Whipsaw Days (Part 4)

[You should read Part 1, Part 2, and Part 3 first.]

[Sometime in the very early morning, Thursday, February 17.]

I remember nothing of the operation. (Thanks, Anesthesiologist!) The first thing I remember, I’m being wheeled to OR recovery. I've had anesthesia before, and I know that, much to Jan's amusement, I keep asking the same questions over and over. I try to show my medical sophistication by asking, “Have I been asking a lot of questions over and over?” “Yes,” replies the nearest person. "Including that one. By the way, your limit is six.” I don't know what they do when you reach the limit.

While I’m in this forgetful state, they’re telling me (I later confirm) that they were able to get all the fungus without getting as far as the teeth. They need to check what they took to make sure there are clean margins -- the outer edges of the excision show no trace of fungus, indicating that it is entirely contained in the removed tissue -- but they are pretty sure they have succeeded. I have a small depression in the roof of my left palate, right by the teeth. If my palate were a fairway, it would be a sandtrap up against the stone wall lining that side of the green.

It’s the very early hours of Thursday morning. I’m going to be back in my bed by 3 a.m. Incredibly thirsty. Plastic oxygen mask on, which is hot and wet and uncomfortable. Mask comes off. I get to dab my tongue with wet sponge swabs, but not too many. I also get to figure how to pee into a handheld urinal while sitting up on the gurney with my legs sticking forward, still not fully coherent. Amazed I don’t make a mess.

Back up to room. Some pain meds, some Ambien, hoping to sleep a little later than usual.

6:30, maybe 7:00, the Junior Posse comes in, somewhat flustered. They had been taken by surprise by the emergency surgery. (I know how they feel!) How was I feeling? Could they look? My mouth is a tourist attraction.

A little later ... Word from someone (ENT?) confirming that everything looks great – didn’t see anything left behind during the operation, didn’t see any fungus on the margin of the tissue removed. Relief. 

Need some rest. Can’t eat, because I don’t know what I am allowed to eat with the recent remodeling of my mouth. Someone will find out.

Relief. Resting. Reporting to family. I feel like I have made it through every test.

In an hour or so, in comes the Senior Posse, with a bad vibe. “How do you feel?” “Apprehensive?” “That’s appropriate, in these circumstances.” The ENTs want to go back in on Friday. They are 99.9% sure they got it all, there is no evidence that they didn't get it all, but that remaining  .1% that could quickly explode is going to keep gnawing at them. Until when, I wonder? Until the surgeons have gnawed off any teeth or bit of jawbone that could be harboring these terroristic molds and fungi? 100% solutions are generally bad ideas.

So, a return, non-emergency surgery is planned for Friday. Emotional low point of this Grand Life Detour, so far. The last surgery was scary, and the fact that they feel they need to go back is scary. I think I should talk to some supportive people, which will inevitably will make me cry, but I’m also exhausted. Napping wins over crying.

Still no word on what I can eat. Haven't eaten since 5 p.m. yesterday. Finally someone tells me all I have to is call Food Service, and they'll tell me what I can eat. The doctors communicate with the Food Service, not with the nurses or patients. I'm on a soft food diet -- applesauce, yogurt, gelatin, ice cream (mistake! the surgery site is very sensitive to heat and cold!).

A little later the ENT anaesthetist is in to talk about how it went last time, so they can adjust for tomorrow. She can’t tell me what they’re actually planning to do this time, and I emphasize that I want that information ahead of time. She’ll see what she can do.

Followed immediately by ID Guy, talking about various scary fungi for a while before I realize he’s delivering good news. I definitely don’t have the Monster Fungus Mucormycosis, which terrifies the medical establishment and would justify a return visit to the OR. I probably have a more common and more easily managed aspergillus, or something like it, my medications have been changed to address this finding, and he’s surprised that there is a followup surgery planned. I emphasize the importance of ID and ENT communicating with each other and with my main team, so we make sure the left hand is not exorcising a demon the right hand has proved does not exist. They will be talking, and I should hear from some doctors before the end of the day.

Some time during the afternoon, during one of the doctor visits, my transport angel from last night pokes his head in to see how I'm doing, as he promised he would.

After 5, which in my mind is the the end of the day, still no word. In hospital time, the end of the day may be closer to 11:59. I ask the nurse if she has heard anything, or if she sees anything on my schedule. No. Maybe it’s not happening! 

5:30, call the leukemia nurse from the clinic to ask for some communication, leave voicemail. 

6:30, head leukemia nurse in the hospital checks in. I don’t think she’s an emissary, just seeing how I’m doing, but she does have information. Everybody’s been talking. (Good!) We’re not on a quest to find more hidden mucormycosis, because we know it's not that. ENT just likes to revisit their work, to make extra sure they were as excellent as they thought they were originally. It sounds like there’s a low probability of more actual cutting, and there’s definitely less risk from the anesthesia this time because we can plan for me to have an empty stomach. The nurse doesn't know if a decision has been made.

Dinner is something off the soft food menu -- don't remember.

Around 10 (maybe earlier -- still tired), go to bed. Still no surgery showing up on my chart. Hopeful relief. Fall asleep.

Midnight, vitals check, and word that I DO have surgery scheduled for tomorrow, but the time is not known. No drinking allowed starting now. I could get a 6:30 knock on the door, or it could be at 10:00. (More likely the latter, since this is a scheduled surgery.) "I'm going to need an Ambien."

The Ambien is not effective. I take advantage of being awake to take notes on the past crazy couple of days. I get a lot down. Eventually, I feel tired enough to sleep.

Friday, 4 a.m., vitals check, surgery is scheduled for 10:00 am. Not sleeping very well.

6:30 a.m., knock on the door. In comes the ENT team. They take a look at their handiwork inside my mouth, pronounce themselves satisfied, and say, "You don't need any more surgery."

After they leave the room, lying in my bed, I raise my hands over my head in the universal sign of celebration.

I Will
Beat You.

P.S. This is the last installment of Whipsaw Days. It's a been a quiet ride since the pardon from followup surgery.