A Line in the Skin (Post # 58)

Please excuse the extra lines radiating out from the scar, 

I'm just thrilled to be without pain!

I thought I was prepared, but as I frantically searched for my healthcare card at 4:45 the morning of my surgery, the thought occurred to me that I simply hadn't allowed myself to think about it. I was just looking forward to having 2 functioning arms again! Also...denial. (Not a huge fan of surgery for some funny reason! 🤷🏼‍♀️)

I arrived at the Day Surgery Unit in the basement of the Royal Alexandra Hospital where I was given the coolest hospital gown. Make that, the warmest hospital gown. 🙃 They're called "Bair Huggers" and are fitted with a vent to allow a hose to blow warm air into the gown. Yes, you inflate like the Michelin Man, yes, you look absolutely hilarious, and yes, it was glorious. 

Not me, just a photo of the Bair Hug with the hose attached below the waist. 

You can also attach it at the shoulder, depending on where you want warmth.

I wasn't able to enjoy the gown for long, as by the time I had reviewed my history with my nurse, received an IV, had my vitals taken, and written "Yes" on my left arm with a marker, it was time to go. I was brought up to the third floor and into the "holding room." Unfortunately, the medications I was supposed to be given prior to operating had not yet arrived from the pharmacy, so I was bumped from first surgery of the day to second while these were administered. The anesthesiologist came by and we went over my history...again. He assured me that he had read through my chart and would be following all recommendations made at my pre-op appointment, including allowing me to wake up completely before extubating me. Yes, I was going under general. (Methinks the surgeon may have regretted not using a nerve block! 😄)

I snapped this covert photo while awaiting surgery. 🕵🏼‍♀️

Thankfully, Marigan, our daughter, was willing to accompany us, 

so Ken wouldn't have to wait alone. 

Meanwhile, Ken was busier than I, making friends with a gentleman in the Tim Hortons line in the cafeteria and hearing all about his wife's cancer. He also made friends with everyone in the Family Waiting Room, while Marigan pretended not to know him. 🤭

After arriving in the OR, my surgeon, Dr. Morhart, made sure that I had marked the correct arm, and laughed when I asked him if he would be willing to take a photo of the tumour, at Ken's request, of course. (The answer was "We'd have to scrub out and scrub in for that, so probably not.") 

The next thing I recall was waking up as the nurse removed my nasal cannula, saying, "You don't need this, you're only on 2 liters of oxygen." As they brought me back to the Day Surgery Unit, I remember thinking, "Hmmm, I think I may need that cannula after all." Obviously, not everyone had read my chart! 😁

The next part is a blur, but apparently I asked for an asthma puffer, as I was wheezy. This didn't help and my oxygen saturation (O2 level) was 88% and going down (normal is 95-100%). I gratefully received a nasal cannula, something I absolutely despised when I was in ICU in 2022, so I knew things weren't great. I couldn't stop coughing, so my nurse continued to turn up the oxygen. Soon I was up to 5 liters, then 6, and then my nurse swapped the nasal cannula for a bigger mask that covered both my mouth and nose. Marigan was less than impressed with my care, but didn't want to be "that" family member, so when my nurse went on her break, Marigan asked the nurse covering for her if we could get an incentive spirometer...an excuse to get her to check on me, since I was in no shape to be using one! 😇 At that point my O2 level was 85% on 8-9 liters. 

This nurse was certainly less blasé and immediately got in my face. Literally. They tried to get me to improve my posture (lost cause) to see if that would help, but that just made me dizzy, and my blood pressure tanked to 89/47, or as Marigan likes to say, 89/dead. 🙃 The charge nurse arrived and called "Rapid," a rapid response team consisting of a specially trained ICU nurse and a respiratory therapist (RT) who show up with a crash cart. However, as Rapid must come from ICU, they recommended calling a respiratory therapist (RT) who could likely arrive sooner. One was called and she arrived with her student and quickly changed my mask to a non-rebreather as I topped 15 liters. Meanwhile, the resident doctor working with Dr. Morhart came by, so including Rapid, there were probably around 10 people outside my tiny curtained cubicle. I really should have charged admission! 

Rapid came and took over from my nurse, as usual, and Marigan filled them in on my post-op history, something that made the Rapid nurse uncomfortable; "I never like to hear the words intubated and proned." I was given a bolus, (500ml of fluids over 20 minutes) while RT poked my wrist to obtain a blood gas level. Surprise, surprise, my oxygen level was 149%! (Should have been 100%; I've always been an overachiever!) Oops, apparently, you can over-oxengenate someone! The resident doctor ordered a chest x-ray, something that I found amazing; the X-ray machine was portable! My results showed a possible lower respiratory tract infection (not likely) or pulmonary edema (more likely).

Marigan tells me that the x-ray machine was similar 

to this one. I don't remember too many details...weird.🤨

At some point, just prior to Rapid being called, Ken phoned his Mom and told her that things weren't looking great, could she please pray. I later heard that the grapevine worked incredibly well and as the news travelled, prayers went up on my behalf. I was beyond touched to hear that a member of my church called her sister-in-law who just happened to be with her Ladies Bible Study (in another country), and they joined in asking God to intervene. 

And He did. 

It really is that simple. I was not doing well at all. With my O2 levels continuing to fall, I was starting to panic at the thought of requiring reintubation and another extended hospital stay. (Meanwhile Marigan was packing up everything, in case they were moving me...like to ICU.) Thankfully, my oxygen saturation went up, my required liters of oxygen went down, and my blood pressure normalized. I continued to improve while awaiting a bed on a unit upstairs, as no one (including me) wanted to send me home. (Oh right, I was also still on 6 liters of oxygen.) However, my parents don't own the book "The Strong-Willed Child" just to take up space on the bookshelf, so I was connected to a portable oxygen tank as I wanted to go for walks with Ken, wandering the deserted Day Surgery Unit. (Warning: the phrase "day surgery" may induce hysterical laughter in my family members.)

I was eventually brought up to the OBS (Observation) section of Unit 33. This is a step-down unit, which has better nursing ratios (2 patients for each nurse) than the regular unit (4 patients for each nurse). With my history, they didn't want to take any chances; I'm just glad I didn't need ICU. 

The following is Dr. Google's definition of OBS: (I crossed out the portions that didn't apply to me, thankfully!)

Observation on Unit 33 (General Surgery/Neuro/Trauma) at the Royal Alexandra Hospital is an acute, monitored level of care. It serves as an intermediate or step-down unit for surgical, neurosurgery, trauma, and orthopedic patients who require Level 1 observation and close cardiac or neurological telemetry.

Patients placed in this level of care require frequent, specialized nursing assessment, continuous monitoring, and early intervention to ensure

stability as they recover from severe injuries, complex surgeries (like spinal

cord operations), or acute medical events.

What this entails:

Monitoring: Frequent vital sign checks, neurological observations, and continuous cardiac or invasive pressure monitoring for high-risk patients.

Multidisciplinary Team:

Coordinated care provided by a specialized team of Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Health Care Aides. 

Specialized Care: Focused interventions for trauma, traumatic spine cases, and complex post-operative surgeries.

Throughout the night, my sleep was disrupted by my neighbours, Hewey the Hoover and Spewey the Spitter.  Hooey was the patient on my right who regularly used suction to rid himself of excess phlegm, etc. On my left side was a patient who probably had some sort of accident (Really missing Ken to ferret out all the details!), and should have had suction, as he was constantly spitting his excess secretions into a tissue. 🤢 It was not a great night's sleep. However, my night nurse, Finella, was lovely, and continued to turn wean me off my oxygen, as she knew I was determined to go home in the morning. 

Morning arrived with several unwelcome realities: I had forgotten just how much damage intubation can cause to one's throat, but I was ravenous, so I just chewed my breakfast into a paste. 😣 I also had a nasty, nasty headache/migraine, due to caffeine withdrawal. They really should have put coffee into my IV, as I wasn't allowed my usual jolt of java on the morning of my surgery. (I was told no food or drink after midnight...until they read my chart, then they said 8pm. I was super cautious and stopped eating at 5:00 pm. Le sigh. A lotta good that did! 🫤) 

When my day shift nurse arrived, she did her usual assessment, looked at my O2 levels and told me that I was unlikely to go home that day, as the magic number is over 91% on room air (no oxygen) and I was still on 4 liters. Ha! Last time someone told me I wasn't going home for several days, I left that afternoon! I was determined to do a repeat. I must admit to finding it rather hilarious that I am so hospital stay adverse, when 3 members of my family (soon to be 4) work in healthcare (more on that later 🥰). 

So I pushed myself...perhaps a wee bit too much. I used my incentive spirometer, I chugged water, I sat in a chair, rather than lounging in bed, and I prayed. Oh, how I prayed! At intervals during the morning, my nurse told me to take a walk around the unit to see if what my oxygen levels were like on room air. The first time I took a lap around I passed one of the lovely cleaning staff members. She was so confused when she came into my cubicle less than an hour later to see me in bed. "I thought you were a visitor!" Gradually, ever so slowly, I was weaned off oxygen and while completing my last lap before discharge, I discovered my nurse spying on me. "No wonder she thought you were a visitor, you were truckin'!" By this time she had figured out that I was not staying another night and was keen to help me reach my goals. BTW, stubbornness isn't inherently problematic, it can be a gift from God. 😇

Pro tips for a speedy discharge:

1. Make sure your oximeter finger is warm, like really, really warm. Wash your hands in hot water or pop it in your mouth if you have to (after washing your hands, of course). This makes a huge difference in the reading. (No idea why, sorry.)
2. Cough just before they measure your oxygen levels. Again, no idea why, but this works. Ask me how I know. 😁
3. Get the adrenalin flowing so hard and fast through your veins until your body develops a psychogenic fever, or wait...no, don't do that. 😏

Huh? What's a psychogenic fever? Well, Dr. Google describes it as follows:

How It Happens: 

When under immense psychological stress, the brain activates the sympathetic nervous system. This triggers the release of stress hormones (cortisol and adrenaline), which directly affect the hypothalamus - the body's temperature regulator--causing a rise in core temperature. 

Diagnosis and Treatment:

Because there is no standard lab test, psychogenic fever is diagnosed by

ruling out other possible medical causes.

Key Characteristics:

◦ Temperature Range: Can present as either chronic, low-grade elevations (37--38°C or 98.6--100.4°F) or sudden, extreme spikes up to 41°C (105.8°F) during emotional distress. 

Drug Resistance: Standard over-the-counter antipyretic drugs (like acetaminophen or ibuprofen) typically fail to lower the temperature.

When I couldn't get warm upon arriving home, I worried that I had an infection and would need to return to the hospital, something I wanted to avoid at all costs! Thankfully, a warm bath stopped my compulsive shivering...and then I was overheated. Like, seriously? I know I'm post-menopausal (thank you, Letrozole...said no one, ever...) but these temperature swings were wild for even me! Thankfully, once I knew what was going on I was able to relax and over the next couple of days, my temperature came down. Phew! 🥶🥵

While I know God was with me through this whole shmozzle, I have no idea why I can't just have a bit of boring in my life. I mentioned this to my wonderful family doc, who simply looked at me and shrugged, "You don't have a boring personality, so what do you expect?" (Excuse me while I go Google "how to be boring.")

Well, that was quick. Yup, definitely never going to pass as boring: 

1. Have no passions, hobbies or definite opinions. ❌

2. Respond to people in a monotone, without changing your facial expression. ❌

3. Be completely predictable....ha!  I stopped reading after that one. ❌

So, why does God allow these less-than-boring things to keep happening to me?

So I can tell others about how wonderful He is, perhaps? 

"Um, Heather, I've read your blog since 2022, the year you were diagnosed with your second cancer, how can you say that God is wonderful?!?" 

My life being less than ideal does not mean that God isn't wonderful. Christians are not given a free pass on trials and tribulations, we are promised them.(See John 16:33: I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.)  

"Right, so remind me again why I should want to join this Trials and Tribulations club?" I had a rather random thought as I watched Ken and Marigan leave the night of my surgery; I am so glad my Best Friend never leaves me. I can talk to Him at any time, and know that He's actually delighted to hear from me. (My BF is Jesus, in case you were wondering. 😊) I used to think "praying without ceasing" meant getting sore knees but not being otherwise productive, but now I know it's just talking to my best friend all day long. Nothing can compare to knowing that I am never alone, even when my emotions try to convince me otherwise. I know, I know, I should just "look down deep within myself" and all will be well, right? Yeah, well, I tried that and all I saw was adipose tissue (body fat) and cellulite, so that was a definite fail. 🐷 Matt Maher and Stephen McWhirter recently released a song, Found It In Jesus, that expresses how well Jesus takes care of us. I'm just grateful that everything I need, I can find in Jesus, because He's still good, even when life isn't. 

Found It In Jesus

Strength for my weakness

Peace for my worry

Rest when I'm weary

Help when I'm hurting

Grace for my pride to humbly receive

All You have for me

[Verse 2]

It's not by my power

But in Yours I trust

A shield and a tower

For all those I lovе

In every season from faminе to feast

You give everything

[Chorus]

The fullness of life

The faith to believe

I found it in Jesus

The greatest of loves

The hope we all need

I found it in Jesus

I searched the world

Both high and low

Running on empty and I didn't know

All I was looking for

I found it in Jesus