Post-op

As I curled up on the gurney last night in room 6 of the ER (if one can curl up on a rock hard gurney) and started to doze, I laughed thinking, who in their right mind goes to an ER for some peace and quiet so they can sleep? But after what I've just endured, sharing a sleeping space with screaming trauma patients and vomiting drunk teenagers is positively serene. But this tale of insomnia has its beginning much earlier in the day. That morning my mom had cataract surgery on her right eye. I was to be her designated driver and all around support system if she needed anything. (Samantha, you're on board for the left eye!) It turns out that cataract surgery is about as easy as getting one's prostate checked. A few minutes of discomfort and some post procedural blurred vision is about there is to it (and I'm talking about the prostate exam here!). Except for the potential of being a menace behind the wheel while driving blind, my mom didn't really need the help. For 80 years old she doing amazingly well. Not one known for missing out on the opportunity for some good shopping or a good meal, my mom and I were having a big breakfast of huevos rancheros an hour after surgery. Two hours post op we were strolling down the cavernous isles of COSTCO shopping for massive quantities of over packaged stuff we can all live without. When I usually go to COSTCO I get a cart and start loading it with all the really cool and really cheap stuff that is at least half the price back home in Friday Harbor. Then about 2/3rds of the way through the store I start unloading the cart, realizing that even though it's all cheap, I really don't want it. Things like an 8 pack of Britta water filters, or a case of motor oil, or a 24 inch pecan pie. Fifty pounds of C and H sugar? AWESOME. Then over in the sock isle, seeing the diabetic coma in front of me, I strain to lift that indiscreet pink bag out of the forklift sized shopping cart and tuck it in amongst the 12 packs of gym socks or the cases of Hostess Twinkies. But COSTCO isn't what I wanted to write about today...at all. I wanted to talk about the fortitude of my 80 year old mom power shopping through the madness mere hours after having undergone surgery. It was great to see although I have to admit that she looked a little goofy wandering around aimlessly with a normal appearing left eye while the right eye was sporting a pupil the size of a basketball. It was disconcerting as an ER nurse to look my mom in the eyes. Not the disconcerting feeling you get when you are talking to someone with a lazy eye and one or both of their eyes wander around and you're never sure which one to look into while you are talking with them....switching furtive glances from eye to eye, afraid they'll be thinking that you're staring at their imperfect gaze. But the other disconcerting feeling...the one that feels like you're talking to someone who has just suffered a major head injury. When we teach new EMT students to assess trauma patients for brain injury, performing a pupil check is essential. It's important that the pupils are equal and reactive to light. That's the reason we are always shining bright lights in your face at accident scenes. (And here begins our tangential medical lesson for the day: Once your brain begins to swell after experiencing a traumatic event be it baseball bat to skull, or face vs windshield, or...well you get the idea, the pressure inside your skull increases and thus begins the process of herniation. This is when your brain gets pushed out of the big hole at the base of your skull. This of course happens right before you die. But before you die and after the brain swelling occurs all that pressure pushes on the optic nerve and that causes one pupil or both to dramatically widen...otherwise known as a blown pupil. A blown pupil is a late and ominous sign of a devastating head trauma. People with blown pupils tend to die. People with blown pupils don't tend to shop at COSTCO for 96 roll mega-packs of toilet paper.) So all that was to explain why I only looked in my moms left eye today after her surgery. It helped that she had this huge clear plastic shield taped ridiculously over her right eye that, while preventing her from rubbing the wound kind of magnified it at the same time. It was sad in that way that you get sad for dogs who wear big cones around their necks when they get stitches or hot spots.
But I started this entry with insomnia. I had a flashback last night of when I was back in Malaysia in the oldest virgin rain forest in the world. Leaches and brown rivers come to mind when remember that place. That and trying to sleep in a rotten shack of a building with a rat gnawing in the wall a few inches from my head. I remember that so fondly as it was kind of a turning point for me as I came to accept a crappy situation I was stuck in and just BE in the discomfort of it. I had this flashback while lying in a hotel room last night just a few feet from my mom in the other bed. I was yearning for the peace I found with the rat. I was yearning for lots of things while lying there...an ipod, the sunrise, death. You see, my mom snores. Not just snores but saws a mean log. Not just saws it but chainsaws it...with a jackhammer. I mean, there was a sound emanating from a woman just 5 feet tall that seemed to utterly defy physics. I was visualizing her vocal cords (I've been seeing a lot of vocal cords lately while intubating patients with a breathing tube) snapping under the pressure of such a force. I wondered if the vibrations could be damaging her healing eye wound. I first heard the preliminary sounds as she dozed off while I was still awake watching CNN. I thought it would be a good idea to stuff toilet paper in my ears before I turned out the lights. Useless. Pillow on top of head and plugged ears? Futile, not to mention uncomfortable. As the night wore on it seemed to get only louder until I could actually feel the vibrations through the air shaking my bed. I am not exaggerating here. The room actually shook. Mini earthquakes rhythmically driving me mad. A rat, a rat, my kingdom for a rat! I have traveled the world on a shoestring and have stayed in a lot of sketchy places and slept in a lot of crowded hostel and dormitory rooms. Groups of smelly, scratching, farting, snoring drunken men I've shared quarters with and none of them hold a candle to my short, little 80 year old mom.
About a half an hour before we fell asleep my sister Samantha stopped by the hotel room on her way to Seattle and to save money she stayed with us that night. She slept in the same bed as my mom. This is where the story gets even more bizarre. This is when I knew I had to blog about this night. This is where it all comes together and makes the pain almost worth it...nah not really even close. Samantha was married to a snorer. My grandmother was married to a snorer as well and gave my sister some sage advice when confronted with snoring...just whistle. Apparently my grandma figured out that the frequency of a whistle could stop a snore cold yet not awaken the perpetrator. But whistling takes a lot of energy apparently, as Samantha later told me, so she has devised a way of sort of moaning at a high frequency that is supposed to mimic a whistle and quell a snore. Well, I can tell you that whistling and moaning in a sing-song voice does not in any way stop an eruption of wheezy roars. What began as annoying and quickly became exasperating snoring took on a whole new flavor with the whistles. I got that creeped out feeling that none of this could be real and that I was actually going crazy a little bit and hallucinating. I mean really. And this is what did it. This is what drove me to sleep in a busy ER where screams of pain and retching seemed like sleep aids.