Surgery Over, the Journey to Recovery Begins

SPECIAL TO THE TIMES

I swim to consciousness. I know immediately what has happened, but it's unimportant, not worth dwelling on. The only thing worth dwelling on is my back as I lie serenely waiting for the distorted images in front of me to firm up into reality. It takes--how long?--two minutes? Ten? Doesn't matter. I think I'm in the recovery room, but it looks a lot like the holding room--who cares? Holding or recovery, I never got to see what was between them--the arena, the floodlit playing field, the combatants brandishing knives and grinning mightily over unsullied turf.

This isn't so bad. Not so bad? It's great! I'm still alive. There is no pain to speak of, no contingencies to fret over. Obviously I'm drugged, but it's a happy daze and I'm completely satisfied to drift in and out of sleep lying flat on my back, motionless and senseless.

The operation started at 10:30 in the morning and lasted three hours. When I'm finally back in my room, my wife, Jan, smiles. The prostate is out! But getting it out was a little difficult because it had shrunk and was sticky, the doctor says, because of the hormone treatment. But it did not appear that the cancer had breached the capsule, and they had been able to spare both sets of nerve bundles that run along the organ. Recovery of sexual potency is possible.

The first night is good. Perfect temperature! I've never felt so comfortable, floating weightlessly on my back with no duty whatsoever but to drift. Blue leggings with air bladders like a pilot's G-suit inflate alternately, left, right, left, right--encasing, squeezing my legs to prevent embolism. A tube blows cool oxygen into my nostrils, and an IV drip, drip, drips into my veins.

The nurse asks, On a scale of zero to 10, what's your pain level? I like her--the balm of empathy exudes from her pores. Three, I lie. How can I tell her one? Or maybe even zero. There's supposed to be suffering, isn't there? I feel the tubes running in and out of me, watch the drainage bag on my abdomen fill with a cherry red liquid, but I don't hurt. At all. Occasionally I punch the button clipped to my smock to deliver a little extra morphine, whether I need it or not.

*

The clock! Slowest clock in the solar system! Drift for hours in a tranquil trajectory back toward the sun, then look up and the hands have moved five minutes. Love it! Let time stop. I get my pleasure from rest, not sleep, floating in perfect comfort. The next morning, there is an incremental return, a baby step toward reality. Breakfast is broth, chunks of cherry Jell-O and tea. The broth goes down and stays, and then a few bites of Jell-O suddenly want to come up again. I hold the kidney-shaped plastic pan under my mouth and gag. It's amazing how much you feel like you're going to die just before you hurl. A few liquid drops dribble out. Red. Blood? No. Cherry. After a while my nurse comes to help me shave and clean up.

For lunch: broth, tea and Jell-O again. This time it sticks. Even better, Jan brought a cup of ice cream.

I go for a walk. Now the reality comes on strong: You'd better go easy, the slice in my abdomen says, grinning vertically from bellybutton to pubic bone, or I'll open right up and spill all your guts on the floor. It's a definitive statement, and I listen and move slowly indeed, leaning on my IV cart handle and nurse. No heroics here, just get 30 feet down the hall to the nurse's station, turn around, come back, and collapse exhausted into bed, clutching the kidney bowl as nausea returns.

In the afternoon my mates from work come to visit, seven of them. I'm touched. Engineers and space cadets all, navigators to new worlds, we're not a sentimental bunch, but here we are doing our sentimental thing. I feel like I need to entertain, show a little energy, exude a little bravado. It's not that bad, I act, and in truth, it's not. I feel pretty good, I say, and in truth, I do.

Dinner is served. Tea, broth, Jell-O. Again, the night blissfully lingers and the temperature is perfect. I have no duties but to get well. I watch TV, I sleep.

*

I'd come to the hospital Tuesday. Now Thursday morning for breakfast I have solid food at last, and afterward it's time for the IV to come out. Rejoice and take a difficult shower and grunt a little with gas as the intestines stir with life again.

As I make my plans to go home the next day, it sinks in that I'm recovering road kill, that I've been run over by every wheel on a big concrete mixer. It's going to be awhile before I'm normal again. If ever.

We'd planned ahead. For my hallway strolls, instead of depending on those damn peekaboo smocks, I'd packed a nice bathrobe. For the trip home, because I have this junk hanging out of me--the catheter in my penis and the drainage bag on my abdomen--Jan had gone out to buy boxer shorts. I try one on. Way too small, and it doesn't open in the front. My waist is bloated from the surgery. Another shopping trip fetches shorts with waistlines three inches larger and snaps that open in front. Perfect.

My penis and scrotum are grossly swollen and discolored. No books I read had mentioned this, and I worry. The doctor, with calm assurance and pleasant bedside manner, explains: We removed both pelvic lymph nodes. The lymph system repipes itself eventually, but meanwhile the fluids have nowhere to go and settle into the lowest place in the abdomen. How long? It's slow, he says. It'll shrink gradually over a few weeks to a month. Meanwhile, I walk bow-legged with little steps.

The third night is worst, not from pain or discomfort, but because I'm out of the euphoria of survival, into the ennui of long-term recovery. In the morning, I grunt cautiously for a half-hour in the bathroom to generate the obligatory pre-checkout BM that tells the attendants that the bowels are fully functional again. After that, I get a little instruction on tending the catheter and the drainage bag. There are two urine bags: a large one for bedtime, connected by a long tube to the catheter, and a smaller one for mobility, strapped onto my upper leg under my trousers. Unfortunately, I have only one pair of trousers large enough to accommodate my enhanced waistline.

Finally it's time to go. I wrap up in my bathrobe and a nurse pushes my wheelchair to the hospital entrance. I ease very gingerly into Jan's car, and we drive three miles home. I do not like the bumps at all. The first day home is the worst of all. I feel totally grotesque and invalid. I get a little weepy. Small things touch me off. I hate for my daughter, Chelsea, to see me this way. I take the painkillers every four hours, more to dull the emotions than to ease the pain.

The second day I take a trip to my computer and send "Hi" to e-mail buddies. I move very cautiously. It takes almost a minute to get comfortable in the swivel chair.

The third day, Sunday, is uneventful, but Monday is full of good news. We return to the hospital to hear the pathology results. It is the best report possible: There was no cancer in the removed lymph nodes; it appears to have stayed entirely within the prostate. I'll be looking over my shoulder for the next few years, but the odds are good for complete recovery.

Rhapsody! Bring on the pain, I don't care! Now I can enjoy watching James, the physician's assistant, remove the drainage bag and pull out the tube that feeds it. It comes out slowly, a sheet of glistening gray plastic rolled up into a long tube. There is no pain at all, but a sucking feeling, not unpleasant, deep in my abdomen, as if he were pulling out a length of intestine. There remains a sizable hole in my lower abdomen just to the right of the incision. It looks like a fatal open spear wound, but in fact it will heal rapidly in just a few weeks from the inside out.

*

Thirteen days after surgery, I'm ready to have the catheter removed. In some ways, this appendage has been the worst part of the whole experience, a constant irritation and reminder of my own surgery-induced frailty. Getting it out is easy and painless, I've heard. We'll see.

I've begun to move about easily, and now I can lean over from a standing position and pick small things off the floor. Doc says I shouldn't lift anything heavier than a book for six weeks.

After the catheter is removed, there will be an inevitable period of incontinence lasting from a few months . . . to forever, if I am one of an unfortunate 2% to 4% of men. After incontinence worries are settled, questions of sexual potency will come forward. Since the nerves were spared, my odds are better than even for recovery in this area, but not by much, and it could take up to a year or more.

*

Adventure, excitement, danger--this is one man's voyage into darkness, no guaranteed return. My major concern before surgery: Am I holding a one-way ticket?

I was lucky. My round-trip reservation was confirmed. Since then, I've been occupied with making the return as comfortably and quickly as possible. And it has been, with a few ups and downs.

You may get a chance to take this trip. If you do, put aside despair; it doesn't get you anywhere. Prepare for the worst and hope for the best, but more importantly, put on an attitude. This is an adventure, and like all true adventures, it combines danger and excitement; balances palpably uncertain risks against rewards.

Bon voyage!

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