Tuesday, March 17, 2009

The post-op post

Morphine hits the backs of the legs first, then the back of the neck, a spreading wave of relaxation slackening the muscles away from the bones so that you seem to float without outlines, like lying in warm salt water. As this relaxing wave spread through my tissues, I experienced a strong feeling of fear. I had the feeling that some horrible image was just beyond the field of vision, moving, as I turned my head, so that I never quite saw it. I felt nauseous; I lay down and closed my eyes. A series of pictures passed, like watching a movie: A huge neon-lighted cocktail bar that got larger and larger until streets, traffic, and street repairs were included in it; a waitress carrying a skull on a tray; stars in the clear sky. The physical impact of the fear of death; the shutting off of breath; the stopping of blood.
William S. Burroughs, Junkie, 1953

Like those wobbly video images of UFOs that change directions at impossible speeds, I take off vertically, propelled to a dizzying height in seconds; fear closes in, I know what’s coming next…with sickening inevitability I drop out of the sky, the ground hurtles towards me, though I stop dead before impact. A gust of wind carries me away; I am a snowflake amongst millions of snowflakes, fluttering, the ebb and flow of the breeze teasing us onwards. There are throngs of happy people in a park; evil infiltrates them, a menacing gang of hoodies fan through the crowd…It’s dark and I am flying through the air once more, this time inches above a road surface, I am going to crash headlong into the twisted metal of a car wreck, nothing can prevent the nauseating crack and crunch as my skull fractures into tiny pieces, flesh torn aside, blood vessels popping like cooking fat, haemorrhaging fast. The road feels neither hard nor cold beneath me, I am weightless, lifeless; a girl in an ankle length nightdress stumbles into the path of an oncoming lorry, caught in the headlamps, she is going to be hit…

I come round from a terrifying morphine dream in an unfamiliar room. Time has no meaning. Through the haze I remember being shown how to administer morphine by pressing a green button dangling above my head; I reach up and give myself another shot. I don’t know how many times I’ve repeated this action. I’m am hot, my mind races feverishly, sleep comes and goes.

A surgeon is explaining to me that they didn’t carry out the ileostomy as planned. During surgery they discovered a fistula in the colon. The colon wall was perforated. An abscess was mentioned. The surgeons felt strongly that it was more likely to be caused by Crohn’s than ulcerative colitis. So instead of taking my entire large colon out, they just removed the section most badly affected. Apparently the rest of my colon looked fairly healthy. All I want to hear is that the operation has been a success. The surgeons are confident they did the right thing. One thing is for certain no amount of drugs would have ever cleared up the fistula. Surgery was the only option.

A member of the gastroenterology team is shaking his head. He is convinced I have ulcerative colitis, not Crohn’s. If this is the case, I now still have a large part of my large colon, which can be attacked by UC at any time. Ulcerative colitis only affects the large colon, so if you take it away, you take away the UC. (Just like a man who has had his foot amputated needn’t worry about getting an ingrown toenail.) The gastro doctor thinks I should have had an ileostomy. In his eyes the surgeons have only half finished the job. This is not what I want to hear.

So it seems my bowels have split the medical profession into two camps. The surgery team thinks I have Crohn’s and the gastro team is sticking with UC. If I have Crohn’s then in the future there’s a possibility that it could come back at any point between my mouth and anus. And if it’s ulcerative colitis, well, that can come back too. Not exactly what you might call a win win situation.

It’s right about now I start vomiting green bile.