Archive for December, 2006

Post-Op Dramas

Tuesday, December 26th, 2006

So there I was, rapidly recuperating from my prostatectomy when WHAM! I get hit by a kidney stone (my fifth; the last one was about ten years ago or so).

Fortunately, my morphine button was all hooked up and available. I whacked that button several times (I later found out that it could only deliver a shot of morphine once every fifteen minutes. The nurses could tell how much I desired the morphine, though, because the machine kept a record of my button hits, successful or not). Floating on morphine, I could deal with the kidney stone pain. But the kidney stone meant I wouldn’t be leaving the hospital as soon as I had hoped. The morphine in my system also meant I wouldn’t be attaining my next marker of recovery (and the main qualification needed for hospital release) — a bowel movement — any time soon. Opiates are constipators.

From lying in one position so long (flat on my back, occasionally sitting up a little) I was getting itchy on my lower back. My brother Bob sent me a can of Monkey Butt Powder to prevent rashes but I had left it at home.

As I write this I recall a bizarre out-of-sequence element of this whole wild ride worth retelling:

There’s an urban myth that a prostatectomy makes your penis smaller by an inch or two due to the way the skin is gathered in the surgical rearrangement of the body plumbing.

Au contraire! What actually happens is that the scrotum swells up to the size of a large grapefruit (a deep purple grapefruit, no less!), dwarfing what the Japanese refer to as the Little Boss by comparison. It’s caused bythe removal of the nearby lymph glands. These glands serve as sort of traffic cops, directing the pathways of blood and fluids. Without them there, the fluids pool according to the laws of gravity. The scrotum is the natural recipient. Things eventually return to normal as the body repairs itself. My first glimpse was a shocker, though!

A big part of my recovery was getting me out of bed and walking again. My first attempt was unsuccessful. I had just taken a hit of morphine. With my wife’s help (she took off work to stay with me the entire time I was in the hospital) I sat up and angled my body to the edge of the bed. My wife helped me to swing my legs over off the bed so that my feet could touch the floor. I slowly stood up in anticipation of walking. I suddenly got very woozy and felt like I was going to pass out. My wife got me settled back in bed. We would try again later.

After the morphine had begun to wear off a bit I told my wife I’d like to try walking again. This time I was successful. Using my IV unit as a steadying pole, I made two snail’s pace “laps” around the corridors near to my room. I joked with one of the old guys I passed along the way. The laps wore me out but it felt great to get back on my feet.

During my recuperation I was told I’d have three choices of body position: lay prone, stand up or sit with my feet elevated. Sitting in a normal position on a chair would make me vulnerable to blood clots. A blood clot could be a disaster. It could kill me or, at the very least, delay my recovery an extra six months during which I’d have to be carefully monitored and be forced to take blood thinners. I knew I didn’t want that. I’ve been very careful about elevating my feet while sitting.

Eventually I passed my kidney stone. It was a small one. I wasn’t sure when I passed it and the nurses were not even concerned with retrieving it.

I began noticing how attractive the nurses were; so the sexual part of my brain at least was still funtioning at its normal obnoxious level.

With the kidney stone gone my next project became kicking morphine so that 1) I’d no longer be addicted to it; and 2) I’d get the opiates out of my system to facilitate that essential get-out-of-the-hospital BM.

I decided to go cold turkey. As pleasurable as each hit of morphine was, I was just going to stop taking it. The withdrawal was not pleasant: sweating, nausea, chills, clamminess, shakes, hallucinations, etc. — just like in the movies. I don’t want to play this up bigger than it was, though. I was only addicted for a short while, so my withdrawal was mild in comparison to that of a long term junkie.

I finally kicked it and really felt at peace and more in control of my will and body. Ahhhh!

I returned to walking, increasing the duration of my walks and their frequency as much as I could stand.

No longer on morphine, the boredom of being in a hospital began to set in and my sleep patterns became less controllable. I woke up at 2:00 AM on Thursday night. I was staring wide-eyed and awake into the blackness of the room. There was no way I could get back to sleep. I didn’t want to rouse my poor exhausted wife, so I buzzed the nurse. She came in and immediately turned on all of the lights, waking my wife. The following dialogue ensued:
Me: I need a mild sleeping sedative so that I can get back to sleep.
Nurse: Just hit your morphine button.
Me: I just kicked morphine; I don’t want any opiates. Just something mild, over-the-counter, like Ambien or Melatonin.
Nurse: It’s 2:00 AM. I can’t give you anything after 1:00 AM.
Me: Why?
Nurse: A sleeping pill this late could make you sleep through the day.
Me (getting surly): And what do you think my lying awake until five or six AM will do to my sleep schedule? Look; this hospital must have every drug in the world. I’m not asking for some heavy dope — just a very mild sedative.
Nurse: I could give you some Tylenol — but it doesn’t have any Codeine in it.
Me: CODEINE?! I DON’T WANT OPIATES! I just want to get back to sleep!
Nurse: Well, why don’t you just tap your morphine button just a little bit…
(I knew that tapping it “a little bit” would give me the same dose as pressing it hard)
Me: DIDN’T YOU HEAR ME?! I JUST KICKED MORPHINE! I DON’T WANT ANY HARD DRUGS!
Nurse: (Long pause)…It’s after one AM.
Me: I know: The rules are the rules and there is no way that you’re going to do any thinking on your own. Okay; here’s what I’m going to do: You leave and go back to your post. I’m going to lie here in the dark and just stare for the next five hours. I will probably go out of my skull doing so and certainly end up sleeping all day long come sunrise but don’t you worry your pretty little head about me. Okay?
Nurse: OK.
…and she turned out the lights and left.

Fortunately, my wife is a walking drugstore. As soon as the nurse was gone she supplied me with the mild sleep aids I required.

Sheesh.

The next day my wife was eager to get me out of the hospital. I was reluctant because I still (thanks to the morphine) hadn’t had the prerequisite BM.

Then I was brought my lunch, the most gruesome excuse for food I had ever seen….

The Operation

Friday, December 22nd, 2006

I feel I need to document this stuff before it fades from my memory. Although what I’ve written about my recent medical dramas has certainly turned a few of you woozy, from letters I’ve received I also know that sharing this information has helped a lot of folks out there.

THE OPERATION
My wife woke me up at 4:30 AM on the morning of December 5. It was still dark out. I began dressing in anticipation of going to the hospital in very loose, baggy clothes. It seemed surreal. I felt out-of-body, like I was above or beside myself, watching everything going on with and around me. I didn’t feel numb; it was more like I was sleepwalking.

I got into the passenger seat of our car and my wife drove us down south to Orange County to the St. Jude Medical Center in Fullerton. We entered the building, found the appropriate floor and began my check-in process. Off with the clothes and into a backless hospital gown. I laid down on a hospital bed and then nurses proceeded to prod, poke and examine me. With just a little difficulty the tubes from an intravenous (IV) drip unit were inserted into the back of my hand.

My anesthesiologist came by and introduced himself. My urologist (and chief surgeon for my operation) greeted me. His eyes twinkled as he said, “I just came by to see you so you know I’m not drunk”.

When it was time for the operation I remember being lifted by my bed sheet and shifted to a gurney. I don’t remember anything after that until I woke up. My wife said the anesthesiologist turned to her and said, “I just gave him the best margarita he’s ever had in his life. You’ve got time for one more kiss.” She said she leaned over and kissed me. Then I was taken away.

I woke up hours later. My first thought was, “I’m alive!”

I was very surprised that I wasn’t sore or in any pain. A nurse came in and showed me the glowing green button on the end of a cord. “This is your morphine,” she explained. “If you feel pain just press that button. It will release morphine into your system.”

There was a guy who was in pain in the room’s other bed. A curtain separated us. He ended up being operated on and released very quickly that evening. After that I had the room to myself.

Unbelievably, it was hours before my wife, mom and youngest brother (Dave is the head nurse at a hospital near Sacramento. I was extremely touched that he drove all the way down to see me through this) were told that I had awoken. During that time I plotted a practical joke. When they entered the room I was going speak with heavily slurred speech and tearfully ask why I couldn’t move the right side of my body. I ultimately decided that faking having had a stroke was too sick a joke for me to play even for my twisted sense of humor.

The three of them came in and it was joyful to see them. I told them the joke I had planned and jettisoned. They all laughed and then my mom told me of the joke they were going to play on me but didn’t.

My mom’s plan was to have all of them come in. When I opened my eyes, instead of being greeted with joy they were going to have long faces full of sorrow — as if they knew something horrible about my condition or the results of my operation that I hadn’t yet been told. Gee… I wonder where I get my dark sense of humor from…?

I guess the fact that we didn’t play those jokes on each other shows that we’re (finally) maturing.

I was given a device to build up my lungs so that I wouldn’t get pneumonia during my hospital stay. Here’s how it works: You put your mouth on one end of the device and inhale. That causes a little marker to move up. You need to steady your inhalation to keep that marker between two arrows. While you’re doing that a gauge rises behind calibrated markings. Your goal is twofold: keep the marker between the arrows; and try to get the gauge to rise as high as possible. The maximum height it will go is marked at 4000.

The nurse told me to practice and try to work my way up to 1500. I hit 2000 my first try. By my third round of this exercise I hit 4000 (thank you, daily running of miles of hills). Yay! No pneumonia!

By the second day I was well ahead of my predicted healing schedule. I passed gas (an important indicator) a day or two ahead of schedule.

Then I got an intense, familiar pain in my lower back. I knew what it was immediately. From lying in one position for so long I had formed a kidney stone.

Success!

Saturday, December 9th, 2006

This will probably be a short entry; I only have short bursts of energy right now and I’m not supposed to sit for very long (to avoid blood clots).

I have two important messages to get across, though, that I don’t think should wait.

My surgery was a thorough success. My skillful surgeons told me that the operation went smoothly and that the cancer had not yet reached the borders of my prostate. The cancer was completely confined to my prostate. The nearby lymph nodes were also removed and biopsied. They were both cancer free. That means I am now completely cancer free!

I was recovering much quicker than expected. On the evening after my surgery, however, I got a kidney stone. I hit my morphine button quite a few times that night and over the next few days. After it passed I made myself go cold turkey (despite my nurse saying, “Oh, go ahead — just take a little hit”) to get rid of my morphine dependence. My withdrawal was unpleasant but brief.

Despite not yet having had a BM (I know, too much information), a usual prerequisite for release, on Friday I checked out of the hospital and went home. I just couldn’t take hospital life anymore (the food at lunch on Friday was the last straw).

So: I’m home, I hurt, I have no energy, but I’m very, very happy.

The other subject I wanted to address was the unbelievable outpouring of love, empathy, sympathy and support I have received from my family, friends and fans. It was completely unexpected. I guess that comes from spending so much time alone at the easel and drawing board!

I am truly, deeply moved by the expressions of support I have received. Thank you everyone. The love I feel from you is sure to make me heal even faster. I’m already getting ideas for projects….

OK…I gotta stand up and walk around. My love to you all!

Bill

A New Morning

Tuesday, December 5th, 2006

Today’s the day.

Surgery.

See you all on the other side (and hopefully not The Other Side).

Bless you all, my friends.

Bill