Necessary Mutilation

I swear I’m developing bipolar disorder (manic depression).  I go from exhilarating highs to crashing lows of despair and doubt about everything bypass.

I was thrilled that Dr. C himself called me directly at work and had clearly read my letter and was considering my needs.  Slightly funny (when he joked about transferring me to the other Doctor!) he was otherwise thoughtful and recommended I meet with Dr. P while on site today anyway - and that as he (Dr. C)  was off this week but would call Dr. P ahead to discuss options.  Joy!  Trust restored!  Hope!

I finished my ½ work day distracted and preoccupied.  I then painstakingly made plans to coordinate plans with my student to treat her to dinner (as is my tradition - a vital part of closure and send off, as far as I am concerned) next Thursday - the only time we could get together before my surgery and her 5/1 departure.

At 1:30 p.m. my husband picked me up for my 2:15 consult and then 3:00 “class” at the Center.  Not so ommbayahish this time, Dr. P spoke with a tone of resignation and sternness - outlined options that included substituting a subclavian line for a pic as this could be done under general anasthesia and my Vena Cava could also be installed through it.  However, just as this was sounding pretty darn good to me, he suggested that there was an increased chance of infection with it, and this procedure best be done days before bariatric surgery (ie:on Thursday) to give my kidneys time to recover to decrease change of renal failure.  When my knee jerk reaction was to balk at taking all of Thursday off (this whole process takes most of the day) so close to being off for likely 6 weeks (and missing my final dinner with Stephanie and numerous client sessions -ack!), he sighed wearily and indicated that I was being difficult and putting their backs to the wall.  He said it might be possible to do everything the day of surgery- but I must get my blood results ASAP to see if my kidneys could tolerate this.  Although both Tom and I listened carefully to everything said, somehow I (we) still left with questions and confusion - especially about which one was being planned and other than praying for success at the hospital with blood drawing tomorrow, what else I should do.

This bothered me throughout the mandatory exercise class and dietary class.  The young fit man teaching us about the Center’s gym was funny and pleasant.  He also did my final weight - egads - over 300! - I’ve gained 6 more pounds!  He was nice enough to acknowledge that last hurrah syndrome that we both knew I was caught up in.  What - no lecture!  How refreshing.  I liked him even better after this.  And, when I splatted to the floor yelling (shit!) during a mandatory medicine ball experience, (obviously I possess no balance and no core strength); he (and others) simply laughed.

Next up was an hour class by “L” (the woman who I’ve left 2 unreturned telephone calls to, and whom I dislike based both on this and her somewhat snotty, crisp manner).  Other than that it was taught by her and that she was rude when I asked about open versus laproscopic surgery, the information was valuable, although a bit overwhelming.  The other annoyance factor was the music piped in overhead during our class combined with the fact that the general wait area is just feet from the café where we were listening.  Can’t there be a quieter, dedicated space where overhead music and waiting room conversations don’t distract from such vital information?  Plus, my husband and I met a woman who told us that her daughter had the surgery with Dr. C in November 2008 and has already lost 100 pounds (hurray!).  However, she insisted that he did it laproscopically on her - causing me to feel confused enough to ask about this in class,  only to be told with reprimand that he ONLY does open.  Well - someone’s wrong.

In any case - feeling disgruntled and lacking closure, after class ended “early”  - I reapproached apathy girl (who earlier had been holding an infant with no greater enthusiasm or emotion than when she greets patients.  In fact, when my husband asked how old the squirming baby was, she blandly answered - “oh, I don’t know its Dr. C’s grandchild”).  Her immediate response as I approached the window was “have a seat” (her favorite phrase, I think).

When I explained that I wondered how I would learn when/what Dr. P and Dr. C decided about how to proceed with my situation, she told me to write my questions and they’d get back to me.  Okay.  Except, as I was finishing it off, a nurse behind the desk indicated that something, something, something, something, something, something - at which point she said I could talk to him further if I wanted.

Yes, please!  So Tom and I waited over an hour so a now very resigned and tired Dr. P could sound like “as I already said…” while I felt more confused about things than ever.  Bottom line it became more clear that everything rests on the bloodwork I haven’t yet been able to produce (”If I have to I’ll cut off my arm and collect a bucketful!) to ensure “normal” kidney function.  It felt as if although on one hand he was steering me to have everything done on 4/28 - when I asked about kidney risk, he clearly answered that although there is a 1% risk of renal failure with gastric bypass and 1% with the other procedures - “1 + 1 don’t equal 2 but 4 or 5″ in this case.

If, my kidney function tests aren’t entirely in the normal range, this won’t even be an option.  And our glimmer of hope that I could have the first procedures done on 4/28 and then the bypass days later suddenly became impossible as he remembered that Dr. C will be off for 2 weeks after 4/28.

So - I guess we must all live with more uncertainty about when and how, and all I can do is pray for paydirt with Sister’s Hospital phlebotomists tomorrow. And if not, how I can find Venus, the Quest phlebotomist who has had success with my tiny veins in the past.

Needless to say, I ended the day on a crashing low of uncertainty and anxiety.

Oh, and I remembered on the drive home that my BUN/creatinine ratios in my last 2 blood tests were both elevated.  Double shit.