A Tale of Two Surgeries

When you least expect it, your advocacy can work.

I have done a couple of notes and a post (Teeny Tiny Surgery) about my cataract surgeries, which are now done.

Photo by National Cancer Institute on Unsplash

Surgery #1

When I arrived for this surgery, I had already talked to the doctor and knew that it was possible to do it without IV sedation. I told him about my history (decades) of difficulty with anyone being able to start an IV because of my skin condition (epidermolytic ichthyosis.) He and I agreed that I would give the Surgery Center a chance to get it right, but if they couldn’t, I would do the surgery without general sedation.

There’s a nurse that checks you in, and I said to her—” nobody is sticking me without a portable ultrasound machine.” She looked at me in alarm and said, “I’m not going to stick you!” I may have sounded a little wound-up, which I try to avoid.

We did the check-in, and she saw that I was supposed to have an ultrasound available for my IV insertion. Skip ahead an hour and change. The admit nurse kept telling people that they needed to get the ultrasound machine, and somehow, it just never happened—no explanation.

My surgeon and anesthesiologist came to see me. The anesthesiologist looked like a surfer dude from Central Casting (in scrubs). The surgeon and I went through the whole thing—still no ultrasound. Being all charming and confident, I told the Surfer Doc, “You seem very confident. I will give you one free stick, one! If you don’t get it, I’m going to do without unless you can find the ultrasound.”

Photo by Marcus Löfvenberg on Unsplash

He was delighted with that deal. He put a little numbing stuff on first, which was nice, stuck me, fished around, and…didn’t get it.

So, I had the surgery without sedation, no pain, no problems.

Surgery #2

The nurse who checked me in this time had checked me out last time (there were about three weeks in between, but I don’t think she sees many patients who look like me), so it was faster for her to get over the initial discomfort that usually greets me.

She took me to the curtained area with the gurney (which is padded, thank god.) She remembered that I needed pillows to go under my knees (my knees are very arthritic and don’t let me straighten my legs all the way.

I noticed a little rolling table parked near the opening of the cubical but didn’t think about it. I had already agreed with the Doc that I was doing without the IV sedation again.

It turns out that the little table was the portable ultrasound! A different anesthesiologist came in. He introduced himself and was terribly sweet. I said, “I’m not going to do the IV since I did my first surgery without.” He said, “Okay. I heard you might say that, but I wanted you to know that we are ready, so you have the option.” I said, “Oh, thanks, but I’m good. I had no pain at all last time.”

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Dramatic Interlude

Everything had been settled with me, and the Doc and the Sweet Guy anesthesiologist, and my nurse was finishing her paperwork when a new guy in scrubs—(this might be a good time to mention that I am lying on the gurney but completely clothed and covered by a blanket, in case anyone was worried about that)—marched in and said, “I hear you’re refusing an IV.”

He was officious and stern and Napoleonic.

Photo by Alex Shuper on Unsplash

I said, “I have already worked this out with my doctor. I just had surgery on my other eye without an IV, and it was fine.”

Cranky said, “Going in without an IV is against department policy. You might need fluids.”

I said, “Go talk to the Doc and Sweet Guy. They know the score.” I came really close to losing my cool but managed not to.

He went away and came back a few minutes later. He sort of patted my arm and smiled and tried to make a joke, “We’re going to let it go this time and stick you extra next time.” Ha ha. Get the fuck away from me. “Okay,” I said.

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On the way from admitting to the operating room, the Sweet Guy came with me and said he would be there in case I needed anything (and so the surgery center can bill for an anesthesiologist, I’ll bet, but I didn’t say that).

Sweet Guy gave me supplementary oxygen, just for giggles, but the surgery went fine and was over in no time.

In the recovery area, I saw my long-term surg center boyfriend. He is a nurse that used to be a paramedic, and is short and bald, and built like a fireplug. He’s been there for every one of my IV debacles and even got a few sticks in in the early days when I was there for a colonoscopy. I’m always glad to see him because he knows I just state the facts about my disability—no need to embellish. We talked a little, and then he helped me transfer back into my power chair.

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Epilogue

You go to the doctor’s office the day after your surgery to check-in. The doctor checks to make sure the new lens is in the right place and to see how your vision is doing. Aces on both counts.

Before leaving, I said, “I don’t know what you did, but everyone was ‘on it!’ today. Dr. Sweet Guy even had the portable ultrasound ready before I got there!”

Doc sort of chuckled and said, “Yeah, it never should have gone the way it did the first time.”

I said, “Please thank Dr. Sweet Guy very much for me. And I wanted to tell you that after the surgery, as I was lying there, I realized that it was the first time in my life that I felt that I was “being cared for” in the medical sense. I felt that everyone was thinking about what would be best for me personally.”

He said, “I’m glad. It is really sad that you haven’t felt that more often.”

“Yes,” I said.