Planning

Yesterday morning I had my pre-op appointments.  Last time I had surgery I did not have any pre-op appointments.  I don't remember the day before my last surgery.  I remember speaking with the anesthesiologist the morning of and signing a piece of paper and that's about it.

I highly recommend the pre-op appointments if you can swing it.  In fact, it turns out there are all kinds of benefits to planning major surgery in advance.  Right after you book the procedure you get a nice little packet in the mail full of info about the hospital, the gift shop, where you can eat at the hospital and in the area, support services as an in-patient, what you should and shouldn't bring, directions, hotels, all kinds of goodies.  During the pre-op orientation you get a detailed timeline of when to eat and when not to eat, when exactly to take the pre-op antibiotics, when exactly to perform the other prep steps (think colonoscopy), and when exactly to drink the gatorade on steroids that is supposed to help you recover faster.  You learn how you're supposed to take a shower with the special soap for three days in advance.  You are instructed not to use any products with fragrance the morning of, or anything with alcohol, not to have nail polish on your fingers (toes are okay), not to wear any jewelry and to be sure to remove all piercings.  You get to see the first ostomy nurse you met at Brigham & Women's after the second surgery who showed you the right products and basically made it possible for you to leave your house and try to live a normal life; you see her because she gets to mark the spot on your abdomen where the ileostomy should go, in the event you have to have one (because maybe, just maybe, if everything looks good, you won't have to have one, says your surgeon).  You talk about options for pain management and discover that the one everyone recommends by leaps and bounds - the epidural - is the one that scares you the most because it took three people five tries and over an hour to give you one when you were twelve hours into labor with your son.  You find out that you are the first surgery of the day, a VIP, however be sure to call the day before to confirm the time just in case something comes up.  (And then you realize, oh right, I was the something that came up for somebody else, way back then.)

Yet there are drawbacks.  It turns out that having major abdominal surgery in an emergency situation with no lead time is in some ways preferable to making deliberate arrangements to be gutted like a fish.  Until yesterday I had been able to keep this event on the horizon.  Now it is looming and giant and speeding towards me and in my face and it won't shut up and all this stress can't possibly be good for me going into it.  On top of it all I have this fear that when she opens me up my surgeon will find more cancer, something capable of evading the blood tests and the scans and triggering no symptoms whatsoever, something she will discover on the eve of my almost being eligible for life insurance again, a day I was really looking forward to so my family wouldn't have to struggle if their sole breadwinner succumbed to this disease or some other unfortunate accident.

On the bright side, when this is over, I'll have even more medical expenses to tally up for you, and together we can marvel at the price tag attached to the miracle of modern medicine.  In the meantime I will take your thoughts, well wishes, meditations, prayers, and positive vibes.  Peace.