This is a little departure from my usual subject matter. But as it relates to choices, what happens to us is not a choice. So here's my story of one of those moments.
It’s never been lost on me that I’ve had a healthy life. When patients come in with pain or devastation, maybe a cancer diagnosis or an autoimmune disease, I usually leave the room thinking how grateful I am to have never felt that way. Of course I don’t know what lies ahead for me. I’ve experienced loss, but medically I haven’t needed much to this point.
I was a patient when I had both my kids but those were planned inductions, went well, and I was in the hospital for about 48 hours each time. I had epidurals and I took ibuprofen once. Otherwise I haven’t really been a patient.
Until this week.
Last Friday I had epigastric pain, just an ache as if something weren’t digesting. We’ve really been eating a clean diet but I thought maybe it was something I ate. Honestly, I thought if I had a bowel movement I would feel better. Well that happened and I didn’t feel better.
Saturday was more of the same, but more generalized pain throughout my abdomen. By Sunday morning, the pain was in my right lower quadrant. Any medical professional reading this already knows what my diagnosis is. I did too, to be honest.
I was sitting by the Christmas tree with my son and I did an abdominal exam on myself. I had positive rebound tenderness, that’s when the pain is worse when letting go as opposed to the pushing in, a classic peritoneal sign. I was eating, I had no fever, no nausea or vomiting.
I didn’t really want to do much. I tried to take a nap but couldn’t really get comfortable. I told my husband “I’m concerned I have appendicitis”. I still had no other symptoms.
By dinner, I did not want to eat which is alarming for me. Still I got the kids to bed and even tried going to bed myself. In just a few minutes of not getting comfortable, I got myself up and told my husband I was driving myself to the ER (he did ask if I was ok to do that and I insisted, of course). Actually first I called the ER, told them it was me but I wasn't calling as Doctor Me, and asked how long the wait time was. She said there was only one person in the waiting room. I said I'd be right there.
I went to the hospital where I work and was seen by an ER doctor that I speak to on the phone frequently. We were talking as he was doing an abdominal exam and when he hit my right lower quadrant I stopped and winced. He said he was pretty convinced I had appendicitis after that since I’m pretty stoic.
I had a CT scan with contrast for the first time ever. The tech knew I was a first-timer, so he said the contrast could make me feel hot and like I have to pee. We chuckled. WTF - it’s so true! For the few minutes I was in the machine, I felt hot as a hare and like I had just peed (I didn’t, really). When it was all done, he said “so that’s a CT scan” and I said “holy shit I felt like I peed!” He said sometimes he jokes with people that now he has to clean up their pee, to which I laughed. Laughing hurt.
It took me four hours to accept pain medication. I really just wanted to sleep, now that it was the middle of the night, I knew I’d be having surgery and recovery, and I wouldn’t be able to sleep with the pain I was in. I’m naive to all of it so I was nervous I wouldn’t feel well. To be honest I wasn’t sure if it would work. This was such a non-specific, gnawing ache in my whole abdomen.
The ER doc came to check on me a couple of times and asked if I wanted anything, “I don’t think your pain is letting up,” he said. It wasn’t. I ended up finally asking for something. When he came back in and said he ordered 4mg of morphine, I said “holy shit”.
As the nurse pushed the morphine, I was turned on my side and I swear my pain was instantly gone and I could doze off.
Between not wanting to eat or drink prior to going to the ER to now having an infection and morphine, my blood pressures were in the tank. As I was dozing off, I heard an overhead call “Sepsis alert, ER 14”. I said oh for fuck’s sake, that’s me. I got more fluids, my lactic acid level was normal. The team was finishing up another surgery and I was next.
One by one the team members came to see me, all people I work with regularly. The anesthesiologist, the OR nurse, and the surgeon. The surgeon explained, as we always do with a planned laparoscopic procedure, that it could potentially become a laparotomy, or a big open incision. I nodded because I know this and say it to my laparoscopic patients. It is scary on the patient end, knowing I’ll be asleep, waking up after a time lapse to find out what happened in there.
Let me talk for a second about my lady parts. This was an all-male team. I have nothing against that. It’s just that I also work with them. So the nurse had me pee beforehand so he wouldn’t have to put a Foley catheter in me, “to save us both from the embarrassment” he said. I appreciated that. He did have to prep my abdomen though, down to my pubic bone, where I had some regrowth of hair that was supposed to be removed via waxing THAT DAY! I obviously had to cancel that appointment since I was tied up in post-op recovery.
The last thing I remember is the oxygen mask on my face and the voice of the anesthesiologist saying “we’ll take good care of you.”
They did. I am so grateful.
I told the surgeon to take pictures of my insides, including my uterus and ovaries. It turns out I had started to rupture my appendix so he did take pictures of pus that was in my pelvis and even surrounding my liver. He was able to do it all laparoscopically.
I remember upon waking in the OR that I was being moved by the nurse and tech from the operating table to a bed, and in doing so my ass was exposed. I remember the nurse telling the tech to cover me up. Can’t wait to talk about that one when I go back to work.
The abdominal soreness was so intense, but truly as I tell patients it gets better every day after a laparoscopic surgery.
I certainly appreciate nurses in my line of work but this experience brought that to a new level. When I was immediately post-op, my nurse put the grippy socks on my feet, unbuckled the SCDs and wiped down my legs, wiped down my abdomen. I’m not one to ask for help (I drove myself to the ER for fuck’s sake) and not only did I feel comfortable asking for help but I didn’t really need to - she just did it.
I learned I love SCDs. SCDs are Sequential Compression Devices, the sleeves that wrap around the calves and squeeze on and off to improve circulation and thus decrease risk of blood clots in the legs. I’ve always had patients love them or hate them. I love that massage. The day I was leaving the hospital I actually sat in bed without pants on specifically so I could keep the SCDs on longer.
Overall I am so grateful that my surgery went well and I’m recovering. My care was excellent from start to finish. I counted how many employees came into my orbit during my stay which was less than 48 hours and I counted 22, including housekeeping and maintenance staff.
I feel grateful that this is the place where I work.
So, from a shit circumstance I learned a lot (seriously that feeling of peeing with contrast is wild) and had great care.
We don't choose our family, what happens to us, or how people treat us. We do choose how we respond.
It’s never been lost on me the amount of trust patients place in us as their doctor or team member. From the patient side, I was sick and vulnerable, trusted my team, and they delivered.
