Last month I had a laparoscopic appendectomy and here is what happened.

Horror of Horrors, Mouse's Musings

I’ve told this story to so many medical professionals last month that I’m not so embarrassed to relate it to you now.

The pain began when I was taking a righteous dump at work.

I carry not a history of wise choices when it comes to what goes into my GI tract. I’ve stories to tell but suffice it to say I’d never worked so hard to pass a bowel movement in my whole life. It was so bad I had to put down Angry Birds and concentrate. My head became light when I arose from the porcelain throne, fingertips and toes tingling. I could barely navigate back to my office in a straight line. And I couldn’t stop shaking. I was cold, so very cold, and I felt an intestinal cramp in my lower right abdomen.

I immediately recused myself from work. It was 7:30p anyway and I got myself home. During the harrowing drive I could hardly grip the steering wheel. When I arrived home, The Girlfriend wrapped me in blankets, and I tried to sleep. The shaking stopped as soon as I was warm and I slept about an hour before the cramp in my lower right abdomen blossomed into widespread pain. By 10:30p I was on the floor, digging through boxes, looking for my LAC-USC medical card.

The Girlfriend drove me to the ER. I had the wrong directions and we drove to the one by the Staples Center first, but I wanted to go to LAC-USC because I remember having a relatively cheap bill there before. My gut suspicion was that I’d ripped my intestinal wall or ruptured a hernia. The lady at the hospital entrance believed me because I jumped right to Room 7, which is basically ER First Class at LAC+USC.

Within 45 minutes I’d been interviewed twice and visited with a doctor. They gave me a wrist band. At that point, my status must have been downgraded because it took a couple hours before I was dealt with. I remember panicking because it was around midnight and I still hadn’t seen my girlfriend, who dropped me off at the ER and went to park the car. It turns out she’d just sat herself down in the waiting room in a corner where I couldn’t see her. At the time I was afraid she was lost. In retrospect, I really, really, really did not want to be alone. At some point they’d stuck me in the main waiting room and we waited together.

The Girlfriend and I slept against each other, a pillow we brought between us, in the main waiting room, until I think about 2:30am. Then I was taken back into The Adult Waiting Room. The pain actually subsided a bit. A sweet older lady with a UK accent periodically checked on me. I think her name was Julie and I think she was a doctor assigned to the adult waiting room. She’d ask me to hop up and down or jam my leg into my abdomen until I yelped. Theories ran from really horrible gas to your appendix has burst already, and that you’re feeling better is actually not a good thing, and we want to do something soon. They thought they might inject me with some kind of colored die and do an MRI to see if it would spill into my guts.

So I sat and waited and watched a Jimmy Fallon rerun for another hour or so before a very patient gentleman named Darren rammed an IV the size of a Toyota into my arm. I fucking hate needles. And by that I mean to say that I am a giant baby manchild and needles make me cry for mommy. It would take about a full day for me to flex my arm at all because I was so repulsed by the thing they’d inserted and taped into it.

Soon after I was given my machinejuice port, I told The Girlfriend for godsake, go home and get some rest. I gave her many detailed instructions on how to perform two hours worth of work that were crucial to my job. My boss was leaving for France later that week and his flight had to be rescheduled. She performed these Heraclean labors admirably by the way.

I shared both Room 7 and later the Adult Waiting Room with many of the same people. One was a young emaciated, shoeless African-American woman whom I’d mistakenly taken for being learning disabled. It turned out her jaw was broken (or something) and her grunts and baleful moans were so frightening because she was unable to close her mouth without intense pain. Another person was an elderly white woman, apparently homeless, insisting that some horrible thing in her brain needed to be drained of fluid. It may have been true. She was loud, unruly, and definitely mentally ill. She screamed at other patients whom she felt were not worthy of care. I did not feel I should receive care before either of these women but I did.

Eventually a cute nurse took me upstairs. (Every woman ever is pretty when you’ve been dehumanized in the ER triage process. Your skin crawls with fluorescent sanitized androgyny and the vaguest hint of hormones is dizzying.) Before I knew it they had me in a gown, on a bed, and hooked-up to machines. I mean it, it was really fucking quick. Slight of hand hocus-pocus hospital magic. All this for an MRI? I asked. Well, no, that’s not going to happen. At least not yet the nurse told me. She scurried away before I could get a follow-up question in.

Then my nurse new Lisa came. Lisa was amazing. Sweet, funny, did-up hair, she reminded me of the African-American girls I went to school with growing up. During the rest of the morning I talked and joked with Lisa as much as I could because I was very, very worried and very, very scared and the only way to hide it away and show it to nobody was to run my mouth a million miles a minute. I was a really fucking friendly guy during my time in the hospital.

Lisa plugged me into the machinejuice machine and soon I had to pee. She provided me with a tupperware urinal thing. Peeing was hard because the same muscles I’d use to squeeze my bladder would make my pain flair and I had performance anxiety because shit there were twenty five people on the other side of that paper curtain and peeing on your back is just hard anyway. My doctor burst through the curtain in the middle of my urination attempt. Then he ran out not wanting to offend. I was peeing in that urinal every single time he came in the room that day which was about four times.

The doctor was unbelievable. Dr. McDreamy. A television cliche. If I was a young woman I would have soaked my panties at the sight of him. And he was charming and funny. He pushed my abdomen and let go. Did that hurt more when I pushed or when I let go? When you let go. Classic case of appendicitis bro. He might not have said bro but I am pretty certain he did.

I could receive no cell reception in this room and that was terrible. A couple times a nurse would slip me her supervisors phone and I would walk The Girlfriend through some of the more confusing work tasks she took care of for me.

I was wheeled out to have an ultrasound. Are you going to tell me if it’s a boy or a girl? I must have told that lame joke to five different people. Before my ultrasound I was lined-up in the hallway facing a young woman, maybe sixteen, who looked like she was dying. I couldn’t look her in the eye because I was telling lame jokes.

I had to pee really bad but was afraid to ask. A Korean man did the ultrasound and it must have taken twenty minutes. His first conclusion was You are very constipated and I laughed incredulously. Then he did more ultrasounding and got serious looking. I winced from pain during the whole thing, not because he was poking my appendix but because he was poking my bladder. God I was glad to be wheeled back. I didn’t get to piss right away because Doc Dreamboat came back in. He told me it was definitely appendicitis and surgery was going to take place, maybe that morning, hopefully by that night.

The determination was made that I had squeezed so hard when I was trying to poop that I pinched and inflamed my own appendix with my abdominal muscles and that is what must have happened. It is idiotic for me to say it but I am kind of proud of that in a way.

The surgeon came to talk to me. I think he was Persian. He was very hip and a little smug. He told me they’d try to use a scope and do the surgery with three small incisions but if there was trouble then they’d have to do a big incision. I trusted him and was glad to meet the man who’d cut my body open for the first time ever in the history of my life face to face.

By early afternoon The Girlfriend had come back. She saw me in my gown and plugged into machines and she broke into tears. I was heartbroken to see her cry and probably cried a bit too. I did not want to be anybody’s burden. I explained to her I’d been in good care and would be getting cut open soon. I had to pee all the time and I slept a lot. IV drips are really remarkable things when you think about it. I asked Lisa how old the technology was but she didn’t seem to know.

Finally maybe around 4:30pm I was checked into a hospital room. Somehow I got checked into the children’s ward which was great because on my way to surgery later I was carted through the regular ward and let me tell you it is a place of nightmarish wights roaming endless hallways of desolation. But my room was private, bright, and had a glorious view of the hills. The television remote did not work.

I had a new nurse I think her name was Lenora and she and another higher-ranked nurse argued about how to hook-up my machinejuice drip and my antibiotic drip at the same time. You don’t ever want to have trained professionals disagreeing over the best way to create a steady flow of foreign substances into your circulatory system especially if needles turn you into a giant manchild crybaby calling for mommy like they do for me.

I laid on my hospital bed and The Girlfriend sat with me. I might have napped. At some point around 7:30pm or so they came in and said it was time to prep me for surgery. Very quickly I was moved to a cart and I was being wheeled away from The Girlfriend and my last words to her were See you on the other side which is a really terrible choice of words. The woman wheeling me was an African-American woman with a thick accent. She said Only thing you got to know is whenever they ask you about your pain you tell thems ten. They say how you feelin’ honey and you answer ten. As soon as you wake up suga you tell them my pain is ten. And they will give you the good juice suga. Just remember ten. Ten ten ten.

I am terrified of drugs and addiction and did not heed her advice. I didn’t really need to.

She dropped me off at surgery prep. A Korean woman some kind of orderly maybe gave me the rundown of what would happen next. Then I met my anesthesiologist who looked younger than me and I am pretty young. He told me all the terrible things that might happen to me while I was under and then I signed a paper that said it was okay by me if I died. I asked him if the knockout would be injected or a mask and he said it would be a tube in my lungs but I’d be so full of drugs I wouldn’t notice. I ignored the word catheter when he spoke it.

Let me tell you they inject you with some wild juice. I was wheeled into the operating room and I asked Where is the machine that goes BING? and some guy cleaning tools in the operating room laughed and said Oh yeah, I liked that song about the universe that opened that movie and I go Oh, this one? Just remember that you’re standing on a planet that’s evolving, revolving at nine hundred miles an hour. I’m really belting it now. That’s orbiting at nineteen miles a second, so it’s reckoned, a sun that is the source of and then I was out cold.

I woke up in intensive care to see the same Korean woman. She asked me some simple questions. I talked about how much I liked Korean food. She released me to my room. A different African-American woman wheeled me back. I forget her name but I do remember that movies were her favorite thing in the world and the Lord of the Rings movies were her favorite movies. She also loved Sergio Leone films and I told her she should watch Il Grande Silenzio and that it would knock her socks off. That movie would knock the socks off anyone who likes movies.

When I got back to my room it was some time after 10:00pm and I had a new nurse. I forget her name but she was very kind and very pretty and when she asked if I wanted any morphine I said no. I never took any morphine because I remembered a John Prine song about the war vet who ruins his life on morphine. It’s called Sam Stone and it’s the saddest song you can imagine and I knew the words by heart as a small child so that is probably why it had an effect on me.

I was so scared that I was as nice as I could be to that nurse and she checked on me all through the night. She was very charmed by my friendliness and said if I needed anything extra at all I should let her know. I did not ask for anything extra but it would have been nice if she’d come to my room sooner when my machinejuice machine started squaking like an impaled duck.

Around 3:00am I think I woke up to the beeping. It just would not stop beeping. I buzzed the nurse and she didn’t come. I kept buzzing. I buzzed all four buttons. I noticed there was no machinejuice in my machinejuice tube. There was neverending beeping going on. I was out of water and my mouth was very dry. I tried to scream out Hello nurse, please come in here hello nurse are you there? but it was barely a whisper probably because I’d had a tube in my lungs during surgery. A tube the size of my arm no doubt.

In about a half hour she came because she heard beeping from the hall. She was shocked that I had not buzzed her. That’s when we learned that my nurse buzzer did not work. What a thing to learn in a hospital.

I went ahead and asked for vicodin at 6:00am and it was the last thing that nurse did for me. Then I got another nurse who wasn’t helpful at all. She didn’t answer my questions and was really interested in getting me out of there. She was the only person who cared for me during the whole ordeal whom I didn’t like.

Hospital food is terrible but I ate all my breakfast. The juice was just sugar and water and I couldn’t believe it. It was basically poison. In a hospital.

I napped after breakfast and my surgeon woke me from my vicodin nap. He told me they got my appendix out and by the way did I have any questions? I was still groggy and said no and he said we’ll see you in clinic then. Later I asked my nurse about when I could shower and how to care for my incisions and she looked at me like she was mad and said I should have asked the surgeon. How was I to know? I was knocked out on drugs and that little bait and switch didn’t seem fair to me. She said she’d get a doctor to come talk to me.

An African-American man with a rolling suitcase and a Raiders hat came by to talk about my hospital bill. He asked if I was insured and I said no. He asked if I worked and I said yes. He said I’d sign up for Healthy Way LA and the LA County Ability to Pay Program and that my bill would be paid for. That wasn’t true though. I told him I thought his Raiders would be good this year and he seemed to like that until he learned I was a Colts fan.

The Girlfriend came back and she was glad to see me. Around 11:00am the nurse told me I’d be checking out soon and I’d better get dressed. I didn’t ask for any more vicodin because after all I’d be leaving soon and boy was that a mistake.

We waited about two or three hours for a doctor to come and tell me how to care for my wounds. The doctor never came and I was mad about that but I smiled and kept it to myself. They wheeled me down to the discharge office. I was given some very non-medical medical instructions by an administrative worker. She said I shouldn’t drive until my post-op clinic followup in two weeks which was bullshit unless the surgeon was wrong when he said I could drive in a few days. She explained what drugs I’d be given and that I’d have to wait about six hours to get them. Holy shit I should have asked for more vicodin.

When they do a laparoscopic appendectomy they fill your gut up with CO2 like a big fucking balloon and then in they use Swiss Army knife like tube tools to rip out and cauterize your appendix. You just have to wait for your body to process that C02 gas. The surgery juice had worn off and the vicodin had worn off and my stomach was extended so far and pushing on all three of my incisions but especially the one on my bellybutton. I could walk myself okay but it was hard and I was in lots of pain. We decided The Girlfriend would take me home and come back to get my drugs at 9pm that night.

She got her car pulled-up to the curb and a surly South African orderly wheeled me out. I remember getting into her car and thinking I do not feel well enough to go home and I should have asked to stay another day. I really felt like that on the drive home because the seatbelt hit every incision and every little bump shook my balloon belly and hurt really bad. It was horrible and I thought of the Stephen King book Misery all the way home which took about thirty minutes.

It took a couple days for that gas to pass and maybe a week more before I was particularly mobile and maybe two weeks until I was at ninety-five percent. I worked from home a lot. The overwhelming impressions I left the experience with were that it is really amazing how many different kinds of people from different kinds of places of different ethnicities used their very valuable skills to take care of me and to keep me alive and that I was really lucky because one hundred years ago the appendicitis probably would have just killed me. The bill is expensive and it sucks but I can pay it. I just won’t be buying a new car now this year which is fine. I have a lump of scar tissue or something under my bellybutton that still hurts some and that bothers me from time to time.

This is a picture of my gut after the surgery. I made a face out of it so it would be less nightmarish but I think the face made it more nightmarish.