Three Operations in Eight Days

My plastic surgeon, Dr. B, is the head honcho of the state’s plastic surgery association, respected, pleasant, but humorless. “I’ve read over all your information and chart notes twice. I know your situation and have a good idea what’s needed.” It seems he’d rather not hear my version of how my Stage I pressure sore suddenly exploded to a stage IV subdermal wound. He’s all business, and I’m OK with it.

He examines the dime-sized hole on my butt that opens to a larger wound chamber that leads to the bone, the ischium. Ninety percent of it is invisible, but the MRI has confirmed its size and shape. Dr. B tells me he’ll schedule a debridement and bone biopsy surgery to open up the wound, clean it out, remove dead bone tissue and send a sample to the lab.

But first he orders a pelvic angiogram. He wants to get real-time images of blood flow in my gluteal area prior to the debridement/biopsy. My doctor friend from far away tells me this is a sign that Dr. B is very thorough.

In the cath lab where angios are performed, the radiologist/doc and his crew prep me while I lie on a slab. An upside-down face appears. “I’m Dr. L, the anesthesiologist. Ever had any problems with Fentanyl? I usually use that for pain along with a sedative.” Fentanyl scares the hell out of me with its reputation for overdoses, suicides, and talk of it being a hundred times stronger than heroin. “Don’t worry,” he says, “I’ll be watching your blood pressure.”

They drip the magic potion into my veins. Immediately I feel floaty yet aware of everything. The radio/doc, within arm’s reach, peers into a weird portable viewing device that slides on runners and hangs from above. I swear I see duct tape and plastic holding it together. “Didja make that thing yourself?” I slur, thinking I’m being funny. He doesn’t laugh.

The rest of the crew stare at monitors alive with images of arteries and veins while they banter about rock music and listen to piped-in golden oldies. “Who’s on lead guitar?” asks one of them. Radio/doc looks up from his viewing device and confidently nails the answer, then turns back to his scope. They’re amusing themselves with rock trivia while I’m on the slab. I don’t know whether to laugh or complain. Surreal.

Five days later I go into the hospital for the debridement/biopsy followed by a colostomy that Dr. B feels is best for me. “We want the wound to stay clean,” he says. I think he knows best but wonder if he is, sorry, a bit anal.

When I wake from the debridement/biopsy, I’m in an air-fluidized bed that sounds like a jet. The Clinitron, a mix of liquid, air, and tiny beads made from sand, is the king of wound therapy beds. The sensation is akin to riding in an outboard motorboat. Sleep is impossible. The bubbling movement of the bed and incessant sound remind me of being on a nonstop flight with turbulence.

After one day of recovery I’m off to the OR again for the colostomy. A 30ish woman leans over me. “I’m Dr. H, and I’ll be doing your laparoscopic surgery.” The confident look on her face eases my worry. “Were you told that tubes will be inserted into your abdomen and you’ll be filled with air so we can do the diversion?”

“Filled with air?” Instantly the worry returns.

“You’ll puff up like a balloon, so there’ll be some discomfort for a few days afterward. Three tiny slits, that’s all,” she assures me.

The next week of recovery is post-balloon hell. The pumped-in air still remains in bodily nooks and crannies, like trapped gas. It moves from my abdomen up to my rib cage and invades my shoulders. Time for round-the-clock oxycodone.

Also Zosyn, a powerful IV antibiotic, says Dr. K, my overly-friendly infectious disease doctor. “I’ll have an IV nurse put a PICC line in your arm attached to a small portable pump in a bag, so you’ll get it 24/7 at home or wherever you are.”

“For how long?”

“Four to six weeks, maybe more. Don’t worry, pardner,” he says, patting me, “you’ll be fine.”

On the ride home in an ambulance that Dr. B insisted on and that my insurance does not cover, reality sinks in: My body is no longer my own. I’m on a conveyor belt moving through a production line — our nation’s health care system. It’s not fair to call it a meat packing plant, but the surgeons are busy incising and slicing around the clock — I am the product, cut up, trimmed and packaged.

And the big event, my flap surgery, is yet to come.

This is the second installment in Journey to the Far Side of Tomorrow, a six-part blog series chronicling our editor Tim Gilmer’s unexpected immersion into the world of flap surgery and all it entails. Look for the third entry in mid-March and read the first entry here