Asking the Right Question of a Smooth Operator

This is the first in a series of articles about my recovery from intestinal surgery which resulted in a colostomy. And about a follow-up trip to the hospital to have the colostomy reversed. Although these articles are dated November 2006, I never really did get back to writing these stories around the time they occurred. This blog post and those that follow on this topic were all written in January 2013. Here is an index to all of the articles in this series.

When I left off on this story I was still recovering from my hospital stay in the initial surgery. I did get back to normal use of my arm and my ability to drive. I didn’t have any particular complications with the colostomy or my brace except for the everyday hassles of dealing with the colostomy. Of course it lengthened the amount of time that it took to get me dressed each day.

One of the biggest hassles was the odor while changing my bag. Naturally we did all of that in my bedroom and there is no exhaust fan there like there is in the bathroom. We invested in a large can of Lysol disinfectant air freshener. Sometimes I wondered which stunk worse… The bag of feces or the Lysol spray. Dad also installed a paper towel rack because we used a lot of paper towels and wipes during the process.

One of the parts of the story I didn’t cover very well in the previous installments was the great affection we developed towards my surgeon Dr. Chad Davis. He was just the luck of the draw that he was the surgeon on duty the day that I had my emergency but it was really divine providence. Someone sent me a get well card with Snoopy on the front cover. On the cover it says “What do you call a really cool surgeon?” When you open it up and says “A smooth operator!” He indeed was that. His entire manner just exuded confidence not only in himself but in me. He didn’t say things like “I can do this”. He said things like “I’m confident that you can handle this.” We were so pleased with him that we especially requested that he perform an upcoming lung surgery on my mother. Mom had a spot of lung cancer on one lung and they had decided she needed one lobe removed. Dr. Davis was partners with the surgeons who had previously operated on her pancreas. Despite the fact that that surgery had lots of complications we liked those doctors but they were more specialized in doing surgery with scopes through small incisions. Dr. Davis was a more general thoracic surgeon and we asked if he could do her lung operation. Over the course of about three months he operated on me, then on my mom, and then operated on me again to reverse the colostomy. We joked with him asking if we could get a family group discount since we were sending him so much business.

I could probably have written several blogs about the events surrounding my mother’s surgery but those details are lost to my memory. We will just say here that things went relatively well for her. She did need to be on oxygen almost continuously after that. We also ended up investing in a little three wheel scooter called a “Go Go” that she used whenever she needed to get around long distances such as shopping or at church. She remained cancer free until 2008. I will try to go back and blog some of that experience. She finally succumbed to cancer in February 2009.

The decision to go ahead and have the second surgery and have the colostomy reversed at first seemed like a no-brainer. I certainly didn’t like having a colostomy. No one does. There were some minor considerations in favor of keeping it however. It’s quite a production to get me on the toilet. I try to go either in the morning or the evening as I’m getting in or out of bed. If I have a quick call in the middle of the day he means picking me up at the lift, laying me in bed, almost totally undressing me especially removing my brace. You then lift me with a Hoyer lift into the bathroom. I do my business and you take me back to bed with a Hoyer, and completely redress me including wrestling me into my back brace again. It’s quite a production and we don’t do it unless we absolutely have to. That means on many occasions when the bowels get grumbling I just tough it out until bedtime. The idea that I didn’t have to ever go through that again did have a minor appeal to it. But it wasn’t enough to outweigh the hassle of the colostomy itself.

The other part of the decision was strictly medical. You recall the anguish I went through over whether or not it was safe for me to have general anesthetic for the surgery. In that case it was definitely an emergency situation I didn’t have a choice. This time I was talking about going back into general surgery with a general anesthetic and recovery time similar to previously and it was all technically optional. I made an appointment with Dr. Vorha to get his advice. He asked me if I was invested in the stock market. I thought that was a crazy question. I told him I had owned some stocks in the past but did not now. He said you know when you read information about some company and their stocks they always have that disclaimer that says something like “Past performance is no indication of future outcomes”. Basically it means just because our stock went way up the past few years doesn’t mean it’s going to keep going up. I certainly know that to be a fact. I bought Microsoft and Intel before the technology bubble burst and lost a good amount of money. Anyway he said that just because I had come through the previous surgery okay it was no guarantee that I would be as successful for the second go around. Ultimately it was up to me.

Dr. Swinney was slightly more confident than that regarding my risks but he agreed it was really my call as well.

At this point I’m reminded of the joke about the little boy who came home from school and said that he had a test that day. His mother asks “Were the questions hard?” And the little boy replied “Now they give you the questions… It’s the answers that are hard.” That’s the difference between school and real-life. In school they give you the questions and you’ve got to find the answers. Sometimes in real life figuring out what the question really is becomes the main problem. My experience is that in real life once you ask the right question, the answers are much easier.

After lots of internal deliberation the right question eventually formed in my mind. Do I want to be more normal than I am now? If you recall a previous installment where my former boss Dr. Merritt MD PhD Chairman of the Department of Medical Genetics was curious about “my diagnosis”. My reply to him was that I didn’t know what kind of muscular dystrophy I had. But if he ever could tell me which one he could cure then I would worry about whether or not I had that one.

For over 50 years I had struggled with this disability and none of the doctors could do anything to make me better. The best I had ever hoped for was to keep me from getting worse any faster than I had to. Devices such as the various back braces I’ve worn over the years fall into that category. But none of them could ever do anything to make me more normal. Until now… Ultimately I told Dr. Davis that the reasons I wanted to have the surgery to undo the colostomy was because it was the first time in my life that any doctor could do anything for me to make me more normal. And ultimately that was why I went ahead with the surgery.

In the next installment we discover that having nonemergency surgery is more complicated than you think.

This post actually written January 7, 2013 5:03 PM