Not a great one this time. When I spoke to the anaesthetist the day before, we talked through the process and what drugs I did and didn’t like (NO KETAMINE). Among other things, she basically said there are two options to anaesthetise me – one that involves putting monitoring patches on my head and one that doesn’t. The one with patches is the nicer option for me, apparently. The one without is less nice. I didn’t really understand this at at all, but I knew as soon as she said it that Mr K wouldn’t be wanting monitoring patches on my head.

I was right.

Going in felt ok, I walked myself in. I got on the table thing under a warming blanket, which was so nice. I’d met my anaesthetist, I felt in control. To be honest, I don’t remember much after that. I think I went off quite quickly.

But I woke up screaming. I was in absolute agony.

‘Where is the pain, Jen?’ They asked, worried.
I noticed the irony of my words as they came out of my mouth.
‘My left elbow…’
‘What?’
Not sure anyone expected that.
To me, it felt like the resolution was ‘there’s no reason for you to be in pain there so you should be ok.’ But I’m not sure if that’s just the feeling I got (and a combined history of being told that) or actually what they said. I’m willing to accept that interpretation and actual life might have been a bit of a wavy line at this point.

I’ll come back to the arm later.

For now… I’m wailing. The pain was excruciating and I was confused.

I was awake and it looked like I was still in the middle of surgery, which was a terrifying thought. But surely that wasn’t the case. I asked where we were and I feel like I got an explanation that I had just had surgery and they had just woken me up. I obviously knew that.
Then I thought she said ‘we’ve just woken you up in surgery.’
Like in the middle? Like… Something went wrong or the anaesthetic didn’t work? I panicked. I blacked out.

I came to and I was still in surgery. Had they really woken me up while it was still going on? I asked again what was happening and I feel like I got explained to once again that I had just had surgery and they had just woken me up. This information was not helping me. I can vividly picture me saying to them, annoyedly: ‘yes, yes I know, you just told me that. But where is this, what is going on.’

I wasn’t expecting to be woken up while still within the theatres. For all my questions of what to expect when I woke up, I would have thought that would be a useful thing to prepare me for. I think everyone has a slight fear that they will wake up during the surgery, don’t they? Even though we know logically it won’t happen, I don’t think that thought ever goes away…

I have been woken up in a few different places – ICU, the wake up room thing before going into a ward… But I had never, in my memory, been woken up in theatre. Everyone was still rushing around in their surgical things, it felt frantic and shouty and scary.

One bit of information that is still amidst the chaos, bookmarked in my mind, and sits in the middle of this confusing, winding vortex is this:
Mr K came in and said that the surgery went well. It was long (12 hours) but he was feeling confident. And he feels better about it all after getting in and seeing it. He thinks he got it all out.

We wait, of course, for the histology results. Then we can release the collective breath we are all holding. I was worried that going in to surgery, they would find out it was a lot bigger than they had initially thought. It surely would have kept growing in that time between the last scan and surgery… But it doesn’t seem to have gone that way at all.

Anyway, after the theatre stress, I was then rolled along to my bed in PACU (which I think stands for Post Anaesthetic Critical Unit, and I think I will talk more about it soon). The trip felt traumatic and confusing and I asked my anaesthetist why we were doing this. I’m sure I had it explained once again that I had just had surgery and was being woken up. ‘Remember, Mr K just spoke to you?’ She asked.
Yes, of course I do. That was obvious. I was just very confused and overwhelmed by the process that was unfolding. Mere moments after a 12 hour surgery, I found myself lecturing my anaesthetist about how she should have prepared me better for this. Get off your pedestal, Jen, let it go.

But the statistics for Delirium/psychosis of patients going through surgery and ICU are scarily high. I would think better preparation when possible would help to manage this…

It was all a bit of a jumble from there. I didn’t have ketamine this time but they must have given me something similar. Perhaps my anaesthetist friends can tell me if they have to sedate me for such a long surgery? Though I didn’t feel sedated at all after that emergency 10 hr operation I had a couple of years ago… And I thought that was because I asked for no Ketamine. Perhaps I need to change my phrasing.

Sedation is the worst. I couldn’t stay awake, I couldn’t use my phone. Though I’m not sure if that was just anaesthetic or the sedation?

Anyway, my anaesthetist came to visit me some time later and we just debriefed on the whole thing. I found out that apparently I’m usually woken up in the theatre, but right at the end. So I don’t usually become properly conscious until much later. This time, however, they started waking me up much earlier so I was getting properly conscious while I was still there. I was coming to as they were packing everything up.

This is something I would have wanted to know so that I could be more prepared. So that when I was woken up still in surgery, I wouldn’t panic and think something was wrong.

As for the left arm… Two days later it swelled up massively. The whole thing was puffy and swollen. From my shoulder and all the way down. I couldn’t make a fist because my fingers were so swollen. I had an arterial line in it and a cannula in it. We know my body doesn’t like them. At the same time my temperature was elevated. This was an adventure in itself, which we will save for later. But the lines were pulled out immediately. I felt somewhat validated for the arm pain I’d had at least…