all these chest monitors. And a finger monitor. And I'm worrying about going to the bathroom and... She shows me the plastic bottle I'm supposed to pee in. After sleeping an hour I tried to use it, but it was too impractical lying in bed, so I stood up to use it and then good luck getting the blankets, which couldn’t be any thinner, back atop me. And I sleep an hour. And then after being up for a while I sleep another hour. I'm wearing one of those masks over my eyes, they give them to you, they think there's too much light to fall asleep. Meanwhile, thank god the woman next to me stopped watching her TV... And at four AM, damned if a nurse didn't wake me up to take my blood again. Exactly why, what had changed in less than four hours, I do not know. I ultimately slept another hour or two and then they wake me up and start trying to replicate the pills I take at home in the morning. I didn't know they did this, then again they didn't do it too well, and they tell me they're waiting for the doctor, but... I FEEL PRETTY GOOD! The stone must have passed. I tell the nurses this and then the doctor comes in and he is skeptical. I'm thinking he's got an investment in doing the surgery. But ultimately he agrees to do another CT, which happens relatively quickly, and I'm starting to fly high, I'll be out of here in a jiffy, I'm gonna walk across the street to In-N-Out, to reward myself. But ultimately the urologist comes back and says...THE STONE IS STILL THERE! I couldn’t believe it. It hadn't moved. Okay, I was now resigned to surgery, but then there was another wrinkle. Since there were a few emergencies, and it was a holiday, the surgery would be delayed. HOW LONG? Probably until after dinner. I can't make it that long without eating or drinking, I'm parched. But the doctor says there's an option. If I'm up for it, they can do the surgery right here, in my bed! Okay... Well, they may not be able to get the wire up inside me, or I might not be able to handle the pain, and if either scenario happens, they're still going to have to put me under at night. But I'm gonna give it a try. Sounds like a cystoscopy. Then again, in the spring I had two, and the first one was PAINFUL! How good was this relatively wet behind the ears doctor going to be? So I wait for a while, until after noon, and this doc comes in with a helper and they start setting up. They're unpacking... Forget all the people working at the hospital, the amount of equipment involved for this surgery... I can see the dollars adding up. And I see in one bag this thread and wire and I say no, no way, this is not going into my body. But when he got the stuff all laid out, he showed me the wire and tube and said THIS WAS IT! And I'm starting to freak. And when in this situation I tell myself I took the bar exam, and passed, when only twenty-odd percent did. So few people passed the bar that recently they made it much shorter and easier. People were pissed they'd gone to law school and couldn't practice, and California needs more lawyers. So if I could handle the stress of the bar exam... However... How often did this guy do this? He seems excited about it. But I'm going with the program, until he tells me the big doctor, the one who he consulted with the night before, was gonna come in and do it. That was a relief. Some alta kacher with experience! But not really. The big guy turned out to only be 42, however he was totally present, he was not punching the clock on me, so I relaxed, not fully, but a bit. And my dick is full of numbing gel. And there's this giant camera, I don't know how it's going to go up inside of me, doesn't look like it would fit. But it does. Turns out the first doc, the younger doc, is doing all the work, the big kahuna is just watching. And the pain is tolerable until... They start pushing the wire up the canal. That's right, it was about as painful as it sounds. But I did not want to blow the whistle, I did not want to have him pull out and go through this again in the evening. And normally they do full anesthesia, you're totally out of it. So I'm being tough, but in addition going completely under is always a risk, not that I was worried, but this was another reason to do it in my bed... Which was in the office. Anything but sterile. It was like the 1860s. Other than even the surgery gloves coming vacuum-sealed in plastic. Finally, they stop. They say they're nearly done, they're going to take an x-ray to check the positioning. That's right, they had a portable x-ray machine. A big Fujifilm contraption. And I've got to raise my body so they can put the imaging plate underneath me and... They shoot relatively fast and then everybody goes to look at the picture and... They're not jumping for joy. Oh boy! So everybody goes back to their position and they start fumbling with the wire again and I've got to pee so bad, and they're telling me I'm being a champ, all I know is we've come this far, but I'M AT MY LIMIT! Finally they say they're done. Compliment their own work and... Now what? Well, I'm' gonna have pain when I pee, like I just did, when I finally released. But that was PAINFUL! And I'm gonna feel the catheter inside me... But I figure how bad can this be, they're letting me go home. But first the big doc says I've got to come back in a few weeks so a kidney doctor can sandblast the stone. It ain't never gonna pass according to this guy. But maybe they'll have to wait longer. But I tell them I'm going to Colorado. But the big doc gives me his cellphone number and then says he's going to go get me a cheeseburger. Well, that strikes In-N-Out, but I can go for that. But when he comes back ten minutes later it's with a bowl of tortilla soup, he says it's their specialty. I don't really care, I'm just so damn hungry. And I take a few spoonfuls and then ask him CAN YOU GET ME A DIET COKE? And he starts talking about needing coffee for the caffeine, but I'm not interested in the caffeine, as a matter of fact, I normally drink Caffeine-Free Diet Coke. And no coffee. But he comes back with a can and THAT HITS THE SPOT! So when in hell can I get out of here? Felice is itching to come pick me up, but I don't want her to sit. They tell me ninety minutes. There's paperwork. But eventually they say I'll be done in twenty minutes and I text Felice, but about nineteen minutes in, the big doc comes back and tells me he's scheduled me for the follow-up next week, for the catheter to be removed and the stone to be blasted. THAT SOUNDS GOOD! And I've got to go to my internist for pre-op. Whoa...really? You just operated on me! But then he gets an idea, WHY DON'T WE DO IT HERE, RIGHT NOW? But I get a text from Felice that she's already parked, but man, let's do it. So they give me an EKG. And then draw some blood. And it takes a bit of time to do all that, and then I'm done. They let me walk out alone, which is shocking. And I get in the car and we get on the freeway, off to CVS for the prescribed antibiotic and... The nurse said I might have some urgency, so she gave me a plastic urinal for the ride. And I didn't need to use it, but man, I was close. And when we got home I went directly to the bathroom and peed and IT WAS INCREDIBLY PAINFUL! I mean really bad. And I could feel the wire inside me. How am I supposed to cope? And I'm so f*cked up on the Dilaudid they injected into me before the procedure. You feel warm and then a bit out of it, but I don't get how people like drugs. Now I'm home, I'm out of it, I can't concentrate, can't read a book, I'm just mindlessly surfing when I'm not getting up to sit on the pot. I finally figure out I'm a bit better if I put a pillow under my knees while I'm lying in bed. But man, I'm still aching. But after hours (we got home around 4 PM...), the Dilaudid haze started to lift. And the pain... I could still feel the wire and now, where the stone is, and that was not so nice. Had they moves it and irritated the canal, or was this what I was going to have to endure for the next week? And the thing about stuff like this is you're canceling your schedule, one thing at a time. First I canceled Tuesday afternoon's PT appointment Then I canceled the morning shrink appointment. I hope I don't have to pay, it's less than 24 hours notice. And then late last night I canceled the podcast I had scheduled for today. And I was supposed to be at the Troubadour tonight for the Gram Parsons tribute, but there's no way I could do that. And... I'm still messed up a bit psychologically. For a day and a half I was in limbo. In another world. And now I'm back and it's the same as it ever was except for the pain. Is this how it's gong to be, as I age, one episode after another? Then I remember that I've gone to the hospital for kidney stones previously, and had one surgically removed. But there was no infection. 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