"You could have died..." Hana Hou Edition
Reflections on a recent surgery experience
A week ago today, I had surgery to repair an umbilical hernia. All the pain and overall discomfort aside, the surgery went great. So why the title? Upon waking up in recovery, still sleep-drunk from anesthesia, I was told that I suffocated and turned blue after they removed the breathing tube due to some obstruction of mucus that my body had somehow secreted during the procedure.
A lot of thoughts have run through my mind throughout the leadup to the surgery itself and as I’ve recovered over the last week.
These are them below but first…
How Does One Even Get an Umbilical Hernia?
A hernia occurs when the muscle wall weakens to the point that tissue or an organ protudes through.
An umbilical hernia occurs around the belly button.
In my case, how I got here was two-fold.
I first noticed a burning, tearing sensation while carrying two cases from an activation for work. I made the strategic error of shifting the bulky objects to one arm and reaching over to switch to one in each arm and felt that sharp feeling in the center of my physical being.
I thought that perhaps I’d experienced an abdominal strain and as long as I went about my business carefully that I’d be okay.
Oh, little did he know…
As fortune would have it, we’d switch up the training blocks that week and while under the leg press a few days later, I felt a unique burning in my belly button that shot down through my abdomen.
The next day, I noticed the discomfort persisted and to my utter horror discovered that my innie belly button had somehow become an outtie. I gave it a week and as it did not disappear, I made an appointment to get it checked out.
Living in the era that we do, I concurrently did research as I waited for my appointment and I had a feeling it was an umbilical hernia. The sober realization descended upon me as from everything I found, the only true fix was surgery.
Nonetheless, I held out hope the appointment with my PCP would lead to another outcome…
Ha, Right! ‘Umbilical Hernia - Not Gangrenous’ It Is!
Umbilical Hernia - Not Gangrenous was the diagnosis I was given after going in this past December. From there, I was referred to a surgeon and had a consultation a couple weeks later.
This was elective and not an emergency surgery. Thankful for that because from when I first experienced the injury, to now, it took about 4 months to get in and get this taken care of.
In this time since I was injured, I was been dealing with this odd discomfort in my core and burning sensation in my lower abs for months.
While I adapted and it wasn’t debilitating, it was uncomfortable, it impacted what I could lift, how much, and there was always the risk of it becoming an emergency, and my movements in and out of the gym were altered as I tried to minimize the risk of making it worse.
In my case, it was addressed early, and would most likely not require mesh based on my surgeon’s assessment.
I consider that lucky and a large part to acting and not waiting.
Google (or don’t Umbilical Hernia) and be amazed at how some people wait for the iconic Alien scene about to happen because the bulge can get bad as more tissue and intestines pop through.
On flip side, I could have just kept going with it, and Alien Resurrection might not have happened. And believe me, I legit debated up until the weekend before if this was something I wanted to do.
Does the Risk Outweigh the Reward
As I went through my final pre-op appointments, the first thing that made me question hard was the statement of:
“First, you acknowledge that medicine is a practice.”
I hadn’t heard this phrase, or maybe I’d not paid attention to its meaning, until Bev was in the hospital last November.
Perhaps more alarming was that the list of risks was legit 3x the length of the benefits.
And then there’s the recovery, of which, I’ve just lived through the first week. It’s a mindfuck how long the recovery can be. In general, it’s at least 4-6 weeks before resuming most normal activity, stay away from lifting anything over 20 lbs for at least 3 weeks, and even then, take it easy, and then up to 4 months for more crazy shit.
The emphasis is that you’re gonna want to chill bc recurrence of reinjury is not ideal.
Add in the nurse at my final pre-game appointment, as nice as she was, she was new there, and her assumption was that I’d need the mesh, which was not what the surgeon had told me (see above) and it increased my anxiety leading up to this because he said if mesh was needed, they’d have to cut me open more than needed to get the mesh in…
In the end, I opted for this because I wanted more mobility and to be able to flow through LIfe more freely and the risk of the diagnosis switching from Not Gangrenous to Gangrenous due to strangulation of the intestine was enough to go through with this.
Why was the choice so difficult?
I’m pretty anti-taking anything. I’m not against it when needed but I do my best to be as natural as possible and I’m that person that won’t take Tylenol or Ibuprofen unless I really need to.
Case in point: I was only on painkillers the day of the surgery and the day after.
Again, while I believe it’s important to take what you need, when you need to, I try to be natural because from years of fasting and observing my body’s response to what goes in, the reality is that I do not respond well at all to pain medication.
It messes with my digestion, which alters elimination, and from my recent experience, coupled with the anesthesia putting everything to sleep, I had a bad reaction that was evident by day three.
I’ll spare the details there, let’s just say…
Mahalo Magnesium Oxide
I’m not gonna go much beyond that and just say thank you again to Bev for introducing me to the ‘gentle’ magic of this because the prescription poop softeners did nothing. What made it all worse was the fact that I couldn’t put any pressure on my stomach for risk of possibly straining and rupturing the surgical site and it was just a whole lot of meh.
Moving On
Perhaps one of the most humbling aspects of this is how weak and uncomfortable I’ve felt throughout recovery.
Each day is better, don’t get me wrong.
But it also presents a new ache as my body has compensated due to the healing of ripped flesh, weakness of my core, and inability to engage it. My back hurts, my hips hurt, and I’m pretty wiped walking after 10-15 minutes.
They say to move, but not too much, and the other day I hit 26 minutes only for the day to end very sore, very tired, and later I’d awake with worry that maybe I overdid it and set myself back because of how sore the pulling in my lower abdomen felt.
In addition to the physical pain and weakness, coughing and sneezing bring terror as I aim to minimize the pressure on my core. I also can’t project my voice. I returned to work on Friday, 4 days after the surgery, and it took all my energy to make it through my weekly report.
My friend and colleague texted me after, sharing how good I sounded, and inside I was like that’s amazing, because that was the most I’ve projected in days and I felt like I needed a nap!
I’m doing my best to be positive and not put too much bad juju out there but it’s been a trip.
“It’s good you’re being honest.”
Taking it a step back to the pre-op checklist:
Stop eating and no drinking anything, even water at midnight
Check-in at 5:30am
Wait for my turn with others awaiting surgery, one happy old man who didn’t want his beard shaved, a little bit kolohe and fiesty older lady who reminded me of both my grandmothers, and another older man, who looked as terrified as I felt.
Review the paperwork, a bit a of rush tbh, but inital, here, sign there, and Bam!
Wait in the lobby of the surgery area until I got admitted…
From there they escorted me to the prep ‘room’ that was really just a large room divided by curtains for multiple patients waiting for the show to start, and then it was:
Take everything off and pack up
Get changed into a hospital gown
And complete a second wipe-down with the anti-microbial wipes that I was also asked to used the night before as well but in this case, they store them in a warmer in the hospital, which was really nice.
Now that that checklist was over, the fun really began as I was visited by the whole team.
CUT TO
The check-in nurse, who kinda preps but was more like a host seating me at a table.
ENTER STAGE LEFT
The IV nurse.
For my IV placement, I opted for my hand and was told, that’s great because the anesthestia team prefers that. As I wrote these words, I feel the pull in my skin, and a slight itch, where it lived in me for a few hours. I was lucky to only have it for a short time, but it was time long enough to leave a bruise that can cleary be seen.
RAPID FIRE REPEAT
I saw the surgical Resident, who I was not a fan of, as she jabbed the fuck out my hernia. It was honestly the most aggressive checking of it that I’d experience from any professional and that didn’t necessarily put me at ease.
From there I saw my Doctor walk in, confidence in his stride, Starbucks in hand, approximately 6:54am, with my surgery slated to start 36 minutes later.
Along come more nurses to ask me some questions, pretty standard questions but some fun ones that you don’t expect:
“Do you use cocaine or meth?”
CAMEO FROM THE SURGEON
Followed by a chorus of nurses where I got grilled hard but on questions like “do you snore?” and “have you stopped breathing in your sleep?” and while the answer is yes to both, I’ve never been tested for sleep apnea.
I’ve never forget the words of the last nurse who said, “It’s good you’re honest because they’ll check on you more to make sure you’re breathing after the surgery.”
Words I’ve replayed constantly after hearing that I suffocated to the point of turning blue...
TRANSITION TO THE ANESETHIA TEAM
Lastly, I was visited by a final set of nurses and the Anethesia Doc, who wore a hair cap with cartoon characters and the phrase:
Keep Calm and Call Anesthesia
Loved the humor and for whatever, I felt at ease with this doctor, and I speculate it’s because I felt her brutal, sincere honesty.
“Does it hurt when I get the injection?”
“Yes.”
No punches pulled and I respected that because it prepared me for the burning sensation that shot through my hand up arm, one of the last things I remember.
So Then I Wake Up and…
The mindfuck that I was suffocating was shared by this same doc as she came to check on me.
A part of me wishes I didn’t waive the photography and video because I would have loved to see what it looks like to turn blue, but imagine coming to after surgery, the fuzzy memories consists of a sequence of:
Saying goodbye to Bev, feeling a sense of how exhausting this experience had been.
Getting administered the anethesia cocktail through the IV and slowly rolling through blurry trip to OR 3 and seeing everything fade as they moved me to the operating table.
And waking in a new place within the hospital and hearing that everything went great.
Except for the suffocation, turning blue, and literally, freckle like dots for days!
Surreal is the only word that comes to mind but hey, if you’re going to stop breathing for a period of time, why not do it in one of the best places to get support?
As I got my glasses back, I looked across the room and saw my first name on the wall. I’d learn shortly thereafter it was for a nurse in that area, but in that moment, as I’ve so often in the past, taken signs as quite literal.
For whatever reason, that’s the place I was meant to be in that moment, even if the only meaning was because it was where I as.
I’m super grateful that everything worked out and now I’m healing but one of fears that lingered in my head, having only had, ironically childhood hernia surgery and limited recollection of it, was that because medicine is a practice, anything can happen in surgery.
When my Dad had his heart surgery, I clearly remember being told the hardest thing is for the patient to wake up after surgery. They aren’t allowed to say major or minor when it comes to surgery (the answer to a question that I asked) but I’d say his surgery was major compared to mine being minor.
Add to that memory that we lost a hanai Uncle far too early in life when he had a kidney operated on. Because every human body is different and in his case, there was a mass of veins in the area where they made the incision and they couldn’t stop the bleeding and yeah.
One of the risks that they make you acknowledge is that in surgery, an artery, nerves, [cut and paste something inside here] could be accidentally nicked and you might need a blood transfusion, which in rare cases could lead to other infections, and ultimately death.
So yeah, I wasn’t stoked leading up to any of this.
Drop in the notion of the idea of my abdomen being sliced open and what contained therein would be breathing the same air as who knows how many people was a little more unnerving.
And it wasn’t always like that. At first, I gave in, butwhat got me was one day was that I had the distinct thought that what if I’m fully conscious during the whole thing but unable to articulate the pain? What then?
While there’s science to address that, it was a concern for a moment and that said, I did make a few mistakes that might have eased my concerns, that I’ll outline to any who might read this.
Do Not, I Repeat
Don’t try to hero it.
If that initial tearing of my abdominal wall came while at work, I did myself no favors there, nor did I make it better by trying to keep going. I should have called it then, because I might not have been in this predicament.
Don’t watch the surgery.
Not helpful.
Less so is that I watched it a couple days before I went under and I about called it right there, that night.
Instead of do not, I’ll say try not overthink it. So hard. So, so, so hard and I don’t know how you don’t but it wasn’t helpful.
But it really is over before you know it and I’m honestly thinking more about recovery and each new day, filled with progress and other aches as my body compensates.
With that, You Should
Do Whatever works for you. There are people living and thriving with hernias and nothing happens.
Ultimately, this worked for me.
I got my Blue, Purple, and Brown Belts in Brazilian Jiu-Jitsu from the lineage of Mestre Aldo Caveirinha, who is known for making the Knee on Belly position a submission, because the pressue is terribly, unbearable, you have no choice but to tap.
Many of his students have extreme pressure games, as do many of jiu-jitsu practitioners, and if I was going to realistically go back and train again, which is a goal of mine, and avoid this becoming a true emergency, I had to go through with this.
I also enjoy lifting weights. While my only involvement with World’s Strongest Man is through an upcoming partnership through work and I have zero interest in doing super, crazy yoked volumes, it’s helpful to have some level of load to push and pull, mostly for longevity.
Playing along the back nine of Life, I’m in the era of diminishing ability to build and retain new muscle mass and if I’m going to have a fulfilling older life, I need to maximize when, where, and how I can because…
What we do today, impacts how we’ll be tomorrow.
Take away my personal goals and longterm focus and look at my current life. There will be multiple times where I have to carry cases of 20-25 lbs regularly and will even have to breakdown pallets from time to time.
And I’m not wired to just watch. Maybe that is mine to work on but I just feel the need to help and be a part of this Life as much as I can.
Picking up groceries yesterday, it pained me to not be able to carry everything.
I’ve been struggling to open the giant front door of our building.
And tonight, I had to ask for help getting out the cast iron pan of leftovers out of the fridge.
Humbling to be unable to do the simplest of things.
I remind myself that this is just temporary, but if I’m gonna be able to show up throughout the remainder of the course and continue to be a healthier and stronger version of myself, I needed to get this addressed and go through the hard parts.
Closing Time
I’ve said it before and will say it once more, as the actor Daniel Zapaca told me,
“The Light at the end of the tunnel doesn’t go anywhere. You’ll get there.”
And as my Mom would later add
“And when you get there, you have a whole new tunnel…
4 months out - I didn’t know what this was.
3 months past - I knew what it was but not how long the recovery would take.
2 months back - I was legit distracted because so much was going on.
1 month ago - I couldn’t imagine the long recovery.
And now I’m here, wading down the tunnel of recovery through a series of 2 weeks phases for 6 weeks then progressing along until 4 months from now.
And look at that, I have my post-op appointment tomorrow. In another week, as long as I take it easy and this continues to get better, I’ll be able to walk 20+ minutes before I know it.
And that’s the recurring lesson - You always get somewhere else before you know it.
Soul best just to be full and present to everything this Life brings - the beautiful, ugly magnificence of it All.
Because we’re all closer to the next experience than we might realize.
Much mahalo to all the healthcare professionals. Mahalo ke Akua for suffocation not lasting too long. And yeah, just wow, soul much Wow.