By the time we reached the hospital, the parking garage was nearly full. How damn many surgeries do they do at 6:00 in the morning? We ended up getting to the registration desk 15 minutes late.

The presurgical waiting room was dark and kind of musty. There were many antique chairs situated in a maze throughout the room. A large plasma screen TV showed a grid with patient numbers, status, and comments. As we walked up to the desk, we were given a number and told to reference that number in all communications about the patient — me. That number would also be used to track my progress through surgery and into the recovery room.

As we sat down to fill out more paperwork, we walked past a young woman who was sitting in a chair, rocking back and forth, crying, and rubbing the beads on a rosary. That upset my wife and I could see her begin to fidget.

One by one, patient numbers were called, random people and family members stood up, walked to the desk, and then walked out the door into pre-op.

“7126″
“That’s us,” I said to my wife. She just gave me this long sorrowful look that kind of made me feel sad. We took all of our belongings and followed everyone else down the hall to pre-op.

Once inside, there was another maze of hospital gurneys separated by curtains. We were led to one of the “rooms” in the middle of the maze. Hospital staff scurried about with portable computers, entering data as they walked from room to room. On the bed in my room was a garment bag and a gown. I knew the routine. Everything off. Gown with the opening in the back. Hair net to catch all of my flowing locks.
I took off my sneakers, folded up my sweatsuit, and put everything into the bag. I had to wear a sweatsuit to the surgery, because it made me feel as if I was more “healthy” compared all the other people who needed surgery. Also, I figured that if I wore jeans when I left the hospital, they would press upon the surgical site. See? I was thinking ahead.

I sat myself in the bed and pulled the sheet up over my legs. My wife pulled the chair next to me and held my hand. Then we just sat and waited.

A nurse came in and took a history. She confirmed everything that was in the records from my preoperative physical the week prior. Nope. Nothing changed.
Then a surgical resident came in, performed a brief physical exam, and took another history. Same questions the nurse asked. I knew I would have to repeat the same history at least 2-3 more times. That’s just the way things go.

Then the anesthesiologist came by and sized up my jaw. Held my chin in his hand and turned my head from side to side like he was getting ready to sock me. Had me open my mouth. Made sure that I showed him all of my intact teeth. He just wanted to make sure that there wouldn’t be any problem getting the tube down my throat.

Another nurse came in and started my IV. By then, word had gotten around the pre-op area that I was a doctor. One of the other nurses chickened out on sticking me for the IV. The new nurse’s hand was shaking when she came at me with the needle. I felt bad. What’s the big deal? It’s not like I’m going to yell at you. She aced it on the first stick and taped it into place.

For some reason, about 5 minutes later I got very nauseous. Just came up at me out of the blue.

“You better get me a bucket quick – I’m going to hurl,” I told my wife. I was getting that tight feeling in my jaw and my salivary glands were doing double time.
“Did they put something in the IV?” I asked.
“I don’t think so.”

I looked across the hall. There was another guy sitting in a bed staring at me. For some reason, I got irritated.
“Honey, can you close the drape?”
“Why?”
“Because otherwise I’m going to jump out of this fricking bed and go puke in the lap of that dude eyeballing me across the hall.”
“Just relax. He doesn’t have anything else to do. Look at his wife.”
He was just sitting in the bed. His wife was hunched over her CrackBerry texting away and completely ignoring him. Not sure what was so important at 6:30 AM on the day of her husband’s surgery, but my wife was right. Then I felt bad for getting annoyed.
OK, buddy, enjoy the show.

Another nurse came by, ripped open several alcohol swabs and held them up to my nose. “Sniff these, they’ll help.”
I looked at her as if to say “are you kidding me?”
“Trust me.”
So at that instant, I became a “huffer” of isopropyl alcohol. If the odor didn’t help, I could always suck the alcohol out like I’ve seen some patients do in the past.
Damned if it didn’t work.  The nausea didn’t go away, but it did get better.

Then an anesthesia resident came by and gave me some Zofran. Cool. Nausea pretty much gone. He began to give me a second medication when Mrs. WhiteCoat asked what it was. He held the syringe so she could see it but so that my line of sight was blocked by his hand.

Mrs. WhiteCoat’s eyes began to tear up.

I thought to myself “Why the heck is she get….”

Whoa.

Here are links to the other parts in case you get lost:
Part 1, Part 2, Part 3, Part 4, Part 5, Part 6

“You can’t keep popping antibiotics to cure your diverticulitis,” Mrs. WhiteCoat told me.

Yeah, yeah. I know. That’s why I grudgingly went to see a surgeon.

Then I started wondering to myself. Aside from those neurologic complications and the increased incidence of tendon ruptures, why can’t I just take Cipro and Flagyl every few months?
Actually, I was more worried about long-term complications from repeated episodes of diverticulitis. Inflammation from diverticulitis can cause strictures, adhesions, fistulas, obstructions, and other badness that I didn’t want to have to deal with later in life.
So … I may as well get this diseased colon of mine removed while I’m still “healthy.”

We decided to stick with a surgeon that we’ve known for a long time. I had seen him a couple of years prior when I had to stay in the hospital for another episode of diverticulitis. He has lots of experience doing colon surgery, plus he’s a good guy. I requested a month off of work, figuring that I would hopefully be back to normal a few weeks after the surgery.

A week before surgery, I got an e-mail with preoperative instructions from the nurse. Had to make sure that I was “cleaned out” before the surgery, so the day before surgery involved drinking lots of laxatives. I decided I wanted to go even one step further. I pretty much only drank liquids for the two days prior to surgery. I didn’t want there being any chance of extra stool in my colon that could contaminate the surgical site.

We had to be at the hospital at 6:00 AM on the day of surgery. That meant getting up about 4:30 in the morning. No problem, I figured, I’ll be sleeping most of the day. I just felt bad for my wife.

While we were getting dressed, she looked at me and said “I could hardly sleep last night. Aren’t you worried?”
I really wasn’t, except for one thing that kept running through the back of my head. It was almost like a bad omen.
One of the last patients that I had seen in my last emergency department shift was a gentleman who was 50-ish and who had been in a nursing home for the prior 4 months. He suffered a relatively straightforward injury. He was shoveling snow when he slipped and fell, breaking his hip. He had a standard hip replacement performed, but that’s when his troubles began. First, his surgical wound got infected. They had to open up and debride some of the infected tissue. Then, the hip prosthesis became infected. He was on intravenous antibiotics for a month. The organisms were unfortunately resistant to most antibiotics, and the infection persisted, so the surgeons had to remove his entire hip prosthesis. Then he was on more antibiotics to try to cure the remaining infections in the tissues. Since he did not have a hip joint, he was unable to walk and was relegated to a bed. Then he began to develop bed sores. He came to the emergency department because his hip was getting more red and was draining pus … again.
When I looked at him, I felt such pity because you could tell that he was a strong, proud man who was beaten down by a bunch of superbugs and wouldn’t even have existed if it weren’t for all these patients thinking that their runny noses and coughs need antibiotics.
Yep, fate being what it is, I could just see myself getting infected by one of these multiply drug-resistant organisms that I complain about on my blog so much. If I had had a temporary colostomy bag, I could deal with it. Postoperative pain, no problem. Infections… now those worried me. And there wasn’t a damn thing I could do about it.

I packed up a couple sets of scrubs and a couple packs of gum, since I knew that I wouldn’t be able to eat for a while after surgery. I put a computer and an MP3 player in the backpack. I also took my phone and an extra battery just in case. Anything else, I figured someone could bring me later if I needed it.

With that, I gave each of the kids a kiss on the forehead while they were sleeping, then my wife and I walked out of the house hand-in-hand.
“I’M driving,” she said.
“Fine, I’m sure they’ll have some nausea medicine there for me when we arrive,” I joked.

On the way to the hospital, my wife kept looking over at me with tears in her eyes while she was driving. “Cripes, it’s colon surgery,” I thought to myself, “it’s not like they’re doing a heart transplant or something.”
I just smiled back at her.

Here are links to the other parts in case you get lost:
Part 1, Part 2, Part 3, Part 4, Part 5, Part 6