The Third Time's a ....

When you're sitting in the surgical waiting room for the third time, it's like no time has passed in between. I remember that stain in the carpet in front of the middle chair in the third seating area on the left. I know where the coffee is, and where they keep the extra tissues. I know how to watch the large screen schedule monitor that displays the current status of each operating room in a coded color with the patient's six digit tracking number that is updated every 45 seconds and tells you absolutely nothing.
I know how to make pleasant small talk with other people who are watching the same tracking number I'm connected to.
I am a professional.

I arrived at Rich's bedside at 05:45 this am because surgery was scheduled for 08:00 and … I am a professional. His room was a flurry of activity because pre-surg was on their way and they were packing up his belongings and getting ready to transport him. Rich and his nurse were so relieved that I got there in time to see him before they took him away. Once we get him ready to go—no easy task with 5 different IV drips through two IV pumps, and a cardiac monitor and four bags of stuff. Where did the stuff come from? He was admitted a week ago with nothing except the clothes on his back and now I'm schlepping four bags of stuff.

We had some quality time together once he was packed up and we waited for them to come for him. And waited. At 08:00 the anesthesiology team was wheeling him down the hall and I was sent packing. At the elevator I saw his surgeon in suit and tie, coffee in hand. He was actually glad to see me because he couldn't find Rich. Someone forgot to tell Dr A. that Rich couldn't go to pre-surg (where the doctor likes to talk to him before they are both prepped for surgery) because he's on a cardizem drip so he had to go straight from his room to the OR.

There was a time that such lack of organization and communication would have made my face pop off, but not any more. I am a professional. And knowing that Dr A is in charge leaves nothing to worry.

At 09:30 our beeper buzzed and I'll admit to a flash of panic. It seemed too damn soon for Mission Accomplished. I'm no doctor but how the hell do you disconnect the stomach from the duodenum, re-route the small intestine and make a brand new connection to the stomach in 90 minutes including prep and close?!?!?! I did not voice these thoughts however because I am a professional.

So we gathered in Conference Room #3 and in less than a minute Dr A was there and informed us immediately that all went exactly as planned. He drew the whole procedure on the dry-erase board in front of us and told us what happens next and answered my questions. I knew what questions to ask, and what not to ask because those questions don't have answers. I am a professional.

At 11:30 I went to the info desk because the large screen schedule monitor shows that Rich's tracking number has turned green, which means “Discharged from OR” for over half an hour now. Last time he had surgery no one told us he was back in his room for over two hours and there he sat waiting for us. So I ask at the desk and they tell me they're getting ready to transport him. Maybe getting out of surgery takes as long as getting into surgery.

It's now Noon. Leaving surgery has now taken almost twice as long as the surgery itself.

I'm just hoping I'm not the first one to tell him that he's not getting anything to eat real soon. He has not had food in over five days. He's not had a beverage in four days and they took away his water and ice chips over 48 hours ago. All he's had is mouth swabs and mouthwash and that's contingent on his solemn word that he will not swallow. There's a really good joke there, but I'm too tired to flesh it out.
Once the vomiting stopped he started getting pretty hungry. He said he dreamt about food all night. He's too hungry to worry about the surgery. He told me this morning that “if someone were to bring me a tray of food right now, I'd get an erection.”

Really. Good to know.

Personally, I would like a nap right about now. I was not ready for my 04:00 wake up. The act of sitting and waiting is not what I would call invigorating. The ideal situation would have been for me to crawl into his bed when he left for surgery and then I'd be right there waiting for him when he got back.

In my head (where the voices stay when we're not in the van) I keep replaying Dr A's words. There is no cancer in the stomach. The tumor just grew and squeezed the opening between the stomach and the duodenum. Eventually the opening was completely shut off and there was nowhere for anything to go except back the way it came. Which created an ulcer at the top of the stomach near the esophagus. And this didn't all just happen in the past week since the vomiting started. It's been quite some time in the works. First noticeable a few months ago when he was popping TUMS a dozen times or more through the night. I would blame myself but no one else caught the problem and THEY were looking at the CAT scan. I don't blame them either. It just is what it is. With what magical insight do you go from reasonable symptoms of cancer, to maybe it's a stomach virus, to wholly shit, the plumbing is totally plugged.

It's been less than a year since Dr A cleaned the abscess out of his liver, so I have total confidence when he tells me that “the tumors haven't gotten much bigger”. And he said the unaffected side of the liver looks VERY healthy. I detected a note of amazement in his voice as he detailed everything that looked good. Apparently I do not have a “poker face” because he quickly, albeit gently, reminded me that “you do understand we will reach a point when we can no longer fix it.”

“Absolutely,” I nodded. “But TODAY you did.”

The he smiled. “You know,” he said, “Rich is my longest living pancreatic cancer patient. No one else even close. If I can get another year for him I'll be thrilled.”

I wish I could convey to you how incredibly humble he looked and sounded as he said those words. Not many people know this, but Dr A's father was a brilliant and beloved surgeon in this area. I don't know if it's true or not, but someone told me his dad died of pancreatic cancer.

This was Dr A's third journey into my husband's viscera. It's become an annual event. I think he saw the difference in me today compared to the first time. Even the second time. He didn't seem cautious with his words to me. He was frank and I was tearless. We were like two seasoned soldiers discussing the latest battle of the war.

At 12:30 we went to the desk again. Rich left recovery an hour ago and is in his room.

Really? Good to know.

The man is in tremendous pain, and he's not a complainer. In fact he does everything he can to stifle his moans. I know he's in pain because I know him. On a scale of 1-10 I would call it 7, leaning on 8. Considering it's 45 minutes after his morphine, I need to take action. Luckily the internist comes in to check him because being present in the room for a minimum of 45 seconds is a prerequisite for the $250 bill we'll be getting. She listens to his heart (he's on a heart a monitor) and asks him how he's doing. His knuckles are white and he manages to mumble "...hurts..." She nods like she gets it only I'm not thinking she gets it. I ask with honey dripping from my mouth if she would be ever so kind and change him from morphine, which has never worked for him, to dilaudid which works perfectly, ending my request with an oath of undying gratitude and a hint of future donations to her favorite charity. I was ready to genuflect before her, but she quickly assured me the med change would not be a problem. Why, you may ask.....? Because I am a professional.

An hour of blissful dilaudid delirium.... he's no longer writhing, guarding or moaning. He's drifting peacefully in and out, no longer complaining about the pain or asking them to remove the catheter and the nasal tube draining his stomach. Perhaps he's visiting his friends, the Hedgehog People. Anytime now he may burst into song and I will have Christmas in June, or be introduced yet again to everyone in his third grade class.
I've learned from experience that I just need to get him through these first twenty-four hours post-op and then he'll begin the most amazing rally his nurses have ever seen.

I have shined it on for all necessary parties, orders are in place, and he's in excellent care. I could even go home and take a nap. In truth I'm reaching the point where I just need to leave so I can have my BIG Cry. Not a big cry, or a Big Cry...this will be the BIG Cry that follows every miracle we get, all in preparation for THE BIG CRY. So I will drive home with the Voices and have my post miracle BIG Cry, after which I will be exhausted but unable to sleep because of feeling guilty about leaving his bedside.

Seriously.

I'm a professional.