Saturday, October 07, 2006
My fat scar
Since a couple people commented on it, I guess I should explain. My scar is rather noticeable and so for years whenever someone asked me about it, I told them about it.
When I was in sixth grade, I sat next to a boy who'd already failed twice. He was much bigger than all the other boys and even had that wispy, teen moustache. I did well in school, he did not. Very soon after the school year started, he let me know that he would be cheating off of me and that I was to let him. If I didn't, or squealed to the teacher, I'd get pounded.
I didn't care for this, so I came up with a plan. For the next multiple choice test I would circle the wrong answers. He'd copy me, then I'd subtly change them to the right answers. I'm sure at the time I thought it was brilliant. Of course, I hadn't thought it through to the logical conclusion. We got our tests back; he got a 0, I got a 100. That afternoon he intercepted me as I walked home from school, pulled out a knife, and slashed me across the stomach.
Except none of that really happened. The kid was real, but he never cheated off me. I just loved telling people that story and seeing their eyes get big.
The real story is more complicated.
When I was ten I started having abdominal pains often. One night it was bad enough that my mom took me to the emergency room. An ultrasound revealed that I had a multitude of small gallstones. Gallstones, deposits of cholesterol or calcium in the gall bladder, are usually a problem in older folks. It's uncommon for kids to have a problem with them. I only had one of the common risk factors: female, fat (obesity), fair (Caucasian), forty (middle-aged), fertile (multiple children).
After various doctors conferred, the recommendation was removal of my gall bladder. It's not a secretory organ itself, it just stores bile produced by the liver. So you really don't need it; the liver will just dump bile directly into the duodenum (first section of the small intestine). The idea was that if I had lots of small ones when I was ten, it was going to be a problem sooner rather than later. I wonder if part of it was also that I was to be the youngest person at the time to have a cholecystectomy - a badge for the doctors.
My roommate at the hospital scared me a little. He'd been accidentally shot in the jaw while hunting which shattered it, and so couldn't speak distinctly. He also drooled a lot. I got to like him after a day though. I imagine some of my distaste for guns came from seeing what happened to him.
The surgery itself wasn't an issue, though I wasn't awake at the time. When the anesthesiologist started the meds, he had me count back from ten. I recall getting to sev...
Recovery was annoying because I couldn't walk well or eat much. I hobbled down the hallways clutching the handrails on the wall; it felt like my thighs was sewn to my chest. I'd get full after a cup of broth. I steadily improved and was happy to go home with a stitched incision. A couple days later I was eating a hamburger (often fatty foods after cholecystectomy cause upset, but I never noticed it) when somebody wanted to see my incision. I pulled up my shirt and everyone saw the small purplish bump on the incision. Not so good.
The sequence of events is hazy, but I ended up back at the hospital being examined by a very concerned doctor. It was an infection for sure. The doctor was worried enough that he started working on it right there in the exam room. No time for anesthesia to take effect so I got the topical cold spray. I was swabbed with some sort of antiseptic and then the doctor popped my stitches.
The next part explains why I have a high pain threshold. The doctor inserted his gloved fingers into the incision and starting pulling out what I recall as pockets of pus. I distinctly remember looking down and seeing his fingers inside me to the knuckle. A nurse - the one who wasn't holding me down - was talking into my ear trying to get me to visualize something more pleasant. She was talking me through getting a good hit in a baseball game. I remember being annoyed because, though I played, imagining a baseball game wasn't all that wonderful for me. But then how was she to know that I'd rather have her talk me through Greek mythology or the plot to The Westing Game?
Now, when I assess patients' pain level ("What would you rate your pain on a scale of 0-10 with 0 being no pain and 10 being the worst pain you can imagine?"), I always remember the intensity of my level 10 pain.
I can't remember much after the fingers-in-the-incision part. I didn't pass out, I just don't recall. The next vivid memory is being in a hospital room with an IV full of antibiotics and the incision packed with gauze. There wasn't room on the infectious unit, so I had been given a room on what I used to call the "terminal kids" ward. Several bald cancer kids and two cystic fibrosis kids were on the same unit. It totally weirded me out when one of the cystic fibrosis kids came to my room and gave me his toys "because I won't need them soon." His mom came by later to get them, apologizing profusely.
I stayed in the hospital for quite a while getting antibiotic therapy and wound care. The wound care consisted of taking off the cover dressing, pulling out the gauze packing (with yellow-green goo), pouring in hydrogen peroxide, gritting my teeth as it foamed up and stung mightily, twitching in pain as silver nitrate sticks were applied to cauterize the wound, then repacking. Twice a day for a long time. Even after I got out of the hospital, my mom picked me up from school to perform the wound care. Because of the infection, I couldn't just be sewn back up again.
So 20 years later I still have a thickened scar running across my abdomen on the right side rather than a thin, white line. Presently, the standard procedure is to perform cholecystectomies laparoscopically eliminating the need to open the belly. Patients now end up with three white dots where the camera and instruments are inserted. Damnit. At least I got a good story out of it.