Going Under the Knife in the Era of Covid

(Photo credit: Pixabay, used with permission)

(Photo credit: Pixabay, used with permission)

Around this time tomorrow, if all goes according to plan, my bloodstream will receive medications that will paralyze and render me unconscious. My breathing will stop, and an expert will stick a tube down my throat. A ventilator will take it over from there for the next 90 minutes or so.

Don't worry, I don't have COVID-19. And while the above details are all true, this isn't my first time to do this.

It's called surgery. And I'm hopeful this will be the last one I ever need to have.

End of an era (of surgeries)

My reproductive system has been giving me (strong) hints for about 14 years that it wasn't happy. My 16-year-old daughter jokes that "since it knocked it out of the park the first time, it didn't have anything else to prove."

After three emergency operations, it's now decided to make things even clearer for me: a wellness check this Spring revealed a large mass, most likely a common fibroid, that is too big for my body to function well. My surgery this time will be a hysterectomy.

This time around is very different than in surgeries past because a deadly coronavirus is wreaking havoc on the lives of so many, including in the very hospital where I will be a patient.

I'm not worried about the operation; I have faith in the skill of my surgeon (and her laparoscopic robot!) and I understand the procedure well. I'm right on that line: still young enough to feel a tad invincible but old enough to acknowledge that even a routine surgery has risks, some serious. I've made my peace with that.

But I am a little anxious about getting COVID-19 during or after the surgery. Since I've had unexplained blood clots, and COVID can impact a person's vascular workings, I've been careful to avoid exposure. Plus, who wants to be coughing when your body is seaming itself back together?

How surgery is different in a pandemic

My surgery apparently couldn't (or shouldn't) be delayed. But if you're considering elective surgery during the pandemic, here's what's different this time, and how I'm approaching it as a patient:

  1. The guest list to the main event was whittled WAY down. In surgeries past, I could count on relatives and close friends to kiss my forehead or give me a wink as I was wheeled off to the OR. Now, I can only have one person come in the hospital with me--and that guest can't leave the hospital until it's all over. (Don't worry, I've got a good one.)

  2. My at-home, post-surgery "squad" is extremely limited. Even though my surgery will be done laparoscopically (we hope!), my doctor put the kibosh on my plan to recover at home alone. After the year we've had, dare I admit I was looking forward to pin-drop-worthy silence and binge-watching Outlander and reading an actual book for pleasure? But alas, I've called in two heroes who have been extra vigilant about preventing the virus. One is bringing soup with homemade egg noodles and the other brings nearly five decades in medicine (thanks, Dad!). Each will take a turn staying one night, and by then, I plan to be feeling at least alive again.

  3. There may not be a chaplain available. Anytime I'm given the option to visit with a chaplain before a surgery, I take it. To pray, to connect, to stay on the front end of any grief or anxiety. This time, when the question arose, I was told there may not be one available, due to the number of critically ill COVID patients and grieving families in the hospital right now. I understood, of course, and told the staff I would not want to take that precious resource away from a patient or family who needed it more. This decision was reinforced when, a few days later, I interviewed an actual Springfield chaplain. Perhaps you readers can just send me some good vibes or offer up a silent prayer for me and we'll call it a day?

  4. The staff will all be masked, all the time. This is normal, of course, in the operating theatre, pandemic or not. But now, the pre-op team and recovery folks and even the front desk staff will be wearing PPE to protect us all from the coronavirus. This is a net positive, of course, weighing the factors--but if you're a one-on-one communicator like me, it changes the rubric, in terms of effort, at least. Note: as part of the pre-surgical routine, I have just been tested for COVID (negative), but the hospital staff are generally not tested unless they develop symptoms (I asked).

  5. You might need to be rescheduled last-minute. A nurse called earlier this month to say they're trying to shuffle surgeries around to accommodate the surge of COVID patients. I'm not sure how all of that works (especially since I won't be in a COVID unit), but I believe it's partly related to staffing. There's also a slight chance that my surgery may be more invasive than just laparoscopy; in that case, I'll need a "bed," or to be admitted to an inpatient room. I'm just one patient--and my case has been evaluated and worked into an enormous orchestra of healing taking place under one roof. I find that impressive and, frankly, amazing.

This is, of course, my experience based on a non-emergency surgery. Depending on how the pandemic progresses, particularly this winter and spring, things could look very different for critical care and emergency surgery scenarios. I've been to enough press conferences to know how many COVID patients, ventilators and available beds are at each local hospital. Both Springfield hospitals are, on many days, going into "diversion" or even "forced care" status, sometimes having to turn transfer patients away because they are essentially full.

During my time at the hospital, I'll be deeply mindful of the scores of patients above or below me who are battling the virus, and the truly heroic health care workers doing their best to heal and comfort them through the defensive armor of gowns and face shields and gloves. I've felt this burden, this reverence, throughout the pandemic as a journalist, but I suspect it will feel different being there.

Other than that, folks, it's just another day on the operating table. I don't mean to sound cavalier about it, particularly this type of surgery--which, for many women, is accompanied by deep grief or sadness.

But it is what it is. I've known for a long time I was only meant to bring into this world one, amazing child. I long ago honored the grieving process and sought counseling for the losses I have borne and the unexpected path I found myself on.

And really, how lucky am I, to live in a part of the world where I have access to the best health care on the planet literally one mile down the road? (My first emergency surgery was in the Middle East -- and it was anything but routine -- but that's a story for another time!)

I'll thank my surgeon beforehand for her expertise and for making my life better, more pain-free. I'll wish her luck and tease her that, "No pressure, but I've got big plans for the rest of my life." I'll tell the nurses that my mom and sister share that noble profession, and I'll let the anesthesiologist know my brother is also one (pro tip: I like to save my anesthesiology jokes for after I wake up).

A silver lining of 2020 is that I've just about perfected the art of "self care." This means, since I'll be recovering for some time, my deep freezer is stocked with everything from crab legs to gourmet cupcakes and other random things I've never bought in my life (there's no way my Instacart delivery driver didn't have serious questions). I've turned my guest room into a spa for myself, with aromatherapy and a machine that makes ocean or forest brook sounds, and a TV with Netflix. I've got heating pads and an electric blanket and a stack of books and a laptop that yearns to be put to use.

If I don't get another chance to tell you, dear readers, Merry Christmas and Happy New Year. I'll see you all on the other side. (Of the anesthetic, not that "other side.")

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