Dawn and I had a date this morning!
The particular venue, arthroscopic knee surgery at Central Vermont Hospital, was arguably not the most romantic choice we could have made. But it was the longest time we have spent together outside the house without children since Samuel was born. So technically this qualified as a date.
It certainly wasn’t the worst date we’ve ever had, though the odds of having a good time were against us. Samuel, our mobile, seventeen-month-old alarm clock woke us at 5:50 AM, and we rushed to get out the door by seven o’clock, leaving a tearful Rose waving from the living room window as we pulled away. Dawn was required to fast before surgery, and Samuel had me up every two hours the previous night. Then, when we arrived we found our reserved room, with its luxurious concrete walls, stainless steel hardware, and twenty-year computer equipment, disappointingly lacking in ambience.
But we rose above these limitations. A guilty and undeserved freedom made us relatively light-hearted. My demeanor, while plodding, absent, gray, with unbreachable periods of vacant staring, might not qualify as giddy, but it was certainly a cut above my daily “Are You Dead Or Alive?” brooding. Dawn herself displayed a certain adolescent nervousness and anticipation, which, I flatter myself to think, was not merely her fear of surgical knives. I wore a button-down shirt for the occasion, and slip on loafers. Dawn looked lovely in a green hospital gown with matching bath robe that she wore jauntily over her shoulders – the IV drip not suitable for sleeves.
Being somewhat out of practice in courting, our conversation stumbled along in short bursts delivered in quiet tones trying to please and be pleased. The silent spaces in between, unmolested by crying, whining, appeals for attention, were breathtakingly novel, but it took professional help to spark the conversation along.
Usually this service is performed by an experience restaurant waiter or waitress with wit and discretion and a taste for gratuities. He or she must flatter the lady without offense. They must provide attentive duty to the gentleman without fawning. They must have a humorous quip ready at the tip of the tongue and disappear immediately after it is precisely dispensed.
Carol, our post-op nurse performed this role admirably, meeting all of Dawn’s physical needs, graciously paying attention to my irrelevant comments, while spinning yarns about her son who caught and broke his finger in his baggy cargo pants running in the back yard. She conspiratorily complained about other patients whom apparently skipped or failed kindergarten, but her relaxed tone and her cheerful attention to Dawn’s needs made it abundantly clear we did not fit in this category.
Dawn had worked out in advance with her anesthesiologist that she would have a spinal block rather than general anesthesia. But when she entered the OR with anxious teeth chattering, he told her, “I’m going to give you a little something to help you relax. You might not remember the next fifteen minutes.” Which was nearly true. She has no memory of the monitors and tubes being attached. She does remember lying on her side and arching her back away from a painful spot in her lumbar region, at which point the anesthesiologist reminded her that she had agreed to a spinal block and would she mind holding still for a moment. She slowly became numb from the waist down. She could not wiggle her toes. She could not even feel her navel. But she could feel her leg floating up in the air somewhere over the nurse’s shoulder. It was very strange, she later reported, and gave her some insight into the phantom limb sensations reported by amputees.
The next hurtle was the video. She definitely wanted to watch the procedure and get a good look inside her knee, but she had to get past the one part of the procedure she feared she could not stomach, the initial violation of her skin. The surgeon held her knee, his thumb appearing on the monitor, and said “Here is my thumb, and here is the incision.” In went the probe, and Dawn wasn’t bothered in the slightest. As her real leg was floating above the nurse’s shoulder somewhere, why should she be bothered by someone else leg viewed remotely on the video screen?
The rest of the surgery was pure fascination for her as they took a little tour inside her joint capsule. The surgeon described all the things he found – two meniscus tears, a 5mm divot in the head of her femur, some chondromelasia (which, as near as we can figure, must be a small enclave in the Ural mountains), some missing house keys, an odd sock lost in the dryer, etc., etc. In between he kept up a running conversation with the anesthesiologist and the two OR nurses about the golfing tournament they had all attended the week before.
After the procedure, I was permitted to see her, laid out on a gurney in post-op with several small white blankets drapped over her. We waited together for the spinal block to wear off, and bit by bit her lower body returned. Starting from the navel and working down to the toes, she first regained her ability to move, followed by the ability to feel external stimulus, followed by an unrelenting itching sensation that worked it way down her backside.
When she could wiggle her toes, they brought us back to the pre-op room, but they would not release her from the hospital until she could pee, and they would not let her try to pee until she had enough motor control to squeeze her buttocks together. I didn’t understand the physiological connection, nor was it explained to me, but Carol, the post-op nurse, admitted that they do allow women some slack in this requirement. When I asked why, she said “Well, it’s easier for women to pee. A woman’s urethra is rather short [she held up her hands about three inches apart], while a man’s is general much longer.” I stared disbelieving at her hands, now fifteen inches apart, before responding, “I wish.”
Carol was great. She made Dawn a peanut butter and jelly sandwich. She brought her hot chocolate and coffee with five sugars. Dawn normally can’t drink these things because they give Samuel a rash when she nurses him. But with the anesthesia she figured she wouldn’t get to nurse him for half a day anyway. When Carol heard this, she reviewed her chart and said, “You got Toradol, which is just liquid ibuprofen. You got Versed, which is a short acting valium-like drug. And you got Novacaine. That’s it. It’s the same thing we give to women during childbirth. They are all safe for nursing.” We found it incredulous that the hot chocolate was potentially more damaging to Samuel than the anesthesia.
Carol then went through the owner’s and maintenance manuals. Do not drive or make important decisions for the rest of the day. Do not shower for five days. The anesthesia in your knee won’t wear off until much later, and when it does you might experience no pain, or you might wake up at two in the morning wishing you had filled this prescription I am now giving you. Ice and elevate the knee for two days. And look out for spinal headaches, which then had to be explained.
In less than one percent of all patients who have a spinal block, the puncture in the epidural sac doesn’t heal and spinal fluid leaks out slowly. After a day or two, enough fluid has leaked out that when the patient stands up, they are treated to an enormous shattering headache that instantly moderates when they lie down again – which they all do, immediately. There isn’t enough spinal fluid left in the spinal column to fill the dipstick all the way up to the brain. If this happens, come back and they will extract a bit of blood from her arm and patch it over the spinal hole where it will coagulate – voila, case solved. Let us hope this isn’t necessary.
Many thanks are due to Dawn’s Dad and his wife who are cooking and cleaning and filling in with childcare duties for two children who would rather be jumping ontheir Mama’s lap – a behavior we have strictly forbidden. This morning Roberta turned her back on Samuel for less than two minutes to put away some dishes. She turned back to find his high chair moved to the counter, and Samuel standing on top and playing with the books, boxes, and pens he found there. She gave up any attempt after that of getting housework done and spent the next few hours chasing him around the house “for miles.”