So I'm back - heyup - and here to chat about all things pre-op (including my absolute favourite thing, bowel prep - urgh). I was absolutely terrified about my operation, I genuinely thought I was going to wake up mid-operation on the table and not be able to tell them I was awake, them not realise and me just laying their stuck while listening and watching them pull out my insides and roam around in my abdomen (It didn't help that I was watching youtube videos about people that this had actually happened to - thanks This Morning). I also told that to my anaesthetist (she probably thought what a right idiot this girl is) but apparently A LOT of people fear that. Yep, could've died on the table but didn't really mind that because I wouldn't have known (makes sense right?).
So it turns out that my operation got pushed forward (yay) to April 12th. If you imagine when you're a kid and you pretend that your pregnant by wearing a really stretchy t-shirt and stuffing a football or 3 cushions off the sofa up your top,then.. you've basically created a real life version of what I looked like. I mean guys, I had got to the stage where I was rubbing/stroking my stomach (like a pregnant woman does!).. madness, rubbing my fucking ovarian tumour (she was now part of the furniture......yeah, furniture that's on its way to the tip).
I went to my final (pre-op) clinic appointment with my surgeon who discussed the ins and outs of surgery. I knew that it could range anywhere between 2-10 hours (yep - big theatre slot booked out for me) and that my surgeon had got involved with other specialist surgeons in case I had to have a temporary stoma (colorectal surgeons) or if it was more complex than required they were on standby. I had originally been told I would go straight to intensive theatre recovery and then be shipped across to ITU but that had also all changed (thank god - I really didn't want to go to ITU). The plan now was to go across to normal theatre recovery and then go to the Daphne ward (that was just the name at my hospital of the ward, it's the gynaecology ward). I was so happy to find that out, I knew from my nurse training that it was a small ward but not only that, it was a ward, a normal ward which meant they didn't expect me to be that unwell after surgery or else they would've held my ITU bed for me ready for post-op (yaas). // My surgeon also ran through the surgery again and pre-warned me again that I had to prepare for the incision site to be way above my belly button and all the way down. At this point (it sounds stupid) but I didn't actually care about the scar (slightly optimistic thinking and not thinking straight) but I just wanted Olga out (my back ache was driving me mad, I couldn't sleep properly, knew it was probably cancer literally sat inside me and I couldn't eat properly - I'm greedy).
Pre-op decisions:
Medications/Pain relief
I say decisions because it was based around my pain relief decisions (down to the medical team really.. I just kind of get the needles shoved in me and infusions and all sorts). The plan was for me to have an epidural (I can't describe how terrified I was for this.. I don't think I stopped going on about it, I was terrified of a needle in my back.. more scared than ever for it to go wrong and for me to be paralysed), a nerve block and a PCA (a pump which I can control to a certain extent via a button which basically gives you shots of morphine when you press it - or a shot of whatever drug is in it - mine was morphine. The pumps are locked so you can't overdose on pain relief or accidently give yourself the whole lot!) alongside oral pain relief tablets and a background infusion of morphine (inside the PCA). I basically got spoilt (luxury treatment - my medical team were and still are amazing) and I remember them telling me all of this and in my head I was like really? The pain won't be THAT bad surely? (I mean you're only cutting my stomach/abs in half and taking some bits out.. how bad can it be?! No, seriously.. I was like, "nah I'll be fine"). The fact that they plan all your post-op pain relief which will all be sorted while you're asleep in theatre so you wake up high as a kite and (hopefully) not in pain is so nice.
Surgery plan, final run through
So I was really lucky and so relieved (I can't really explain the feeling - I know right, I tend to always say "I can't explain it" yet I am writing a blog trying to help people out, bit pointless.. oops, sorry guys!) to hear that my surgeon had opted for the "fertility sparing" surgery. I remember him saying to my mum "if she was your age, we would have just taken everything out" (by that he means all my reproductive organs.. full hysterectomy, both ovaries and tubes out etc) but the fact that he, and the team, were willing to work around this and do everything in their power to allow me to have children in the future (they already knew I wanted them, I had obviously been to the IVF clinic and they had discussed this with me many times) is amazing. I can't thank them enough for the numerous amounts of MDT meetings they had just to provide not only the best and safest surgery but to allow it to be possible (maybe) for them to just remove the one ovary and fallopian tube, therefore leaving me with the possibility of still having children in the future as my womb and other ovary would potentially be left.
Nil by mouth and bowel prep (the second worst part about this all.. falling short of first place which is taken by steroids)
I knew I would have to be nil by mouth (for the people like me who don't know what this means - I didn't when I first started and then realised it is literally in the name - it means nothing to eat or drink) but it was always the question of "how long for?" (I'm greedy and eat around 2 hourly unless I am on a shift, then I just continuously eat for my entire break basically... actually, having said that.. since olga was removed, I am not as hungry as I used to be, nor as greedy, so - maybe she was a lady in high demand of food). The nurses explained to me I was to have nothing to eat or drink 5pm the day before my surgery other than the pre-op drinks provided to me which I was to have in the morning. My operation was scheduled for the afternoon so I was to be in for lunchtime as my surgery was an early afternoon slot, I think around 2pm (good time that, for a surgeon I mean, as in if I was a surgeon.. good time choice, I'll stop talking now). Now for anyone worried about being nil by mouth, to be completely honest you will probably be shitting yourself (and not from the bowel prep, which we will come onto shortly - oh yes, its got its own section) for your surgery and won't actually want to eat or drink anything anyway (and this is coming from the person who eats a load of crap when she's scared/nervous). Also, the pre-op drinks will fill you up as that is what they're designed for.
BOWEL PREP:
Oh my god, THE worst thing I've ever had to have. I don't know why it didn't taste nice to me at all. Other people who have had it, whether it is my patients or my friends, have never really said the taste to be that bad. Ok, so to me it tasted like gone off, flat mouldy lemon squash (and believe me I then mixed it with actual squash and made it even worse). Oh, by the way bowel prep comes in 2 sachets of powder which you then mix in 2 jugs of water (I believe it's 750mls each jug) and drink it within a certain time frame (I can't remember the exact time frame they give you because I decided to break the rules and down it all at once to just get it over and done with - yep, nurses really are the worst patients sometimes). I think they spread the drinks out across 4-6 hours (so that was 4-6 minutes to me and the biggest drinking game with my dad ever mate, thank you). The idea is it basically cleans out your whole bowel, yep your ENTIRE bowel. See where this is going? You basically.. and I am so sorry for my language here but "piss shit out of your bum" (that's my most used quote when people ask me what it is like). Towards the end of the effects I didn't know whether I was pooping (I thought I was) but it was literally liquid ("was that a wee or a poo?"). The idea of bowel prep is because in surgery you will need a clean bowel (not all surgeries ask for this by the way so don't worry if you don't get it, definitely don't worry - you're lucky and I am jealous of you) but because I could have had work done on my bowel, the surgery was very close by to my bowels, my surgeon was checking them physically (yep - with his hands, lush) and I could potentially have a stoma they didn't want the contents of my bowel in there leaking everywhere (?Infection source but also - you don't want to be operating on someone working your way through shit - simple as - I am sure there is a much more medical reason and a much better way of putting that but hey). So anyway, my dad and I sat round the table in my parents kitchen. I made up the drink, had a straw in the glass of it (because I might as well imagine its a cocktail right?) and suddenly dad starts banging on the table like we're in a pub going "drink it drink it drink it" and "we like to drink with mary-ann because mary-ann is our mate.. and when we drink with mary-ann she downs it in 8, 7, 6, 5, 4......". Safe to say I got to 1, attempted to down it while half laughing at my dad (he isn't like that at all normally but does have a habit of randomly coming out with unexpected stuff) but as soon as that drink touched my lips URGHHHHH. Anyway, thanks to my dads help (who continued to count down and clap for me on all my 4 other back to back glasses of it) I managed to keep it down AND THEN... The wait, the wait of "okay.. when is this going to happen?" starts. It isn't actually as quick as you think when it first starts (I genuinely thought I was going to shit myself) but my god when it gets going, you can't leave the toilet. I continued to wee out of my bum for the rest of the night until I basically exhausted myself, vomited and fell asleep. And to finish off, as my sister reminded me, people pay for the "classier" (but essentially the same thing) version of this.. clonic irrigation. I'll tell you my surgery properly in a moment but I have to add, I made it into hospital and survived the 35 minute journey in without exploding so, if you're reading this and worried you're about to have bowel prep, you won't be incontinent (you just might be a bit confused as to what bodily fluid is coming out of you for a while - haha, this blog is gross)
Surgery day:
Surgery day was eventful to say the least. I woke up, still shitting.. (but to be fair, it was pretty settled by then) and my phone rang, great (please don't say it was cancelled). It was my specialist nurse asking if I could come in earlier as my anaesthetist had asked for some urgent bloods to be done before surgery (what urgent bloods?! Why were they urgent? Urgh, why now). So of course, my dad being as good as he always is, rounded me up, got me straight into the car and drove me there (this was about 0800am I'd say so HELLO RUSH HOUR). Meanwhile I am sat there drinking my pre-op drinks as something to do and wondering a) why did they need extra "urgent" bloods, b) half calmed down - started telling myself they probably weren't actually urgent (they were.. I was trying to brainwash myself) and c) getting pissed off (regrettably - it was no ones fault and no one did anything wrong) at why did they not do these bloods previously. That's literally how emotions work! To be honest, from what I remember (and my dad might say this isn't true and rush hour was bad - I think I've blocked the journey out or - chemo brain) rush hour actually wasn't that bad that day and we made it in in pretty good time. The nurses at the day surgery unit were expecting me and I got taken straight into one of the nurses cubicle/office thing. My mum was making her way in at this point. The nurse took my blood (I accepted they'd be decent at taking bloods as they do it all the time, otherwise guys - always go with the PA if you're offered one, always) and I put on my TED stockings (essentially compression stockings that are these gorgeous white, skin tight stretchy stockings that make you feel like you've just gone on a 6 mile run when you're pulling hem up over your heel because they're that difficult to get on). I spent my whole first year nursing placement on an orthopaedic ward where I spent 60% of it sweating and out of breath while I went round every fucking morning applying these to patients (and soon realising it wasn't actually that exciting and the staff obviously made out it was to get poor innocent 1st year me willingly doing it, HA, I worked it out now) so I saved the nurses a job and put them on myself (by the way, it is actually easier if you do put them on yourself so.. if you ever have to wear them, please save us nurses/HCAs the gym workout and do it yourself). I also got given the sexy gown to put on so by the time both the anaesthetist and the surgical team came and spoke to me I was sat there with no makeup on, looking like humpty dumpty while stroking my fake cancer baby bump in a oversized hospital gown with these horrendous looking stockings suffocating my fucking calves (hot). My anaesthetist explained that the bloods she took were looking at my clotting factors which was essential to get before going ahead with my epidural and she was very grateful I had come in early for this. She sat and explained about my surgery again and what was going to happen (she was the nicest lady and I've never got to properly say thank you, I was super scared about being put to sleep and she didn't make me feel like the idiot I was being at all) and then left. Soon after a member from the surgical team came (AND IT WAS THE DOCTOR WITH THE AMAZING HAIR - yaaas), she was there for the all important consent forms. The forms that ask you if you consent to not only the surgery but to any research but not just that, along with the consent forms come the risk of the surgery. I don't even remember what risks she was telling me other than the important one - death. Death is pretty much a risk at every single surgery or procedure no matter how big or small and it has to be explained. I bloody knew it would be so why did I get so scared at it?! I remember it literally took my breath away (and not in the romantic way - I've never said that quote before, haha - weird) but I just gulped, sucked it up, pretended it didn't bother me and just went "yes" AND LAUGHED (I bloody laughed - ffs). Then came the time for me to sign for my surgery to be done and this was horrible. The reason it was horrible wasn't because of what I was signing for, I knew my surgery right? I had been preparing for it for weeks now and had been told numerous times what it was going to entail right? .. Wrong. No I hadn't, well, I had.. but in my head I thought that previously when I was told they were going to be doing the fertility sparing surgery that that meant that's exactly what they were doing and only what they'd be doing. I had no idea that I still had to sign consent saying that if they got inside and found cancerous cells everywhere that they had consent to remove everything. What I mean is that I had to sign on that piece of paper that I consented to potentially waking up in theatre recovery with absolutely no chance of having children, ever again. It makes me cry writing it, it makes me cry thinking about it, it was horrible. I was so happy before when I was told it would be fertility sparing that I hadn't even thought properly, I hadn't even taken a step back to realise that of course, if they had to, they'd have to remove everything. All of this I found out minutes before walking down to theatre. I had no time to process it. I needed the surgery. I knew I needed the surgery but at that moment I wanted to back out so badly because I could wake up, I could wake up and never be able to have kids and you know what.. I SIGNED for that to happen, I signed for that to be OK.
*Next time: Post-op, theatre recovery, my stay in hospital.*