As a
safety measure, once everyone was on hand, the nurse in charge in the surgical suite called a timeout
before the first incision was made. During
the timeout, the surgeons, nurses, assistants and technicians were identified; I was identified; my allergies were
identified; the various procedures to be performed on me during the operation
were identified; and written consent for each procedure was identified. What a great way to prevent confusion and
mistakes.
I was
surprised to learn that my urologist made the incision (I thought the general
surgeon was going to start the operation). It was a midline incision starting a bit below the bottom tip of my breast bone
with a detour to the side for my belly button and then straight to my pubic
bone. The size of the incision signaled the
magnitude of the upcoming operation.
My two
urologists then worked in tandem to dissect from the skin down to the bladder because
the first order of business was to remove my bladder. They stopped at “the discovery of severe
scarring with electrocautery” in the area of the tattered first mesh.
This is
the part about which I feel very sad. This scarring by electrocautery (a method to stop bleeding) is from a
summer 2007 surgery to place a mesh for an abdominal wall hernia. The surgeon was represented to me as an
excellent technician. Ha! I referenced him in my blog
entry, “A Tale of Two More Surgeons” (December 2, 2011) as one who was disrespectful and uncaring
and had left his bad attitude and energy all over my poor abdomen. Now I see he caused even more damage and I
feel angry.
My urologist’s partner scrubbed out and the
general surgeon, who is an abdominal reconstructionist, scrubbed in. He spent more than one and one-half hours using
a scissors and other cutting instruments to cut apart the scarring and
adhesions and free up my bowel. He
also removed the remnants of the synthetic mesh.
No wonder
my pain postoperatively was described as excruciating. My mental consciousness was “asleep” during
surgery but my anatomy and physiology, which was experiencing so much cutting and being moved around, was awake.
This
brings to mind the anesthesiologist(s) and the wonderful work he did in
tempering the pain during surgery and keeping me under anesthesia so
skillfully for eight long hours, a very lengthy surgery.
The
general surgeon scrubbed out and the second urologist scrubbed back in. My bladder and pelvic lymph nodes were
reached. These lymph nodes were
removed for examination by pathologists and all came back clean. It is reassuring to know that no small cell cancer
invaded them.
My
bladder, however, had evidence of not only the initial tumor destroyed by chemotherapy but also a second tumor. The
nerve! What this means is that within 10
weeks of my diagnosis, a second tumor formed and grew but then was annihilated
by the poison of chemotherapy. What an
aggressive cancer! Thank goodness chemotherapy was more aggressive.
After my
bladder was removed, the urologists turned their attention to creating the
ileal conduit. After they finished the
majority of this work, my urologist scrubbed out and the general surgeon
scrubbed back in to remove my gallbladder. Then with my urologist’s help they finished the ileal conduit and repaired my abdominal wall hernia by placing a new mesh made of biologic material.
My
abdomen was sewn back together by the general surgeon and the skin was stapled
shut. As a result, my incision looks
like a vine winding its way up my belly. Other views are that it looks like a railroad track or a map, but I’m
sticking with a vine.
I did
well throughout the surgery. A
remarkable, complex surgery performed by a room full of remarkable
professionals and technicians.
© Jean DiMotto, 2012 Website: www.jeandimotto.com
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