March 28, 2008 - Incarcerated

Incarcerated. That’s the word I heard a couple of days ago from Dr. David Cheli, our family physician, after he took one look at my bulging navel. I have an incarcerated umbilical hernia, it seems. (Or had, anyway.)

I’ve known about the hernia for several years. It’s given me no trouble, and Dr. Cheli’s advice was simply to let it be, avoiding any strenuous abdominal exercises that might make it worse. These things sometimes do require surgery, he told me, but as long as the hernia wasn’t bothering me, there was no reason to go under the knife.

What’s happened this week is that the hernia did start bothering me. On Tuesday, I noticed it bulging out further than before, and I started feeling some pain. It looked and felt like someone had come along during the night and inserted a golf ball under my skin, just to the side of the navel.

I went to bed on Tuesday hoping the situation would resolve itself on its own, but when I awoke on Wednesday and noticed that not only was it still the same size, but that it had become inflamed, I figured it was time to pay a little visit to the doctor.

Dr. Cheli took one look at it, told me I’d probably need to have surgery that very day, and immediately flipped open his cell phone and began making arrangements. He called Dr. Gornish’s group (the surgeon I’ve seen twice before in the operating room, first to implant my port and second for the abortive attempt to do an excisional biopsy of a lymph node in my neck). Another member of the surgical group was available that day; it turned out to be Dr. Mark Schwartz, who had removed Claire’s gall bladder several years ago. Dr Cheli also phoned Dr. Lerner, to make sure there was no reason, from the oncology standpoint, that I couldn’t undergo surgery. Dr. L gave it a green light.

I appreciated the fact that he also phoned Dr. Gustavo De La Luz, the pulmonologist who treats me for obstructive sleep apnea, to make sure he was on board this time around. I’ve had trouble with anesthesia in the past – waking up on the operating table during my port-implantation surgery, as I went into an apneic episode and the anesthesiologist scaled back the juice. Dr. Cheli wanted to be sure those issues were addressed, this time. He told me Dr. De La Luz or one of his associates would stop by and see me in the hospital, and presumably intercede on my behalf.

Did I have time to stop on the way to Ocean Medical Center and get a little something for breakfast, I asked? Not a good idea, said the doc. Better to have an empty stomach before surgery. Well, I thought to myself once I’d heard that, I guess this is really happening. (How swiftly life can change.)

I did make one stop on the way to the hospital – at home, to pick up my prescription meds, and a couple of personal items like my iPod and a book to read. They were expecting me, in the Emergency Room (Dr. Cheli had phoned ahead). Soon after getting me into a hospital gown and tagging me with an i.d. bracelet, they told me I’d be admitted for sure. Claire met me in the E.R., and stuck with me throughout the day.

The afternoon passed pretty quickly, with a trip over to X-ray and news of an on-again, off-again CT scan (it was called off at the last minute, for some reason I never did discover – although not before I’d already imbibed the contrast fluid). Around 5 p.m., I found myself flat on my back in the operating room, arms stretched out cruciform-fashion.

I’d previously learned I’d be having general anesthesia, rather than light sedation. This includes intubation to keep the airway open, so apnea wouldn’t be an issue. (General anesthesia is standard for this operation, anyway, it turns out.) “I’m going to start you with a little sedation now, said Dr. Chen, the anesthesiologist – and, the next thing I knew, I was waking up in the recovery room.

I stayed in the hospital overnight, coming home yesterday. I have another week or so ahead of me of recuperating at home. So, here I am, in much the same state I was in during my chemo treatments (minus the hair loss and the nausea, of course). The pain pills make me feel a bit wooly between the ears. The difference is that, this time, I’ll be over it in a few days.

Incarcerated. Yes, it’s the right word to use, for now.