Emergency Appendectomy

Post date: Mar 4, 2014 2:59:07 PM

I had a pretty good scare last week. Shortly after a late lunch on monday I began to experience acute and extreme pain in my lower abdomen. Now, with my years of skateboarding, climbing and construction I have experienced many different forms and levels of pain (did I ever tell you about the nail in the knee?) , but this.. well this truly had me concerned. 

The pain seemed to radiate from my belIy button fanning back through my body into the back of my upper thighs and up to my tailbone. If you have ever had a bad sprain or break, think of the apex of that pain; that pain that you can feel in your teeth. Instead of it being over right away though, keep it going for a few minutes. I felt like a was going to vomit. I thought I was about to die right there on the spot. For a moment, I was truly terrified.

After about ten minutes of a rather awkward position in my chair the pain subsided enough so that I could move. I made my way to the parking lot and drove to the hospital (~10 minutes away).

I hobbled into emerg and saw the triage nurse almost immediately. After triage you register and then wait. The pain was beginning to go away now, all that remained was a dull pain to the low right of my belly button.

I guess triage was concerned because even with a packed waiting room I was in to see a doctor in what was probably less then 1/2 hour. The doctor ordered urine and blood tests and suspected appendicitis. I was told that sometimes a blockage can occur that will cause a lot of pain but then will clear up by itself. I was sent back to the waiting room.

A little under 2 hours later I was called back in to see the doctor. The blood test reported a high white blood cell count (possible infection) and the pain while waning was still present. This was enough to prompt the doctor to call the surgeon. A CT scan was recommended.

The next few hours sucked. In preparation for the CT scan I needed to take a contrast dye orally. I think there was 3 doses 1/2 hour apart. All I can say is yuck, the stuff is disgusting.

I looked at my watch, it was now 2130 (this journey began at around 1500) and I was lying on the scanner bed waiting. The technician (is that what they are called?) had performed the first few scans but because I needed an IV contrast as well (risk of anaphylactic shock I think?) we were stuck waiting for a doctor. It took a while. The IV makes you feel warm all over. It also makes you feel like you are peeing; you aren't. Although I was convinced that I would be the first to challenge this.

Scans are over and I go back to my waiting room. Everything about this entire experience so far is way outside my comfort level. I am anxious, tired, overwhelmed and feel a little strange (probably close to an anxiety attack at this point). I keep poking at my belly and telling myself that there is no pain, dissonance kicks in. It was like I was trying to convince myself that there was no pain; I am wasting everyones time. I should go. Me and my brain..

Anyway, this surreal moment ends abruptly when a surgeon pops into my room and says: "The OR is prepped, we are going. Now" There was something about the way "Now" fell out of his mouth that made me think the results from the CT revealed a little more than the pain and blood test did. It is close to midnight now and I am scared.

I am standing in a johnny shirt and boxers going through the motions with two really nice nurses (I am on autopilot now, canned chatter). I had called my wife right after talking to the surgeon, she arrives. We are waiting for an anesthesiologist and I am extremely anxious. Once he arrives his demeanour calms we down a bit. He is funny and saying all the right things. We make our way to the OR.

The room is quite large and dimly lit accept for the operating table which appears to be well lit from some unseen source. It is quiet. I am helped onto the narrow table and my legs are strapped in at the knees. My arms are outstretched at 90 degrees and a very warm blanket is placed over me (nice touch). Everyone is working around my head from behind. The nurse holds an oxygen mask over my face and he tells me to relax, the anesthesiologist says something like: "here is your rum and coke". Lights out.

I guess they cut the right wire, I woke up in recovery. The surgery lasted a little under 2 hours and left me with 3 holes in my lower abdomen/pelvic area. There is one hole in my belly button, one about 3 inches to the left in my waistline and another about 3 inches below the belly button. The bruising didn't appear until a few days after the surgery.

A note about the recovery room: Try not to say too much at this point, it will just be stupid talk. You will probably have the same conversation over and over again and will likely admit to anything.

Once I was stable (breathing on my own, not bleeding out) I was taken back to my room. I was still pretty out of it at this point but I do remember the nurse pointing out the call button. If you need anything, press here she says. I tell my wife that all is good and that she should go home and get some sleep. I am exhausted. 

It is a good thing that I took note of that button because shortly after my wife left the pain got really, really bad. I called the nurse and she returned with a shot of morphine. Lights out for the second time.

I woke up at around 0700 and was really groggy.  I saw the surgeon at around 0800. He looked over my wounds and said everything looked good. He told me that I could probably go home that day. There was pain. They were using a scale of 1 - 10  and I was telling them I was about a 4 (it was probably closer to 7 but I wanted to go home). 

To leave I had to overcome a few hurdles. As there was an infection I needed to go through a few bouts of antibiotics (via the incredibly uncomfortable catheter in my arm). I also needed to eat something significant, pee (a considerable amount) and poop. 

Peeing.. heh, a hurdle indeed. You have no idea (or maybe you do) how difficult it is to pee when you are relying on gravity alone. Even though you have to pee, you can't assist in any way, there is no pushing it out. At this point you are literally waiting for it to fall out of you. It took a while.

I managed to escape just before 1900. I spent the next 2 days prone with 3 pillows supporting my upper body. I took 2 tylenol every four hours. The pain was always present but never got out of control. Transitions (sitting/lying down to standing) were brutal during the first 72 hours.

There was an associated 'side effect' pain that I found incredibly uncomfortable. When the procedure is performed they inflate your abdomen with air to make room to work. As it dissipated it caused a great deal of pain in my shoulders. It felt like someone stabbing down into my shoulders beginning from the neck. This pain occurred a few times each day a couple days after the surgery and then ceased. I was also incredibly bloated during the first few days as well. 

It has been a week since the surgery and I feel good. Most of the bruising is gone and there is only pain when I stand up or during erratic movements. I can tell I am healing. I can't drive for 2 - 3 weeks and no heavy lifting for 6 weeks. I will live.