Thunder Down Under: Part V
Continued from Thunder Down Under: Part IV
WARNING: The following is graphic, at times disturbing, and true with plenty of TMI to go around. Part I doesn’t include anything too disturbing, simply the events leading up. If you’re squeamish, easily disturbed or simply aren’t interested in the details of a serious medical fiasco, I recommend not reading beyond Part I. This entry covers the details of the past several days, starting around 2 PM Monday afternoon when I first experienced an inguinal hernia rupture while working as a ski instructor.
The word croaks from the other side of the curtain, a tired sigh of exasperation and displeasure. It interrupts my slow, steady breaths, each a little too long and a little too deep to signal my well-being. Obviously, I’m not tucked alone in a corner of the emergency room. I didn’t really expect to be.
“How’re you feeling?” the nurse asks as he slides past the curtain.
“Could be worse,” I reply. I’m not sure I actually believe my own words. I’m shivering, wishing they had removed my sweaty ski socks.
“I’m going to give you something for the pain and some anti-nausea meds.”
He fiddles with my IV. I don’t bother to turn and look. I don’t ask any questions. I can feel the slight warmth of strange liquids flow into my left arm. My shivering ceases for a moment before returning the same as ever. The mental effects of the concoction seem negligible.
“Do you need anything else?” he asks. I feel a wave of nausea start to wash over me.
“I think I’m going to be sick,” I say, stifling the urge.
He passes me a small bucket and begins to ratchet the bed even more upright. I grip the metal bars at the sides of the bed and pull myself up, relieving my weight from the back. It shoots nearly vertical as I hunch toward the empty cup.
Ignoring the pain, I clench my stomach, the searing an afterthought to ejecting whatever volatile material is sitting in my stomach. My entire body is tense with the effort. The knuckles on my left hand glow white as they squeeze the metal handrail. The white plastic cup seems to cut into my chest through the flimsy hospital gown. And then I erupt.
In one loud explosion, I burp like there’s no tomorrow. Nothing else follows, the caldera in my belly apparently sated by my sacrificial out-gassing.
The miniature ordeal seems to awaken me, my eyes wider, my mind more lucid. I notice a slight soreness in my back and grab the pillow I had tossed aside, sliding it beneath my lower back.
“That’s better,” I say, dropping the cup to the of the bed, its lip still tucked between my fingers.
“The doctor will be with you shortly,” the nurse tells me ads he leaves.
My body is still for the first time since I left the ambulance.
“Fuck…” the moan reaffirms the my solitude is a falsehood.
“How are you doing?” I ask the unnamed voice. I wait for an answer, but none comes. “Sorry if I’m bugging you. I’m feeling a little better for the first time tonight. Just wanted to see if you wanted to converse.”
A small moan precedes his answer. “Sure, talk, whatever, man. Fuck.” The words roll out slowly, lacking precision. I can’t guess what cocktail of drugs he might be on, but he doesn’t strike me as a conversationalist. I decide to leave him be.
I blink a few times and then close my eyes, relaxing as I begin to note the cold. My shivering is returning slowly and steadily. The constant vibration brings with it constant discomfort. It’s not quite the shooting, burning pain of before, but I couldn’t say if that’s due to my relaxation or the small bit of pain medication now flowing through my system.
I’ve always tried to avoid anesthetics and pain meds. When I had surgery on ingrown toenails from soccer as a kid, they found I was actually resistant to the anesthetic used. They had to send for something stronger before they began work on the other foot. Upon having my wisdom teeth out, I didn’t even touch the hydrocodone prescription foisted on me, finding that as soon as the local anesthesia wore off, I felt a bit tender, but fine. The handful of migraines I’ve had in my life were always successfully treated with sleep and nothing more. The only time I recall really appreciating a pain medication was the cough syrup with codeine I used when I was saddles with both strep and mono in the same stretch; without it, I doubt I could’ve slept enough.
“I’m amazed you guys beat me down the mountain.” The voice causes me to pry my eyes open. Liz from HR is standing in the doorway as promised.
You know, flashy lights, sirens and all that. Hard to stop us, I want to say. “Hey,” is all that stumbles out.
“How are you doing?”
The question can only elicit pretenses at this point. “Alright,” I reply. My knees flutter back and forth through my shivering. “Sorry,” I intone. “It hurts to talk.”
“That’s ok. I’m going to let you rest,” she tells me.
“Ok,” I say with a mix of relief and disappointment. I’m far from my normal entertaining self.
The long day is beginning to wear on me. I’ve been up for nearly sixteen hours, the last twelve of them spent either actively running around a mountain with kids or fighting off waves of pain.
“Are you Benjamin?” the doctor asks, looking up from her chart as she sweeps into the room. In another time and place, I could envision her a queen, sashaying through the palace with firm nobility and surety.
“I am,” I say. My voice seems quieter than I expect.
She introduces herself and continues, “I understand you’ve got a hernia.”
“That’s what they tell me.”
“Do you know what a hernia is?”
“In a very general sense.”
“It’s when the bowels or intestines push through your abdominal wall,” she explains. “We’re going to have to lie you down and take a look.”
“Lying down hurts a lot,” I tell her. I know it’s not an option to stay in this position, but I remember the searing fire rising through me the last time I tried.
“Well, we’ll have to try.”
“I’d prefer to lower myself,” I tell her as I grit my teeth and grab the side bars. They drop the back and a slowly let myself fall backward. My feet dangle straight off the bottom. Every few degrees increases the pain, a burning fire in my gut. By the time I hit the mat, it’s a raging inferno in my right side.
“Oh yeah,” she says with resigned acknowledgment. “We’re going to give you some morphine and try to push your hernia back in. If I can’t, we’ll have the on-call surgeon take a look and you’ll need to have surgery to fix it.” The nurse is already futzing with my IV, the promise of succulent morphine welcome in the throes of pain.
She slides the curtain closed a bit more, and pulls the blankets from my body. Carefully, she lifts my gown. I can feel her fingers, warm to the touch, press gently around the epicenter of pain. Each press feels like knife stabbing into a nerve. She presses more firmly on the point of pain. I fight from writhing, from crying out. Either the morphine hasn’t taken effect or the fact that it’s been pressed into my bloodstream is a godsend. I feel as if an entire section of my body is made of pointy things, thorns, needles, blades, all poking and prodding, slicing through the thin veneer of control.
I can’t tell when the pain ends and they begin to lift me back to a more seated position. The blankets are replaced, the pillow adjusted. I know I pulled myself upright, but I can’t recall the instruction to do so. The doctor seems unfazed.
“The surgeon will be in shortly,” she tells me, as they leave.
I breathe deeply, closing my eyes and turning all my attention to the auditory. I can hear Rob, the head of the ski school, arrive and relieve Liz.
“Hi,” I say, peeling my eyes open as he pokes his head around the curtain.
“Hey. How are you doing?”
“Well, there goes my immortality,” I tell him.
“Human like the rest of us, huh?” he replies with a smile.
“Mind if I take a picture?” he asks me.
“Go fir it.” He pulls his phone from his pocket and carefully line it up. I give a thumbs up and grit a smile.
“That’s great,” he announces as the fake shutter sound clicks. “End of year slideshow for sure.”
“Of course,” I say with an eyeroll.
The anesthesiologist comes in and talks to me about allergies and the plan. I give him a rundown of previous surgeries and experiences.
“So will it be open surgery or laparoscopic?” he asks.
“I don’t know.”
“Hasn’t the surgeon come and talked to you yet?”
“Nope,” I say.
“Oh, well it’ll be general anesthetic either way, but there are subtle differences depending on the procedure.”
“Ok,” I tell him.
All the information, the faces, the drugs, the fatigue, the pain, it’s all beginning to blur together like an impressionist’s version of film. I’ve become a passenger in my own body. Everything seems to happen whether I’m ready or not, no time to fret or worry, no care or way to stop it.
The surgeon arrives. He’s announced a moment or two before by the fiery haired receptionist. He strolls in with a down vest over his scrubs, his hands tucked in his pockets and a confident air about him. It seems impressive and reassuring, as if this is just another day at work for him. Like the EMTs before him, I envy his bedside manner.
A hernia, as the doctor had said, is when the bowels or intestines push through a hole in the muscle. Some of these holes are already there, since the intestines need to reach up past the lungs and down to the anus and rectum. Some close up soon after birth, such as the umbilical canal. Others are accidental tears in the muscle tissue. A tear in the muscle doesn’t guarantee a hernia. It’s only a hernia if the intestine pushes through. it’s a little like pinching a balloon to create a balloon animal; the act of pinching the tube or sac causes a divide in the chamber. The part that’s separated might congest and cause severe pain, or it might die due to lack of blood, or it might pop back in easily. In the latter case, rest alone can be an ample cure. In the former two, surgery is often needed.
“We’ll be doing open surgery,” he explains. “If there’s any tissue death, we’ll need to remove a portion of bowel and reattach them. If that’s the case, it’ll be five to ten days in the hospital and one to two months before you’ll be cleared for moderate activity. If there’s no tissue death, we’ll push things back in and apply a wire mesh to help hold things in place. You”ll be out of the hospital tomorrow and should be able to resume activity in about three weeks.”
“When will I be cleared to be back on skis?” I ask.
“Probably two to three weeks if we’re able to do the mesh repair.”
He offers some more words of assurance before disappearing to prepare, but I’ve heard all I need to. In my head, I’m mapping out dates. The Level II exam is the end of January, which means there’s a chance I could do it if I’m recovered and back on snow before then. It’s a slim chance, but it’s hope. All my hopes are that I don’t have anything dead or septic.
“You don’t have to stay,” I inform Rob. “I won’t be very good company.”
“That’s ok. I’ll hang out until you head off to surgery,” he tells me.
People shuffle in and out of the room, collecting things, moving things, prepping me. Rob waves as they wheel me out into the cold corridor. They move through an airlock, gently explaining everything that’s going on. I’m not really paying much attention. They have me painfully shift to an operating table. Elbow, foot, hip, slide, repeat. They strap a mask over my face and tell me to breath deeply. I remember getting my adenoids out and how they told me to count backwards from ten. I don’t remember reaching five. There are no specific instructions this time.
I close my eyes and let the calm darkness envelop me.
Continued in Thunder Down Under: Part VI