... went great!
We had to wait a tad longer than expected, but we were treated respectfully and kindly considering we were in an HMO cattle call Surgery setting. Pre-op was a loud but an organized chaos. I watched carefully as the charts, meds, nurses, computers, gowns, patients, and more flowed through the system and was mesmerized by the hum of it all. The nurses, for the most part, were extremely friendly, introducing themselves and smiling, bringing what was needed, backtracking when I explained they were saying the wrong information and finding out the correct information... it was good times in the Pre-op area.
Sarah yacked with the Anesthesiologist for a few minutes as they talked about the heavy sedation she was going to have. He asked all those standard questions about loose teeth, contact lenses, etc. and she answered in the negative. His eyebrows raised as he saw she had a third of her lung removed - in 1967 - because of a cancer that was never named. Wow, great that she survived so nicely! The doc ordered Versed and the other meds along with an anti-motion-sickness medication because, apparently, those that barf after surgery tend to also be those that get motion sickness... that would be my Sarah! He also ordered some Zofran to be on stand-by in case she was put under general anesthesia (they taped it to her IV bag) and I was sent home with Phenargan suppositories. Of course, she never even hiccupped.
The next person in was the Doctor/Surgeon, a cool woman we called by her first name (as she called us by ours). We'd met her only yesterday, but already seemed like good friends. She went to get her hair done before coming to the hospital, but already had her pretty Surgeon's cap on... we told her her hair looked great anyway. She laughed a lot.
The Doc said that in the middle of the night she thought she should also do a hysteroscopy and I was really glad she thought so. I'd meant to ask about this, but forgot. So they ended up doing the D & C, the hysteroscopy, and the endometrial ablation.
Once the doc was gone, the Nurse brought the Versed... as far as I'm concerned, one of the coolest drugs on the planet. Now, I know some of you hate it, but I love the stuff. I think it is the most fabulous memory eraser when serious pain is involved. (NOT that I want it introduced in childbirth!) So, Sarah takes her Versed and within a few minutes is looped like she has had about 5 stiff drinks. She turns into an 8-year old and tells me to turn on the tv; she wants to watch cartoons. I look at her blankly... never ever having heard her uttering those words before. She snapped at me to turn the damn tv on! She wanted to watch cartoons! I grabbed the hospital remote control thingie and turned the tv on... flipping channels to see what I can find. I found the breastfeeding channel and briefly thought about telling her that was a cartoon (she had her eyes closed already), but decided I shouldn't do that and kept going through the channels. I found Bob the Builder (how do I even know this character's name?!) and stopped there. She opened her eyes - sort of - they bobbled around in their sockets as she tried to focus and then she let then drop back inside their shield of lids. When she started snoring, I changed the channel back to the breastfeeding one (to see what it was saying) and, without missing a beat, she said, "I'm watching that!" Chuckling, I clicked back to Bob and settled in for the duration.
The Operating Room Nurse came in. She was a delight! Sarah talked to her, but doesn't remember her at all. She explained everything, and realized that her paperwork wasn't correct about what procedures they were doing and was happy I knew what they were going to do so she could go get the equipment and set-up the room appropriately. Off she went, smiling happily!
A few minutes later, the Nurse-Anesthesthetist came by and said he had questions for Sarah, too. I looked at him and said, "Uh, you know she's had Versed, right?" He pressed on. "I know you've been asked these questions before, but I need to ask them again. Do you wear glasses? Contact lenses? Have any false teeth? Crowns?" She answered appropriately for each question. Once finished with his queries, including asking about her lung surgery, he then started telling her about going to sleep, waking up and recovery. I was baffled about why he was telling her anything she wasn't remotely going to remember... saying again that she'd had Versed... and he said he had to tell her about the surgery protocols. I shrugged and then began to "hear" what he was saying as he described the "sore throat" and "breathe deep"... all issues related to general anesthesia, not the deep sedation I'd already been told she was having by the Surgeon and Anesthesiologist. The NA showed me the order on his paper and I told him it needed to be clarified before the surgery began... not that it was going to cancel the surgery or anything, but because it would affect the length of time of the surgery, the recovery room and her post-op recovery at home as well as their need to be aware of her severe barfing issue post-anesthesia.
The NA left to go ask the Surgeon about the type of medication that was going to be used, but came back saying he couldn't find her... he would keep looking. I reiterated the importance of not beginning the surgery until I knew the type of anesthesia that was going to be used and he stated his agreement that I would be called in the Surgery Waiting Room and told before the surgery began.
Sure enough, the OR Nurse called and said they were sedating her. I was really glad.
I'd been told if she was sedated, I wouldn't see her for one hour fifteen minutes to one hour thirty minutes, so I left my computer and books and purse with Sarah's mom and went down to get something to eat. All that was left was cookies and also got an iced tea, returned and she left to go get Sarah's meds and went to go eat away from the hospital... to return a couple of hours later.
Not 40 minutes after I kissed Sarah buh-bye, her Surgeon appeared in the doorway of the Waiting Room telling me (by name) to come on, let's go see Sarah! I was stunned! "What are you doing here already?! Is everything okay?" She said everything was great, that she was still asleep, but we could go back anyway. I had Sarah's mom's stuff, my computer, my book back and my 40-pound purse... the Surgeon laughed and came to help. As we we schlepped it all back to the Recovery Room, she told me the surgery went great, that her uterus now looked like the outside of a cantaloupe - exactly what it is supposed to look like. She said the hysteroscopy went perfectly as did the D&C. She told me she might have "lochia" for about 6-weeks, but she might not have anything, either... both were normal. The lochia can be any of the colors... reddish (rubra), pink (rosa) or yellow/white (alba). So far all she's had is pinkish when she wipes and whitish in her pad. Is she more than excited or what?!
When we got to the Recovery Room, Sarah was sleeping soundly and the NA and her Nurse were talking about the surgery. The Surgeon verbally winked, saying I was a Nurse-Midwife, and that she'd given me report already; I didn't correct her (is that bad?). She said she'd she me in a month and headed out. I thanked her so much and she waved and smiled as she dashed through the multitude of green scrubs and manila charts.
The NA left next and the Nurse kindly said to me he knew I knew the routine, but once she awakened, she would get up to pee, come back and he would take out the IV, she would get dressed and then she could go home.
Sarah's eyes sprang open.
"Go home?" she said loudly, scaring the Nurse. I laughed. I told him that she hates the hospital and will do anything to get out and go home. He repeated the instructions and she said if she knows the rules, she can do it; she was ready. He said, "Well, you have to pee first." She sat bolt upright and swung her legs over the side of the bed. He lunged to her side, worried for sure that she might teeter off the edge; she didn't. She got off the bed and we escorted her to the bathroom.
Hmmm. Someone was in the bathroom. The Nurse said it wasn't his patient. Who the heck was in there... put his hand on the sign that said: For Patient Use Only and Sarah said so loudly people looked at us - PINCH IT OFF ALREADY! The Nurse and I almost peed our pants laughing so hard. Sarah was stone-faced. The Filipina Nurse sheepishly came out of the bathroom and our Nurse pointed to the sign again and read it aloud for her and she said, "But the other one was full," and he said, "Tough." As our Nurse walked away, Sarah said, "Get the paperwork ready!" He laughed.
Sarah and I went in, she sat down and couldn't pee. She said, "They put that damn catheter in me, didn't they? I said they put a straight cath in, I was sure, so they could empty the bladder really good to get it out of the way for the surgery. She said she could feel that. (Sarah has a terrible history with catheters.) She said she didn't think she could pee and I turned the water on and said she could, I was sure she could. She did. She put her pants on and we headed out.
Back at the bed, she nearly hollered, "Got the paperwork?" He asked, "Can I get the IV out first?" and he came back to the bed quickly and took the IV out. He asked her to give him a minute to get the paperwork ready and when he came back, he handed me the post-op instructions and had her sign the sheets of paper before asking her if she wanted a wheelchair or not. She said, "I'm walkin'."
And we headed out of the hospital, Sarah walking to the elevator, out of the hospital, out to the parking lot, rode home with me, got into bed and promptly fell to sleep for another 12 hours, only waking to take her Naproxyn.
She remembers nothing of this adventure after getting the Versed shot.
As soon as I got Sarah tucked into bed, I was called to a birth and had to leave her in the care of her son (he did a great job) and I got to the mom's house at 6:30pm and she delivered at 8:06pm. It was a great birth! A beautiful girl - just over 8 pounds. NOT a shoulder dystocia and mild issues I handled well and comfortably. My apprentice, bringing her 7-week old daughter, is getting better and better at assisting. It's interesting bringing a baby to births. A topic to write about another time.
I'm going to a birth tomorrow. How do I know? I just do. I'll write about it after its completion (and with permission). Think VBAC thoughts, please!
My Sarah is doing fantastically. I am having a great time as a midwife. My kids are beautiful. I love my life.
I love my life.