Sunday, May 19, 2013

The Healing Ridge


Two weeks past hernia surgery, and what a crazy time this has been.  I didn’t feel like writing about this thing until I found my way out of the woods, and I can surely say, past few days that’s been happening.

This thing quietly announced itself in late March, got it diagnosed in early April, spent the next few weeks finagling with the surgeon and financial department of the hospital to ensure I didn’t get hammered too hard financially.  God bless this surgeon – this guy bent over backwards to help me save a small fortune in expenses and over charges.  He really didn’t do much work in this sense – just pointed me in the right direction and gave me the right names in administration to talk to.  But he refused to move forward until he knew I was getting a fair deal, and he assured me it wasn’t a bad thing to wait a few weeks as the hernia was on the smaller side and not a critical case.

That’s what I realized over the course of April as I essentially did nothing but dwell on this.  I couldn’t go the gym as I didn’t want to exacerbate the condition (although I felt perfectly fine, save for this small marble poking through just about my navel).  I told everyone the truth: at no point was I in any sort of real pain.  When that thing first popped through, it was irritating more than anything, and a few days later when the surgeon somehow massaged the thing farther back through the abdominal wall, I could barely feel it.  He also let me know … I always had this, meaning that potential opening in my abdominals, so that something like this was bound to happen, sooner or later.  This made me feel better as I was totally unaware of lifting or straining to make this occur.

But he did assure me, we should operate and patch this up as opposed to leaving it, not wanting to take the chance that it could enlarge somewhere down the road.  If you research the web when you have a medical condition, you’re going to find all sorts of contradictory opinions (and a lot of wrong-headed horseshit that will only frighten and depress you).  With hernias, the main issue seems to be  the anti-surgery folks who preach that surgeries are bad and long-term failures, and you’re better off adopting a new diet and physical regimen to live with this thing.

For every one of those missives, I’d find 10 times the number that suggested surgery was the only real solution, if done correctly by a good surgeon.  (Speaking solely of small ones like the one I had – I’m sure large ones, say baseball/grapefruit size or larger, are another story all together.)  I had two doctors, a family doctor who had no financial gain in my getting surgery, and a surgeon who did everything he could to reduce my fees, suggesting surgery as the best option.  I stumbled across some very good surgeon blogs with doctors writing about their experiences in the operating room, and that’s where I learned a hernia operation was pretty straightforward and basic as compared to other types of surgeries. 

So while this thing might be considered routine and very basic in terms of surgery … boy, it’s on you that they’ll be cutting your body open and taking chances with your long-term health, regardless of how basic it is.  It’s a huge deal for a person to have any sort of surgery – any time your body is cut open, anything could happen.  I’ve seen this with other people in my life, some of them feeling like dogshit for a long time after surgery, sometimes for weeks or months, depending on complications.

But I was glad as hell when the day finally arrived, and I walked down to the hospital to meet up with my friend from work who also lives in the neighborhood.  I couldn’t do this alone – any time a hospital puts you under to perform surgery, you need someone along to make sure you get home all right.  This was early in the morning.  We walked into our designated waiting area, and there were already about 20 people there taking up all the chairs.  I thought this early in the day, we’d be there alone, but, no, there were many other people either about to be operated on or friends and family members.  A bad start!

I stood around for about half an hour, filled out some necessary forms, but was luckily called in within the hour. I was being scheduled first, I guess because it was a basic operation and a good warm-up for the rest of the surgeon’s day.  Met with the  pre-op nurse, she took down my info, got me naked and into those crappy under-sized gowns, at which point, I was led out, met up with my friend and led through some doors that turned out to be the pre-op room, people moving everywhere, a beehive of activity.  The nurse led us to a bed in the corner and said wait here.

Seconds later, my surgeon appears out of nowhere, shorter than I remember him, this rambunctious Greek with a look of mischief in his eye,  like one of The Marx Brothers in his gown and cap, but happy to see me.  Got the feeling like I was hooking up with Captain Quint to load up the Orca and head out to kill the shark, that sense of positive expectation.  We chatted for a few minutes, and he went nuts over my friend, saying this must be your wife, no, girlfriend, no, well, whatever you are, you should think about becoming one or the other, because this guy is the real thing, he’s like a champion racehorse, etc.

He had a very good way of putting me at ease with a constant stream of goofy compliments, keeping things loose, and I knew enough to roll along with the tide of good feelings.  Hell, I’m a pretty relaxed person to begin with, and now that I was on the cusp of being cut open, I felt at ease and ready to roll with whatever came my way.  He could see this about me, even when I was in his office, and I could tell he was over-joyed to have a patient who wasn’t gripped in fear or coming into this thing with a negative attitude.  Then he said, Billy, let me lift your gown up here and see what’s going on.

And, boy, did he … with my belly and balls hanging out, while my friend blushed, and medical staff milled around doing their pre-op preparations.  They’ve obviously seen naked people many times before, so no one blinked, but I could see out of the corner of my eye, my friend was freaking out, probably thinking, motherfucker, I didn’t sign on to see Bill’s balls and belly hanging out!  She had that casually indifferent look of a subway rider not wanting to look too hard at a homeless person quietly sleeping in his funk on the train.

Put your finger on it, Billy, the surgeon said, meaning the hernia, and I did, at which point he got out his magic marker, and scrawled a few arrows and numbers onto my belly so he’d have the directions written right on my skin when he went in.  He called out the type and size of mesh he wanted to use to patch up the hole to his assistant, and then he rolled down my gown, said, look, here comes Julia (fake name), she’s going to handle your anesthesia, Julia, we’re cutting this guy a break financially, please don’t forget that when you send him the bill.  He slapped me on the back, got up and sauntered off, and that was the last time I saw him that day.

Julia, an Asian women in her 50s, took my hand and said, Billy, come with me, like a little girl with a secret place she wanted to show me.  That secret place was the operating room, which I hadn’t known was about 15 feet from where I was sitting.  Bright lights shone down on me from the ceiling … the star of the show.  You really get the feeling like you’re the star performer in a high-school musical, hardly famous, but everyone in that room is there for you.  And it was her, what looked like her assistant, and two guys in the corner who, for the life of me, I don’t know what they were doing, but they seemed busy finagling with various pieces of equipment.

There was the operating table, which was like a cross made out of bedding material, so I lay my body down on it and spread my arms out accordingly.  Julia hardly said anything to me, just asking if I was comfortable.  I had no idea how long this would take, but when I fully horizontal with arms extended, she took my left arm and said, let me give you this little intravenous shot, which she did.  I wasn’t really talking or looking at anybody at this point.  I had a little Mona Lisa smile on my face because I was so damn relieved this was finally happening.

I blinked my eyes and woke up in a different room, on an inclined bed.  What woke me up was a nurse gentle tapping my cheek and saying my name.  It was the most blissful, rested feeling I might have ever had in my life.  My mind had been blanked out, even my sub-conscious.  Whatever they put in that anesthesia … I wish I had some to go to sleep every night and wake up feeling that way.  I wasn’t in abject pain.  Didn’t feel tired.  But I looked down and saw this bulge of gauze and medical tape on the center of my belly.

That’s when I became aware of a stiff, mildly bruising pain in my abdomen.  Hell, I was still smiling.  One of the nurses commented on it, said your smile puts me at ease.  The next thing I became aware of was that I was far from alone.  There was one nurse on a computer in a corner, and three more walking around the room with clipboards and such.  There was a woman in a bed next to mine quietly crying while her spouse or boyfriend held her hand, but it seemed like good tears, tears of relief.  I smiled at her, and she smiled back.  The room was freezing, probably around 60 degrees.  I was wrapped in towels and felt like a baby in a swaddling manger.

The nurses kept talking to me to make sure I was in the moment.  I was completely in the moment.  Whatever anesthetic and pain killers they were using, I did not feel one bit stoned.  I recall the time being about 9:15 when the surgeon was talking with me and my friend.  It was now 10:30, so the whole thing had taken roughly an hour.  I could see that I was in the immediate post-op room, and right next door, was the room where I was going to wait this thing out once the nurses were convinced I could stand up and walk over there by myself.

Which didn’t take long.  This was all going surprisingly easy.  Getting up was a bitch, as it would be for the next few days, but not impossible, and it felt good to flop down in the reclining chair in the next room, where the discharge nurse immediately gave me some tea, cookies and Percocets, and told me to relax, you’re going to sit here until you’re ready to roll.  We’re going to bring your clothes around in a few minutes so you can get changed, but until then, sit back, relax, we’ll be talking.

There were two other patients in that same area, both in various stages of getting their asses out of there.  They were gone in a few minutes, and it was time to put my clothes on.  That’s when it occurred to me, you’ve just had surgery and are not the same anymore.  Had no problem getting my shirt and shorts on, but when I bent over to tie my shoes, oh, the dull throb of pain my abdominals sent to me.  I didn’t scream or gasp in pain, but, man, it let me know, this is what you’re going to be dealing with for at least the next few days, this very sore, swollen spot right in the middle of your belly.

They finally let my friend back in to see me, and she told me later, she thought that I hadn’t even had surgery as I looked so normal, composed and relaxed in my street clothes.  I was that coherent.  Whatever the medical profession has done with anesthetics and pain killers in the past few decades, it’s clearly grown in leaps and bounds.  It was good to have her with me, as she’s a very dependable, at-ease person. I got her talking about work, and we went on for the next hour about the various dramas and situations, which took a load off my mind as it got me completely out of my situation.

The discharge nurse said, Bill, let’s go the restroom now, so I did and had no problem walking or urinating, went back, got my prescriptions and discharge papers, thanked everyone I could in the immediate vicinity, walked out, and realized how compact that entire surgical area was, all this shit had happened in about a 50-foot radius, from the main waiting room, to the pre-op room, to the operating room, to the post-op rooms.

My friend got us a cab, got me to the nearest pharmacy to my house, picked up some Oxycodon, I sent her back to work, thanking her for all she’d done for me, walked the block back to my apartment, and conked out in my recliner.

“Conked out in my recliner” describes the next six days.  Sure, I got up quite a bit to get stuff from the refrigerator and what not, but I only went out once a day around noon to go to the grocery store or a near-by restaurant, mostly to have that small daily workout.  The best thing you can do after surgery is nothing.  Just recline.  Watch TV.  Get high on prescription meds and let time float by like a cloud.  I had a bunch of episodes of Thirtysomething on tap on Amazon Prime, focusing in on the episodes that involved Miles Drentell, the “evil” advertising executive who haunts the main characters with his mysterious ways.  (I would have loved to work for Miles Drentell.  Whoever wrote this show didn’t have a lot of experience in the corporate world, otherwise they’d recognize he was a pretty good boss in general, not the insane prick this sometimes weasly show made him out to be.)

Sleeping and reclining are the orders of the day after something like this.  I had thought I was going to come charging out of this thing like a bull, but there was just no way that was going to happen.  Four days later, I took off my bandages and got a look at this thing, which was discouraging.  The redness, the swelling, the stitches.  It looked and felt like shit.  Speaking of which, bowel movements were crucial in this process.  The pain killers tended to cause constipation, on top of which the hernia itself was caused by bulging intestinal matter, so having it pushed back into place would have some effect on this process, hopefully positive.  Luckily, I was shitting normally after the second day, having over-dosed on prune juice and stool softener the first day resulting in diarrhea.  It took effort for me to even fart without feeling a mild pain in my abs.  That first really good bowel movement, two nights later, felt like it should have been accompanied by a marching band playing this.  Standing up from the recliner?  Luckily, I have a rocking recliner, and I could heave myself up after rocking the chair with a “1-2-3” count.

Six days later, my mobility was enough that I could stand up with only minor discomfort, so I decided to try braving rush hour and get back to work.  I made sure to order some drawstring scrubs on Amazon as sitting upright with this surgical scar for hours would be a challenge.  I ordered a size too large on the off-chance that my size would be skin-tight or too small, which was a mistake, but what could I do.  The pants were so baggy that I looked like M.C. Hammer in his “Can’t Touch This” video.  The inseams were five inches longer than what I normally wear, so I had to go out and buy some safety pins at the drug store to hem them inside the cuffs.  I looked like an idiot, but there was no way I was going to wear normal pants with that incision right at my belt line.

That first day back was awful.  The incision felt irritated and raw all day, swelling against the bandage I had in place in a very bad way, like the damn thing was going to burst through again.  I left work early and let them know, rest of the week, I got to get out at 3:00.  It was just too exhausting to deal with that sort of low-level discomfort all day long and could use that extra hour or two to nap or relax when I got home.  Which I did each day.

The worst thing I’ve dealt with leads to the title of this post.  All along, that swelling on the incision had hardly decreased.  It was irritating as hell, a constant feeling of low pressure, especially when I sat upright in a chair.  I could feel it going down ever so slightly each day, hardly at all.  By last weekend, I was wondering what the hell was going on.  It was a very dark weekend.  Since I had the bandage off when I was at home, I could look at this thing, see the still irritated and red skin and, worst of all, that lump around the scar.  I was convinced that the hernia had somehow burst through again, or something was going very wrong with my recovery.

I typed in “hernia ridge” on Google when I could feel this spine-like ridge along the internal incision that was slowly becoming apparent as the general swelling began to decrease.  And that’s when I came upon this site that described what I was feeling.  And a few other sites.  All of which confirmed that the swelling that had been driving me crazy and convincing me that I was very fucked up … was actually the healing process in full bloom.

That’s what it was: a ridge of tissue forming along the incision, in this hard, spine-like series of small lumps that was my body starting to protect itself by covering the incision and making it heal.  And since that day, every day has been better, but it’s still a disorienting feeling to have that hard little ridge right above my belly button, almost something like you’d expect with an erect penis, this weird feeling of tissue engorging itself for a purpose that the body understand implicitly, but your mind doesn’t quite grasp at first.

I met the surgeon again a few days ago, two weeks after the surgery, for a post-op follow-up, and he was as effusive and friendly as ever, sweeping right in on me in his examination room, asking me how I felt, ordering me to drop trow, doing the cough check, feeling around my abdominals, then running his finger over the scar, ah, that lump, you know this is the best sign possible, don’t you.

Well, for a very dark few days, I didn’t, but I assured him that I did now and was glad to see and feel it.  I wish he or one of the nurses had told me that I should be on the lookout for this!  It would have saved me at least four or five days of psychological torture as I drove myself nuts with thoughts of impending doom.  If you’re reading this and either haven’t had surgery or are going for it, please, do yourself a favor, ask the doctor what signs you should look for immediately post-surgery that you are healing properly or not.  You’ll save yourself hours or days of darkness, and the last thing you want to feel after surgery is any sense of foreboding or failure.  You want to feel normal, know you can’t, but in absence of that, you want to feel secure that you are moving in the right direction.

And I was.  I am.  I have been all along.  It’s such a blow to the senses to go through something like this that you feel a constant pull every step of the way to focus on negative outcomes, and will be prone to taking anything that isn’t obviously positive as a sign to start worrying.  Which is a mistake, but one that’s nearly impossible not to make when you have more time to dwell on the condition of your body.

As it is, this healing ridge, this new little spine, I can tell, I won’t be hitting the gym until this thing goes way down or disappears.  It makes sense, the amount of time you’re told not to exert yourself physically, to let your body heal itself and recover.  This thing makes me feel very vulnerable, and I get the feeling if I were to try to heave something very heavy right now, this thing would strain or break open somehow and cause me a great deal of discomfort.  Thus … this is why doctors tell you, give it a month or two, at a minimum, to do any hard physical labor or gym work.

“Vulnerable” is a good way to describe the overall feeling I take from this experience.  I feel a lot more vulnerable than I once did, when I thought working out hard and religiously, day after day, week after week, year after year, would somehow shelter me from any physical ailments that would befall lesser beings.  Well, so much for that.  I’ve learned that as we get older, sure, there are things we can do to help our bodies, preventative medicine of sorts we can administer ourselves in terms of diet and exercise.  But after a certain point, for most of us in our 40s and 50s, our bodies let us know, there are going to be things happening every now and then that are beyond our control, sometimes fatally so.

This one was relatively easy (and it’s been hard in and of itself, believe me).  Cancer?  Other diseases that occur in the age range where genetics kick in and become health factors as much as anything we can do to prevent them?  It makes sense to keep yourself as strong and vigilant as possible, mentally and physically.  You better believe, when I feel certain enough of myself to hit the gym again, I will be there.

This is one of those differences between child and adulthood.  Between being young and old.  The realization that you must move with time, adapt to it, learn how to swim with it, and that sometimes, the tide will turn against you, one time at the end for sure.  I had zero health issues in my childhood, teens, 20s, 30s and most of my 40s.  It’s a wonderful thing not to worry about your health, to just be healthy and normal, and I’m going to do whatever I can to get myself back to that place as soon as possible.  This thing has taught me how to fight, and I mean fight in ways that makes sense, as opposed to the senseless ways so many of choose to do so.

I recall that feeling I had at the start of this, with the Eagles song that so perfectly nailed how I felt: all alone in the center ring.  And I don’t really feel any less alone now as a result of all this, but now that I’ve felt my way around in the darkness, it doesn’t frighten me as much as it once did.  This song by Van Morrison captures where I’m at now.  I had figured when I first heard this song years ago, it would one day tie into my life in terms of a broken heart, or the passing of a loved one.  As it turns out, it ties in solely in terms of healing within myself.  Another of those things that can only come with time and dealing with adversity.

1 comment:

Anonymous said...

Thank you for this wonderful article. I am facing hernia surgery and am anxious when I think about it. Your hilarious article made me laugh out loud (no, didn't make my hernia hurt, but my hound dog looked at me funny). Good job!