Tantalus

Three cheers for the unexpected.

I often take chances (or, "calculated risks").  Today started out rather chancy.  I ate breakfast, against the nurses' explicit pre-surgery directions, trusting in a fast metabolism and healthy digestive system (halfway through a 16-hour fast, I was starving).  I walked twenty minutes to the bus stop without confirming the shuttle schedule.  I didn't write down my appointment room number, trusting to a vague recollection in a photographic memory.

I figured all these chances were small, compared with the towering uncertainties of the sedation awaiting me.  So when my meal digested just fine, my shuttle arrived with five minutes to spare, and the receptionist cheerfully pointed me to the right floor, I still wasn't about to buy tickets for the Powerball.

I only half-listened as the doctor reviewed the pre-surgical disclaimers with me.  Go ahead, hit me with the big one, I thought.  The sedation part.  Not a word.  "Any other questions before we get started?" the doctor asked.  "What about the sedation?" I blurted.  "Sedation?" he replied quizzically.  "That would be too dangerous, to put you under general, or to sedate you heavily.  We'd have to insert a feeding tube and everything.  No, we're just going to use local, with some medication for the pain.  Do you...do you need general?"  "No, no, no...I'll be fine!  That's great to know.  That's what I was most worried about."  He looked confused.

Mt. Zion is a much more comforting facility than Parnassus.  No DMZ here.  The receptionists, nurses, and doctors were uniformly pleasant, approachable, and helpful.  Which was good, because the preparation for the surgery was, in itself, dehumanizing.  You strip to the waist and wrap in a threadbare hospital gown (with burn holes helpfully marking the more personal areas), then balance on a towel-wrapped diving board of an operating table.  Plastic trays snap in to support your arms and a large roll of blankets elevates your knees.  ("This should make you more comfortable!")  After the requisite pain of locating a vein for the IV (the last time for a while, I hope dearly), it is time to Prepare The Site.

First they removed the gown ("we're going to expose you for a minute here" - good thing I covered up for modesty) in order to tape down my right breast.  Amazons, athletes, or cross-dressing Revolutionary War soldiers - bless 'em all, maybe it gets easier with repetition.  It didn't exactly spur me to mount a charge against the enemy.

Then, they inserted the oxygen tubes.  This was, by far, the most uncomfortable part of the procedure.  Little icicles, burning cold, stuffed up your nostrils; the light-headedness hits you instantly.  Why dish out $20 a pop for an oxygen-bar hit?  (And how "flavoring" improves the experience, I know not.)  They dotted me with sensor diodes and strapped on a blood pressure cuff, which with bomb-ticking precision, every sixty seconds, death-gripped my right arm; meanwhile, on my left index finger, they snapped on a blood-oxygen sensor.  My pulse began to beep-beep-beep irregularly on the monitor.

They scrubbed down the site (my left clavicle) with a chokingly caustic orange solution, and taped around the site with towels and pads.  They raised my table and lowered the large ultrasound unit.  My field of vision narrowed to the blinding lights and an occasional nurse's head bobbing in and out; maybe a bloody glove or two.  "We're going to give you something to help you relax..."  Yuck.  My headache tweaked tighter.  I shut my eyes.  Beep-beep-beep went the monitor.  Squeeeeeeze went the blood pressure cuff.  Nurses talked about me in the third person.  Doctors circled like vultures.  Is this what you feel like, I wondered distractedly, when you're about to die?

Two doctors operated on me; one was clearly training the other.  The procedure basically re-threads a vein from your neck into your clavicle for easy access; the ultrasound helps the doctors locate the vein.  The lidocaine injections were not pleasant.  They never are.  The rest of the procedure was fairly rapid, consisting from my vantage point of varying degrees of pressure on my collarbone, punctuated compulsively with the beep-beep-beep and the squeeeeze, strange cold dripping feelings and the nurses' heads in sharp relief against the searing white of the operating lights.

The BP cuff got on my nerves.  I started squeezing back.  Who am I to lie there in quiet submission?  Every time it started pumping up, I'd clench my fist and flex my biceps.  Squeeze.  Flex.  Squeeze.  Flex.  Flex.  Ha.  It always gave up first, slowly deflating in defeat.  Ha.  Me, one; BP cuff, zero.

When it was over, a nurse cautioned, "Don't stand up just yet."  As if I could: I was still entangled in a web of towels and tubes and tape, with the ultrasound unit hovering just inches above my chest.  Eventually all my parts and pieces were disconnected; I swung my feet around and stood up.  I walked to the door.  The floor lurched gently beneath me.  The nurses were a bit taken aback, too surprised to sit me down.  "Are you sure you're ok to walk?" they asked, reaching to steady me.  "Sure, I'm fine," I replied, confused.  "This is just three- or four-footers.  Wait 'til you get in 12- or 15-foot seas.  Then things really start to fly."

It was all a bit anti-climactic.  My neck has a permanent crick.  I can't turn my head more than an inch or two to either side.  The non-rate who drove me home (inexplicably, I have to say, as I was not sedated and had no problems walking around: the shuttle would have worked out just fine) took me on a screaming Grand Theft Auto tour of San Francisco, complete with screeching stops and blaring music: probably not the best treatment for someone with recent neck surgery.  The lingering headache I always get from local anasthetic is finally wearing off.  And I got home starving - dove for the freshly stocked refrigerator - and winced to discover that chewing and swallowing were terrifically painful.

But I have a guaranteed direct line to a vein for the forseeable future.  They can use it for labs, and CT scans, and as long as it's flushed at least once a month, I can keep it in.

Three cheers for small miracles.