Yohan’s Surgery #4 – Before the Knife—the Anesthetic

June 22, 2016

Everything is fun and games until the anesthesia wears off. The most polite Yohan I’ve ever witnessed was in the recovery room immediately following surgery. He was still under the influence of a light sedative and thanks to the nerve block that numbed his leg from the knee all the way to the toes, he was in no pain whatsoever.

“Thank yhou, thank yhou very much for efrything, he slurred. “Yhou are all wuhnderful.”I don’t think he was addressing any one person in particular, but anyone with whom he made eye contact.

When the nurse gave him cellophane-wrapped hospital bran cookies, Yohan gushed, “These are the best bran cookies I’ve ever eaten!” He was full of peace and love when sending a group text to his closest friends, “I love you guys all so much!” He was funny, extremely polite and grateful for every service rendered, from the surgical team’s work to the small cup of juice offered by the diligent and kind nurses.

The six-hour drive home was long and tedious, but his spirits were high, knowing that the whole procedure was over and done with. The nerve block would last 24 hours and we were well equipped with pain medication. Megan, Yohan’s girlfriend, was waiting with open arms, ready to offer him the care and support he needed. She was up for anything and made it clear that no chore large or small would be too much (the things I’ve asked her to do-yikes!). She’s been nothing short of wonderful.

We all fell fast asleep as soon as we hit the bed (no, not the same bed). It had been an exhausting ordeal, but we thought that we had turned the page, that it was finally over.

Little did we know, the worst was yet to come ….

Yohan’s surgery was more extensive than I had imagined. The list of procedures included a heel osteotomy (the surgical cutting of a bone), a first metatarsal osteotomy, tendon transfers, calf muscle release, plantar fascia release, pinky toe straitening and three more procedures I have since forgotten. In essence, his foot was surgically reconstructed and it was screaming in relentless, merciless pain. The morning’s mild discomfort was getting worse by the minute.

When I left in the morning, he was sleeping soundly and Megan was up and ready to tackle the day. Checking my phone on the way home, I was greeted by Megan’s frantic texts, each rating Yohan’s pain on a scale of 1 to 10. Scrolling from earliest to latest, I saw a 4, a 6 then an 8. Yohan was moaning and groaning in agony. The nerve block had worn off and the medication was definitely not providing enough relief.

Yohan’s doctor and surgeon were both overwhelmingly receptive and helpful, guiding us through the day, advising us on how to safely lessen his pain with a complex combination of medications. It took a long time to get the unbearable pain under control, but by 4 p.m., Yohan seemed much more comfortable.

The respite did not last long. By 9 p.m., the pain latched on with a ferocity I myself have never experienced. The maximum opioid pain medication did not quiet the heartless beast. In fact, it only seemed to enrage it further. So, here we sit, at 2 a.m. in the ER. We wait, along with all the others who are sick, in pain, suffering. We all want the same thing—release from the grips of the tormenter.

A few thoughts……

Don’t let your pain get out of control. Pain is a personal experience and each person is unique. Your doctor wants you to say so if your pain is not manageable.  Don’t worry about “bothering” the surgical staff or appearing weak. Pain, if left uncontrolled, will hinder your recovery because healing occurs faster when pain is well managed. Play an active role in your pain management treatments. You deserve the best possible care available.

Yohan’s Surgery #3-And 7 Hours Later…..

After four hours, we started to wonder, “What is taking so long?” He was wheeled away at 7:30 a.m. and should have been done by noon, at the very latest.  A female voice called our cell phone on behalf of the surgery team several times to tell us that all was fine and to hang tight.

Then again, that is what the hospital voice had said about my neighbor’s husband a few years ago and when we arrived for a visit we were informed of his untimely and unexpected death. “Just get to the hospital as soon as possible,” the earlier unknown caller said. “All will be ‘fine’.” Yep. I’ve heard it all before and all was not fine. The word fine is really all about covering up the truth with a neutral and superficial word. Ever ask, “Hey, how are you today?” and get the answer, “I’m fine, thanks.”  Do you really think that person is fine or are they saying it to be polite, to avoid burdening you with the truth of their misery or to continue on with their day? You see where I’m going.

Here’s what I learned about waiting patiently:

-When all is “fine,” don’t watch the clock. Find something to occupy the time, which slows waaaaaaaay down when you feel stressed. I answered emails, read, watched soccer with my husband (I hate watching sports on TV), walked around aimlessly and used the bathroom more than I really needed to. It gave me a sense of accomplishment.

-Texting and emailing family and friends back and forth not only helped to pass the time, but also reminded me of the importance of friends and family in my life,  people with whom  moments of happiness, sorrow, embarrassment, fear and vulnerability are shared freely, truthfully  and willingly. How grateful I am for you.

-For God’s sakes, do not keep your gaze on the hospital recovery room doors. Everyone but the one guy you want to see strolls through those doors. And when the orthopedic surgeon does finally show up, he’ll come when you least expect it and through a secret set of doors you’ve never noticed before.

I changed my flight home not once, but twice. By the time 2:00 p.m. rolled around, I could no longer keep my mind in that little worry-free zone it had been cooped up in since 4:45 a.m. when the alarm screamed, “Rise and shine!” I was losing it. Gilles does not show his worry. He keeps it hidden way deep down inside, but his quiet demeanor speaks volumes. His uber calmness made me all the more anxious.

Finally, at 2:20 p.m., Dr. Glenn Pfeffer burst into the room (through that secret set of doors) and with his hands high in the air and a wide grin on his face, yelled in an exuberant voice, “Everything is fine, perfectly fine! (No way! There is that word again!).”  Then, with body language that acknowledged our concern, he sympathized, “You must have been worried.  I get it.” He saved the best for last: “The surgery was a resounding success. “

“Some feet are more challenging than others” he admitted. “Realigning a CMT foot is a complex and intricate process and I strive for perfection.”  Nine procedures and seven hours later, perfection was achieved.

Will I worry about the overall success of today’s surgery? Most likely. I am committed to taking 30 minutes out of each day to honor my distress before moving on. A friend told me, “You can’t go backward. It’s done. Ask your questions, embrace the present and move on from there.” And she’s right. Onward and upward.

Yohan’s Surgery #2 – The Wait

The worst part is the wait. Waiting for the weeks, the days, the hours, leading up to the surgery. Now there are only minutes before they bring him into  the OR for this life-altering procedure.  Dr.Pfeffer arrives smiling, wearing scrubs and a sports coat, an odd mix bridging the everyday academic with the skilled surgeon he is.

I know Dr. Pfeffer personally. He’s a brilliant surgeon, the best of the best, a perfectionist in every sense of the word.  I would have chosen no one else for this delicate and complex procedure. But I found myself intensely examining Dr. Pfeffer for signs of fatigue, wakefulness, discomfort. “What did you do for Father’s Day?” I ask, hoping to hear that he did not drink too much wine or attend a big party the night before Yohan’s surgery. He reassured me that he had a relaxing day at home, reading articles about CMT. “About CMT foot surgery? ” I laugh uneasily. I think he ignored my last question. If I were him, I might have done the same. All this after last Friday’s email where I wrote, “Take it easy this weekend. We need you in tip top shape on Monday morning.” Seriously?

Whatever the age, I realize it is very difficult for me to trust even the best with Yohan’s care. A mom’s internal alarm system? Overly anxious? Public outcry constantly reminding the public, Do Not Trust your Doctor. Don’t believe me? Google “Trusting Doctors” and you’ll understand where I am coming from.

The longer he stayed with Yohan, looking over his charts, asking questions and engaging in conversation, the more we all relaxed. Bedside manner is everything! Dr. Pfeffer’s calm and reassuring voice  infused us all with confidence and  his steady hands examined Yohan’s left foot one last time. And just to make sure left does not become confused with right (haven’t you heard those horror stories?), he sharpied a big YES on the left ankle (and I did not even have to askJ.) Hugs and kisses were not sparse as Yohan was wheeled down the hall. Calmness reestablished.

So now we wait. After one hour, we received news that all was well. The surgery should last another hour and as the time passes, my heart races, beating faster and faster with each passing minute. Here we go again……time to breathe.