Dailies: September 13, 2013 (Appendectomy Edition)
Hey, so remember in the last post when I said we would be getting back to regular posts now that things have calmed down from the whole it’s-summer-and-we-are-trekking-through-Newfoundland thing? Well, we got a big monkey wrench thrown into that merely two days following that grandiose promise. It goes a little something like this.
Alexandra woke up feeling a bit off on Saturday morning. We went into the bakery, and, thinking that she was just hungry, she (and I) ordered breakfast. We planned for the workshop session that was to happen at noon. But by the time ten o’clock came around, she was feeling so lousy that we decided she should stay at the bus and rest. It must be indigestion, we thought.
So off I went to the workshop. Like most of the communities we work in in the warmer months, we had to be a little creative about scheduling. In this case, the Saturday session was for two participants and we had scheduled one for the following Thursday (last night) for everyone else. Doing things this way is a little more work but it is nice in some ways, too: the session can take on a more conversational tone if there are fewer people around.
I didn’t realize that I had been getting messages from Alexandra the whole time I was at the workshop about her increasing distress, and so, when at the end of the session my phone suddenly came back into service, I had an alarming assortment of BBMs and missed calls. Sarah gave me a ride back to the bus, where I found Alexandra a little bit better, but still with pretty pronounced pain.
We eat a lot of beans in general, and particularly that week we had been eating nearly nothing but beans. One of our conjectures in the past has been that Alexandra’s system can’t handle so many beans at once–too much fiber or something. So we figured that’s what it was, and with a little peppermint tea and a hot water bottle, she was starting to feel better. She slept well that night and the next morning was better still. Her appetite was still quite minimal, but the pain had diminished considerably. We hung around the bus working and cleaning things, and in the afternoon we had a nap.
As evening approached, however, the pain returned and brought chills with it so I fished the thermometer out of our little first aid kit and took her temperature. It read 38.1 C (100.5 F). Whoops. I conferred with Alexandra’s mother, a nurse, and we decided it would be best to have it checked out. Sarah kindly loaned us her car, and so we set off to Dartmouth General Hospital, about a forty minute ride, around 8pm.
At this point, Alexandra hadn’t eaten anything for 35 hours.
We arrived at the hospital and they treated us kindly. We had an encounter with some very friendly but nervous student nurses as they tried to get an IV in. They confirmed that she had a slight fever, but all her other vitals were normal. We sunk pretty far on the triage list, and so she napped for a little while. The doctor made it in around 11:30, asked some questions, and determined essentially what we had suspected: appendicitis. He was going to send Alexandra for an ultrasound, but it was a pretty fair bet, he said.
But the ultrasound was inconclusive for appendicitis (and usually you can see it on someone of slight build). What it did turn up, however, was evidence of a burst ovarian cyst–a benign issue that causes plenty of abdominal pain but is inconsequential for health. Meanwhile, Alexandra was feeling better by the moment and her temperature was well within normal bounds. When the next doctor followed up, he felt fairly confident that the cyst was the source of the pain and that it should subside over the ensuing few days. They hadn’t ruled out appendicitis, but usually that one is an ailment that gets worse continuously and quickly, so you know it when you see it. The decision to have a CT scan was left up to Alexandra: it would determine the precise condition of the appendix but is also the source of harmful radiation. He left us for a moment to discuss, but came back just a few minutes later wrinkling his brow. “I’m going to send you for a CT scan,” he said. “I don’t think it’s anything, and you’re feeling better, but if you left I would always wonder so let’s just do it.”
Four cups of gross chalky radio-dye later, Alexandra was on her way to the CT. The results took a while, and so we discussed what we’d like to eat when we left, since it was now a good 54 hours since she’d eaten. I had even seen a poutinerie just down the street (beats hospital food any day)–joy seemed close at hand.
Our doctor was at the end of his shift (with his jacket and backpack on) when the results came back. He paused at the rack, looked at the folder for a moment, and grabbed it and came over to us. He flipped a sheet over. “Well,” he said, “the CT results are consistent with…acute uncomplicated appendicitis.” He put the folder down. “I am really glad I sent you for that CT.”
The surgeon came by next to explain the procedure, which would happen that evening at the earliest available time. They were going to do it laparoscopically, which means that they pump the body up with carbon dioxide and then use a camera and a tiny tool to reach in rather than making a large incision. The forecast length of the surgery was to be 45 minutes to an hour–a piece of cake. I dashed back to Seaforth to return Sarah’s car (which we still had) and took the bus back into town after only getting lost once. I may have forgotten how to transit.
I got to the hospital just as Alexandra was being prepared for surgery, so we got to spend a few minutes together before I got kicked out into the hall to wait. Up until this point, I hadn’t been too concerned…modern medical science makes problems like appendicitis pretty manageable, I thought. So I sat on a bench outside the surgical ward and read from our old copy of the MacLean’s Book of Lists around 9pm. An hour went by. Then an hour and a half. A little strange, I thought. But the nurses happily assured me that the surgery hadn’t started until 10pm. Okay, great! I went back to my bench. At 10:50 the nurses told me the procedure was going to take just a bit longer, so they were going for tea. But then it was 11:30. And then midnight. Two hours in, not only is my skin starting to crawl but there is also a family half a world away waiting for the news about their daughter through me. The nurses were nowhere to be seen, and as a matter of fact no one was in my entire side of the building. I wandered in despair.
Around 1am I was really fearing the worst. “How could I let this happen?” I thought. “We came THIS far to get Alexandra killed by a rogue appendix in Nova Scotia?” A call snapped me out of it. The recovery room nurses were saying that Alexandra was out of surgery, resting comfortably.
I rounded the corner into the surgical hall and Dr. Watson, the surgeon, was speedwalking towards me, already talking as if reading my mind: “She’s fine, she’s absolutely fine.” I almost collapsed in relief. Dr. Watson looked fatigued, red marks from the pressure of her mask still on her face and dark circles beneath her eyes. The easy appendectomy to cap off her workday had not gone as anticipated. She explained that Alexandra’s “unique anatomy” made removal of the appendix considerably more difficult and labour intensive, but in the end it was accomplished with the same results as a normal procedure.
Alexandra, meanwhile, was shaking off over three hours of anesthetic. The clock on the wall opposite her bed was revealing, and by the time I made it in to see her, she was certain that something had gone wrong. It took a great deal of consoling to convince her that everything was fine (drugs make that difficult), but the nurses and I managed to convey that while it had been a bit complicated, nothing serious had resulted. Her vitals returned to normal about an hour later and we were able to move upstairs where, as luck would have it, the only available bed was in a private room. By the time we got to sleep and all the family had been notified, it was close to 4am.
The next day brought with it the trials of recovery. The incisions themselves are fairly inconsequential, but a side effect of the laparoscopy is that the carbon dioxide they pump into you scatters throughout your abdomen and exerts pressure on your nerves, causing shooting pain throughout the torso. The doctors stopped by on their rounds and talked to us for a bit; they were fairly certain that Alexandra was headed for a complete recovery, but they wanted to keep her a little longer to be sure. They finally let us out around 9pm Tuesday evening. Again, Sarah graciously drove us back to Seaforth and put us up at her house.
The subsequent days have been uneventful. Alexandra is healing rapidly but we are grateful to have been inside since the surgery because abdominal incisions would make getting onto our raised bed in the bus quite difficult. It is predicted that she will feel almost completely normal in about a week, and her wounds will have healed well enough to lift and carry weight in about six weeks. Meanwhile, she is watching the swelling and bruising take over her abdomen: “I look like a weird potato!”
If you like, you could always watch the video on our Facebook.
The great part of this trip is that it really brings to light the goodness of people. Someone we have only known for a week has given us full run of their house, their food, and so on. As in Alberta, where Karel let us take over his house for the better part of a month, we have met some truly excellent people here in Nova Scotia. And I’m fairly sure that the same generosity can be found many other places.
Meanwhile, we had the second workshop on Thursday evening. Accompanied by the noise of the Crib Players’ Club upstairs, we quickly went through the technical elements of the cameras and of film in general. Alexandra was at home resting, so I had to try to police myself against the tendency to talk really fast (which was carried out with moderate success). I love it, too, when people ask questions about getting cameras and film…perhaps we are sowing the seeds of future celluloid filmmakers?
We will also be having a couple of public appearances in our remaining time. One of our contacts, a professor at St. Mary’s University in Halifax, put us in touch with one of the hosts of the morning television program on Global here and we will be taping an interview with them on Monday. A week later, we are going to be putting on a public exhibition and talk at St. Mary’s University…very exciting! Hopefully we don’t get too tongue-tied…
Alexandra’s mother arrives for a visit tomorrow! Hopefully this week will afford us more opportunities to write again.