And Now, I'm Finally Awake!

I don't know what the big deal about Vicodin is, but for me, it's not "all that".  Makes me groggy and dopey(er) for about 24 hours after I take one.  It may kill pain, but it kills any kind of decent functioning too.

As Leslye reported earlier, I'm through it after about a day and a half of sleeping.  I didn't out-sleep the cats, but I worked on it.  The worst I have to report is a soreness underneath the left side of my mouth, the inability to open my mouth wide enough to take big bites of food and a sore throat from the tracheal tube used during the surgery.  As I've been doing a lot of comfort eating lately, this may work to my advantage.

It occured to me that there may be people out there who have never had surgery.  By surgery, I mean the going to sleep kind, not the stuff they perform in doctor's offices.  In keeping with the educational nature of this blog, here's what I went through.  All you first timers, pay attention!

First off - no eating before hand - usually 8-12 hours before.  Surgery is usually scheduled early in the morning, so this doesn't pose much of a problem except to coffee drinkers.  If you take medicine in the morning you're allowed to take it with a "small sip" of water.  I usually cheat and go for at least one big gulp, and so far no problems.  The reason?  Some people are made nauseous by the anesthesia and the operating room staff doesn't want to clean up after you any more than necessary.  You also stand a good chance of inhaling (aspirating) the contents of your stomach during surgery should you get sick, and that's not good.

Once you arrive for surgery, you'll be questioned at least 1000 times for your name and birthday.  Bear with it, it's for your own good.  You're probably not the only one at the hospital getting surgery that day, so everyone there wants to make very sure that they're doing the correct procedure on the correct person.

DO NOT let anyone write on you except the surgeon.  This was a new one for me.  Leslye decided to inject a little humor into the situation by writing something like "no step" or "other side" or "not here" with a purple marker over the scar on my right neck from the last surgery (this one was for my left neck).  I thought it was funny too, but nurse's eyes got big as dinner plates when she spied the graffiti.  She wanted it scrubbed off right away because she said the surgeons are supposed to ink out where they're going to cut and initial it; everyone there is trained to look for the purple ink and she didn't want any confusion over what was being done.

Next, you'll get a visit from the anesthesiologist who will of course: ask for your name and birthday.  They usually ask what your weight is (Don't lie!  It's written down somewhere!) and if you've eaten anything.  They'll tell you about how long you're going to be out and warn you about the tracheal tube.

The tracheal tube ("trach", sounds like "trayk") is a tube put into your throat and partway into your lungs to make sure your lungs are exchanging carbon dioxide and oxygen the way they should.  During anesthesia, you're so "asleep" that your breathing is very shallow, usually not even enough to move the air all the way out of your windpipe; so left on your own, you'd simply be moving the same air up and down inside your windpipe.  The trach takes up the slack by pumping the volume of air in and out of your lungs that would normally be moved by your now soporific diaphragm. It's also a delivery system for anesthesia gasses and medicene.

They'll tell you that the trach is uncomfortable if you're awake enough to be aware of it and if you feel it, don't panic -- you are getting enough air.  I can vouch for both parts of that statement.  Once I felt it going down my throat right before the lights when out.  I thought "Huh.  They're right.  It is uncomfortable."  Then I was out.  Another time I was waking up and felt this THING in my throat and thought "This must be the trach.  It sure is uncomfortable."  Then I fell back asleep and woke up later without it.

You'll almost certainly wake up with a dry mouth and a sore throat.  The sore throat is from the trach scrubbing up and down your throat, the dry mouth is from something they give you to dry up your mucus membranes.  Dry membranes help keep your airways from clogging up and helps prevent pnuemonia.  I'm convinced that amongst the team of people keeping you alive at this point is someone who's sole job is to keep you supplied with ice chips.  You're still too sleepy to actually drink anything, but you'll be offered ice chips, and at this point in your life, there is nothing better than having a piece of cool ice placed in your dry mouth.  Don't pass it up.

One thing the anesthesist usually does in his or her job is administer a drug that causes short term amnesia.  This is supposed to help blunt the trauma of major surgery, but it's also a source of merriment for your spouse.  For instance, I remember only bits and pieces of my recovery and drive home, and don't remember walking inside my house, talking to my mother, and going to bed, though I've been assured these things happened.  My first clear memory is that of being offered a glass of something to drink later that evening.
 
You may come home with a fairly recent innovation (at least to me), a "JP drain" or "Jackson-Pratt drain".  This is a small bulb about the size of an egg made of silicone-like material with a small tube connected and a small drain port.  The other end of the tube is buried inside you near the point of surgery draining fluids away from your wound into the bulb.  Back in the olden days, drainage was accomplished by letting the fluids seep out of the incision onto the bandage covering the wound, necessitating a change of bandages at least once each day.  The JP drain works by squeezing, then capping the bulb causing a gentle suction on the tube.  This causes some of your precious bodily fluids (that you don't need any more) to drain into the bulb for emptying later.  To empty, simply uncap the drain port and squeeze the contents into a cup.  Squeeze the air out of the bulb, cap the drain port, and you're ready to collect some more fluid.  Nothing about having the JP or emptying the JP hurts, it's just annoying and a little creepy having this tube and bulb literally hanging off of you until the doctor removes it.

My next step is to wait for healing.  I originally heard from the radiologist that she doesn't start RT until four weeks after surgery.  This is because radiation effectively stops any healing and she wants to make sure her patients are healed before going about the business of destroying tissue.  In my case, it may be sooner, maybe as soon as two weeks post surgery since (I've been told by professionals!) that "I'm young" and that "I heal well".  Next appiontment is about two weeks from now, so we'll see what the doctor has to say.