World In Motion: Part II -- Middle of a Health Storm

WORLD IN MOTION: PART II

While in the midst of a health storm...
By Lu Sobredo

(I live with a crippling chronic autoimmune illness known as Rheumatoid Arthritis or RA. When I was hit by another personal health storm in December 2018, writing about the experience was my refuge. All the while, my family faced the journey in the ensuing months in 2019, winter storms have also descended on California. To get the backstory, find out here: World in Motion: Part 1.)

The week of February 10, 2019 ushered in another winter storm that unleashed itself on Northern California. Not a desirable backdrop when unease already simmers within me. Weighing heavily was the uncertainty of a medical condition. Periodic lightheadedness and dizziness have become norm for about two months now. Fortunately, vertigo has not visited since the last attack alerted by body in December. I kept anti-dizzy pill close at hand just in case. Conquering that apprehension has taken precedence. But the turbulent rainstorms were hard to dismiss. The atmospheric river was to descend with force onto Southern California later; and it did. But not before wreaking havoc on our side of the State. The heavy rainfall caused flash floods in some places. Fallen trees devastated neighborhoods and were hazards on the road. The snow at 10 inches or so in the sierras did not make travel safe. Winter storms are a painful disruption to routine; yet more so when faced with health storms of your own. 

A large enough window of calm from the Thursday morning storm made for a pleasant ride to the endodontist office for step two of my root canal. The numbing injection into my gums also numbed the heavy sensation in my head. I could only suspect the source to be from the mass in the frontal lobe, the thought of which made me wince. About to feel sorry for myself, I was stopped on my tracks by the many voices of family and friends. Their message: physical pain is a signal that you’re alive. I know. The alternative is far from inviting. 

THAT FATED DAY IN MARCH

A woman about my height was dressed in a long, peasant dress. The dress draped protectively on her. The base color of her dress was black with vibrant red and rust orange floral design. The blossoming flowers were printed all around her skirt. The woman had dark, shoulder-length hair. At least 40 or older. She walked up to me, much too close to my face, boldly violating my private space. I reacted with force and hurled the words: Go away. I struggled to utter the words at least three times but to no avail. She still stood there. I thought perhaps I should say the words in Spanish to have any effect at all. But I didn’t have the words. 

By this time, I heard my husband’s voice gently saying, “I am here with you.” That’s when I realized I was lying next to my husband while I slept, and he, still awake with his iPad. He heard me mumbling, "Go away." I was having a nightmare. My hubby always says, dreams are your brain cells bumping, crashing into each other in the night. On the other hand he also believes that what we can see is not the only reality. That there are likely alternative realities in other realms. I dozed off again. The conflict in my dream faded without resolution.

When morning came, I woke up with a nagging desire to process the nightmare while the details were still retrievable in my mind. Maybe the nightmare was my response to the reality I heard from the neurosurgeon yesterday. The woman in my nightmare was a metaphor to the mass that has invaded my brain and I was desperately ordering it to go away. And perhaps, my dream-state was insisting that if I spoke the words in Spanish, the woman would understand me. Maybe it was my spirit recognizing that this mass of one-and-half-by-two-inches that found a home inside my skull was a foreign body that has no business being there. Why Spanish, a foreign language I am currently learning, came to symbolize the solution? There are a few speculations for another time. But, what I marvel at is how the mind finds boundless ways to soften harsh realities of our life journey.

That nightmare came on the same day my husband and I met my neurosurgeon, a gentleman about my age. His medical credentials, stellar: current Chair of the Department of the Neurological Surgery. Graduated with honors from Harvard Medical School, Rhodes Scholar among a long list of impeccable achievements. 

That long awaited consultation took place on March 1, 2019. Landing an appointment 9 1/2 weeks  after a general referral was sent by my primary care doctor, made for a long, hand-wringing-filled few weeks. When I told my neurosurgeon how long I waited, even he was bewildered. He said it should have taken no more than one week. This is something he is trying to change. Then, he gave me his cell phone number for when I ever needed to reach him. The gesture was a good sign from the Universe. 

Headed to my Neurosurgery Consultation. ©James Sobredo

That meeting was enlightening. It was hopeful, alarming and comforting all at the same time. My husband and I saw with our very own eyes on the large screen the visual from the MRI taken on December 21, 2018 of the mass in my head. 

I was told that I needed a more current MRI before the surgery. I think it’s called PET-MRI (Positron emission tomography-Magnetic Resonance Imagery). It was needed for a precise and molecular image of the brain. Another thing I had to mentally prepare for. Had I mentioned that I dread tight places and jarring harsh noises in my ears? Believe me, the ear buds the imaging technician gives you during the procedure do not shield one’s equilibrium. 

Even when I think I do everything asked of me in order to keep my medical symptoms at bay…I take precautions to reduce risks of adverse effects from medications I ingest. I avoid the sun. I avoid exposure to infections to which I am vulnerable because of a compromised immune system. And I am diligent about taking all the medications every freaking day of my life these last few years. Yet the body still rebels? The body acts like it is at war with itself. What could one do?

All those precautions are for naught when an infection arises at the worst time and in the most inconvenient locations on the body. I try to rise above all of it. But at times, I break down. Irrational emotions erupt. Uncontrollable tears pour out. Maybe out of self pity, maybe out of disgust about what the health-gods have dealt me. And by now, the Universe must know that it hasn’t dealt a card in this game of life that I have not faced with steely stubbornness and even grace. But, it is damn exasperating at times. 

My body needed to be at tip-top shape in preparation for my surgical procedure to remove the mass from under my skull. Just then, I faced some low grade throat infection and thrush/yeast infection on my tongue. The prednisone pills I take for anti-inflammation makes me susceptible to these types of infection—viral or bacterial. The drug does not discriminate. The weakened body is at a loss. The drug has no feelings, no conscience, no investment in my well-being. It pretends to help. It pretends to moderate the pain. But at what cost?

My life routines had to be literally put on hold until the scheduled date of neurosurgery. That date was confirmed for March 14, 2019. And the PET  MRI must be done beforehand on Sunday, March 9th. 

I must wait for the rest of the details: what time to report at the hospital’s  Admissions Office, time of surgery, and precautionary instructions for me as I prepare for that event. It’s interesting that the surgical procedure on the fated date was to occur in an operating theatre where medical students or other doctors could view the procedure. I was to expect a call no later than two days before March 14th. On March 11th, someone from the anesthesiology team would call to interview me on my medical history and confirm the list of medications I currently take.

It’s like living in mystery--as all would be revealed in due time. That’s what it felt like. The whole thing had all the elements of a Shakespearian drama, hopefully not, since that never ends well. Maybe not, more like a television soap opera. You know what’s going to happen; but you are not allowed to take a peak at the daily script.  Keep away the script from the actors to keep their acting skills fresh, I suppose. But this is real life, and I literally feel like being on the precipice of a cliff,  precariously leaning to view the outcome of my own story. 

I was eager to get the PET-MRI out of the way. The results could help show the activity of the mass in my brain. My family accompanied me at the Imaging Center of the hospital on a Sunday, March 9th and we arrived early at 2:45 p.m. for a 3:15 p.m. appointment. We wanted to make sure we allowed room for the unexpected. And as I surmised, when the technician had to inject a dye, it took at least three attempts to find my deeply submerged vein. But what’s a few needle pokes to my arms and hands to test where the butterfly needle would meet its match? It did get done. The waiting was nerve-wracking: so was the uncomfortable procedure. The procedure was over by 5 P.M. 

My husband and son kept me entertained and occupied for the few days before the critical phases of the upcoming day of the “reveal.” The day the Right Frontal Lobe Craniotomy would be performed.  Hubby planned a relaxing dinner out at Kyodai on the night before the scheduled surgery. Eager to put aside concerns for tomorrow's surgery, I cheerfully celebrated by watching basketball on television at the restaurant. The Golden State Warriors team was a pleasurable distraction. I was counting on the Splash Brothers, Steph Curry and Klay Thompson. They accommodated with a nail-biting team performance of 106-104 over the Houston Rockets. 

Mussels and Bread at Kyodai. ©Lu Sobredo

Shrimp/Vegetable Tempura at Kyodai. ©Lu Sobredo

Extreme patience is a learned virtue I suppose, a muscle memory of sorts. I see it in spades in my husband and son who are caregiver-survivalists. Living with me and my medical trials? It was bound to happen. 

The phone calls came. The representative from the anesthesiology team reached me. They did a thorough confirmation of medications I take and current and historical medical conditions, especially as they affect the anesthesia for the surgery. The representative from the admission team called to walk me through the preparation for surgery. I must report at the Admissions Office of UC Davis Medical Center’s main lobby at 5: 15 a.m. The last clear liquid intake must be no later than 3:15 a.m. I will meet my pre-op nurses shortly after I get admitted.

That fated day of March 14, 2019 came. I awoke with quiet anticipation for one of the most important verdicts of my life; something I’ve nicknamed the reveal. Was I ready for what was to occur? Despite the trials placed along the way of this life journey, I have been immersed and cloaked in blessings galore. My husband made his career and life choices with me in mind and with our son by our side. Our shared life events have been too numerous to recount in one hour while waiting to leave for the hospital. I have an unbelievably dedicated and loving network of extended family and friends all over the globe praying for me. 

I took a quick shower and was dressed by 3:30 a.m. Took the prescription meds I was allowed to take with a sip of water at 3:15 a.m. The last clear liquid my body could have before the operation. My family woke up in time to get ready to take the hour drive to the hospital and with time to spare before checking in for a 5:15 a.m. admission. It was a beautiful brisk winter morning at 43°F. 

 Dark Early Morning Arrival for Neurosurgery Day at the Hospital. ©James Sobredo

The Hospital in Daylight. ©James Sobredo

Throughout all of this I was relatively calm, pensive, albeit expressionless at times. As the day got closer I felt positive, engaged as well as detached. After all, what was about to happen was out of my hands. I have done all the preparations on my end—the lab tests, the waiting, the hand-wringing, sobbing, anticipating and praying. Further infections averted. My soul, fully soothed. Now everything else was in the medical experts’ capable hands. And I had all the faith in the world that everyone involved would be filled with the kindness, grace, alertness and wisdom as the Holy Spirit would will it. 

THE REVEAL

A hint of tension permeated the air when arriving at the hospital that fated day on March 14, 2019. I stepped out of the car and felt the cool morning breeze striking my face. The brightly lit lamps in the parking lot obscured from my mind the darkness that surrounds 5:00 a.m. However, nothing could obscure the reality of my impending brain surgery. 

My son kept me company while his dad parked the car. Mr. Aguirre greeted us at the Admissions Office on the appointed time of 5:15 a.m. He likely utters the same bureaucratic words to all patients as he explained the documents I had to sign. Yet, he had the right amount of warmth and his own brand of humor, making our interaction genuinely personal. 

Mr. Aguirre Securing My ID Bracelet. ©James Sobredo

Once the hospital ID bracelet was safely around my wrist, my son, hubby and I headed to the elevator that would take us to the third floor. Hardly anyone was at the hospital lobby except for workers. 

In quiet my family rode the elevator with me to the third floor. A nurse at the counter (nurse #1) told me to take a seat after she checked off my name on her list. I barely had time to select where to sit in the waiting area when another nurse called out my name (nurse #2). She also explained to my family that someone would escort them to the pre-op room to see me before surgery. She exuded such friendliness that without hesitation I waved good-bye to my family, followed her to the pre-op room, and put on the hospital gown as instructed. Before Nurse #2 exited, she advised me that my pre-op nurse would come talk to me about the next steps. I didn’t get the names of the first two nurses as the whole interaction took seconds. Therefore, knowing full well that I might not recall much after the surgical procedure, I asked my son if he’s still in the room to record on his cell phone the names of the attending medical staff from then on.

Two more nurses later, Joyce (nurse #3) and Peggy (Nurse #4), I wondered how many more nurses would be assigned to my case that day. Each worked in tandem with one another to take my vital signs; ensure the patient record was accurate; ascertain that my health directive was in place (in case something happened and I couldn’t make health decisions for myself); and connect me and the needles to the IV. Each step at the pre-op was to bring me closer to the moment of surgery. It felt like I was watching the peeling of the onion one layer at a time--methodically and with precision. And this went on a few more times within a span of an hour or so. 

When all was said and done at the pre-op room, I have met two nurses, two anesthesiologists (Dr. S and Dr. B), the medical resident (Dr. O) who would assist in the surgery (an additional one was already in the operating room); and two surgical nurses (Nurse #5 and Nurse# 6) whose names faded into ether land once the anesthesia drugs took effect. Of course, the head neurosurgeon (Dr. H) was already dressed in scrubs, and he peaked in, smiled, waved and assured me, “We’re ready for you.” The Right Frontal Lobe Craniotomy was scheduled for 7:00 a.m. 

The operating theatre, aka operating room, was reserved for four hours for the surgical procedure. It was like a theatre production, but at a teaching hospital. And I was not in the audience during the act of peeling the onion. I was in the center of it all; hooked onto IVs, connected by needles and probably tubes to what I presume to be life-sustaining devices and contraptions. My body was kept comfortably warm by a lightweight, puffy, paper-like blanket inflated by heated air. The multiple curtains being peeled toward the scene when all would be revealed kept me enthralled enough: the surgery itself subsumed in the drama of it all.

The tranquilizers injected into the IV was meant to relax me. It lived up to its intent rather quickly. I do recall my husband and son in the pre-op room. Clearly etched in my mind were their hands touching mine, and the kisses on my forehead accompanied by voices (theirs and mine) saying, “I love you.” 

Hubby in the Pre-Op Room. ©James Sobredo

The last sliver of memory was the sensation of being wheeled off on a gurney. Drifting into unconsciousness was like fainting, but much more instantaneous. Grateful that the anesthesia was extremely effective. I have absolutely no recall of the time of surgery.

Being Wheeled into the Operating Room. ©James Sobredo

Being spared from the pain during the operation was a much welcomed and appreciated blessing. The severe pain felt hours after the operation was another story. The reverse process, when emerging into consciousness after being under anesthesia for about three hours, does not happen suddenly. That I discovered. 

Several hours later, with my eyes still tightly closed, I heard the sound of voices chattering around me, which gradually increased. Hallelujah! This was major cause for celebration. It meant I came out of the surgery very much alive. As I opened my eyes, a kind female voice greeted me with, “You’re awake.” Her name was Grace (nurse #7). She proceeded to ask: my name, if I knew where I was, if I could tell her the month and year, and what surgery I just had. All my answers pleased her, which I suspected declared me fully awake. Or perhaps she was happy to confirm I was the patient as indicated on her list. I was lying on an incline position with my head tilted to the left. There was no sensation on the right side of the head, only the feeling of my body floating but with heavy rocks pressing down my skull. I knew I was in the post-op, recovery room.

My throat was dry, scratchy like sandpaper as I swallowed. I spoke, but it wasn’t immediately clear if the nurse heard me. When Grace asked what my pain level was, I felt like I was in the twilight zone and the grogginess made it impossible to judge. She gave me two choices: Oxycodone or Extra Strength Tylenol. My choice? Tylenol, of course. Besides, I was apprehensive about taking heavy duty pain drugs, so I stayed quiet for sometime. In contrast, my husband told me my neighbor who was already on maximum dosage of morphine kept asking for more. His Filipina nurse kept replying: "You are already on maximum level of morphine. Only your doctor can approve a higher painkiller." 

In the back of my mind were flashes of communities ravaged by opioid use in the U.S. Images of lives destroyed reported on television, in print, and social media were fuzzy in my mind. But they were on my mind. Thus, I am very cautious of taking excessive pain drugs and becoming dependent. Even at the height of my jarring toothaches and excruciating RA pains in the past months, I did not succumb to the prescribed painkillers outside of extra strength Tylenol. 

A few minutes later, I felt something was wrong. “Was that a drip of water on my right shoulder, please look,” I begged the nurse. I was glad to have found my voice. Scratchy throat and all.

Grace quickly said, “Don’t move. Don’t touch. It’s blood from the incision.”

She promptly paged the resident on duty, a third year resident, Dr. O who assisted in the surgery.

Just then, my husband and son were allowed in the post-op recovery area. I was comforted by their presence. First time we laid eyes on each other since our early morning goodbyes before I was wheeled away. Shortly, Dr. O appeared and inspected the incision. (I nicknamed him in my mind as I did the other doctors, based on the first letter of their last name). It turned out, my incision needed one more staple. I heard him ask for a staple gun. I imagined it to be a small medical staple gun, not wildly different from an office staple gun.

“I’m sorry, this will sting,” he warned.

He calmly, but firmly ordered the nurse to add morphine and pain killer  to my IV. In my head, I questioned: Both? Yes. Both.

“Sorry, I might need to put three more staples. Here comes the sting...And another sting... And another.... Done.”

No freaking kidding me, I thought, but did not utter the words out loud. Later, my husband confided how difficult it was for him to watch knowing my anesthesia was wearing off. My husband surmised that it must have felt like stapling your finger accidentally. Except, this was stapling into my skull, and it was deliberate. The pain felt raw. Just think, since staples were used, it meant at some point staples would be removed. 

“Just breathe,” I mused. Breathing meditation helped. The bleeding stopped. The pain medication eventually worked wonders. Even my RA-afflicted joints benefited from all the pain-numbing drugs.

My recall was fuzzy, but apparently a resident anesthesiologist came by to check on me at post-op. Anesthesiology comes with its own risks. In fact, it is often the most dangerous part of surgery. It’s best to be cautious to ensure risks are reduced and mitigated. Luckily I did not have side effects to be concerned about. 

What was my physical state when the pain drugs took effect while in post-op? Imagine an invisible helmet crowding and pressing heavily against your skull. The feeling and the image of such should have been unsettling. However, the drugs worked swiftly. I rested, oblivious of my surroundings and the other post-op patients who were in varying stages towards consciousness.

At Post-Op With My Son. ©James Sobredo

While rising from a deep sleep at post-op, some memory returned. Not anything about the surgery, but about my neurosurgeon Dr. H peering into my bed area to say they were able to fully remove the tumor which the modern medical world refers to as the "mass." The most important part was that the tumor had not attached itself into the brain, except for the threadlike portion that held it in place. It was a matter of lifting it whole. The verdict? The mass was benign. The biopsy would of course confirm for sure, but not for another month or two. This time the waiting would be worth it.  

Another good news: I would skip the need to be in the Intensive Care Unit (ICU) altogether. Until a bed opens up in the Neurosurgery Unit, in the East wing of the 5th floor of the hospital, I would have to stay in post-up. Another bed did not open up until after breakfast the next morning. They relocated me to a more private and quieter space of the post-op recovery floor for that first night. 

The revelation. The good news left me speechless. The tumor was benign! I was thankful for the outstanding performance of the surgical team, the whole medical team which included anesthesiologists, surgical nurses, surgical residents and the lead neurosurgeon. I was overwhelmed by the outcome. The fact that the tumor was benign finally sank in. My family and I breathed a deep sigh of relief. I won’t have to endure any toxic post-surgery treatment, like those we’ve known including those we’ve loved. For example, my own mother and mother-in-law in their battle with cancer that took them from us too soon. My Mom Patty was 53; my Mom-in-law Violetta was 65. My eyes welled up. My husband kept saying, "You're one of the lucky ones." He offered to show me a picture on his phone of the mass that was removed. Dr. H had taken a picture of it with his cell phone and had shown it to my husband after surgery. A copy of the photo now exists in hubby’s phone. 

I said, “NO.” 

I just wasn’t ready. Five weeks after the surgery, I still am not. I don’t even know what the outline of the incision looks like. I refused to look in the mirror. I could only imagine it these days as I live through the roller coaster process of healing. As the hair slowly grows back from having been shaved for surgery, perhaps I am shielded from ever seeing it.

TO BE CONTINUED…

(Stay tuned for additional details of this pot-hole in my life journey. My three-night stay at the hospital after surgery was a lesson in navigating the recovery process, incident of the first meal post-surgery, hospital roommates, more nurses and the healthcare system in general. The healing process so far has had its hills and valleys, but I am simply grateful the healing is on track. I am told it’ll take up to a year for my head to feel normal again. I resumed medications for my chronic RA, but not soon enough before the joint pain resurfaced once the anesthesia and pain drugs wore off. Such is life. And that’s just it, I am alive.)

©Essay by Lu Sobredo

ALL RIGHTS RESERVED

ACKNOWLEDGEMENT:
Thank you to Adrian Sobredo for helping edit this essay and to James Sobredo for the remarkable photos.

About the Author 
Lu Sobredo is writer/publisher at Lu Travels Abroad, a blog dedicated to folks whose limitations do not hamper them from traveling. A year into early retirement her world collapsed from the diagnosis of Rheumatoid Arthritis (RA). Her total life changed, but she did not let RA define her. With love from family, friends and an awesome doctor, she regained some functionality--her new normal. She will have RA all her life. And she now writes about life and travel with RA. During the pandemic of 2020, she stays put and writes poetry and a first novel, a travel of sorts but in the heart and mind.