I am so overwhelmed at the severity of the riskiness of this whole procedure.
The Anaesthesia Doctor that consulted with us, turns out, had Hawt Doc as the person she was trained with(?) or worked under(?) whiile she was doing her residency. She was super awesome by the way. During the consult, along with all the other stuff we had to discuss, she wanted us to mentally prepare ourselves for the likelihood of complications arising at any time — all of my health conditions mixed with any surgery involving anaesthesia will always be complicated and VERY high risk. Not to make the whole procedure sound gloom & doom, something she wanted us to know & be aware of is that I’m one of those patients where all sorts of things could happen or nothing at all could happen. We always hope nothing will happen, but we can’t be naïeve and stick our heads in the sand thinking that everything will be peachy keen from the get go. For a “normal” person, there will always be risk, but for me, the complications are all over the place and as ridiculous as this sounds: even the complications are complicated.
Just to prepare for the surgery, some of the stuff we had to discuss was the whole gamut of where to have IV lines put in (I have one cooperative IV vein and it’s NOT in my hands) and whether or not to have a central line installed (she is thinking no, thank goodness, but I suppose even that could change). They will probably have a tube inserted into the artery in my wrist so they can regularly take samples to measure blood gases. Unfortunately, because I have Reynaud’s, that procedure tends to be an automatic “no, we can’t do that because it can cause [permanent] damage”, but they will most likely be doing it anyways because she thinks the benefits of safety totally outweighs the risk — I should probably make sure they do it in my non-mouse side so there is still the potential for gaming :P Interestingly, that “procedure” alone requires local anesthetic and she wanted me to know that they have lots of really good drugs on hand to make things easier. Because of the PAH, another tube will be inserted in the crook of my elbow to remotely measure the condition of my heart and the stress that the procedure is causing, so it too needs to be closely monitored at all times.
As to the actual surgery, things are still being decided as to what the best course of action would be. Interestingly, doing the surgery laprascopically isn’t actually the safest or best option for me. The gas that they use to inflate the abdomen is really bad for people with PAH — it constricts all the blood vessels in the body. With PAH, your vessels are already constricted, so essentially, it sounds like the CO2 would completely shut them down. That is definitely not good times.
The thought that Anaesthesia is currently juggling in her head is if it would actually be better and safer all around to do a laparotomy. The options for anaesthesia become a little more varied and potentially favourable — one option she’s considering is a spinal block, which is basically freezing me from the waist down. The logic of this is it would leave my heart and lungs potentially less stressed and “untouched” because I wouldn’t have come out of general anaesthesia which shuts down your whole body, and no gas would be involved because they would just be making a simple incision to remove the ovary. To be honest, of all the needles and procedures I’ve ever had, the thought of someone sticking a needle into my spine freaks me out and terrifies me. She wanted me to know that in her opinion, it’s actually not as bad as I think it is… Plus there are drugs and local anaesthetic ;)
One of the issues that I didn’t realize would be an issue is the need for a breathing tube. If they do a spinal, we might be able to avoid one (at least that is my understanding) but if they have to use general anaesthetic, they will probably want to put it in while I’m still awake(!!!) — there will be some really nice drugs involved with that too, as she was quick to point out and again happy to inform me. It turns out that beause of the damage Sally caused, I can’t open my mouth as wide as they’d like to put in the tube and the biggest problem will actually be taking it out. If they end up putting in a breathing tube, then ICU is definitely going to be involved and she would like for them to take their time removing it — preferably over the period of a few DAYS.
There’s a good chance I will be in the hospitsl for way longer than just “a couple of days”, which would be the case should everything go with no complications whatsoever. I hate the hospital. I already hate the constipation that I know is going to happen from all the drugs they pump through my system…
I think I need to go and do some serious stress baking for the next two weeks :/
T-Minus 2 weeks and counting…