vital signs

There can be no more powerful sense of well being than the feel of walking out of the hospital under your own power. I know this after a four-day stay, one that turned out to be a little longer than anticipated.

I went in Monday morning for a standard procedure, one of those classified as “minor surgery.” Earlier this spring, in the course of a standard, once-every-few-years colonoscopy, my gastroenterologist had spotted a small polyp under my duodenum and suggested it needed removal. It’s the kind of growth that, if left unchecked, can mutate into a cancerous growth and so we took the precaution of scheduling what’s called an endoscopic duodenal adenoma.

Basically, they burrow inside of you and pull the thing out without making an external incision. I never got to see the contraption they used since I was under heavy sedation for what turned out to be a wo and a half-hour procedure. But as I came to understand, they basically snake a tube down your esophagus, wend a little cutting device down as they monitor it and maneuver the cutting edge so that they can snip off the polyp. Amazingly, they then fish the polyp out and bring it back up so that they can biopsy it.

The catch is that the procedure, while fairly common, comes with about a 30 percent risk of internal bleeding. That’s why they keep you overnight for observation; they need to keep probing you every few hours with all sorts of tests to determine not simply vital signs like blood pressure, heart rate, oxygen level and sugar but more detailed chemical measures of blood levels, the most important of which indicate hematocrit and hemoglobin.

I’ve managed to avoid hospitals most of my life. After visits for a tonsillectomy at the age of 12 and an appendectomy when I was 15 I had only spent one night in a hospital over the next 52 years, for dehydration in 2000. I had made plenty of visits to see others in the interim, but it is a very rude awakening to find yourself supine, wired up, in a frumpy bed, poked and stabbed every few hours, cut off from any normal sense of daylight, mental stimulation or interaction and helplessly awaiting while a succession of medical experts look at you through the vantage point of a chart.

I’m not faulting the care I got. Hartford Hospital is one of the premier health care units in the country. And it was extremely helpful to engage in conversations with the various nurses and primary care assistants who were tending to me in between visits by the specialists. The nurses and aides turned out to be a source of real support, not only because they were the eyes and ears of the whole system but also because they were the one element of a human dimension that embodied respect, humor and wisdom.

I was kept on a liquid diet to ease any burden on my digestive system and to keep things simple if I needed a follow up endoscopy. And it quickly became obvious based on the numbers they were getting about my blood that I was, in fact, bleeding internally and would need a follow up procedure the next day to staunch the wound. So down I went again under sedation, this time only for about an hour, and the doctor reported being hopeful that they had, in fact, cauterized the bleeding..

That’s when I hit an emotional low point. You’re used to a certain bathroom regimen, knowing very well the highly personalized sequence of various gasses, liquids and solids that bubble up, pass through and clear your body. It’s usually a comforting ritual, or at least supposed to be when your body is functioning the way it is designed. Like an extraordinary little machine, it takes in nutrients, processes them, stores some of them and expels the unusable parts. And now, all of a sudden I had introduced a violent interruption into the normal course of things in the form of an internal incision that’s designed to save me but that throws my routine bodily sequence completely out of whack. I had complete control in getting to the commode but none whatsoever of what was coming out, and it felt very alien, very scary.

I knew it was a standard procedure. I knew it all was according to a certain repeatable medical logic. But still, I occasionally got terrified that I was now losing control, that the flow would not stop, that I would end up helpless and blithering in a nursing home, with my wife and family and the grandkids(!) visiting me like some vegetable in a garden. I also know my wife experienced her own version of these fears. She’s awful at hiding them, as am I, but we at least pretend to express them to ourselves. Though I have to say that this time we were helplessly honest and blubbering in expressing our shared fears.

I try to stay fit, walk a lot, do a lot of aggressive yard work, keep stretching and try to keep moving and eat a reasonable diet. So I had faith that my body would gradually assert itself. Which is exactly what happened. And it was an amazingly empowering thing to watch within a matter of a day as my body established a modicum of control. The blood flushed through. The normal H levels returned. And what had felt like an ugly leak gradually assumed more controlled form.

I don’t believe in prayer. The last time I tried it, I was twelve years old and my father was heading off for hernia surgery. Halfway through my bedside appeal to a higher power I realized that the important thing was that the surgeon should do a proper job. I haven’t been on my knees for holy help since.

What I believe in is medical science, the power of nursing, good sense, and self discipline. I also figure that emotions are powerful and have their own logic and that it’s okay to feel panic, fear and helplessness. My wife and I have an agreement not to apologize to each other when we are emotional dishrags. It’s part of being human.

So is being sick. As is wanting to recover, which is what the health care community is supposed to be about. When it works well, it feels very empowering. These days we should all be more appreciative of how hard they work and how much they care. It’s what enables us to walk out on our own power.

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