My Relationship with Surgery: Anxiety, Pain, Depression, Fear, Honesty, and Progress

Hello Everyone,
I am being admitted at 6am EST tomorrow morning, Wednesday, April 20, for my rescheduled kidney surgery at Thomas Jefferson University Hospital, rescheduled my first scheduled surgery attempt on March 18. (For those unaware of the story, an intravenous line of saline infiltrated the tissue in my arm rendering the surgery unsafe to complete at that time). I wish I could tell you all that I were merely mildly nervous and overall feeling strong as I was able to do last month. But that would be a lie, and I am not feeling strong enough cognitively or emotionally in the mind and body to put a false front forward and later be honest with some of you individually in private. I am writing this post in an effort to process the myriad of anxiety-inducing emotions that I am physically, mentally, and emotionally trying to process right now before I try to get some sleep prior to my 4am wake-up time.
I had three major leg surgeries at the ages of 2-3, 5, and 9. I have no memory of the first surgery as an infant; however, I remember the ones at ages 5 and 9 vividly.Arguably,  the second surgery at age 5 was unfortunately more painful and memorable, which makes sense as although both latter surgeries were extensive, the first of the two was more extensive. I’ve included links at the end of the post that detail the most major portions of my leg surgeries.
Having had no memory of my previous surgery then or now, all I knew was that I was going into the hospital to have a lot of changes made to my legs in an effort to help my walk more safely and effectively. I was told that I was going to be put to sleep and wake up, and that was the end  of it. I remember waking in the recovery room with many other young kids crying in pain and nurses and techs running around rapidly, no one staff member paying any particularly adequate attention to any of us young patients; I can’t imagine any of us were above the age of 10. After several seconds of observing my surroundings, I instantly felt the unbearable sensation of my own post-operative pain. As I mentioned, the nurses and techs were running around rapidly, and when I cried desperately to see my parents, I was told hastily, flatly, and with no seeming inkling of compassion that I could not see them and would not be able to do so for a while yet. This was in 1998 at A.I. DuPont Hospital for Children, and they had yet to do many of the major renovations that they would complete at the turn of the twenty-first century. By my third surgery in 2001, the renovations afforded a more spacious recovery area, seemingly more staff on hand, and a far less amount of time, it seemed, to be able to be reunited with my parents.
In the 1998 surgery, I had to remain in the care of the hospital for roughly a week; due to the less extensive nature of the 2001 surgery I only needed to stay for two or three days. In both surgeries, however, I was required to wear knee immobilizers, which are basically these restraints made of thick foam and heavy duty straps which force your legs to remain straight and immobile. At the time, I could imagine comparing them to a non-lethal yet equally painful and anxiety-inducing cousin to phylactery used to restrain death row convicts on execution day. (OK, maybe that was an exaggeration. But they weren’t fun). The need to wear the immobilizers throughout the night resulted in absolutely no sleep, nothing to do but stare at the clock and occasionally talk to my mom and overnight nurses. I would also, in both cases,  need to wear the immobilizers during the day and night, albeit periodically and not constantly, go to intensive and exhausting physical therapy visits no less than three days a week over at least a month with each surgery, an unpredictable nature of how tired I was going to feel day to day and equally unpredictable amount of physical, emotional and mental pain varied from day to day.
I do believe that I have had lasting trauma from the experiences of these leg surgeries which first began to manifest itself in noticeable anxiety and depression at the age of 13. Throughout high school, I only received intermittent counseling both in and out of school as treatment. When I finally started receiving medication treat said anxiety and depression (pharmaceutical in addition to regular counseling) at age 18, I was told by my therapists and doctors that my surgeries likely contributed to several deficiencies in several neurotransmitters like serotonin and norepinephrine which result in anxiety, depression, attention deficit symptoms, etc. This is something I still deal with even though I am taking a comfortable dose of regular medication. Tonight’s anxiety, sadness, and plain fear resulted in a full blown panic attack just hours prior to this posting.
The above accounts are not intended as a cry for help, nor are they intended to incite undue alarm, worry or concern for my mental and emotional health; the writing of this post is calming me with every word I type. However, I am still afraid. I still very closely identify with the 9-year old going in for the 2001 surgery just after Christmas and begging my mother with all-consuming fear to let me opt  out having remembered even more recently and vividly the pain of my previous surgery. Ultimately, I need to be honest with myself about these feelings in order to move through them, and the easiest way for me to do that is to write about them. I am writing publicly, not to garner pity, sympathy, or worry from you, my loved ones and readers, but for the sole need to be uncensored and nakedly honest with myself, the people who love me, and those who enjoy my writing. It is somewhat a form of catharsis, especially while in the process of calming down from my panic attack this evening, but it is also an acknowledgment that fear of physical pain is something that I will always have, that it is not necessarily something one grows out of, and that it is nothing more than an expression of my unique human experience. It is also a reminder to myself and to all of you that depression and generalized anxiety are chronic illnesses that need as much constant attention and monitoring both from the self and medical professionals as do the blockage between my right kidney and ureter and two right kidney stones for which I am having surgery tomorrow morning.
I will conclude with the following: While I am nervous still about tomorrow’s surgery, it is a far different procedure from my leg surgeries detailed above. It is urologic and not orthopedic, it is laparoscopic (i.e. minimally invasive, smaller incisions), and it does not involve the pain associated with bone and muscle-intensive procedures as were my childhood surgeries. This is a mild source of comfort, yet pain will still be felt, and right now I feel about as mentally and emotionally prepared as I will be when the anesthesia enters my veins tomorrow. Another mild worry is a third relapse of an infection with which I’ve dealt twice called C. Diff which results from exposure to certain amounts and classes of antibiotics, but my doctor is committed as much to a successful surgery as he is about limiting to the amount of intravenous antibiotics that I receive to the absolute minimum necessary to prevent a third relapse. I should return home from the hospital likely by next Monday, April 25 at the latest, but as early as Friday, April 22, which will give me my long-awaited opportunity to vote in the Pennsylvania state primary on Tuesday, April 26. (This is my first non-incumbent presidential primary since I’ve been  registered to vote, as well as several local and state-level congressional elections, so it’s a hugely important matter for me).

Thank you so much for taking the time to read this post. Please consider visiting the links I’ve sprinkled through the post as well as those below. If you’re reading this, know that I love you, and I appreciate every vibe, text, email, comment, prayer and whatever you send my way over the next 24 hours and resulting days in the hospital . The last word in my post title is PROGRESS, and that is what I am vowing to focus on with every ounce of my being.

Best,

Joe

LINKS:
Laparoscopic Pyeloplasty A medical explanation of the most pertinent of the procedures I’m having tomorrow (in addition to a kidney stone removal and kidney stent replacement);
What does depression feel like? Trust me – you really don’t want to know An article written by Tim Lott for The Guardian on the perspective of depression from the self and others.
The most major of my leg procedures; just about every muscle in each leg has also been nicked and released:
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