I Wanna Hold Your Hand

July 29th, 2009.

I reported to the second floor of the outpatient wing of the hospital for my laser varicose-vein surgery. I was the third patient of the day; the highly efficient Dr. G. had us stacked up like airplanes in a holding pattern over the Thames on the way to Heathrow.

First stop: an interview with a man named Massoud who took my blood pressure (I WILLED it down to 100/65), my temp and the information about my next of kin, which is always a reassuring thing to be talking about before a surgical procedure. I was issued my white ID bracelet and my red allergy bracelet, although the only thing that happens when I take sulfa drugs is I get a headache. I had been informed by the highly efficient doctor’s highly efficient secretary (administrator?) that I’d be talking to the anesthesiologist, so in an incredibly sexist move on my part, I asked Massoud if that is who he was. No, he is a nurse, he informed me. Oops.

Next stop, a bay with a gurney and a curtain where I donned the attractive blue Johnny gown, the weird space-slippers from 2001: A Space Odyssey, and the highly crunchy disposable non-woven fiber “pants” which are undies in Brit-speak. I donned my iPod and settled in to wait while Dr G. and team worked on patient number two. A long spell of Hildegard von Bingen’s 12th century Canticles of Ecstasy put me in the properly meditative pre-surgical mood.
Perhaps here is where I should mention that I elected to have this procedure done unsedated. As a self-respecting hypnotherapist, I felt that a few needle jabs of lidocaine, which would numb the appropriate areas of my leg, would be sufficient to get the job done. As a former needle-phobe, I am proud of my ability to focus “Down and In” in order to transcend the fear of potential pain. After all, this is the woman who went through six hours of un-drugged pushing in a vain attempt to get that first baby out, courtesy of the birthing hypnotherapy she learned from the head of the Harvard University Counseling Services. Hubster and several friends shuddered at the thought of undergoing any procedure involving needlesunsedated, but I had just had a double-cyst aspiration with lidocaine only (they don’t even OFFER chill-out drugs for that procedure) and the time I had the sewing-machine needle removed from my finger they didn’t drug me either, just gave a jab of numbing lidocaine in my hand while the surgeon “poked around” (which is the technical term) in my fingertip for the sliver of steel that lingered after the rest of the needle was removed.

So when Dr. G. came in, I was resting comfortably wearing the headphones, deep in a past-life reverie about having been a nun in 12th century Germany. When I opened my eyes and raised my head, I think he was a little startled. Massoud had made it clear that most patients elected to be sedated, and HE certainly seemed skeptical of my wish to skip the drug cocktail. Dr G. said “Oh, you’re relaxing!”. We had some homework to do before he could begin the procedure. The all-important Statement of Risk and Legal Waiver had to be signed. I made sure it would be him performing the procedure, and not some team of eager medical students. He assured me that was the case. Then he sat on the floor and asked me to stand in front of him so he could draw on my leg. Whipping out his Sharpie permanent marker, he marked my right leg with his initials, then drew a line down the presumed location of the greater sapehnous vein. This work of art was embellished with squiggles across the shin, above the places where the “varicosities” bulged out in all of their pulsing, painful blue glory. These were the areas of vein to be tied off and extracted in the procedure known as a Phlebectomy. I imagined that he would be going in there with a medical version of a crochet hook, and making fancy knots with sutures, and embellishing the whole thing with a fringe.

While I was standing there being decorated, I remembered the last time I’d had an “ablation” procedure, which was back in 2006. That summer, I had my uterus “zapped” (that is the technical term) by radio waves, from the inside, in order to stop the ridiculously heavy monthly periods that kept me trapped in the house for five days out of every month. The doctor who had done that procedure had been my gynecologist for about ten years, and I knew him well enough to play a little joke on him before the surgery.

How many times have we read about people waking up from surgery having had the wrong kidney removed, or the wrong leg amputated.? Yes, I know that we only have one uterus each, but I decided to identify the proper orifice with marker before that particular procedure, during which I sure as hell would be sedated. So, the morning of my “endometrial ablation”, I took a blue Sharpie marker, and drew an arrow on one thigh. The arrow pointed to the correct opening to the uterus, and was marked “Here”. The other thigh got an arrow pointing to my rear end, with the statement “NOT here”. I got dressed and went off for the day surgery laughing to myself at the joke I was playing on the unsuspecting doctor. When the anesthesiologist resident came around to start my sedation drip, I couldn’t keep it to myself any longer. I told her “I left a message for the doctor”. “Umm hmm” she replied, probably thinking that I was off on my sleepy-time trip already. The next thing I remember about that surgery was being transferred from the rolling gurney to the operating table. I tried to talk. “She’s awake” said the doctor. I tried to mumble “I left you a message”. I’ll never know if they figured out what I was trying to say, as once I was on the table I was completely out, and I was too embarrassed to ask the next time I was propped up on the table for the annual smear job.

So, for the current situation, I let Dr. G. do all the scribbling. He then went to check to see if the operating room was ready, and I took a detour to the loo. When I came out there was no one around, and I had to wander back out to the area near the changing bays with the back of the gown a-flap to find someone to direct me to the operating room, which I entered under my own steam. The staff were not used to the patient arriving on her own, and had already “marked” the surgery time as starting when the doctor went in, until they noticed the table was empty.
The medically-squeamish have my permission to skip this part. Dr. G. explained everything he was about to do, and then did it. From my point of view, it involved injections of lidocaine into the ankle, and then the thigh. I could feel something or other going around down at my ankle, and was told that they were inserting the catheter containing the laser into the greater saphenous vein. More injections up at the thigh area numbed the first area to be “zapped”. The doctor warned me that “some people experience a taste” as the lasering gets started. Almost immediately, I noticed an intense burning smell, and realized that my flesh was on fire from the inside. I wanted to shout “OH MY GOD CAN’T YOU SMELL THAT?” but settled for having one of the nurses hold my hand. I switched my iPod from soothing medieval chanting to the Beatles. As I did not have my glasses on, I couldn’t see the tiny print on the iPod, so had to settle for letting the nurse choose a Beatles album randomly. Unfortunately she did NOT pick “I Wanna Hold Your Hand”, but chose the album Revolver instead.

I figured the more distracted I was the better off I’d be, so I chose the imagery of Dr. G as a little boy, playing with a light saber from Star Wars. This made me laugh, and the nurses looked at me a little oddly. I decided to keep my imagery to myself so as not to embarrass the doctor, just in case he had been a childhood Jedi Knight.

Sooner or later the laser got a tad ahead of the lidocaine, and there was an intense burning sensation in my ankle. At least they were already down in that area, having started up top at my inner thigh. Next, several more injections in the front of my shin, and over the outside ankle bone allowed the doctor to perform the “phlebectomy” procedures, which entails tiny incisions and removals of the painfully bulging veins created by the venous backflow. After about 40 minutes they wrapped up my leg in a huge swath of gauze covered by stretchy tape. My right leg looked like a mummy. I was wheeled back out to the recovery (changing bay) area, where a nurse took my vitals and kept an eye on me. As I had not been sedated, I was allowed to have water immediately. Someone sent down to the kitchen for a tray of sandwiches, and I was served tea right there in recovery, and then was allowed to hobble out to some chairs to consume the sandwiches. Take that, Mt. Auburn Hospital of Cambridge, Massachusetts, and your measly post-surgical packaged crackers! Another half hour of being watched, and I was allowed to leave the scene under my own power.

Meanwhile, Hubster was busy at work. He is not too fond of hospitals or procedures involving needles, (understatement of the century—the astute reader will remember me having to babysit him after his sedated visits to the dentist) so was given permission by me to be far, far away. And far away he was, having planned on being in Croyden for the morning, and Leatherhead for the afternoon. I had been asked several times who was collecting me, and I had to keep telling various personnel that Iwas getting home on my own. Was I taking a cab, they enquired. No, I told them, I live just around the corner and I am planning to walk home. Eyebrows were raised. I figured it was easier not to explain. I reminded them that I had not been sedated during the procedure, then they’d ask again why no one was coming to collect me. I almost had to do a little jig to prove that I was OK to go, but it’s hard to do a jig on a painful leg that is wrapped so tightly that it cannot bend.

I had cleverly purchased an LL Bean collapsible walking stick while in Boston, so used that to assist myself in getting to the elevator (lift). I was sad to see that Fabian was not at his post at the rear reception desk, and took my time meandering through the twists and turns of the hospital’s ground floor. Once I rounded the bend outside the pharmacy, I had a clear view all the way down the corridor to the front reception desk. When they saw me coming, both Kumar (the cashier) and Fabian (receptionist extraordinaire) both came out from behind their desks to cheer me on. I felt like an Olympic athlete as their encouraging cries pulled me closer to the front doors of the hospital. Just when I had been starting to feel very sorry for myself for having to go home alone, Fabian turned around so his back was facing me and said “Marj!! Climb on!! I’ll carry you home!” I declined, as it not only would have been unseemly, but physically impossible with the painful mummified leg. I told Fabian that if he wanted to be my “arm candy” he could walk me home, but he couldn’t really leave his post after all. I had to explain to them that the distance I had to travel was only twice the distance from the hospital’s front door to the nearest corner, which placated them. Off I hobbled into the afternoon sun.

The surgeon had allowed me to go home even though I didn’t have the required thigh-high surgical stocking. I was advised to get them at a pharmacy down on Wigmore Street. On a whim, I hobbled PAST the front door to A Flat on Abbey Road to the bottom of Hill Road, and turned the corner onto Nugent Terrace. A small independent “chemist” (pharmacy) is located there. I picked up a package of NuRofen PLUS (the over-the-counter Ibuprofen plus Codeine, if you can believe that) and enquired about the grade-2 compression stockings. AHA! The pharmacist, who USED to work down at the Big Chemist’s on Wigmore Street, knew EXACTLY what I needed, and had some in the back room! He said he didn’t even think that Big Chemist even had them in stock any more. My good leg was duly measured as to circumference at ankle, knee and thigh, and Voila! A pair of Size Medium Sand-coloured Grade 2 compression thigh-high open-toe stockings were mine for only seventeen pounds. The kindly chemist even threw in a pair of Grade 2 closed-toe panty-hose for good measure, for free, because they didn’t have a use-by date on them and he knew they were fairly old and couldn’t really sell them and I needed them, after all.

Thus endeth my excitement for the day. I hobbled back to the flat, took two NuRofen PLUS, and stretched out on the sofa for the duration. Hubster had arranged to be home in time to make dinner. The rest of the day is a blur.

Epilogue: It is now three weeks later. The surgeon had suggested that the recovery period could be anywhere from a couple of days to a couple of weeks. He reported that one patient had been back out on the golf course after two days. I think that would have been impossible in my case. For one thing, I would have had to have take a golf lesson. For another, I could not straighten the leg without pain. Walking was helpful, as it stretched out the scar-tissue that was my former vein, but after a period of having the leg bent, as in overnight, stretching it out the next day was a big challenge. After two days I did hike up to Swiss Cottage, the neighborhood a half-mile to the north, to purchase small appliances for the new flat. I was able to haul a toaster, a coffee maker, an iron, and something else back in my Turbo Cart while using the cane, but that amount of effort on Friday morning wiped me out for the rest of the day. Every day around 3 pm I had to put my feet up. The blood in my right leg had to find a new way to leave my leg (via the deep veins instead of the peripheral ones) and it seemed a little confused in the beginning. There would be twinges of pain and odd bubbling sensations mixed in with the general achiness.
I used the cane for two weeks. It was most helpful in letting the car drivers know that one would be going through the zebra crossings s-l-o-w-l-y. It also got me a seat on the bus on more than one occasion. My walking mechanics were off for two weeks, also, with a shortened stride on the right side and the left leg taking the brunt of the work, resulting in LEFT leg pain, and hip and knee pain in both legs. Walking was both good for stretching the scarred vein, but not so good for the rest of my lower half.

Today’s follow-up visit with Dr. G. has revealed two things: One, the leg is healing well. Two, The second floor, where I had my surgery, has been closed due to the fact that the floor has been found to be "sloping". This is in a building that was completely renovated only eighteen months ago. All the consultants have had to time-share space on the lower floor. I guess I got onto the surgical schedule just in time. Third: When I told Dr. G about moving my belongings through the Famous Zebra Crossing on the 40th Anniversary of the Crossing of Abbey Road, he told me that his birthday is August 8th, the very day I was out there being interviewed. I think that was a good omen.