In Surgery - Part 2: What a Wonderful World

It's been 3 months since my arthroscopy. I can't get my surgeon's MOA on the phone. She doesn't reply to my emails. I have realized that a surgeon is only as good as his hands and only as available as his MOA. I've now passed the one year anniversary of my diagnosis and my every waking thought is about having my surgery and getting on with my life. This holding pattern is purgatory.

I have learned this past year that protocol is a bit of a sham. I have no intention of waiting in some imaginary queue. When I do get Ms. P on the phone, I lie: Dr. G was clear that I was to have my surgery 1 month after my arthroscopy. Ms. P taps on her keyboard and replies that she doesn't see any notes to that effect but if he told you that, then...oh, I have an opening for February 17th. It is that easy. After all the fighting and waiting and suffering, it comes down to a single, well-timed phone call. The lie was more of a partial truth anyway. What Dr. G actually said was that I needed to wait at least a month before my next surgery. I feel like I have reached the summit of a mountain. February 17th is 3 weeks away. I am almost giddy.

Dr. G meets me in the nurse's office, where she and I are completing my pre-op paperwork. He smiles and says: so you're ready to do this, are you? It's as if he doesn't know I have late-stage KD. It's as if he's forgotten that we last talked about this surgery 8 months ago. I am struck again by the irony of a surgeon not comprehending the loss of the use of one's hands. I just smile.

Dr. G brandishes a menacing-looking red marker and starts mapping my arm. Some circles here, a line or two there, a definitive "L" on the back of my hand. God forbid they get the wrong arm. I am not comforted by this extra security measure. See you in there, he says over his shoulder as he goes to prep.

I am a little disappointed that Brian is not my anaesthetist. We had talked about round 2 back in October and he'd said he'd be around. I actually don't have just one anaesthetist, I have a team - a team-in-training, it turns out. I tell them about my last nerve block wearing off after 3 hours. They exchange glances with each other and say they'll top it up.

I am decidedly wasted when they wheel my bed into the OR. This will be a longer surgery than before. And noisier. Electric saws, pliers, and chisels. Ok, the chisel could be my imagination - but I'll never forget the crunching sound of the pliers or the whirr of the saw blade cutting through bone. Or the bits of bone and flesh that spit out of the wound. I don't get the tv screen for this one. I am grateful.

My surgery is called a PRC and involves the removal of the proximal row of three bones, one of which is the lunate - the source of all my trouble. The surgery allows for the distal row to slide down into the vacated space, in turn helping convert the existing joint to something more akin to a hinge. Like a door.

There is a point where I can feel incredible pressure and my OR anaesthetist slides a syringe into my IV. The pressure fades away.

In recovery, I am quite helpless. I think my gown is twisted. One of my breasts is hanging out. I don't really notice or care. A nurse discreetly shifts and tucks my gown until I am covered. In an hour or so, this same nurse will try to help me put on my underwear and bra. I am too stoned to stand and my right arm is like jelly. She has to remind me to hold it up because otherwise I don't remember it is there and it thuds to the side of the bed. Getting dressed seems to take forever and makes me giggle like a little girl. God bless nurses.

Incredibly, I've been discharged. This time, I have the pain killer prescription filled. This time, when we get to the already-full ferry, my husband declares us a medical emergency and a vacant spot magically appears. We learn that this spot is always left free for any emergency. I store that little nugget away in my cloudy mind.

I am three bones lighter, high as a kite, and on my way home to rest and recovery. Hallelujah.

What a Wonderful World:

	Louis Armstrong - What A Wonderful World .mp3
	Found at bee mp3 search engine

In Progress - Part 1: There's No Other Way

The rain is bucketing down, sheets of it, constant and punishing. How will we find the hospital if I can't even see the road?

Elvira is sitting beside me, white-knuckled, possibly praying. She is a good friend. I am thinking how ironic it would be if we are in a car crash and rushed into St. Paul's emerg by ambulance. Would I hop off my stretcher, broken leg askew, or worse, and say right then, must pop up to see Dr.G about this pesky wrist thing. Morbid thoughts? Maybe. Oddly, I am buoyed by them - it puts my condition in perspective. Now if we can just get there.

This first visit will be one of many and the route my mind and car are mapping through these unfamiliar and busy Vancouver streets will become as etched and automatic as the drive from my home to the grocery store. The parkade, the street, the fastest hospital elevator, and the waiting room protocol become small lessons I will quickly memorize and master.

We are both in dainty summer dresses and sandals, no jackets or umbrellas, completely unprepared for a rainy day downtown. I don't know what we were thinking. We weren't thinking we'd be spending the whole day in the city. My appointment is for 9:30 a.m. It is now 9:45. The ferry was late and the roads were brutal. We bolt from the covered parkade for the side door of St. Paul's. It is, by chance, the exact door through which we should be entering. Not knowing this, we follow the blue and yellow lines around St. Paul's until we eventually ask at an information desk. We are guided back to the door we initially came in. We're off to a good start.

I am worried that Dr.G won't see me now - I am worried I have insulted him by my lateness. I don't know it yet but he is going to raise the bar on waiting room wait times. Whatever the national average is, multiply that by 5.

What is both wonderful and terrible about St. Paul's is that it is a teaching hospital. What is both wonderful and terrible about Dr. G is that he is an excellent, well-respected surgeon. The wonderful and terrible thing about my new surgeon working out of St. Paul's is that it will be almost 3 hours before my name is called and I am ushered into an examination room. Late shmate.

The past 5 months have been hard and I've hardened myself as well - buttressing my body and fortifying my expectations. My cynical self is completely unprepared and undone by what happens next: it is Christmas again.

I am greeted with smiles, two interns, and two surgeons, one of whom I assume is Dr.G. I'm hoping he's the cute one on my right. Elvira is led out to the hall while four heads lean in and four sets of hands try to get their hands on my hands. The questions come; the range of motion and strength tests come; much nodding and writing and whispering takes place. Bilateral Kienbock's. My tiny examination room is literally abuzz. I feel special. I feel like I am finally going to get the treatment I need.

The cute surgeon leaves. He is not Dr.G. The three remaining men huddle around a large screen showing my MRI. I have no idea what they see. Dr.G is like an excited kid - he wants to show and explain everything to his interns, to me. He is constantly in motion. The interns move aside so I can see the image. I suspect Dr.G is a great teacher. He is patient and thorough. It is like there aren't 40 more people in the waiting room.

During my examination, we discussed all possible procedures, even MCD. Dr. G seems willing to try it or at least consider it. All treatment options are open.

I hear Dr. G say do you see this? but I'm not really following. I've been lulled and comforted by these knowledgeable men-of-action. I know what they are discussing is important, urgent, but to me it is a melodic background. I'm jarred to attention by Dr.G. Look right here. The lunate has collapsed oddly. On the left. Can you see?

I guess I can see it; I don't know. So what. You just told me you can do anything. I'm thinking these thoughts and I'm feeling strange again because one of the interns is now looking at me closely.

What he means is there is nothing we can do. A salvage surgery is your only option now. The intern says this softly and kindly and I am deeply grateful for him at this moment. Dr.G, too, is gentle, suggests I go have lunch before I come back to get my right arm casted and book the surgery for my left.

I've read about salvage procedures; they sound as horrible and permanent as the word itself. I am devastated. Screw lunch. Elvira and I run, hands like useless umbrellas over our heads, jaywalking across Burrard and down Georgia until we find a bar. We slip, dripping, into a booth. Two martinis please. Cold. Dry. Martinis. It's 1:25 in the afternoon.

There's No Other Way:

	Blur - There's No Other Way .mp3
	Found at bee mp3 search engine