Adventures in Cholecystectomy Land – Part 1

daVinciProbably more than you wanted to know, but …

I promised myself I would blog about this, and so I am:

I went to the hospital on Friday for my pre-admission session, in preparation for gallbladder surgery – by an actual robot! – next Friday. Before surgery, they want to make sure you’re up to it, so they do blood tests, EKG, etc.

I aced the tests. One of the nurses even told me she really liked having people like me, because so many of her patients were, you know, smokers and such, and had multiple medical problems. She asked me all the questions – Are you a smoker or drug user? Do you drink alcohol? Ever had a heart attack or stroke? Any trouble breathing or swallowing? Etc. – and I answered No, No, No, and we just sailed through it.

Heh. One question: Do you have any religious preference you’d like the doctor or hospital to know about?

Easy one: No. (You ain’t gettin’ ME to tell one or more possibly-goddy people I’m an atheist and then placing my life in their hands. I’d sooner sweep into a restaurant and insult the entire minimum-wage staff just prior to dining. )

There was something on my EKG she found interesting, but she didn’t explain it, so apparently it’s not something I’m going to die of right away. Probably all the beat-heavy hip-hop music I listen to has given me one of those satanic stopped anapestic heartbeats.

She poked around at my neck and throat and listened to my chest and back, then had me lay back and pushed at various parts of my abdomen, asking me each time if it hurt, with me stifling laughter each time. “I have to know you REAL well before I stop being ticklish,” I explained.

(Fair warning: Now that you know I’m ticklish, if we ever meet and you think it would be cute and fun to tickle me, I will react badly, and I’m not kidding. I consider it be a form of assault. Try buying me a drink first.)

There were detailed instructions about what I needed to do pre-surgery, including stopping taking aspirin and several other blood-thinning medications several days in advance, and meticulously scrubbing my lower abdomen the night before and morning of the surgery.

She cheerfully answered all my questions, of which I had about 20.

Should I shave my chest or belly?

(Side note: I’m furry as hell. Not hairy, but furry. I’m covered from neck to knees in silky mostly-gray fur. Part of my proud mammalian heritage, in my view. I see those dolphin-slick boys in the laser hair removal ads, and they strike me as mega-creepy.)

No, no shaving. They will clip a very small area on my abdomen on surgery day, and prefer patients not presuppose anything.

What’s the name of the robot doing the surgery? I thought there would be a funny in-house nickname like Mr. Cutty or AstroBoy, but “We just call it ‘the daVinci.’”

Is the doctor himself going to be doing the actual surgery? “Yes.” (Although I had to sign a paper saying “I, the above-named patient authorize Dr. Whatsit and whomever he/she may designate as his/her assistant, including Wherezit Hospital personnel, to administer treatment and/or arrange for post-hospital care as he/she deems appropriate.” Which seems to say my doctor, the one I’ve actually met and like and trust, could do anything up to and including leaving a note for the janitor to come in and do it with a hacksaw and plunger.)

What happens if there’s an emergency during surgery, say the power goes out? “The hospital has backup generators, so that won’t happen.”

Can I specify that I receive no blood or blood products? “Yes, but you probably wouldn’t need it anyway.”

Can I get the painkiller prescription before the surgery, so I won’t have to shamble into the pharmacy post-surgery and stand there in agony while they dole out the pills? “No.” (I suppose I can understand that, but damn.)

How long will it all take? “You arrive at 6 a.m., the doctor will come in and greet you. Surgery begins at 7:30, and takes about an hour from start to finish. (The doctor had told me the actual procedure takes about 10 minutes, so I’m assuming the rest of that is prep time and post-surgical backfilling.) After that, you’ll be in Recovery for about 2 hours, coming out of the anesthetic, etc., after which you can go home.”

Will I have to come back for removal of stitches, etc? She was a little unclear on that. “The incision is so small, there may not even be any stitches. Internally, the neck of the gallbladder may be simply cauterized.”

All in all, a fairly pleasant visit.

Except this was the SECOND nurse. The first one, whom I’ll call Nurse Diesel, was not all that pleasant.

See, shortly after I was ushered into an exam room and took off my coat and loosened my shirt, Nurse Diesel came in and sat down at the computer and began firing off questions and typing in my answers.

I asked “Do you mind if I record this, so I can remember what you tell me later?”

“No. I’ve been at this hospital for 18 years, and I’m a valued member of the staff …” (I don’t remember her exact words, but it was something like that.)

“It’s just that they said I could ask questions …”

“I have 15 minutes to get this done, and then I have to get on to other things.”

“I only want …”

She practically whipped away from the computer, turning toward me with and asking intensely “Okay. Okay, what is your BURNING QUESTION?”

I gritted my teeth and looked away from her. She appeared to take my silence for acquiescence, and went on with her questions and instructions, with me giving quiet monosyllabic answers.

After a couple of minutes of it, I said “You know, I’m so angry right now I’m not processing what you’re saying.”

There was a pause. “Well, what can I do to help?”

“Not be YOU.”

“I could … get you another nurse.”

“Yes, let’s do that.”

Exit Nurse Diesel, stage left, and the entrance of the second nurse a few minutes later.

I meanwhile had tucked in my shirt, put on my coat and hat and prepared to walk the hell out of the place.

Oh boy, when it comes to any sort of service situation – restaurant, store or gas station – I’m not a very demanding client, but the one thing I DO demand is respectful treatment. Diss me for even a few seconds and I’m outta there like a rocket. And I never go back.

But this time I talked myself out of leaving. “You really need this surgery. Don’t walk out. Don’t walk out.”

So I was still standing there when Betty came in. And Betty was nice.

I did tell her what Nurse Diesel had done, and why it had irritated me.

(To be fair, it’s possible Nurse Diesel took my question about recording as a sign that I didn’t trust her, and was documenting it so I could sue or get her into trouble later. But to be fair to ME, she didn’t let me finish explaining any part of what I was trying to say.)

“I could get you a patient’s rights representative if you want one.”

“No, it’s over. It’s done. I just wanted you to know about it.”

But my last question, delivered in a flat voice, was: “Is that woman going to be on my surgical team?” Because that was a deal-breaker.

“No.”

The strange thing about all this is that I have a profound trust of doctors, probably too much of it. Some deep part of me seems to assume they know exactly what they’re doing, and sometimes I even fail to ask questions about things I honestly want to know, apparently just assuming that these benign godlike beings are going to take care of me.

But the encounter with Nurse Diesel shook me. I suddenly felt like a steer in a chute, headed toward a slaughterhouse, with no caring or fellow-feeling anywhere in sight.

I’ve actually started to worry about the whole thing. I know I’m going to go through with it, but …

This is major surgery. It’s the most minor of the majors, I’ve read, but it’s still opening me up and sticking objects inside me to remove parts I’ve had for 60 years.

There could be complications, there could be contamination, there could be unexpected conditions encountered. A power surge, a sneeze, a muscle twitch at the wrong time.

There could be, may be, even probably will be, a group of people working on me who neither know nor care about me as an individual. People who would suffer, if there is some sort of incident that injures or cripples me, nothing more than financial repercussions.

I am, at last, a little bit afraid.

  • MaryL

    My gall bladder was removed by humans but all went well and I hope all goes well for you.

  • Karen Locke

    Buck up, Hank. All will be well. I’m playing the statistics in saying that, but you can trust the stats. You’re going in (mostly) healthy. You’re going to come out completely healthy, except for an incision that will take a few days to heal. With all of your fans rooting for you, how could the outcome be otherwise?

  • mouse

    This was a really entertaining and relatable story! Thanks for sharing it. I hope everything will go well. I’d say “don’t worry,” but what do I know. It sounds as though you’re in a pretty well-run facility, notwithstanding Nurse Diesel — which is more than many of us can say. Very best wishes for a positive experience and a full and quick recovery!

  • Trebuchet

    I just got home from six weeks in the hospital and rehab facility following surgeries for a broken back and leg. There’s a huge difference in the people skills of medical personnel. Just as there is with people in general.

    Hope the surgery goes smoothly!

  • Woof

    I had my gall bladder out the laparoscopic way ~15 years ago. Hard to believe, but 7 days later I was doing yard work. Wasn’t supposed to be doing that, but I was.

  • rowanvt

    I offer comfort and cyber hugs. And scary-ish anecdotes. Might be best to just stop reading at the sympathy part.

    I had an appendectomy a year and a half ago. I loved the doctor who diagnosed me in the E.R, the nurse who joked with me while placing my IV catheter (I’m incredibly needle-phobic) and laughed with me when I asked what gauge the IV was (18! D:) after the fact and said “Well, I’m glad I didn’t ask before hand because I probably would have run screaming from the building”, and the surgeon who answered all my questions.

    I did NOT love the majority of the nurses I dealt with though. This seems to be an E.R nurse thing specifically. I don’t understand those folks. The other nurses were all fine.

    I’m an RVT. This is equivalent to an RN for animals, only I actually do *more* than a typical single RN (radiographs, phlebotomy, prescriptions, dental cleanings and extractions, anesthesia and recovery, etc) and this means that I understand the terminology, the drugs used, and the equipment used. Especially something as simple as an IV catheter.

    They stuck me on a liter of LRS, opened the line up and left. I had fun calculating the fluid rate in my head (my appendicitis was more boring than painful, I actually thought it was just bad ovulation cramps or something) and then the bag ran out. I called the nursing station and asked if they were going to stick me on a new bag, and since they weren’t could someone please come and do a heparin lock to the catheter as I really didn’t want it to clot and go bad. Nothing. I was completely ignored. I spent an hour asking everyone possible (nurse who wheeled me to ultrasound. Nurse who wheeled me from ultrasound to CT. Nurses at CT. Nurse who wheeled me back from CT to my room. Nursing station again) to please come check my IV. I flagged one nurse down and said “Look, see this? See how the catheter is acting and this backflow of blood up the t-port that is not moving as I attempt to force fluid into the catheter? It’s clotted.” The nurses response: “No, it hasn’t clotted. Don’t be silly.”

    …….. Because I work with *animals* and so can’t know squat, apparently. I flagged another one down and with very angry voice declared that I KNEW the catheter was clotted and I wanted it flushed NOW. This nurse agreed to do so and then said “Woah, it really *was* clotted! Good of you to notice.” Arrrrrrrrrgh.

    Even better, and scarier, was when they started me on IV antibiotics and I started having an allergic reaction in the form of horrible burning up my arm and my arm turning mottled red. I called the nursing station and they effectively ignored me. My boyfriend was with me and I walked him through turning off the fluid pump. It took 5 minutes for a nurse to show up. I can’t imagine what would have happened if I was alone or more incapacitated than I was.

    If you have read my scary anecdotes, I do recommend asking they start you on any IV antibiotics *prior* to knocking you out just to make sure you aren’t allergic.

  • sheila

    Before it hurts to laugh:

    When I had my gall bladder out, the anaesthetist asked me where I wanted to go,. You see, he had a tube of anaesthetic which would send me to the Bahamas, or one that would send me to Hawaii. Which did I prefer?

    I said I wanted a fit young man (I’m 50) with a feather fan and a pitcher of mojitos. (This is my way of dealing with nerves.)

    The entire theatre staff burst out laughing. And I thought, “Right. Now they all see me as a person, not a gall bladder case.” Which was probably completely unnecessary, but it didn’t do any harm either.

  • Cathy W

    Rowanvt – I spent a week in the hospital with pneumonia once. The nurse the first night had rigged up some kind of automatic switching system where she hung two bags on the rack and the second one kicked in as soon as the first one went dry – I think switching from antibiotics to plain fluids. None of the other nurses knew how to do that, and they had to move the IV site EVERY. Single. Time, because the previous one was left sitting unused for too long. I was running out of veins in my arms.

    Hank – when you go in for the surgery, be prepared to confirm your current medications repeatedly. I think I kind of snapped at the sixth person who asked – but every person who came into my pre-op bay asked me about each individual medication…

    As far as the prescription – they may not be able to give it to you in advance, but they may be able to send it electronically to the pharmacy of your choice. Will you be driving yourself home? It may be that in recovery they’ll drug you up real good, and the person driving you home may be able to run in to the pharmacy and get the pills without a huge wait.

  • Tracey

    Hank, best of luck with the surgery and I’m sure you’ll breeze right through it without any complications whatsoever.

    I echo what Rowan said, and my advice for anyone who has to be hospitalized is to have a healthy advocate with them. I can’t stress this enough. A few years back I spent some time in a critical care unit, then was stepped down to a regular hospital room before I could be released. I spent a month in the regular hospital room. My support (friends and family) all had regular jobs so they visited mostly during the evenings and weekends. In the beginning I was completely bedbound, and there were entire days when I never saw a nurse in my room…entire DAYS with no care whatsoever. I swear I am not making that up. Were it not for the very kind food deliverers who fed me and filled up my pitcher with water, I would not have eaten or drunk until my friends/family visited and they took over my care. Additionally, even though I was NOT on a catheter, entire days would go by where I didn’t pee once. That only occurred to me years later (that’s how injured and ill I was that it never occurred to me).

  • cazfans

    You might not want to admit to atheism (down here in Alabama where my Mom (also an atheist) had an ophthalmologist take her hand and look to the ceiling and pray with her before cataract surgery) I certainly don’t, but I did ask the digital cuttlefish to write a hallmark sort of thank you card and I made a card out of it and gave it to my surgeon on my first post of visit after my cholecystectomy and got no flack. So I thought you might like it.
    http://freethoughtblogs.com/cuttlefish/2012/08/24/atheist-thank-you-cards-v-1-0-hospital/

    I’ve heard I had an angel who was watching over me
    And who saw my operation safely through
    But the heroes and the heroines, as far as I can see
    Had no wings attached—and so, I’m thanking you.

    Thank the doctors and the nurses, the technicians, and the staff
    Thank their teachers, too, for all that they have done
    Thank the EMTs and drivers, thank the folks who made me laugh
    Thank the donors—even those who think it’s fun.
    Thank the people on computers making sure it all goes well
    Thank the bureaucrats who made it go at all
    Thank the people I’ve forgotten (likely more than I can tell)
    Thank you, all of you, for answering my call.

    Like many of the FTB bloggers & horde that man’s a genius ;^)

  • cazfans

    You might not want to admit to atheism (down here in Alabama where my Mom (also an atheist) had an ophthalmologist take her hand and look to the ceiling and pray with her before cataract surgery) I certainly don’t, but I did ask the digital cuttlefish to write a hallmark sort of thank you card and I made a card out of it and gave it to my surgeon on my first post of visit after my cholecystectomy and got no flack. So I thought you might like it.
    http://freethoughtblogs.com/cuttlefish/2012/08/24/atheist-thank-you-cards-v-1-0-hospital/

    I’ve heard I had an angel who was watching over me
    And who saw my operation safely through
    But the heroes and the heroines, as far as I can see
    Had no wings attached—and so, I’m thanking you.

    Thank the doctors and the nurses, the technicians, and the staff
    Thank their teachers, too, for all that they have done
    Thank the EMTs and drivers, thank the folks who made me laugh
    Thank the donors—even those who think it’s fun.
    Thank the people on computers making sure it all goes well
    Thank the bureaucrats who made it go at all
    Thank the people I’ve forgotten (likely more than I can tell)
    Thank you, all of you, for answering my call.

    Like many of the FTB bloggers & horde that man’s a genius ;^)

  • cazfans

    Sorry for the double post word press told me there was an error the first time.

  • dgrasett

    I hope you have arranged for someone to be there to drive you home. Even day surgery needs that.

  • Woof

    I remember still being fairly alert and aware going into the O.R. (to get a spiffy new titanium shoulder) and announcing “WOOF, TABLE FOR ONE!” (Well, not literally “Woof”, since that would only confuse them, but you get the idea…)

    That may have also been the time I short-circuited the discussion about how they were going to get me off the “trolley” and onto the table. “Hell, I can do that!” And I did. I was definitely stoned, but not near as stoned as they expected me to be.

    I’m a big guy, and I’ve had several surgeries (and many “procedures”) so the droopy juice they give you before they actually put you out doesn’t always work as well as they expect.

    So… Give ‘em hell, Hank! Make sure they remember you.

  • http://sciencenotes.wordpress.com/ Markita Lynda—threadrupt

    A healthy advocate, e.g. to go _fetch_ a nurse if necessary, is a very good idea.

    I suggest writing all your meds down on a file card and just handing it to them. If you are allergic to any medicines, write that down, too. My mother was allergic to morphine and yet I had to remind them when they were wheeling her in for her second operation. They gave her a red wristband.

    It’s “major” because of the general anaesthetic, not because it’s complicated.

    The permission you sign lets your surgeon step back and let a junior doctor practise on you. :-)
    Best of luck!

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  • MG Myers

    Best wishes for a speedy recovery, Hank! My thoughts are with you.

  • fusilier

    Good luck w/ the gall bladder.

    I had my prostate removed about 15 mo ago – stage III – using one of the daVinci machines. Incision MUCH smaller than hands on. I was standing the next day. Couldn’t get up by myself for a week, but I could stand by myself.

    [pedant mode]It’s not a robot, it’s a waldo.[/pedant]

    fusilier
    James 2:24

  • Olav

    Don’t worry, you are going to be just fine.

    Very good storytelling too. One thing that I noticed in your tale: backup generators. Frankly, I have very little confidence in them. That’s because I had a few experiences with them in computer rooms, where they never did come up quite as fast as needed and promised. Backup batteries I do trust. I suppose medical/surgical robots also have them, to bridge the time between the initial blackout and the generators coming online.

    Sorry for the diversion. It’s the nerd in me.

  • otrame

    Your story brings up a good point. You do not have to tolerate being treated like that.

    One thing to remember is that in the last 15 years or so the work load on nurses has become literally impossible. I try to keep that in mind that these people have more work to do than can be done. I recommend complaining to the admin. something along the lines of “they did the best they could but you need a lot more nurses on that ward…” and then add specific failures of treatment.

    You should also remember Meissner’s constant: If you take the entire human race as a whole, a certain percentage are assholes. If you divide the human race into groups, by gender, by race, by nationality, by profession, a certain percentage of each group are assholes. That percentage is a constant.

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  • DobbHead

    I suppose medical/surgical robots also have them, to bridge the time between the initial blackout and the generators coming online.

    My understanding of hospitals is that they are required to have an uninterruptible power supply which is usually a battery system backed by generators so the hospital is protected against both rapid fluctuations in power supply and long term shortages of power.

    Out of curiosity Hank, are you opposed to blood transfusions? If so, why? If you’ve answered this in your blog before, I apologize: I’m only an occasional reader.

  • jnorris

    Robot doctor’s name: Maximilian from the movie Black Hole.

  • bradleybetts

    Don’t worry Mr. Fox, I’ll be praying for you (jks) ;)

    Seriously, I’m sure you’ll get through it fine.

  • crocswsocks

    We’re with you, Hank. Good luck!

  • Gwen

    Hey Hank. It will all be well. Not comfortable for a while, but well. See you on the other side of the drugs.

  • Gwen

    Hank, how are you doing? Surgery was Friday, right?

  • http://www.facebook.com/profile.php?id=19217851 travisdykes

    Damn, that sucks.

    Kinda pisses me off too, because I just graduated and started working as a nurse and when nurse treat patients like that it can make my job harder in the future because the patients don’t trust nurses and it makes the profession look bad. A big part of the job as a nurse is advocating for the patient and making sure they get the care they want and know what is going on in their care. Being in a rush is a poor excuse for her doing her job poorly.

    Hope you’r surgery goes well and that you feel better soon, and that the rest of the staff there treats you better.

  • http://www.facebook.com/profile.php?id=19217851 travisdykes

    Got a bit distracted by the unprofessionalism of “nurse” Diesel (she might not have actually been a RN, could very well have been a nurse assistant or LPN)

    Anywho, shouldn’t be too afraid to check atheist on the medical forms as long as your not at a religious based hospital. Even here in Shreveport, if one of the staff members is getting on you about your lack of religion, and you directly ask them to stop, if you get in touch with the patient advocacy office or patient rights officer/representative you can usually not only get your situation resolved pretty handily, but can make it less likely they pull that kind of shite with other patients. You can also report her to your states Board of Nursing and they will get on her hard about that kind of unprofessionalism.


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