Thursday, March 20, 2008
On the Nose
Is it possible to look any more ridiculous? Me, outside the lovely Poliklinika Modřany after my surgery, sporting a bandage the idea behind which hasn't advanced much past the Middle Ages or Saturday-morning cartoons.
The idiotic Mr. Bread Roll waving at me from the lobby didn't help calm my nerves.
Neither did the shifty-looking guy selling cheap leather goods from a table near the elevators.
This was supposed to be a hospital, after all, and it was my first time under the knife. I had already made the long and depressing drive out to the beleaguered Prague suburb of Modřany, past graffiti-soaked train stations and some of the most depressing urban architecture I've ever seen.
Seeing the hospital for the first time, the Poliklinika Modřany, also didn't instill any feelings of confidence or calm. It was a classically drab Soviet-era hospital, with a muddy, trash-filled parking lot and a gaggle of ill-looking folks standing outside the sliding glass doors, sucking hard on awful-smelling cigarettes.
I was there to have my nose operated on -- a septoplasty -- to correct a deviated septum, that piece of cartilage that divides your nostrils. Mine looked like an S when it should look more like an l.
I'd also be undergoing general anesthesia for the first time. I admit to having had a few nerves, and probably would have even if the operation had been taking place at the Mayo Clinic. But this particular procedure was taking place in the Czech Republic, a country whose medical services I've never been particularly impressed by.
So I was just looking for a little reassurance when I walked through the hospital doors, something to inspire a sense of confidence.
And that's when I came across Mr. Bread Roll and the leather-goods guy.
I made my way up to the fourth floor, where I encountered a classic Soviet-style scene -- a room filled with all manner of sad-looking folks and many unhappy children, all seated outside of closed white doors with little or no indication of what, or who, was behind them.
No receptionist to greet you and point you in the right direction.
Just a room with five or six white doors, all closed.
I knocked on a few, was received rudely, but eventually found the right one.
Once inside, I felt much better.
My surgeon, Dr. Tomas Fort, whom I had met previously, said he'd performed hundreds of septoplasties. In fact, he said, it was his favorite procedure.
My anesthesiologist was a very attractive woman who also put me at ease.
The operating room looked, well, like an operating room.
I "accidentally" took this picture of the operating room as I was putting on my hospital clothes.
I put on a green hospital shirt, laid myself on the table, and some needles were stuck in my arm. I'd be getting my anesthesia intraveneously.
"How are you feeling?" the anesthesiologist asked.
"I feel fine," I replied.
Two seconds pass.
"Oh, I feel a little something now."
"Nighty-night," she told me, and that's the last thing I remember.
(Here I must insert a hilarious anecdote told to me by my old boss and dear friend, Tim Bunn, the former executive editor of the Syracuse Herald-Journal in Syracuse, New York. In an e-mail exchange, I asked Tim if he'd had general anesthesia when he underwent shoulder surgery a few weeks ago. Here's what he had to say:
"My shoulder operation was my second encounter with general anesthesia. My first was so long ago it hardly counts: I had my tonsils out in 1952 and they put me out with ether. Believe me: Better they put you out by having Mike Tyson clock you with a left hook. Ether is awful stuff.
I don't know about you, but today's general anesthesia was a very nice trip. First they gave me some kind of Valium-like substance through my IV to get me ready. Mellow.
Next thing I know they've wheeled me into the operating room and the anesthesiologist has an oxygen mask over my nose and mouth. "Breathe deeply, Mr. Bunn, and in a moment we'll administer the anesthesia through your IV."
I wake up sometime later in the recovery room wondering who I am and where I am. Moment by moment, I regain some of my faculties. My wife is at my side. I see a bunch of nurses walking back and forth. Some are wearing green scrubs, some blue, some have two-tone scrubs on. One comes up to me to ask how I'm doing. I look at her and say, "You are very attractive." (She was.)
She thanked me, though it occurred to me that it was quite out of character for me to say such a thing to a stranger.
Across the room I see my surgeon. I yell across: "Hey, doc! Are there any female surgeons here or are all these women nurses?" He tells me they have no female surgeons. "Why the hell not?" I demand.
One of the nurses, apparently trying to pull the fat out of the fire for the doctor, says, "Maybe it's because in orthopedic surgery you have to have the physical strength of a man."
"I don't think so," I say. "On 'Gray's Anatomy,' one of the surgeons is an orthopedic surgeon, and she's a woman."
Awkward silence in the room.
In my drug-addled brain I hear all the nurses cheering for me: "Yeah, the chauvinist bastards would never let us get ahead. You tell 'em, Mr. Bunn."
Pretty quick, they get me packed up and out of there before I set off an
Recovering in the recovery room, but feeling well enough to snap a self-portrait after my harrowing 45 minutes in the operating theatre.
OK, back to my own story ...
I woke up with the nurses and the doctor asking me to slide over onto a recovery bed. I was pretty groggy. My nostrils were packed full of bandages, and I was also wearing a ridiculous-looking bandage under my nose, held in place by another bandage that was tied behind my head.
I have to admit that the bandage under my nose looked like something I could have fashioned out of stuff found in my bathroom or garage at home (a rag and some twine ...), not something applied by professionals.
I also found some blue-green goop smeared generously around my eyes. I looked like I was wearing mascara. I found out later that this gunk is placed in and around your eyes to prevent them from drying out during the operation.
I slept off the remaining anesthesia for an hour or so. At one point, blood started to leak out of my nose and run down my face. I called lamely for the nurse, who came and wiped me off and readjusted my blood-catcher.
"Dracula," she said.
Dr. Fort eventually stopped by, asked me how I was doing, and if I was an athlete. I said I cycled and played squash.
"During the operation, your heart rate was 36," he told me. "That's what marathon runners have."
He also told me my blood pressure was very low during the operation and that they had to give me fluids to coax it back up a bit.
Daisy came to drive me home. Before leaving, Dr. Fort told me not to shower or drink any hot liquids for awhile. "Have some water, or beer," he said.
I like a doctor who prescribes beer.
Once home, I laid down on the couch and nursed a beer.
One of our cats, Chicho, made himself at home on my lap.
Couch? Check. Beer? Check. Cat in my lap? Check. Remote controls? Check. Stupid-looking bandage? Check. Let the healing begin!
Later that day and all through the night, my nose bled like a stuck pig. I even called the doctor to make sure that was normal.
It turns out that I've had a little complication with the healing -- a hematoma (a collection of blood) that formed in my left nostril and that has required periodic drainage over the course of a few more visits to Modřany.
Despite some local anesthetic, I felt like Dr. Fort was poking a red-hot knitting needle through my face during my most recent visit, as he drained the hematoma and also removed some stitches. The nurse had to stand behind me and push my head forward so the doctor would gain some traction inside my nose. Yikes. It brought involuntary tears to my eyes.
"I am not an animal. I am a human being." The morning after, bloody unhappy.
It's been 10 days now since the surgery, and I'm feeling much better. I still can't breathe properly through my nose, but the doctor says that's normal and that the benefits will come in time.
I have to say that, overall, the experience has been a positive one. It's pretty nice to be able to have such a procedure done competently in a foreign country and have the doctor speak my language, when the reverse cannot be said. My Czech is laughable.
It might be a good idea, however, to move Mr. Bread Roll so he's not the first thing patients see when they come through the door. (Am I the only one who finds it funny that there's a bakery and, nearby, a snack bar selling sausages and beer, all on the ground floor of a hospital?)
A good friend submitted this as a "Separated at Birth" entry. I don't think Jack Nicholson would have looked quite so cool in "Chinatown" if he'd had to wear a string bandage around his head.