Vestigial Organs – by I.P. Freely

Strap in… going to be a long one.  If you’re sensitive to coarse language or graphic descriptions of medical procedures, you may want to stick to my dental articles.  This story will make you cringe, at least.  🙂  But, it does get interesting, I promise.

I’m nearly 48 years old, and until now I had never spent time in a hospital (not counting ER visits for minor trauma).  I’ve never been seriously ill.  I’ve never had a scalpel applied to my body.

Just another day at the office.

On Monday night when I got home from the office, I complained to my wife that I was having some pain in my abdomen.  It wasn’t bad.  Maybe gas or indigestion?  So, I continued my evening as normal.  At about 9pm, kids and wife went to bed, as usual.  I assumed my normal position on the couch for the routine TV + computer time.  And, as is normal for me, I fell asleep on the couch.  About 1 am, I woke up (also my usual routine).  I got up, took a whiz, and performed my usual security check of the house before going to bed.  During my security rounds, I felt the stabbing pain again.  Same location.  Lower right quadrant of abdomen.  Shit!

A little knowledge isn’t always dangerous.

My medical background was enough to know about “McBurney’s point.”  That is you take your right hand and make the Hawaiian’s “hang-loose” gesture.  Put your pinky on the iliac crest (#3 in illustration on left) and your thumb on your belly button (#2).  One third the way from the iliac crest to the umbilicus (#1 – about where your ring finger is) is where your appendix resides.  Press there with your other hand.  OW!  That’s not good.  Worse yet, suddenly was experiencing full body chills and shakes.  Sweating.  Even though I KNOW this combination of signs and symptoms is the perfect storm of appendicitis (with only one symptom yet to present itself), I got in bed to see if the body shakes and sweating would calm down.  Nope.  I sat up in bed, and my wife, Chriss, woke up.

Denial is not good medicine.

Oh crap.. I feel like throwing up.  Dry heaves at the toilet.  That’s the last symptom in the full symphony of appendicitis.  You’ve GOT to be kidding me with this shit!  Chriss then wisely suggests we get my ass to the hospital.  She calls an ambulance.  And, then we call my MDVIP doctor.  He gets on the phone right away (remember this is 1 am) and tells us to get to a very specific hospital (rather than the one closer to home to which the ambulance would have likely taken us).  So, we cancel the ambulance, wake up the kids, and off we go to the hospital.

The E.R. turns out to be quite efficient, even though it was very busy at 1.30 am.  They get me checked in and triaged almost immediately.  Not too long afterwards, they get me into a CAT scan.  Yup… that appendix looks angry.  I was in pain, but it was not unbearable.  The ER staff seemed surprised that I wasn’t demanding pain meds by brand name.  They had to ask me if I wanted anything for pain.  Nope.  I’m good.  (This tidbit will become more relevant later in the story.)  Then I was scheduled for surgery at 9am.

My MDVIP doctor comes in and helps arrange for a private room for me.  Nice.  Next stop is pre-op.  They take me to the surgery prep area.  Another busy place.  Nurses are nice.  They go over my health history for the umpteenth time.  And, that’s all good.  I could tell they are crossing their “Ts” and dotting their “Is.”  They want to make sure they’ve got the right diagnosis, on the right patient, scheduled for the right surgery.  Fine by me!  Then a nursing assistant got the honor of shaving my Sasquatch-like torso.  Several minutes later a surgical nurse inspected the job and deemed it incomplete.  I had been shaved for a conventional appendectomy, not a laparoscopic surgery.  So, she finished the job leaving me with what I can only describe as a full frontal reverse Mohawk.  I’m used to seeing myself fully hirsute (not including my ever-expanding forehead), and it looked damned weird to me!

I met briefly with the anesthesiologist who confirmed I was going all the way under with general anesthetic.  I was more nervous about that than the surgery itself.  Then I met briefly with the surgeon who informed me that he hoped to perform the surgery laparoscopically, but he may have to go in conventionally if it gets ugly in there.  OK… I understand.

Comfortably numb…

Again, they asked me, “You don’t want pain meds?”  Nope.  I’m good.  Eventually, it was go time, and they gave me a sedative.  I believe it was Versed.  I’m just not a “druggie” kind of guy.  So, I don’t get excited about narcotics.  And, I don’t remember feeling any kind of “rush” or euphoria.  I remember being wheeled into the O.R.  And, that’s the LAST thing I remember.  Poof!  GONE!

For obvious reasons, I can’t relate any details of the surgery itself other than it was accomplished laparoscopically.  And, they reported that while my appendix looked quite angry, it had not burst.  That’s always a good thing.

The appendectomy was the EASY part.

Next thing I knew was I was waking up and being wheeled to my private room.  Surgery was reported a success.

My dick… my dick… is on FIRE!

I was given I.V. morphine for pain control, which is apparently routine.  And, I was pain-free, as it relates to the surgery itself.  But, my pee-pee hurts.  And, I can’t pee!  Well, I could TRY to pee… but it was BURNING.  Now, I’m not talking about a little sting.  I’m saying it felt like my penis was a World War 2 era flame thrower.  WTF?  It was then explained to me that they catheterized me for the surgery (and decatheterized me while I was still under general anesthesia), and it’s normal to feel a bit of a sting on the first few urinations.  Well, folks, I’m not a drama queen, nor am I a wimp by any measure.  But, my dick is on FUCKING FIRE.

Yes.. I’m a doctor, and I should use proper anatomical terminology, like “penis.”  But, I’m not one for formality, and sometimes bluntness is better than eloquence when trying to tell a story laced with emotion.  And, I believe talking about my dick being on fire is different than talking about a fractured fibula or torn medial meniscus.

I kept trying, but all I could get out was a single drop, and it was AGONY.  I was screaming so much in the bathroom, my poor 10 y.o. son was so upset, he had to leave.  (OK… taking a break from writing… as I’m breaking a sweat just writing about this.)

(I’m back.)  By now it’s getting the late afternoon, and I haven’t pissed.  And, my bladder is getting distended.  It’s VERY uncomfortable.  A nurse suggests they may have to catheterize me.  Oh no…. let me try some more.  I tried… and tried… and tried.   Still my dick is on FIRE.  No joke, it felt like I was sticking it into an open flame.  “Oh it might sting a little.”  It’s not fucking stinging.  It’s ON FIRE!  They don’t believe me, it seems.  Finally, I’m so uncomfortable, I agree to being catheterized.  Two nurses are tasked with the job.  They warn me it will be “uncomfortable” and ask me if I’m sure it’s what I want.  Hell no, I don’t WANT it… but, the alternative isn’t working for me, either!  So, I brace myself and focus my mind on just getting through it.

Holy mother of God!

What proceeded to happen would make the CIA’s “waterboarding” of al Queda prisoners look like “Romper Room.” (I wonder how many of my readers are old enough to get the Romper Room reference.)  Again… I’m not wilting flower, lightweight, scaredy-cat, or drama queen.  I’ve faced down death twice.  Once was running out of air while scuba diving at 80 feet.  Another time I was in my car with my wife, blocked in on train tracks…. with a train coming VERY quickly.  Under pressure, I can make shit happen.  I don’t panic.  And, I got myself out of both of those situations unharmed.

I’ve been catapulted off the flight deck of an aircraft carrier in a Navy jet.  I served on the USS Independence as the first response to the Iraqi invasion of Kuwait (first Persian Gulf War).  I’ve even walked across 15 feet of red-hot coals with my bare feet (at a Tony Robbins seminar).  What those two nurses did to me makes ALL of that seem like child’s play.  If the arch-enemy of my beloved United States of America had captured me and done this to me, I would have given them the nuclear launch codes.

I’ve had a broken arm set without anesthetic.  I’ve been banged up in a variety of ways throughout my life.  Broken bones.  Stitches.  Been there.  Done that.  Multiple times.  Not once before have I screamed out in agony.

When your patients say “it hurts,” believe them.

But, THIS was the most motherfucking pain I’ve ever experienced.  Remember, I was already on morphine!  Again, I’m sweating just telling this story.  It has affected me deeply.  When I told the story to a hospital volunteer (and 3rd year medical student) I had to fight back tears.  I am not kidding when I say the ENTIRE hospital wing heard me scream.

The nurses got the catheter snaked all the way up my urethra, but hit a brick wall at the internal urinary sphincter (at the bladder).  They tried to push through it a few times… all the while telling me to “relax.”  In the end I begged the two nurses to stop, and they did. It felt like someone was shish-kebabbing my “manhood” with a sword that had been sitting in a kiln for an hour.  As good as I may be at word-smithing, I cannot adequately describe this pain.  Nevertheless, they seemed to dismiss my account of the pain.

Oh, you men are such babies!

Now, many women have been catheterized and will smirk when a man complains about this.  But, it bears mentioning that a female urethra is 1.5 – 2 inches long, and it’s a straight shot.  A male’s urethra is about 8 inches with a race-track-worthy chicane (multiple curves) ending with a constrictive prostate gland.  OK… even if it’s just 7 inches because the room was cold!  😉  It’s a much longer trip, and it’s not straight!  And, it will become apparent later in this post why my particular situation was crazy painful.

Desperation and no sympathy…

At this point, I was at a total loss over what to do.  I kept trying to pee.  Fire…. pure… white-hot fire at the end of my dick.  My bladder was screaming at me and under extreme pressure.  The nurse said they’d call in the urologist.  So, I waited.  And, waited.  The morphine did NOTHING for this pain.  They gave me percocet.  They might as well have given me PEZ candy.  My wife calls my MDVIP office and is told that a little burn is normal, and I should just “push through it.”  This advice does not make my wife happy.

So, I called my MDVIP doctor’s office.  The nurse there bluntly told me that I shouldn’t call them, if the nurse already said she’d called in the urologist.  This upset me, and I hung up.  (I will be dealing with that issue in the future.  That’s NOT MDVIP service.) I then got a call back from my MDVIP doc’s office telling me that they’ve called in a urologist.

“Herr Urologist” is here to see you.

The urologist arrives at around 8pm, and he’s clearly annoyed to be there.  It’s his time off.  He asks me if I’m ready to be catheterized again.  I express my concerns and my previous experience.  He also seems to dismiss my description of the pain.  I ask him what he will do differently than the nurses.  To this he replies, “I will be successful.”  Oh great. Again, he asked, “Are you ready?”  When I stammered about my reluctance, he admonished me, “Listen… I’m here at 8 pm.  I’m NOT coming back at 3 am.  I’m not coming back again.  So, are you ready?”

I then tried to engage in some friendly small talk…. something else I’m good at… to gain his good graces.  I find out he’s from Peru, and so I launch into my best Spanish and tell him how I grew up in Venezuela.  I figure I’ll try to make friends with my wartime prison guard / interrogator.  It seems I’ve stumbled upon the healthcare version of Stockholm Syndrome.

He says he’ll numb me up first.  Now… surely any reader here can understand that it takes a desperate man (me) to agree (and look forward) to getting a NEEDLE IN HIS DICK.  I don’t normally watch when I get a needle anywhere, but I watched this one.  I watched him stick a needle in my dick, and I liked it!  Mind you, it hurt!  But, I knew I was going to get SOME relief.

Now that my dick was numb, I asked the urologist if I could try to pee on my own.  He rolls his eyes and is reluctant because he’s already got me all draped and prepped.  But, I’m a clever lad, and like I said, I can perform under pressure.  In perfect Spanish, I said, “I’m BEGGING you to let me try.” He relents and says I have three minutes.  Sure enough, I get to the bathroom and peed 150 ml into the little portable urinal.  Even that much felt good.  But, that’s all I could squeeze out.  And, in-so doing, I feel the lidocaine wearing off… a bit of burning coming back.

The urologist then looks at me and says, “That’s not enough.”  And, I know he’s right.  There’s a lot more where that came from.  So, back on the bed, I go.  I asked him to AGAIN stick me with some lidocaine.  He does.  He says, “are you ready?”  Luckily my favorite nurse was there.  A sweet young Haitian woman named Josalie.  She was a real doll.  And, believe me, when you’re this desperate, all modesty is GONE.  We clasp hands, and I tell the urologist to go.

Once again, the pain is horrific.  A red-hot skewer going up my dick.  I feel like I’m being branded from the inside-out.  I’m screaming and cursing in TWO languages.  The urologist dismissively and arrogantly says, “oh please. Shhhhhhhhhh!”  He tells me to stop hyperventilating.  He gets the catheter in, and I start draining urine.  650 ml immediately…. and a whole lot more later.  I’m so relieved and emotionally drained, I’m thanking the urologist profusely… and apologizing for my behavior.  More evidence of Stockholm Syndrome!  He then helped himself to a gourmet lollipop from the box my periodontist friend had brought (admittedly for bribing nurses to come visit my room).  And, off into the “moonset” did my urologist go… without ever seeing him again.

Pus?  From WHERE?

The next morning, I’m feeling much better, but I’m still feeling pain “down there.”  I take a look myself, and there’s pus… yes, pus… coming out of my wanker.  I tell the nurse about it, and she says that doesn’t indicate an infection, necessarily.  Oh yeah?  In my training, we learned that pus, swelling, or fever indicate infection.  She then says, “yeah, but you don’t have swelling or a fever.”  I had to tell her that it wasn’t an inclusive list.  Any ONE of those indicates infection.  She says, “well, we’d need to get a culture.”  That’s great.  Please do that.  But, can we treat it empirically with the most common antibiotics used for urinary tract infections?  She has to call my doctor first.  He OKs for Cipro but cancels the culture because he doesn’t think I have a UTI.

Well, guess what doctor??   I fucking DID have a UTI, and THAT’S why it burned like a motherfucker when I tried to pee.  It wasn’t “stinging a little.”  I can take that (and a lot more).  When I said it was burning like it was on fire, that’s exactly what I meant.  Let me stick a torch to your dick, and then maybe you’ll understand what I mean!  I’m not shy, nor am I overly dramatic to gain sympathy.  I say what I mean, and I mean what I say.  And, that’s why I acted like an animal being skinned alive when they catheterized me TWICE.

Remember… this is the GOOD hospital in my area.

The moral to all of us in the healthcare professions…  If your patient says it hurts, either believe them, give them the benefit of the doubt, or at the very least FUCKING HUMOR THEM.

And, the rest of my hospital experience…

Once I got the Cipro in my system, I started to feel much better.  Uncomfortable “down there” but MUCH better.  Now that that pain was ameliorated, I was finally feeling the normal post-op pain associated with the appendectomy.

What is the deal about liking narcotics?

Every so often, the nurse would come in and tell me it’s OK to get more morphine (and that compared to most patients I was getting very little).  Now, I will say that I did like the absence of pain that the morphine provided.  But, I totally do not get the attraction to narcotics that seems to be rampant in our culture.  I did not get any euphoric sensation from the morphine.  In fact, when it was injected into my I.V., I would get what I would call a “full body headache” that would last for about 30 seconds.  It’s a very UNpleasurable feeling.  I could even taste the morphine, which is pretty yucky.  I did NOT like the morphine “rush.”  But, the pain relief was welcome.

I had several conversations with various nurses about how many patients demand narcotics by name, amount, and frequency.  Based on my own experience, I just don’t get it.  I don’t like them at all… just a necessary evil on occasion.  I hope I never have such occasion again!

This is not to diminish the plight of those who are addicted, nor is it intended to impugn those folks.  It seems some have a gene or trait that makes drugs pleasurable.  I obviously don’t have that trait.

Bye-bye Foley catheter!

On the third day, it was time to take out my catheter.  There was a nurse and a nursing student.  The student would be removing my catheter.  I had already met her, and she was very nice.  I gave them the nutshell version (no pun intended) of my catheter experience.  I worried how it would feel coming out.  And, worse… I worried if I could pee without being on fire… lest we have to RE-catheterize me.  The mere thought brought tears to my eyes.  They explained that removal would be a lot easier than insertion.  So… breathe iiiiiiinnnn…. and EXhaaaaaaaaaaaale.  Swoosh!  Like she was starting a lawnmower or spinning an old-fashioned top.

It was out, and I had a little coughing fit.  Don’t know why, but I did.  It didn’t hurt.  But, it did feel very weird.  So, now I’m told to drink a LOT of water.  OK… but that means I’m going to have to pee.  Oh GAWD, I hope I can pee!  I never imagined that my sole focus in life would, at some point, become about a mundane primary bodily function.

But, I did follow orders and forced water.  And, then it came time to pee.  And, so I did!  A little sting, but no fire!  Well what do you fucking know???  It DOES “sting a little” like they told me earlier.  But, that’s not what I was feeling before, you nincompoops!  When I say FIRE, I mean fucking fire!!

I’ve never been so relieved in my life.  I’ve always had a happy relationship with “Mr. Hoo-Ha.”  I never thought it would ever be my “enemy.”  But, for a while there, we battled hard (again, no pun intended).

Be nice to nurses.

I will say that overall, my nurses were outstanding.  But, I did have my favorites.  A few were there to do a job and little more.  I enjoyed chatting with my nurses, even though they were far too busy to spend a lot of time with me.  I kept many of them laughing, and they said I’m not like most patients (in a good way).  Those nurses saw me in all my “glory.”  I’m not the kind of guy who defines himself by, or is particularly proud of, his “manhood,” so I’ve always been a bit modest.  But, modesty has no place in these situations.  I was at their mercy, and offered my full cooperation.

I’ll never forget Josalie.  In fact, I will make an effort to communicate with the hospital about her exemplary performance.  I’d like to send her flowers, too.  Flowers sent.

It’s lonely out there in space…

(Borrowing from Elton John’s “Rocket Man.”)  I can see how many hospital patients could get very depressed.  Family can only visit for so long.  Nurses don’t have much time with a heavy load of patients.  Thankfully, there was a “American Choppers” marathon to keep me entertained.  And, I also am fully updated on the fight between the President and Congress over the budget deficit and borrowing limits.

Having an I.V. line and a Foley catheter made me feel like a trapped animal.  Even though I could get up and walk with my tethered accoutrements, it was not comfortable… especially with the tube up my wiener and tugging on my bladder with every step.  It just felt very weird and uncomfortable.   So, I was mostly confined to my bed.  It was very liberating to go off the I.V. and the Foley catheter.  After that I paced back and forth in my room quite a bit.

Good things come to those who wait… and wait.

Getting discharged was quite the process.  In fact, everything in a hospital takes time… lots of TIME.  My discharge process was started in the morning, but I didn’t get out until 6 pm on the third day.

Last night I slept on the couch in the living room, and it was pure bliss.

I was supposed to go to Arkansas this weekend for my 30th high school reunion.  Obviously, those plans got canned.  And, that sucks.  We could reschedule a trip to Disney World, but we can’t reschedule a 30th reunion.  But, I’m sure glad I didn’t have my appendicitis during a flight on the way there, and I’m also glad it didn’t happen there in Arkansas (away from home).

In the end, I count my blessings.  There are far worse things that can happen in life.  I have my wonderful family and many great friends to lean on.  I appreciate all the well-wishes I got by email and on Facebook.

The Dental Warrior soldiers on!  Back to work on Monday!