Giving up my Appendix for Lent

Friday night was possibly the most painful night of my life. I didn't know it at the time, but my appendix was inflamed.

The day started fine and I had food from the local cafe for lunch, a few pieces of fruit for snacks, and half a restaurant meal at Brewsters following archery. The "half" qualifier was because I've been trying to stay in my points target this week for weight watchers. The "Mac and Meatloaf" they sell is 32 points, and I only had 16 to spare.

From lunch on, it felt like I had a rock in my stomach, and I started to get chills after finishing my meal at Brewsters. Instead of hanging around chatting, I opted to just go home and sleep it off. There wasn't much sleep.

Around 11pm it started to hurt. There was nausea and I had the chills bad - I just could not get warm no matter what I did. Finally, the chills overwhelmed the pain at around 1am and I took a piping hot shower for about a half an hour. This warmed me up and also cut the pain down some. I moved the trash bin to my bed in case I barfed.

The pain returned and kept getting worse. A few times during the night I thought about getting up and going to the hospital, but didn't because of a combination of weird mental issues: Moving made it hurt more, embarrassment, denial that I had anything seriously wrong with me. The pain also moved around a bit, starting around the belly button and gradually settling in my lower right-hand side. For the record, it felt something like trying to pass broken lightbulbs. This only convinced me that it was some kind of food poisoning, and that the bad food was working itself out. I'd always assumed that appendicitis was simply a sharp pain where the appendix is. This turns out to be incorrect - the way it occurred is actually classic appendicitis symptoms. Around 5am, the pain subsided and I passed out from exhaustion.

I woke up around 10am Saturday morning feeling like I'd had the shit beat out of me. As in, I figured I'd had abdominal spasms hard enough that I thought I'd actually bruised my lower intestine. I mentioned this on FB, where several people chimed in with "maybe it's appendicitis". I didn't think it was (I was still working on the food poisoning angle). But I looked up the symptoms. The symptoms lined up so precisely, that I was of two minds. The first was "No no no, this is an absolutely inconvenient time to have appendicitis, so it can't be true". The second was "I guess I'm going to the hospital. Better take a change of clothing and some books because I'm going to be there at least overnight."

Sadly, there were no car2go-s in the neighbourhood, I had to drive my own car.

Foothills hospital runs a very tight ship. And I was lucky enough to go in when there weren't many cases. Now appendicitis is one of those things that gets you pushed up towards the head of the line, but even so, there simply weren't that many people around looking for treatment. It was -30 out, so that might explain part of it.

Triage and check-in took a few minutes. I was literally taking my seat in the waiting room when they called me in. Now I was in the hurry up and wait line of a modern hospital for something that wasn't immediately fatal. The ER doctor asked me a bunch of questions and did a bunch of tests with his hands. That's when I learned that "rebound tenderness" was a thing - specifically, a thing I had. The doc then sent me for an ultrasound.

After an hour's wait, I got in to see the ultrasound technician. The ultrasound showed an inflamed appendix sufficiently clearly that they didn't schedule an MRI. It was at this point that I noticed a certain repetitiveness amongst the professionals at the hospital - they were all asking me the same questions.

"Name?"
"James."
"Birthday?"
"February 30th, 1968."
"Any allergies?"
"Not to my knowledge."

I called the tech on it.

"I noticed everyone keeps asking me these questions even though you've got the answers on the chart you're holding - is it deliberate?"
"Yes, it's to ensure we don't make a mistake."
"Well OK then."

At this point I resolved to simply answer the questions no matter how many times I was asked and to do so without snark.

I hung around longer and they eventually found I was waiting in the wrong area - the area with the normal chairs instead of the super comfy recliners. They made me sit in the recliners. Eventually I met with the surgeon who was assigned to me. He had a gaggle of residents following him. They asked me questions, repeated a bunch of tests and then he asked opinions. At one point I think he deliberately low-balled my condition.

"The inflammation doesn't seem too bad - I was thinking of just prescribing antibiotics and sending the patient home."
"I would not feel comfortable sending this patient home."
"Excellent."

They then suggested surgery and advised me of the possible outcomes. i.e. complications that could include scars and death. The former I wasn't too worried about. The latter? Well more on that later. I signed some consent forms and they added additional questions that would, once again, be repeated at every stage:

"Have you ever had surgery before?"
"Yes, twice. First when I was six weeks old to fix a birth defect in my hernia. Second, when they knocked me out to remove all four wisdom teeth when I was twenty-two."
"Any adverse reactions to general anesthetic?"
"Not to my knowledge. Based on a small sample set, I come to pretty fast."

Around this time I cancelled the Oscar party I had scheduled for the following night, and also called nosarious to come get my car.

I waited in my recliner some more. Gave Gerry the keys and read my book. Finally, a nurse called me up.
"Good news, you've got a room and they're sending you straight into surgery."
In my mind I panicked a little - I was going to get cut open right away?!? Outwardly I just followed orders. Strip down, wait on the gurney. An orderly came and pushed me down to the OR. Unfortunately, I wasn't the only appendectomy patient in the queue and the guy before me was worse off so they slotted him in before me. The orderly then took me up to my room to wait.

Nobody looks graceful transferring from a gurney to a bed.

I got to cool my heels for an hour waiting for my spot in the queue. The nurses took good care of me and fed me (via my IV) some antibiotics, just in case. And I got to contemplate my mortality. All kinds of things could happen. I might have a bad reaction to the anesthetic, my appendix might rupture, the surgeon might fuck up. All in all, this could be my last conscious hour. And I took deep breaths and tried, unsuccessfully, to put it out of my mind.

Finally, I just decided that if I died on the operating table, that would be a "good death". Just turn out the lights and never turn them back on. I wouldn't even know anything had happened - no pain, no suffering, no existential angst. It would suck that I didn't have a chance to say goodbyes, but few people do.

Meanwhile the rational part of my brain would chime in "you know dying during routine surgery under these circumstances is long odds right? You probably face equal odds just by driving for a year."

They wheeled me back to the OR and I tried not to imagine myself on the Green Mile. Once there, in the holding area, I got a surprise treat, halfdane866, who works at the hospital, had left a note for the OR staff to treat me right (though I like to think they'll treat everyone right, even the jerks). The nurses in the holding area wheeled me to the OR and there was some light banter.

"We're not that good at this - hopefully we won't bump you into too many corners."
"I'm sure your driving skills are up to the task."
"Well you do have two women drivers, so who knows?"
"I would never make sexist remarks while going into surgery - I might wake up to find you shaved off one of my eyebrows."
"Oh, we can't do things like that - ethics."

Incidentally, aside from the lead surgeon, everyone who treated me was female. All the nurses, the anesthesiologist and her assistant, as well as the assisting surgeon. Since I generally get along better with female professionals than male ones, this suited me fine.

After the requisite questions from the anesthesiologist, we chatted for a bit. I think this was deliberate on her part to put me at ease. Turns out she knits, and wanted to learn weaving and had almost bought a loom off of someone a few years back named Anne. Since I know an Anne who was selling a loom a few years ago, this was an interesting coincidence. I suggested talking to halfdane866 if she was interested in the SCA.

Finally it was time. I was on the OR bed, stretched out like Jesus on the cross and had assorted tubes and wires attached. The surgeons had arrived and they were ready to go. The mask got put over my mouth and I was instructed to breath slowly and deeply. Also that I was going to dreamland, so I should concentrate on a good dream. I tried to imagine sex. At some point they turned on the anesthetic and the ceiling started to swirl. I think I managed to mumble "getting woozy now."

I came to. A nurse was there and was asking me simple questions to gauge my level of consciousness. I imagine she only had to ask these once, but it's entirely possible that this was going on for some time before I was aware of it.

"What's your name?"
"Pbbble."
"Do you know where you are?"
"arrgphhht."
"What's your name?"
"Jaaaaaaaaa."
Do you know where you are?"
"Fuuuuuupital."
"What's your name?"
"James."
Do you know where you are?"
"In the hospital." (Nailed it, first try!)

Interesting thing about being knocked out like this - it always feels like a slice of time has been removed from my life. Whereas I don't get that feeling from sleeping.

I was super anxious upon waking, because I felt like I was in danger of choking. My mouth and throat were super dry and that was contributing to the feeling. That my throat was sore from being intubated (because you stop breathing when they give you a general anesthetic). I focused on not choking as they wheeled me up to my room. I do remember reflexively correcting the orderly when he called me "Mr. Sire".

Back in the room I was given a sippy cup by the nurse. That and the effects of the anesthetic going away caused the anxiety to go away. By this time it was 10pm (I went into the OR at 7pm). I watched a little TV while the nurses and aides monitored me. Every 15 minutes for the first hour, then every hour until about 3am, then every 4 hours.

I slept. I answered questions, mostly "no" to "are you in pain?" and I observed that hospital beds are ridiculously comfortable. I followed up with the assisting doctor who observed that If I could drink, eat and piss, there was no reason not to discharge me.

That other appendectomy case in the OR before me? We ended up sharing a room so I got to listen in on his treatment. I feel inordinately proud of not needing any pain killers while he was asking for more hits of morphine. Inordinate, because from what I could glean from the professionals involved, I had the most routine and problem free appendectomy ever. Everything was caught in plenty of time to be taken care of with the minimum amount of intrusion. Roommate had a somewhat more problematic case. Even still, I suspect he was discharged a few hours later.

Total time in the hospital, about twenty-six hours.

So to Dr. McKinnon and his team, and to Nurse Mary Jane and Nurse's Aide Val (the two whom I saw the most while recovering), thank you.

And now off to my next adventure, where simple things like sitting up, blowing my nose, and being able to sleep on my side are all rock-solid achievements!