Details for the Big Day

By this time next week, the surgery will be complete and I will be in recovery. I am scared of the unknown. We don't know what the results are going to be. I won't know the results until I wake up from surgery. My gut is telling me the results are not going to be the results I want. My gut is a bastard though. The anticipation becomes heavier with each passing day.

I had a pre-op phone call with my nurse at the Cleveland Clinic today to work out all of the details for the big day.  This is what I know:

Tuesday, November 28, 2017

• CLEAR LIQUID DIET ALL DAY
• 1pm: Stoma marking appointment at the Cleveland Clinic.
• While I'm at the Cleveland Clinic for the stoma marking I also have to get blood typing done.
• 2pm: Take the first of two rounds of antibiotics
• 3pm: Take 3 Dulcoax tablets.
• 5pm: Mix 238 grams of Miralax with 64oz. of Gatorade. Drink 8oz. every 15 minutes.
• 10pm: Take last round of antibiotics.
• NOTHING TO EAT OR DRINK AFTER MIDNIGHT

Wednesday, November 29, 2017

• NOTHING TO EAT OR DRINK
• Shower using regular soap.
• Shower using Hibiclens (an antiseptic skin cleanser) from head to toe spending at least five minutes on my torso area before rinsing off.
• 5:30am: Check-in at Cleveland Clinic hospital, unless they call me and reschedule the time.

Surgery is estimated to take about 5 hours. It's going to be a laparoscopic sigmoid colectomy and they will insert a catheter and place ureteral stents during surgery and the stents will be removed before surgery is complete. Possibly sub-total colectomy. Possibly open surgery. Possibly temporary or permanent ileostomy or possibly temporary or permanent colostomy.

• Once surgery is complete they will talk with my posse in the waiting room.
• Expected to be in an intensive recovery room for about an hour and a half after surgery before they move me to the room I'll be staying in for the remainder of stay.
• Estimated to be in the hospital for 5-7 days and the Dr. might advise me to stay in town for a period of time after I'm released before I can travel home.
• The catheter will be removed a few days after surgery.
• I'll have a pain pump to squeeze and control my pain medicine after surgery.
• I'll have to do deep inhalation breathing exercises after surgery.

My Unscarred Belly's Reflection

I find myself lifting up my shirt more frequently when I'm standing in front of the bathroom mirror to look at my unscarred belly's reflection. When I get dressed and undressed, I glance down and stare at my bare stomach. How can it appear deceivingly healthy on the outside when it is a  disastrous mess on the inside? Suddenly, I have this weird fascination with constantly stealing glimpses of my gut.

I took this when I woke up from my nap yesterday.

 It likely won't look like this for much longer. 

When I'm in bed, I place my hands on my abdomen to feel my belly. It's smooth and it doesn't hurt to touch. I don't feel foreign material, scar tissue, or tenderness. Sometime last week, I started looking at my belly whenever I wake up... envisioning and preparing for the worst case scenario when I first wake up from surgery. My eyes flutter open and then close. As I take a breath I slide the blanket off and lift my shirt to reveal my stomach. I tilt my head down and as I let the breath out I open my eyes. I cry every time I open my eyes. I imagine a lengthy incision held together with ugly staples. I picture a shit bag attached to a new asshole. I hear the sobs of my mom and Taylor only to realize the sound is coming from me, not them.

Despite the fun and distractions I have thanks to my friends, it's getting more difficult to stop thinking about the surgery, the outcome, and the recovery that awaits me. I look at the photo above and I think that's not me, that's not the me I'm going to be in a couple of weeks at least. And so it goes, another day passes, another tear falls.

My Ass Cannot Catch a Break

Last week, I had a chest x-ray scheduled on Tuesday. When the nurse checked my vitals, she informed me that my doc was going to be sending me to an imaging center to get my chest x-rayed so that a radiologist could view the images and conclude the findings. We decided to do the other pre-op clearance stuff instead. I had eaten prior to my appointment that morning, so we couldn't do the required pre-op lab work. At least we were able to do the EKG. For the EKG, my pants stayed on! It was a nice change from most appointments.  My doc couldn't retrieve the EKG results while I was there because their system was down. According to my doc, my blood pressure is equivalent to blood pressure of fourteen year olds (amazing!). He also raved about how happy he is to see me weigh in at 160lbs!  160lbs feels awesome to me, too! Of the many things I'm worried about post-surgery, weight loss is one of them. Right now, I feel strong physically as well as mentally. In the past, losing weight had a way of fucking up that strength for me.

On Wednesday, I met my friend, Brittany, for breakfast in Clermont prior to my cystoscopy appointment with my urologist. I stand corrected, Clermont is neither podunk, nor bumfuck (lol that correction is for you, Britt). It was great to catch up with her at breakfast and be distracted from my forthcoming doctor appointment.  We arrived at my appointment at 9:30am so that I could get a shot of antibiotics an hour before the procedure at 10:30am. Britt waited in the waiting room while I went in the back.  As my nurse mixed the antibiotics in a syringe with some kind of numbing agent, I let her know that my friend would be coming back with me for the procedure. My nurse seemed concerned and wanted me to make sure my friend knew that I would be exposed (umm, how else are you going to stick a scope up my urethra?) Once she was done shaking the syringe, I rolled up my shirt sleeve. To my surprise, she said, "I have to give this to you in your buttock". So, I dropped my pants and underwear. Apparently, it's painful and the butt check offers the biggest muscle to inject it into. I smiled and laughed to myself as I walked back out to the waiting room to join Brittany. I let her know what happened. My ass cannot catch a break!

Before I got into position, the nurse said it won't hurt and would only take two minutes. Soon enough, I found myself sitting on the exam table with my feet in the stirrups and nothing but a modesty paper covering me below the waist.  The nurse rubbed me with something to numb the subject area. I can only describe what I felt next as a shot in my pee hole! WHAT THE FUCK! I do not know what caused that pain (was it a needle to numb me further or something else like a clamp to hold my urethra in position?). I didn't ask either. Just thinking about it again makes me short of breath. Brittany let me hold her hand and I know her presence helped me endure the craziness of a cystoscopy. The nurse told me not to get off the table while she went to get the doctor (haha). Once the doctor put the scope in me, we were able to see my bladder on the screen. They pumped sterile water into my bladder. There was notable abnormal inflammation and lines he said indicate that I strain to urinate (I don't think I do).  We did not find the fistula. The scope was super uncomfortable and he let it drop out when they stopped pumping the water, so then he re-inserted it back in which seemed awkward. Normally, I don't seek company at my appointments, but this is one I am fortunate Brittany was there to help me through it! Thank you, Britt!!!

This week I will finish all of my pre-op testing on Tuesday by getting lab work, a chest x-ray and a cystogram. Hopefully, a cystogram will be nothing compared to a cystoscopy. After that, the only appointments left before surgery are my call with a Cleveland Clinic pre-op nurse on November 22nd and my stoma marking appointment at the Cleveland Clinic on November 28th.

T-Minus Three Weeks!!

I'm still processing my cystoscopy experience this morning, so I'm going to save that post for next time and post about running and recovery instead. I plan to run four more times before surgery (November 11th, 18th, 21st and 26th). These last few runs will be treasured. I will take note of the strength my body possesses to power forward. My opportunities to run before surgery are numbered and the inevitable break-up is fast approaching. Surgery is three weeks away!

Despite all of my excuses, running charms me and casts a magical spell over my mentality. I think the fact that I keep showing up to run while I'm facing bowel resection explains it well. One of the benefits of the spell is having the fortitude necessary to handle this shit storm better than I thought I would. I will not take these last few runs before surgery for granted. I will let each run remind me that I am more incredible than I give myself credit for.

The thought of recovery being hellish scares me. If I struggle during recovery, I am going to read this paragraph. I am determined to recover successfully! In order to have a successful recovery, I will follow the doctor's orders as reasonably required, fight through the pain, take naps, and accept the results of the surgery as my new "normal" no matter what.  I will allow myself a healthy amount of time to mourn my old "normal". I will ask for help when I need it. I will not give up. I will attempt to get other aspects of my life back to the state they were in during the months before surgery. I will not intentionally shut people out. I will be brave enough to be somebody's role model. How's that for commitment for you?

2017 Wine and Dine Weekend

I joined three other running divas for a weekend at Disney's Wine and Dine 10k and half marathon (19.3 miles). We met at Epcot around 4AM on Saturday to take a bus to the Magic Kingdom parking lot for the start of the 10K. Badass Doreen made us coordinating costumes for each race. For the 10k, we represented different countries in Epcot (America, Germany, Italy, and Mexico). The 6.2 miles flew by as we chatted, told stories about being drunk, enjoyed the on-course entertainment, and posed for pictures!

After the 10k, we went straight to Animal Kingdom to explore Pandora - The World of Avatar! The Avatar Flight of Passage ride was out of this world! It felt like I was actually riding a Banshee! The effects were super cool. It's like as a futuristic version of Soarin' only you're on a Banshee in Pandora. We rode other rides and took advantage of photo-ops with characters. By 4:45PM we went to get our cars at Epcot before checking into the hotel.

The shower at the hotel was amazing! I started a pillow fight and jumped on all three beds (its my hotel tradition). Two of the divas went on a two hour adventure to pick-up dinner. I took a nap while they were on their adventure. Once they returned, we ate dinner and had a funny conversation about their dinner adventure among other topics that exhausted runners find amusing(basically everything was funny at this point). After dinner, we went to bed.

On Sunday, we caught the bus from our hotel at 4AM to the Magic Kingdom parking lot for the start of the half marathon.  Our costume theme was Beauty and the Beast (Beast, Belle, Gaston, and Lumiere). The fellow runners and volunteers loved our ensemble! I video called my sister, Kim, and we sang "Happy Birthday" to her. I also video called Taylor, which was fun even though I woke her up (sorry, Taylor). I got into character as Gaston and boasted about my charm, beauty, and muscles throughout the race. I was arrogant and narcissistic!  Whenever anyone cheered, I acted as if they only came to the race to cheer me on.  It was a blast! We focused on having fun and stopped for photos along the course. Another running diva was handing out cold towels at the finish line, so we found her and took a selfie together! After her volunteer shift, we all went to lunch.

Most of us took a nap after lunch to rest up for the after party at Epcot Sunday night. We washed our outfits so that we could wear them to the after party. The running divas even made doing laundry fun! Cindy and I explored the hotel. We played ping-pong, went down slides, enjoyed a bedtime story, and learned how to draw Nemo. The after party started at 8PM and ended at 1AM. We entered Epcot around 8:30pm and we left around 1:15PM. We rode rides, ate and drank at the food and wine festival vendors, and took advantage of more photo-ops with characters. In one of the lines, a guy was excited to see Belle (Cindy), until he saw Gaston (me) and then he wanted nothing to do with Belle. He asked me if we could take a picture together and inquired if I could flex for the photo. He handed Belle his phone and before Belle took our picture, he felt my muscle. I told him it was real! lol After taking our picture, Belle proceeded to take a selfie of her and the Beast. It was absolutely hilarious!

By the time we got back to the hotel early Monday morning, it was almost 2AM. Despite not feeling my best, I kept up with the divas all weekend! I experienced stomach pain this weekend. I gave vague answers when I was asked how I was feeling. My plan was not to acknowledge the pain. The pain wasn't constant. However, when it hit me, it took effort not to hunch over, moan from the torment, and wrap my arms around my belly until it went away. Speaking of pain, the bottom of my left foot also hurt. Was it really hurting though, or was it ghost pain?  Whether real or not, pain probably slowed me down a little, but it didn't stop me (story of my life). this weekend was the break from reality I needed! I laughed so much that my face cheeks hurt, too!

A Seemingly Qualified Urologist

I had my new patient appointment with a urologist today. When the nice nurse lady asked why I was there, I explained I was there to schedule pre-op tests ordered by my colorectal surgeon. The doctor didn't try to offer a different course of treatment, he accepted the pre-determined course and asked if he could call my surgeon to verify exactly what images/results we are looking to take away from the tests. My urologist used his cell phone to call my surgeon on the spot. After he left a message for my surgeon, he explained that he prefers calling to get answers rather than e-mailing or writing letters. I went into the appointment thinking I was going to some podunk urologist in Clermont, but at this point I was seriously impressed and thrilled to have found a seemingly qualified urologist.

We discussed the two tests (cystoscopy and cystogram) I was there to schedule. Both tests put me at risk of getting blood infections due to the colovesical fistula. He mentioned that he and every urologist in the country would not perform the tests without putting me on antibiotics to reduce the risk of infection. I voiced my uncertainty about being allowed to take antibiotics this close to surgery. I countered that if the risks are pretty high, should we even consider moving forward with the tests. Blood infections are nothing to take lightly. Once my uncle got a blood infection, it ruined his chances at surviving what ailed him before getting the infection (he died). My doc assertively recalled that I work in risk management, and said the risk should be analyzed.  Without antibiotics, the risk of getting a blood infection is about 40%; whereas with antibiotics, the risk is only about 5%.  When my surgeon calls him back, he will confirm that it's okay for me to be on antibiotics. I also called the Cleveland Clinic and they confirmed that I can take the antibiotics my urologist prescribes.

• My cystoscopy is scheduled for Wednesday, November 8th. I have to arrive at 9:30am to receive a shot of antibiotics and the procedure will start at 10:30am.
  
• I have to call SimonMed or an Orlando Health radiology facility to schedule my cystogram. I've already picked up antibiotics from the pharmacy and will take them the day before, the day of, and the day after my procedure.

Before I left, my urologist asked me how I found his practice. I told him that I called numerous urology groups and his offered the soonest new patient appointment.  Perhaps he was disappointed I didn't select him for his reputation or qualifications.

The best part about the whole appointment was that I only had to drop my pants to pee in a cup!  It made me wonder why gastros and colorectals don't collect stool samples at every visit.