Nov 18 - Post Surgery

 I gave myself the very best runup I could to surgery day. Bed very early - wrestling with my shitty sleep schedule to pull it into something surgery adjacent. Did everything I could to try and nudge my bullshit towards a better day. I suppose in a way there's always a deficit to pay. And you typically pay it afterwards. But. If you try hard, sometimes you can pay a little beforehand. Albeit. It doesn't always work. And you don't get much out of it. Half the problem is the batteries won't take a charge. Trying to overcharge them beforehand is a bit of a losing battle. Nevertheless. Sometimes. It can help a little.

I wasn't great on the day of the surgery. I am never great. But. I was better. I could feel that line of critical unwellness and where it was. And it kept stable. Over there. Within sight. But not straying closer to me.

The first 30 minutes of waiting in the waiting room passed in a blip. A sure sign I had a little strength. I recognised it. I thought to myself that I was thankful that today at least, I wasn't on the floor terrible. I could sit up. I could operate. I had a little strength. I compared it to Friday. Like night and day. And Friday wasn't even the worst by a long shot. Just having enough wellness to sit upright and be normal shifts everything over, suddely things become copeable with, everything starts to seem doable and possible and oh I remember this, this is how I always was. Like. Normal fucking people. I didn't jinx it. I didn't push it. I was just very thankful my bullshit was behaving itself on surgery day. A boon. In fact. Of all the times I have been into the hospital for surgery, this was by far my best feeling day. Best being subjective.

As it turned out I was ok all the way through. No dips. No bullshit. No exhaustion out - until the aftermath anyway. My god. My tinnitus was squealy. A little dizzy. A little skittish. A little ill. In no state to do much. But very copeable with.

I'm not sure why they make you wait so long for surgery. I was one of the first ones in. They get you there for 11am. And don't start the first surgery until 1.30pm. There is as far as I can see no reason for it. It leaves more than enough time to get everyones paperwork done and get you to see all the surgery team you need to see - assuming you are in for a "major" surgery like I had ( needing a full team as opposed to some quicker in and out 15 minute procedure ).

I was in by 1.45pm. And by the time I was back in the land of the living it was 4pm. Which seems about right given the others.

As ever once you do get to surgery, you get a glimpse of what a well functioning all you could wish for health service might look like. Everyone knows what they are doing. Everyone gives a shit. Everyone is very capable. There are no fuck ups. There are no wants. There are no shortages. Professional. There is nothing you can hold fault with. It's everything you would want from a proper health service. It's a shame the rest of the NHS, or perhaps, just the bloody GPs, couldn't be held to the same level of quality. When I shared that insight with my brother he said he had a similar experience, and that in his opinion, the GPs were by far the worst bit of the service. The broken bit. It does make me wonder if that rotten apple doesn't end up spoiling the barrel a bit. Then again. The delays I have had getting what should be relatively routine surgery done shows that it isn't all sunshine and roses.

That being said.

So this time, they dithered about whether I should have a general anaesthetic. The anaesthetician was friendly and flat out gave me a choice. I could have - effectively - an epidural, or a general. My preference. Depending on agreement with the surgeon about the epidural - it was iffy whether it would be ok or not. The surgeon thought they could get away with it, I had no preference - secretly I would have preferred general, not because of squeamishness of the surgery, but rather just give me oblivion. My motivations are fucky. So epidural it was.

So there we are. Chatting as they get me ready. We are talking AI. They have all locked into the fact that I am writing an AI agent for work, that I am an IT expert, and they have in their surgery someone who can answer all their questions. They numb up my back. And go in with a needle into my lower back with a pinch.

Nope. Can't get through the ligaments the anaesthetist says. Can we get a bigger needle. Here. This is our biggest needle.

Tries again.

Nope.

They get me to shift. Here let me try the attending surgeon says.

They try again.

A bolt of lightning goes very specifically through my right calf. Yow I say out loud.

The pain is ok. Don't get me wrong. Unpleasant. But meh. I deal daily with worse shit.

Where was that asks the attending. Right calf I say.

Back out, too far someone says.

For the fourth time a needle pokes in my back. This time my right thigh goes off like I've just touched a live wire. I know what that feels like now after having the nerve induction test. It's the same feeling. I know this is them lighting up - incorrectly - my nerves directly - touchy touchy with the needle. This isn't what you're supposed to do.

Where was that they ask again with a little tension. Right thigh I say.

They back out again.

Fifth time lucky.

This time my whole right leg goes from hip to heel. Youch.

Where was that they ask again. Right leg.

Some muttering. Ok. One last try. Otherwise we will switch to plan B.

I am not sure they properly got it in on the sixth try. I think they were halfway in, when a very familiar feeling overtook me. I managed to spit out. I don't feel well.

I could feel the blood drain out of my head. A static come up over my tinitus. My stomach drop out. And I instantly felt very ill.

The male nurse in front of me said. He's fainting.

Everyone scrambled. Get him down, get him down. Put the bed down. Get the oxygen. Everyone moved around me and I dwindled to a spot. I didn't pass out. I did that very familiar thing I do. Close call. My arms stopped responding. I could hear them somewhere. But my small amount of focus was on breathing. Not throwing up. Not passing out fully. And feeling terrible.

As is often the case I had instantly broken out into a "pain sweat / passing out sweat". Also something that happens a lot with me. It's like a system malfunction. Who knows what to do. I know. Lets just dump sweat suddenly.

The scientist in me surrounded by people who knew. After a while I said oh I broke out in a sweat everywhere.

Yeah said the nurse. That's fainting. It can be part of it.

Oh really.

I said I felt ok though. The pain was ok.

Yeah said the nurse. Your cognitive bit of you was ok with it. The lower bit of you was not.

Uh huh.  

I've had this before a few times. Like when my back spasmed out. Painful. But ok. And then I started to black out. With Hazel behind me at that time. And I said to her, oh, I think I'm passing out. Hilarious. Very calm. Very measured. Hey. I'm losing consciousness. Bye.

They fed me oxygen for a while. And very slowly the nausea abated. I started to feel a little better again. But that whole thing. Very familiar. This is how I often get. Yikes. Am I always at the point of passing out. I think. As it turns out. I have a very high pain tolerance. And least. A conscious very high pain tolerance. It's always "ok". To the steely willed just do it thinking bit of me. The rest of me however, the more animal bit I don't have control of in the shadows is not on the same page. I think the result is. That I can sail through my critical pain threshold without much conscious concern. And then watch aghast as my automnic system goes into crisis and collapses. Hey. We're failing. How fascinating. Zonk.

Eh. Which. Eh. Now I think about it. Sounds about right.

It's also probably why everytime I have surgery they say, oh you will need painkillers, hows the pain etc, and I say, Zero. Or. One. Non event. Move on. They are kind of surprised. But they roll with it. 

Whilst on the oxygen and I am slowly recovering, they fully zonked me out. And that was that.

2 hours passes.

The next thing I know I come back to a shadow of awareness fighting. I get the impression I am struggling against people, trying to sit up, they are pushing me back down to the bed. Some random flitting thought about AI. And I am in a situation I need to fight.

I submerge a little again.

Thoughts scattered nothing there, just the animal breathing, the tiniest of awareness I am being wheeled to recovery. I feel like shit. Like I have been run over by a truck, through a plate glass window and off a 10 storey building to impact the ground below. It's a bit like a CFS/Whatever dump. But bad. And figured in with some kind of physical trauma.

Not around the area of surgery. I get nothing from that.

But the rest of me. Feels like it has been in a war. It's very rough.

I start my round of coughing. Same last surgery. The intubation has scraped the fuck out of my throat. It's sore. I can't stop coughing.

The nurse offers me water through my bleary senses.

That was brutal I say.

It can be the general anaesthetic she says.

I've had general before. This is nothing like that. This is brutal.

It could be where they gave you multiple anaeshetics the nurse says. 

I slump. Brutal. I repeat.

Very slowly I recover. They wheel me back to the surgery ward still in half an out of it state. This is different to the times before.

I can feel my eyes are punchy. Like they sometimes get. How interesting. Perhaps my CFS has finally reared its head during a surgery. It has decided to wreak havoc whilst I was compromised. Hmm. It is not good.

Slowly I come to my full senses. And I am exhausted. I feel so tired. This is new. But not new for CFS. Uh huh. The more I think about it in hindsight. The more it smells of my CFS finally losing its shit and flipping the table at some point during the surgery. Interesting. But also. Copeable with. Very unpleasant. But it didn't kill me. ( sadly ).

I am connected to a drip. A bag of fluid following me around. I have only just become aware it's there. It snakes down into the canula in the back of my hand. At some point the bag is done, and they take it away. I don't fully notice. I just notice at some point it has gone, my canula is still in, very very slowly back feeding a plasma heavy blood out of me - watery pink fluid. 

I get my post surgery toast and juice. They want you to eat and drink. It's not really optional. They get you to pee. Sort out your paperwork. How bad are you bleeding they ask. Eh. Ok. I am dressed. My bed has a sizeable patch of blood and plasma. A wad of absorbent material soaking it up. It looks like someone has given me a minor stabbing. Which. They have. But as per usual. Zero pain. I might have an open wound. But I can't feel it really. A tingle perhaps. In the scale of things. It doesn't even rate. Perhaps my nerve endings don't work. Although. All the prodding in the back. They very much clearly do. So, not that then.

30 minutes later. I was out of the hospital where my brother picked me up.

My back started to feel very bruised. Like someone had repeatedly punched me there. Nothing from the surgery area. But someone had danced a tango on my back.

When we got back home my brother wanted a look.

Oh he said. Yeah. You have a mark here. Here. Here. Each time he touched my lower back. You also have a red line up your spine he said. They've poked you about a lot back here.

Heh.

I had related the faff with the epidural to him already.

"Poke him til he passes out" I said. We laughed.

Surgery upshot.

The surgeon came round afterwards, as they do. I've brought the whole team he says as an array of young faces crowded at the end of my bed. A small army. 8 of them. None of them over 30. Uh huh. Apparently my butt was subject for the learning of the younglings. How delighted they must be.

So the state of affairs is that my fistula has largely healed up in the intervening 2 years. The seton has now been removed - so for the first time in six or so years I don't have a plastic doodad in my ass, nor stitches - the wound laid open - again - and the hope is at this point that over the next month it does its final bit of healing and that's that. No further surgeries are scheduled. That being said. It could be the case says the surgeon. That it heals, and about 2 months later it starts being an issue again. At which point. Back to surgery. He said if that happens to contact his secretary, just go direct to the surgery team, and they will get me back in. But. Hopefully not.

So maybe. Six years in. Three surgeries down. We're finally at an end.

I picked up that wound babysitting Ares when he broke his leg. Oh so long ago. Sitting on the hard floor for days. I fucked my butt up. A lot of hassle. And suffering from CFS in hospital waiting rooms. And I would do it all over again if it made my furry butt boy feel better. Them. Before me. Always. As fucked up as some might think that is. To me. It doesn't even get a call.

Today my CFS has kicked in. Post surgery you say ! Of course you will feel rough ! Except. Previous surgeries. I have felt the reverse. Better. This time. Not so much. I am tired. Exhausted.

Today I woke up. My brother was up. Chirpy. I was like death warmed up. He has over a decade on me age wise. Older. And this is how I should be. Chirpy. Not permanently fucking exhausted. It crossed my mind in an instant the difference.

Ho hum.

Surgery done.

But perhaps more positively. I managed to eke out a better day for it. Whether by luck or intent. It gives me a little hope that if in future - inevitably - I am in hospital again. It might not be an excruciating experience. I might. Have a little strength.

But who knows. Maybe I got very lucky. Maybe the collective power of peoples positive thoughts put their thumb on the mystical balance and tipped it my way. Maybe me practicing some very clean prior preparation was good enough to nudge it in the right direction.

Regardless. Thankful. It could have been so much worse.