The Recovery

The evening of the surgery, after dozing for a bit, I made my first walk. At this point the epidural was working better (more information on epidurals here), or I was still feeling the anesthesia from surgery, but either way I felt just fine making my loop around the unit.

Making the journey with my nurse Randy

My crowded 'Care Board'

The next two days were a lot of lying around, waiting to eat real food. I was on clear liquids only until I was able to fart (a hilarious benchmark) which would demonstrate that my bowels had woken up from the anesthesia. This took about two days, though when they did wake up my gut was pretty rumbly, and many of my walks were to and from the bathroom.

This in itself wasn’t so bad, I could navigate in and out of bed without too much difficulty. I was however, hooked up to a number of devices that had to be dealt with before I could go anywhere. I was wearing air compressor leg thingies that squeezed my calves every few minute or so to prevent clotting, I had two lines from the IV pole (IV line and the epidural) and that thing they put on your finger to determine your blood oxygen level which alarmed like hell when I took it off. And a Foley catheter for good measure. I would call the nurse who would detach me from my baggage and help me into the bathroom.

On Thursday, the day after the surgery, the epidural stopped working again. The epidural runs numbing drugs (good ones) into my back along my spine, numbing the area enervated by that part of the spine. If the epidural is misplaced or moves, a different area is numbed. In my case, the area around the surgery site wasn’t numbed at all (they test this by putting ice on it, the colder the less numb), but my right leg was offline. I was pretty uncomfortable, but I had just had surgery. Wasn’t I supposed to be uncomfortable? People would ask me to rate my pain on a scale from one to ten. This made no sense to me – at best, a ten scale was a necessary invention for a totally subjective experience. What is a ten on the pain scale? Stubbing my toe feels like a ten, but that doesn’t mean I limp to my morphine cabinet. Also, it’s not hard to deduce that a higher number means more pain meds. Anyway – the pain was definitely there, somewhere on the pain scale, and my nurse called the epidural people to fix it. The anesthesiologists decided they would replace the epidural with a new one.

I was on the fence about this – I didn’t know that replacing the epidural would do anything; for all I knew it was working perfectly. And I knew that moving was painful, and lying still was less painful. But we went ahead with it and I was awfully glad we did. The wheeled me down to the surgery area and we set up in a big room in an unoccupied area of the basement. My Mom was visiting at the time and waited outside. They pulled a bunch of tape off my back which had been holding the line in place and had me sit on the edge of the bed and slump forward, rounding my shoulders, ‘opening’ my back in a way. The doc felt my shoulder blades and hip bone and oriented himself around my ribs and spine – he would press his finger on the side of my spine and hold it there, then another spot. He found his place.  ‘You’re going to feel a pinch and a burn’ – this was the lidocaine and always the worst part. I felt it, some shuffling, and something dripped down my back. He asked me to be as still as possible, more shuffling, and a lot of taping, and it was done.

I laid back on the bed. The doc then pushed some drugs through the epidural line to see how it was working. Within about 2 minutes I could feel nothing from my chest to my hips. No pain. Zero. This apparently is how it is supposed to work. This well placed epidural made the next two days pretty comfortable.

A lot of the stay was like many other hospital stays – lots of Netflix (I binged the new Sherlock series, which was awesome), lots of C visits, and lots of visits from other folks. I had a small crowd Thursday evening after they had replaced the epidural. 

Nicole, who brought some fabulous recovery food and Paul, who was happy to be there

Dad and Bruce, you can see the box for the leg thingies at the end of the bed

What I looked like most of the time - though not always so smiley

Dr Hall, my kidney doc had stopped by Thursday to say that the tumor they had taken out did in fact have renal cell carcinoma in it, though it looked well contained. Friday morning I got a bit of a jolt with some more bad news. My surgeon (Urologist Dr Heller who I like a lot), stopped by to say that in addition to the carcinoma, they found another cancer – type 2 papillary renal cell cancer, which is apparently ‘rare,’ like everything else that has happened. This one wasn’t picked up with the scans and was just starting to develop. Unfortunately this type of kidney cancer is bi-lateral, which means it is likely developing in the remaining kidney (though not the transplanted one). He said the other one would have to come out within the year.

The news hit me a bit that morning when it felt like the epidural was AGAIN not working well, and I hadn’t really eaten or slept in several days. After a nap and some food I was feeling more settled about it. It became the next thing to do, and I was beginning to figure when I should do it.

Given how my recovery has gone so far (I was off meds on Sunday and walking at the gym Tuesday), I’m less anxious about the next surgery. I can wrap my head around it – I know that it will pass. There were a number of rough moments, including Saturday night when I came home. My gut had been acting up a lot, and I was eating a deliciously hearty soup that was not helping things. I took a pepto chewable and spent the next two hours doubled over, feeling like I had swallowed a desiccant pack. I could feel this thing in my stomach and it felt awful. We talked about going back in, and ultimately called C’s dad, an ER doc, who helped us relax a bit. When it started to subside, I was finally able to breathe and had a good cry for everything that had happened in the past few months. For the record, here’s a picture of me blowing my nose into a towel. 

 

The long view of recovery from surgery can be similar to the recovery of anything else. When in the throes of some malaise it can be hard to remember what being healthy/happy/in-shape was like. Like imagining a hot summer day in January, or picturing being able to breathe through your nose can be hard when you have a cold. Will I ever be rid of this? Of course I will. But my struggle is always to maintain that perspective, not to resist whatever I am going through (a sore side, not being able to cough well, etc). When the load gets lighter I am reminded that recovery is a transition, not a stable state. And I remember that not two weeks ago I was sweating away on an elliptical, where I'll likely be two weeks from now. 

Overall it has been a surprisingly smooth process. I’m home now, very comfortable, eating well and playing video games. I ordered Call of Duty and have been trying to make sense of it. C is back at work. She worked from home the last two days to help me get settled, which involved cooking and attending to me, in addition to running the house - as always I would have a hell of a time without her. I can cough comfortably now and have a healthy reading list. Here’s a good summary of what I’m up to:

Thanks for reading!

The Surgery

I think I’ll frame the surgery itself within the two days where it was my primary concern. Tuesday, a week ago today, Corinne and I both worked full days at our jobs. I picked her up at 4:45 and we went to the Bulldog NE for burgers and watched American Hustle at St Anthony Main. The evening was a good one for relaxin and distractin. My nerves had cooled somewhat and I thoroughly enjoyed the movie. Going to bed, I felt like everything was in motion – the waiting was over at that point – I was fully engaged in the surgery. We shared some tears and smiles and went to sleep. 

Washing up the evening before (C was excited about documenting the event)

Us being sad / scared for the surgery

Feeling ready!

The next morning was slow and easy. C had breakfast and I couldn’t eat or drink anything, so within about an hour of waking we drove to the hospital. The woman at the welcoming desk said we could take the elevator on our left ‘when we were ready,’ which I though was a nice touch. We were ready, so we descended to the pre-op area.

It was a small crowd waiting for us – both of my parents, C’s mom and after a bit her sister. We had a lot of bags and occupied a corner of the room. I checked in and in a few minutes, enough to say hello and make airport jokes about our many bags, I was called back to get prepped.

The prep felt like a countdown, slowly ticking to surgery – blowy air gown (to stay warm/cool), IV, visits from the surgeon, blood draw, visit from anesthesiologist, nurse anesthetist, and finally the family could join me. They checked my INR level (I had stopped blood thinners the week before) and gave me the first dose of valium, which didn’t feel like much. For pain management they were going to place an epidural to numb the kidney area of the body (in addition to being put under for the surgery itself of course). This process took about an hour.  

The shirt has warm air moving over my chest, poofing it out. Many a boob joke made. 

After some tears, kisses and hand squeezing, I was wheeled around the corner and into the OR. I tried chatting a bit with the techs, though they were pretty reserved and stood along the wall with their hands in front of them. The OR was cold, though I had the familiar sensation of the cold not registering with me physically. The epidural people felt for my shoulder blade hips and ribs and told me to lean way over. I felt a lidocaine shot in my back that, like the cold, was painful and not painful, like the pain was being explained to me. The OR itself looked old somehow – maybe it had 70s tiling? I laid down, someone put a mask on me (oxygen he explained) and I was out.

Here are a few waiting room photos:

Dad and Lora

C's Mom and my Dad - who had some reading to do

At the room, Dad my nurse and Lora

I woke up on my left side in a great deal of pain. I became aware of my IV pole with a yellow box on it, and a woman telling me something about the epidural. My side burned, and whether I moved or lay still, I was uncomfortable. Someone said the epidural works on gravity, and should work its way to the site. I heard beeping. Gradually I became aware that there were other people around me; specifically a man facing me in the next bed, maybe 6 feet away, who wasn’t in much better shape. I heard a fair amount of groaning, and some of it was coming from me. I had no awareness of several catheters and IV lines in my body. After about an hour or this, my family came back to see me – though I don’t remember that visit well. I do remember being in less pain. Another few minutes and I was on my way to a room.

The transition from moving bed to laying bed can be tricky, as I couldn’t really move on my own. Usually I am sort of heaved by people lifting and moving the sheet I’m laying on. This time a ceiling lift dropped and connected to the sheet beneath me and hoisted my nice and smooth burrito style over to the bed. C’s family poked their heads in (all I saw of them that day) and went on their way. C sat with me a while (possibly with my parents?) as a stream of people asked me questions while I tried to keep my eyes open (fail).

I'm actually awake and looking at the camera - you can see the epidural IV in the yellow lockbox  

Thus began my recovery. Thanks for reading!

Home!

Hey folks! Back snuggly at home, on the couch, surrounded by things to eat, drink and watch. C has been taking good care of me. I’m not quite up for a full report just yet, but I wanted to drop a note here saying that all is well, the surgery went smoothly, recovery hasn’t been too painful, and all I have scheduled for this week is eating drinking and watching things; in addition to puttering around the house and avoiding the outdoors. I’ll work on the full report, plus pictures, in the next few days.

As always – thanks so much for your thoughts and well wishes. Knowing that we are not going it alone is a big part of a comfortable recovery for us. And thank you for so many offers of food, visits and errands. We are good for now on all counts, but I will certainly be up for some visits in the next few days. Thanks for reading!