Tuesday, October 28, 2014

Not just a cheap date

Yesterday I went under general anesthesia for the third time in my life, all of which have been in the last 9 months. 

This time it was to address the initial diagnosis from my ENT that I had polyps on my vocal cords.  2014 has been a very difficult year for us to say the least and when it rains, it pours.  From wisdom teeth removal to the disastrous water pipe breakage to Siri having surgery to the broken air conditioner to Rachel losing a close friend and then everything compounded with the stress of a knee that won't heal from surgery and the final semester of grad school for Rachel, it seems like we just can't catch a break.  Not that everything was negative; we did get engaged and had a great vacation in Seattle and San Diego to celebrate, but it still seems like the world is conspiring against us.  Luckily we still have each other, the dogs and of course family and good friends who pray for us.  As I told Rachel this morning, things could be so much worse for us.

At the hospital yesterday, I was admitted early and it wasn't long before I was visited by the RN, Laura.  She told me about the entire process for the day, including details on the procedure that Dr. Teachy would perform.  She reminded me a number of times that should would be there the entire time during the surgery and when they woke me up.  She referred to one of the medicines she was administering as providing an similar effect of a tall margarita, but only gave me half a dose at first because some people are cheap dates.  Though I wasn't in the mood to laugh, her joke brought up my spirits when she had to give me the full dosage into my bloodstream and I still didn't feel anything.

There was a brief time before the anesthesiologist came in so I took the opportunity to pray a little and even dozed off.  When she arrived, we talked a bit about my vital signs.  My heart rate was 51 and I remarked that it was a little high today.  She then told me a lengthy story about once when she thought she had mercury poisoning and it caused her heart rate to drop very low.  Though she was weary scrubs, I imagine that based on her personality if I saw her in public, she would be wearing a flowery dress and Tevas, to say that she seemed like a free spirit.  

Dr. Teachy came to visit and further explained the procedure.  As with the first interaction I had with him, he was very brief and to the point.  I had to ask several questions that I felt were important that he did not initially cover.  My biggest concern was the cause and the probability of recurrence.  As I previously wrote, most of what I know about this condition was found on Google with very little coming from the Doctor himself.  His bedside manner in educating me was very poor at best.

The official diagnosis was that I was suffering from laryngeal papillomas on both vocal folds. This was much different than the initial analysis that I had vocal cord polyps. Papillomas are technically growths (termed neoplasms) which may be benign, pre-cancerous (termed dysplasia) or cancerous (termed malignant).  The majority of papillomas are benign but very rare, impacting less than 2 adults per 100,000 in the United States.  The probability that they may be cancerous is between 3-5% and will be determined through biopsy with results known on Thursday.  One of the most common causes other than by virus, is laryngopharynheal reflux (LPR) which I have a family history of on my mother's side.  It was good that this was diagnosed early, as laryngeal papillomas has no cure and may return at some point in my life.  Dr. Teachy did say that this is known to affect some long distance runners as they chronically have a suppressed immune system.  Some people will require multiple surgeries throughout their life to deal with this and for some it may stay in remission forever.  The surgery would involve a laser targeting the blood supply of each papilloma.  This is a very delicate procedure to limit the vocal cord scarring which may lead to permanent hoarseness.  

Finally I was brought into the operating room where there seemed to be a lot of activity.  I was relaxed and kept telling myself that despite the severity of my condition, this was a routine operation for these experts in their field.  I was wrapped up tightly with blankets that were bound to me with velcro, making me feel like a mummy.  I was very alert of my surroundings even several minutes into the anesthesia before ultimately falling asleep.  

I don't remember when I woke up but the first thing I did was ask if my nurse was there.  I don't know why I did this; maybe because she was the last person I saw before I zonked out and that she had said that she would be there the entire time.  Someone said that they called Rachel and she would be waiting for me in the recovery room.  The time lapse between that point and seeing Rachel may have been a few minutes or it may have been an hour, though I speculate that it was somewhere in between.  Rachel said that she tried to ask questions about the procedure and recovery to the doctor, but he was just as short with her as he was with me.  I don't know for sure but I feel like they were rushing to get me out of there.  

As compared to waking up from my knee surgery in February, this time felt much worse.  I was extremely groggy; like they woke me up too early and I was still under the heavy effects of the anesthesia.  I couldn't sit up or lift my arms, so Rachel had to help me get dressed.  I was fully alert but just had no ability to move.  It was very creepy, like being paralyzed.  I was put into a wheelchair to brought outside, where Rachel was parked right up front.  I had my eyes closed the entire time and felt my head bobbing, but I knew every turn, every stop sign and every lane change from driving this route hundreds of times since I have lived here.

I was able to get out of the car and walk inside with some help from Rachel.  We went straight to the bedroom where I laid down and was greeted by two licky beagles.  For the next few hours I would rotate between being fully awake and trying to remember all of the details from the day to being half asleep.  My tongue and throat were still numb, so I could not swallow at all.  Combined with the recommendation that I can not clear my throat, made it very difficult to breathe with the mucus build up in the back of my throat.  It sounds gross but I eventually found a good angle where it would just drain down the back of my throat if I had my mouth open just right.  Rachel brought in some pain meds and antibiotics that I choked down with some Gatorade.  I really did feel much more lucid than after my knee surgery and numerous times I encouraged Rachel to go to her two grad school classes.  She was adamant about staying home with me and I joked that she would just be watching me watch Netflix.  

Going from a 5,000 calorie per day diet down to zero is not easy.  I was very hungry and when Rachel came back from the grocery store with Jello and pudding, I was jealous of her eating Hardees.  I wanted a cheeseburger.  I finally got up around 6pm and ate some pudding which hit the spot.  I had good intentions of writing this blog last night, but I just didn't feel much like typing.  So while Rachel did homework, I laid on the couch with Siri and Fiina.  We watched a great show on the Food Network claiming that hamburgers were the perfect food.  It wasn't helping my growling stomach.  It felt good to lay upright so the fluid would continue to drain downward, so even as I fell asleep, I stayed on the couch for a couple of hours.  

Overnight and into this morning have not been that pleasant.  I still can't swallow very well and am very hungry but it hurts to eat anything.  I have been trying to drink as much Gatorade as I can to stay hydrated.  I woke up numerous times with my stomach growling and also with numbness in my left hand.  I took off one of the medical arm bands that may have been on too tight.

So onto the recovery mode... 7-10 days of absolute restricted talking.  I honestly haven't even tried as I am a little afraid about how it will feel.  After that, I can begin talking for 5 minutes per hour for the following week.  Then beyond that I will add more and more talking each week until about the 8-week mark in which I will be back to normal.  The doctor said that I could run right away if I wanted to; something that made all of this misery not seem so bad.  I will probably just rest, walk or ride the trainer for a few days or until my sore throat goes away.  I don't know how it will feel with intense breathing of a running workout on a sore throat.

So the immediate concerns will be addressed in two days when I find out the results of the biopsy.  The papilloma did not look cancerous and 97% of the time they aren't, but I won't feel better until I hear the positive results.  Beyond that, it will be regular checkups to make sure that they have not returned.  I really don't want to ever go through this again.