Tag Archives: surgery

Like a Fish Out of Water; Surgery and the Hospital Outside the Psych Ward

Well, it’s happened. I’ve made it through my hysterectomy slash bowel-resection surgery and in hindsight it appears that having an exploratory surgery a month previous to this one gave both my doctors and myself the opportunity to work all the kinks out before tackling the more serious subject of my bowel being invaded by endometrial tissue.

The two weeks leading up to surgery were torturous and the overwhelming amount of anxiety I was feeling about the aftermath led me to skirt around the fringes of paranoia when it began to escalate.

Generally for me, paranoia tends to take the form of the belief that someone is trying to kill and/or undermine me in some way. My paranoia stemmed not from the surgery itself but from the 5-7 days I was expected to spend in the hospital recovering after surgery.

I had never spent time in a hospital –that is to say, I have never spent time in the hospital, save the psychiatric ward. Trying to fend for myself in a psychiatric ward (and by that I mean communicate properly with my doctors and nurses about my particular medication sensitivities and the odd tendencies of some of my psychiatric symptoms) has often led to both a communication breakdown and further exacerbation of whatever unfortunate mental state that landed me there in the first place. This is an issue I’ve had with many regular doctors as well, so the idea of being drugged (or asleep) in a hospital bed and at the mercy of whoever was on duty that shift frankly scared the hell out of me.

To offset my crippling fear of facing (another) abusive nurse or another medication slip up (as happened with my last surgery) I spent the week leading up to surgery generally huddled in my apartment making list after list of instructions, drugs to avoid, people to contact in the event of psychosis or mania induced by medications, etc. followed by lists about each of the lists, color coded and copied several times over to be available on my bedside table.

Though I found this slightly soothing, there was still an extraordinary amount of fear. What would happen if I had to share a hospital room with a stranger? Would my PTSD land me in a situation where I became manic or psychotic -as it has several times in the past? And what about if I did become manic or psychotic, how would the hospital staff respond to that? The hospital I was to have surgery at doesn’t have a psychiatric unit, so I was baffled at what might take place if I needed one.

A touchy subject for me, given my history of difficult hospitalizations and abuse in hospitals. Thankfully it was not one I needed to explore, because after speaking at length with my surgeons and anesthesia team on surgery day we made a quick decision that allowed me to bypass the use of narcotic pain killers almost entirely. I opted instead to receive an epidural, which numbed my body from my waist to my knees, rendering the use of the narcotics (that have proven to be big time triggers for me in the past) unnecessary.

So not only was I not triggered by the narcotics, I did not require much medication for nausea (also a trigger for me) since I was without the narcotics. I was able to be put in a private room (given my mental health history and luck regarding room availability) and since I only had to take a small fraction of the drugs I would have otherwise, I was generally alert and able to communicate with the staff more easily regarding my drug allergies and (psych) medication needs. My alertness definitely helped ease my concerns in the area of paranoia… though I did wake up once or twice in the middle of the night certain that the balloons next to my bed were up to no good.

Actually, the bigger problem (in terms of my mental health) in the hospital was the fact that my vitals were being taken every hour over night, so I was not able to get more than 45-50 minutes of sleep at a time. Sleep disruption can also be a trigger for me (both in terms of mania and depression) so I opted to get home from the hospital as soon as humanly possible.

Generally speaking, the staff in the regular part of the hospital were much more kind and eager to listen than those I have met in the psych wards in the hospitals I have been to. I feel very lucky that they treated me respectfully and did not discount my concerns merely because I have a mental illness, something that unfortunately is a serious issue in many psychiatric units today.

I definitely can’t say that I went the four days in the hospital without any mood swings at all, but they were generally depressive waves… much more easily managed laying around in a bed all day than mania. In the last week I’ve been home they have definitely been increasing in frequency and severity, but I am hopeful that being able to finally diversify my meals a little bit and spending more time without intense pain (rather than with it) will help tip the emotional scales back in my favor.

All in all, I would say that the surgery and hospital time went better than I expected. There were no incidences with bad medication reactions, or particularly volatile interactions with the staff (ok, maybe one), and it felt like a totally different experience when my doctors made everyone else adhere to my psychiatric and physical particulars.

The difference this time around surely came from one of my surgeons having had a foster daughter with bipolar disorder. He has a first hand experience seeing the sorts of episodes and behavior that can be triggered (for me at least) by many medications, among other things, and there is no doubt in my mind that this led to him directly telling the staff to take my concerns very seriously. Frankly, he seemed just as concerned about triggering me as I was, which is how I imagine (in a perfect world) healthcare professionals should act!

Anyway, I am glad to be home.

There and Back Again; A Bipolar Surgery Patient’s Tale

While I’m not in a position to either calmly nor collectively express myself right now, I thought it important to pop in and let everyone know that at the very least, I survived surgery last month.

Healing from the surgery itself seemed to bring me no more pain than I was experiencing prior to the surgery, however I hit a number of speed bumps that have made it exceptionally difficult to write.

The first was a nerve in my abnormal cavity being pinched by my diaphragm post-surgery, and while this was very painful it was the fact that the doctors couldn’t rule it out as a blood clot that made things very intense for a short period right after surgery.

After that I had a really bad reaction to some of the medication I was given (not a new experience for me, given the reactions I’ve had to most psych drugs… I have the same problem with drugs in all categories). After being unable to consume anything but water for three days (including my normal medications) I slipped into a very interesting delirious state that quickly escalated into mania.

So the third hurdle was a bipolar one and frankly one I was rather expecting -though I can’t say I was expecting mania, more of an expectation for depression (given the pain). Things started out energetic and euphoric and after a couple of days without sleeping my boyfriend confronted me about his concern that I wasn’t resting properly. This was enough of a red flag for me to prepare myself for taking my as-needed I’m-kicking-mania-to-the-curb antipsychotic that evening, but even if it hadn’t been the paranoia and conversations I began having with people who were not present later that day were enough to get the job done.

After taking the emergency rispiridone I spent 48 hours in a zombified, half unconscious state. It wasn’t until the emotional void wore off that I found myself plummeting down the depressive rabbit hole.

I’ve gone back up and back down a couple times since, had probably twice as many panic attacks as usual, and I am honestly really struggling to find a balance between taking care of myself and resting. I expect that this is difficult in a normal situation, but resting when I can’t sit still and going to my follow up appointments when I am feeling exhausted has been doubly difficult. The emotional roller coaster isn’t fun, but not being able to rely on my body for information on how it is feeling at any given time (since my energy level fluctuates with my mood, not my level of health) is confusing, at best.

It is important to me to try and take a positive spin on this, and even though this has been difficult I am generally managing to claw my way through (with a LOT of outside help). Despite how overwhelmed I feel, finding out this week that I will need a second larger surgery in a month or two to address the issues found during the first surgery has left me with a loss for words. When it is hard for me to identify how I feel about something, it is even more difficult for me to write about it.

I have many thoughts and experiences I want to write about, and while they are things I plan to share I have no foreseeable timeline. In the meantime just know that I will be posting whenever I find myself in a place somewhat less tumultuous.

Thanks for reading!