Do you have any children?

The spouse of one of my co-workers asked me this last night.  It’s a bit of a loaded question, isn’t it?  I don’t fault her for it, it’s not like she dwelled on it when I said “no”.  But it is one of those things that makes me wonder how people in my position who had wanted kids must feel when it is asked.  It must be terrible.

My aunt, who is about 85, shared with me her own experiences with infertility way back in the 50s.  Backing up a bit, I should say that this is my father’s sister.  He has three.  None of them could have kids.  Between thyroid disease and/or endometriosis, they were trying to conceive in an era where I think the many different reasons for female fertility challenges were not at all well understood and where remedies were hard to come by.  I know that the first “test tube baby” was conceived within my lifetime.  It’s one of the first science news stories I remember being very aware of.  My paternal grandfather’s mother also struggled with “female problems”.   What started our discussion on this was that I participated in a genetic study on endometriosis.  They asked for an extensive family medical history and so I asked my aunt.  She was the eldest of the sibling set and was very aware of who had what. Once we had broken the silence on talking about it, she was able to share these anecdotes with me about her early adult life with this disease.  E.g., when she was first married, she told me, it didn’t take long before family and friends started calling her mother to ask why she hadn’t had kids or become pregnant yet.  Let that sink in.  You are a young but grown woman who is bright and who had wanted to continue her education beyond high school to become a teacher.  Your uptight Italian father said no, since he feels it is important for women to have babies and not to have jobs.  You wait, and finally you are married to your sweetheart, who has survived an extended stay in a Nazi prisoner camp and a bout of tuberculosis.   You are delighted that you and your beloved are together and married and you are excited about starting your family.  Months pass.  You start wondering what’s wrong, since you still are not showing signs of pregnancy.  You don’t really talk to anyone about it because people don’t do that back  then.  And then extended family and friends start calling YOUR MOM to ask about some very personal details of your life, your marriage, your intentions, your body.  Like there is something wrong with you, like you’re intentionally and stubbornly keeping yourself from conceiving.

Like my aunts, and their grandmother, I struggled with endometriosis from my adolescence.  I recall one particularly clueless doctor telling me that I probably would never be able to have kids.  My attitude then, and now, was “well good thing I don’t want any!”  And I didn’t, I truly never had.  As a young child, I had played with dolls but not baby dolls.  My dolls were projections of my conception of an adult me.  They had jobs and kitchens and cars.  They did not have families.  I remember playing dolls with the daughters of a family friend once, these girls had Barbie and Ken, and the play-time devolved into a screaming match between Barbie and Ken about who worked more and why they didn’t have time to take care of things around the home.  I recall Justine, the daughter closer to my age, bobbing Barbie up and down excitedly (the universal gesture for “the doll is talking”) and vocalizing Barbie’s increasing intolerance of Ken’s slothfulness.  “I work 100 hours a day, 8 days a week….” Barbie shrieked at one point to Ken, who was busy packing a bag and preparing a get away in the pink plastic sports car parked outside the Dream House.

I have had three surgeries for Endometriosis (02, 07, and 11), four if you count the scar tissue removal one this Spring.  I finally had had enough and said it’s time to get rid of the uterus.  This decision came after I’d been told that at my 07 surgery, there was evidence that the implants had worked their ways into the walls of my uterus.  Not the lining, the muscle tissue.  It was described as “enlarged and boggy”.  I referred to it as “old boggy” for years after.  In 11, I said goodbye to Old Boggy and had them take it out.  It has helped.  I remember researching the surgery in the months leading up to it, and finding a lot of chatter about the emotional impact of hysterectomy.  It irritated me for a while, mostly because I was like “god damn it, I want to know what HAPPENS.  Where do they put your ovaries?  What do they do with the ligaments and all that crap that used to hold your uterus in place?  I don’t give a crap about the loss of woman-hood.  Who the hell cares?  Old Boggy is not the seat of my gender identity!”  But thinking about my aunts, and thinking about friends I’ve known who really wanted a kid and struggled with conceiving or carrying a child made me realize that this probably is a big deal for a lot of women and the results of my internet searches were just reflecting that.

So I wonder, for those women, what it must be like to be at a party where two of the three married couples have young children who are doing all of the cute and/or annoying things that children do that draws adult attention, to be asked “do you have any children?”  It must suck.

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Reckoning

It’s coming.  I’m nearly out of the short supply of pantoprazole the covering GI doc wrote for me after I was given a half script the last time I saw my GI doc.  I truly dislike the doctor finding process.  There should be an interview stage, where you can meet with them and ask them questions to see if you will be a good fit.  It would save everyone time and I’m fairly certain in the long term save money as well.  Changing docs means repeated procedures, tests, etc.  I can’t tell you how many times this GI doc has re-ordered tests my primary already did.  Usually, I skip them and just tell her to get those results.  Maybe this is part of my “difficult patient” charm, but I see no reason for me to have two thyroid panels within a month of each other just because one doctor doesn’t want to take the time to get and look at another doctor’s results.  Especially not when the ordering doctor isn’t even going to be the one to have to go and get the previous results.  That’s up to the patient.  But it’s dispreferred and I think it has to do more with wanting to be able to quickly look in one (electronic) place for the results than anything having to do with good medicine.

I may (and I say this with some significant reservations) be looking into a pelvic floor dysfunction group – and those groups have GI docs.  Either BATH 1 or BATH 2…not sure which.  BATH 1 is closer, they seem to have a less surgery-centric approach, and they at least mention dysfunction of types other than cystocele and uterine prolapse.  BATH 2 is where my GYN surgeon and gynecologist are.  Both claim to take a multidisciplinary approach, but when you look at their medical staff, BATH 1 has GI, colorectal surgeons, and PT where BATH 2 lists two urogynecological surgeons.

I’m reminded of my naive question at the nurses’ station waaaaay back when I was a wee little newbie worker.  My first “real job” was as a unit secretary on an inpatient surgical unit (the kind of unit that has been changed to outpatient/ambulatory care now that patients are hustled out post op without waiting for the all important eating, drinking, and voiding requirements).  I wondered out loud why so many of our patients were on the GYN services.  The nurses shook their heads at each other, then explained to me that for “female problems”, most of the treatments are surgical.

We had a fair number of GI patients too.  Which brings me back to my main point.  Finding a new GI doc.  Ideally, I want someone who doesn’t think “functional” disorder means uninteresting and not worth her time.  I want someone who sees a diagnosis of a functional disorder as a hypothesis which she is willing to revise or revisit should new evidence – even evidence from systems other than my stomach or gut – present itself.  And I want someone who thinks of ALL of me – who wonders about the sores in my mouth as much as she thinks about the motion of my intestines.  Someone who cares about my nutritional status, someone who recognizes and incorporates into diagnosis, treatment, and general approach that I have some sort of screwy systemic thing going on which may be connective tissue based, may be autonomic nervous system base, or may be both, and which I’ve had all of my life.

Tomorrow I see my gynecologist for a routine check up and we will talk about pelvic floor dysfunction referrals.  I don’t need a referral, but I feel better about having one.  I worry that self referral is another sign to doctors that you’re a difficult and unstable person/patient.

But that’s tomorrow.  Today, I need to call the current GI to ask for a new script.  Bracing myself for this.  I’m guessing it’s not going to be easy since I already called twice about it when I first noticed the screw up and they have yet to resolve it.  This is  the “no, seriously, she needs to deal with this” call.  I hate those calls.

rrhoid alert

Erg.  I’ve got ’em.  I’ve had them for a while, but whether it was the month of narcotic pain meds or the surgery itself or the straining to pee, they’ve gone into overdrive.  They being the little slices of hell called hemorrhoids.

Doing home care.  I already have a sitz bath, thank god, because I’m on a “no baths” restriction post-op.  Sent hubby out for epsom salts.  I really hope this responds to home care because I am not in the mood to add another doctor to the list of medical specialists I see.  😦

They say that you get them from constipation, from straining.  That’s the classic reason.  And the classic “cure” is to improve your diet.  Unfortunately, you also get them from – well, to put an indelicate topic somewhat more delicately – going too much, which is where I fall on the spectrum.  And so far, there’s no diet or meds that make that stop.  I’m down to 124 lbs now, lost more since this thing started although on reflection it’s really been on a downward trend since January.  I want to blame the Colace, which I had been taking on account of the pain meds in April.  But I haven’t taken Colace in a while and I’m still, er, going.  I’m sure any trip to a doctor for this is going to include a well intentioned but largely clueless lecture about fiber.  Ha, fiber?  Fiber just makes it worse.  I’ve had doctors tell me to have more fiber, then when I shed pounds like a teen beauty pageant contestant, to for the love of god stop the fiber.  Only to repeat that cycle again when I have a new doctor (for a while, in the Olde New England Outback, my GI doctors kept leaving the state so I was rotated through an entire practice until I finally had it out with one of them whose crazy rude office/medical assistant suggested that I was taking laxatives).

busy bee

One week post op.  I’m weaning myself down off the prescription pain meds.  Difficult since my favorite OTC is Ibuprofen but it really does a number on my stomach if I take it daily.

Today, I found a place I might be able to live and job posting for a job that I could do.  Full time, which isn’t ideal, but then I remind myself that I did this job full time for nearly three years and if it hadn’t been so RIGID in terms of time, so unrealistic in terms of task, and so toxic in terms of atmosphere, I probably could have kept at it.  I’m trying to hold on to hope.

So today, I touched up the resume, wrote two drafts of my cover letter, and made a bunch of phone calls for new places to live.  One viewing scheduled for Wednesday – it’s a two family (not my preference) one bath (also not my preference) but it’s the top two floors of the house, there’s a washer/dryer IN UNIT (wooo!), the location is ideal, and the price is good.  A mix of pros and cons but definitely worth a look.  I managed to mention that I have publications when talking with the real estate agent.  Oh yeah, I’m a published researcher, that’s right.  It came up when I gave my husband’s name:  “oh, his last name is different” the agent remarked.  I replied, “Yes, well, I’m an academic and I had published some papers prior to meeting my husband.  My advisor told me that if I changed my name when I got married, it would mess up my publication history so I just kept mine.”  BOOM.  Take that!

I don’t usually boast about the research cred but if someone is going to be socially tacky enough to comment on married people not having the same last name in 2012, then I find it both personally satisfying and socially advantageous to turn that tacky faux pas into an opportunity for self promotion.

pre and post

Let’s start this post with the following caveat:  I’m coming up on pain med/lay on the couch time so I may stop abruptly.

Pre-op.  I’ve had four pelvic surgeries in my life, and several upper and lower GI scopes.  I think all but yesterday’s were in the AM (one GI capsule endoscopy was started a little late and had continuing restrictions for the next several hours and that also sucked).  And now I know why they will remain in the AM.  Lack of caffeine.  Not long after starting the IV for my 12:50 surgery, the familiar little sparkling geometric pattern popped into my vision.  “Ah shit, I’m getting a migraine”.  The anesthesiologist was the first person I saw to tell this to.  Lack of caffeine, stormy weather, disturbed sleep for the last three weeks.

After asking me a few questions to make sure I actually HAD migraines and that this wasn’t some kind of seizure or something, he said “I’ll see what I can get you for that…” and came with massively awesome drugs.  Versed and Fentanyl.  Holy cow, now that is how you clobber a migraine.

Talked to doc pre-op and asked if he could do a bladder hydrodistention to look for any evidence of interstitial cystitis (IC), since he’d be in there, I’d be under, and there is a bladdery component to this.  Sure thing, we went over how cystoscopy wasn’t the most sensitive for IC, that you can have IC and not have visualizable findings.  Yup, I know.  But if this lap turns out to not show much that could have caused all this pain, I’d rather have done the cystoscopy now than wait and have someone recommend it in July, and expose myself to more anesthesia laden procedures.

Findings:  no evidence of IC.  One (or some) adhesion(s) between the cecum and abdominal wall that the surgeon felt was unlikely to have caused all that pain, or so he told my husband.  The drawbacks of being an add on for a procedure (and slow to wake from anesthesia, I was out for twice as long as the surgery took) is that you don’t get to have that immediately post op Q&A with the doc.  The doc’s office has my follow up scheduled for JUNE!  LOL, or SOL (swearing out loud), take your pick.  I’m going to consider this an oversight, a vestige from my surgery initially being scheduled in June rather than the office thinking that 7 weeks out is an adequate time frame for a follow up post-op appointment.  I will be calling them today.  Also calling to ask about the restriction the resident wrote:  no fioricet.  Um….which part of “I get migraines a lot, I spend most of the summer in a migraine state and outside of summer I get them about once every week or so” did she not get?  Just writing “no fioricet” without any indication of how long “no fioricet” stands on someone who is a walking migraine is not ok.  More evidence of specialists’ reductionist approach to medicine.  Each body is just a collection of parts, and this is MY part so this is the only part I will care about and I will care about it as if it exists in isolation.

Right.  I am about to have to encounter this with the attending too, since the third reason for my call to GYN Surg today is going to be about medical leave.  Yes, this was a “minor” laparoscopic procedure with minimal cutting.  However, when it comes to anesthetizing and then poking around my bowel, there is no such thing as minor.  I also have a slower constitutional recovery, I know this from past surgeries.  And where I work, there is no such thing as a reduced work load or schedule.  So I am not going back until I am truly ready to go back.  But accepting this as legit means accepting the validity, the reality of the autonomic fuckery my body is predisposed to.  And it has been my experience that autonomic fuckery is not something reductionists can handle.

Ok, time for meds and couch.  Then phone calls.

trust

My therapist asked me how I felt about having a diagnosis.  The diagnosis being Ehlers-Danlos Type III, a clinical diagnosis made by a genetic medicine specialist.  Blood work for EDS IV is pending.

Although the list of symptoms/presentation reads like a list of shit that’s wrong with me, I find that I distrust the diagnosis.  Some of this is because I know it will be questioned by many, many doctors, as all clinical diagnoses are.  “Well, how do you KNOW you had Lyme Disease?  I see your blood work here and it didn’t meet the criteria…”  For that one, I don’t bother arguing with them about how they seem to be thinking of surveillance criteria, which the CDC states are specifically “not intended to be used in clinical diagnosis” (or sole basis for diagnosis).  I just show them the EM rash picture and they say “Oh” and shut the hell up.  EDS Type III does not have a reliable test.  It’s “picture” is a mosaic of mostly “subjective” symptoms.  I.e., it is readily invalidated by any doctor choosing to do so.  And they do choose to do so with great frequency.  I consider much of that to be the result of a misapplication of the scientific method by people who are either inherently intellectually lazy or whose intellectual curiosity and excursions have been effectively beaten out of them by years of social reward for unquestioning conformity to authority and punishment for independent thinking (too often seen as feckless, unreimbursable meandering in the context of our education and health care systems).  Oh also there is sort of a tendency towards pissing matches among competitive people and my own experience working with, living with, and married to health care providers suggests that competitive types are over-represented in medicine.  It’s hard to make it through pre-med, med school, and residency if you do not have a strong competitive streak.

So all that said, while it is nice to have a name for that illness…the next time I have to fill out health care accommodation forms, for example, I will have a succinct and rather all encompassing diagnosis…I find I am less than enthusiastic about disclosing this diagnosis to other health care providers.  Like my GYN surgeon, for example.

I mention him because I am about to be cut up.  Well, rather cut into.  Now, I believe that more imaging would have been a good idea.  Perhaps a urology or general surgery consult.  But my providers are of the mind that if it’s not something that the morons who read my CT in the ER saw, then it’s not imageable (really I just can’t trust radiologists who read the CT of a woman who’s had a hysterectomy and bilateral salpingectomy as “the uterus and both adnexal regions are normal…”) and that if GI doesn’t want it, then I should follow up with the GYN surgeons.  And the GYN surgeons, being surgeons, are just like “hey, well it might be adhesions.  We can cut into you and look.”  Because an exploratory lap is not a big deal for them.  It’s like a walk in the park.

Initially, they offered next week and the very end of May.  I took the very end of May because at the time of the consult appointment, I was not in pain and had not had it in a few days.  I tend to have a ridiculously optimistic outlook on this shit, despite all my apparent cynicism.  No pain for four days?  Well then clearly it has resolved!  Stupid me, it came back on Wednesday night.  A little gnawing pain, oh maybe it will go away.  I’ll take half a pain pill.  Then a few hours later another half because it’s back.  Then the next morning, I wake up pain free and think “woo hoo!” only to shower for work, go to empty my bladder and have lancing LRQ pain that felt like I had been run through with a serrated knife.  Ok.  So take half a pain pill.  Nope, pain still there.  Take the other half.  Pain still there and escalating.  Call in to work, take another pain pill, squash myself up on the couch in a cushion cocoon, cry a little bit, talk to my husband who is concerned and stressed about moving, surgery, timing, etc.  And then call GYN surg back, still crying and say “Um, I’m really sorry to have to ask but do you think you can still do next week?  If I wait until the end of May, I’m going to end up using all my leave time from this pain.”

And so pre-op appointment today, surgery Monday, EDS-III possibly making recovery longer than the one the surgeon is going to recommend (they seem to assume all women will be back running marathons and horseback riding in one week after a lap).  I have more forms to fill out, little time to do it, and a surgeon to convince of the need for at least three weeks recovery.

While I have the optimism I spoke of earlier, paradoxically, I have a tendency to distrust that people will do the “right” thing when it comes to making my life more or less crappy.  I need to get over that.  Ultimately it’s about not wanting to have to push when I feel like the wrong thing is being done, or the right thing is not being done.  It’s about not wanting to be seen as pushy because pushy people are a pain in the ass and pain in the ass people are bad patients who invite invalidation, disregard, and maltreatment.  But not pushing gets you left in the dirt too.  So as always, I struggle to find a balance.

Hot mess?

Yep.

 

Pain has been back twice. Last Friday & today.  Bad today.  And right now, my blood pressure is 77/45.  Blood sugar is 67.  And exploratory lap is scheduled for Monday.

manic monday

My husband was out of town this weekend to visit with his family a few states away.  His brother’s birthday, his sister in law’s birthday, and just general “let’s all get together”-ness.  That’s nice.

I haven’t had the need for that in my own family in over 10 years now.  And the last two families I did do this sort of thing for certainly didn’t love me for it.  What I remember of it is largely pain in the ass running around, feeling like you’re trying to please all the people all the time, etc.  My own family actually was pretty chill on the whole “hey gang” kind of planning.  “Hey gang!” being my term for what I see in these other families – it’s not enough for the visiting family member to plan his or her trip so as to maximize time with all family members (equally).  All family members must engage in activities, and all activities must involve all family members.  This is in fact a strictly enforced code.  My current husband’s family is definitely a “hey gang”.  My ex husband’s family was also although they didn’t think they were, which actually made it that much harder to address.  The guy in between’s family was ok with members going off to do their own thing providing it was approved by the family patriarch as appropriately cool – e.g. preferably involving expensive toys and large amounts of alcohol.  Any other independent planning was seen as wuss-tastic and insufficiently important to leave the family behind, and therefore subject to undermining.

While my husband was gone, I planned to have my sister over to visit.  She’s been having a rough time with work.  This coming week was my first full time week back and my husband and I planned out how to split up errands and chores on the weekend so that I wouldn’t be exhausted heading into it.  My husband suggested that my sister might be able to help with grocery shopping.  Or not.  My husband explained that he didn’t mind going grocery shopping when he got home Sunday.

Friday night two things changed.  My husband’s family called to tell him that plans changed to suit the convenience of the ones doing the hosting.  The practical result was that my husband now had to travel a bit further and would spend more time in transit and less time with the family.  My sister called and told me that she had quit her job on Tuesday, with no notice.  Just quit.  And that maybe now she’ll be homeless but at least she’ll be homeless with a clean conscience.

Bright and early Saturday morning, my husband got on the road.  My sister didn’t call until 4:45 PM and didn’t actually make it here until about 6 (she lives about 20 miles away).  So no grocery shopping.  I spent the next nearly 24 hours playing career and life counselor to her.  My husband came home in a distant mood.  I was exhausted and had just lay down on the couch.  He went shopping and asked if I would rest while he was out so I could help prepare food for the week when he got home with the groceries.  Which I did.  We cooked and I cleaned and were done with it all by 8:00.  I was happy because I thought I’d get into bed early and get a good night’s sleep to start off my big first week back at full time.

Nope.  My husband had other plans.  Other amorous plans.  This did not end well.  Had his plans been stated explicitly, I might have been able to discuss it without getting pissed off.  However, they were not.  There were four reasons his plans were a bad idea, all of which I’d have expected him to know.  First, non-explicit.  As a sexual abuse survivor, I require actual communication of intent and consent.  Even with my husband.  None of this just tumbling into sex shit for me.  I need to know the person’s intentions and I need to be given a no strings attached chance to agree or not.  Second, I was fucking exhausted.  Third, it was Sunday night and my first week at full time since before Christmas.  The Sunday night sex plans are not a terribly great idea in general – hell, there was even a crappy pop song addressing that in the 80s.  Fourth, he was distant emotionally earlier and we hadn’t really reset.  I need that reset time.  See number one for reason.

And now I’m upset.  And tired.  Happy Monday.

a couple of tips

If you’re having gynecological surgery – granted I’ve only had laparascopic surgery so I can’t say that this will generalize to laparotomy surgery – here are a few things I’ve learned.  I’ve had three, one in 2002 which definitively diagnosed the long suspected endometriosis, one in 2007 which added a diagnosis of adenomyosis, and one just a few weeks ago which removed my uterus, cervix, fallopian tubes, shaved a bit off an ovary, removed multiple endo lesions including resecting the left uterosacral ligament (which apparently was affected by the endometriosis).

1.  Find an experienced surgeon.  Do not assume that just because your GYN doc says that s/he can do this surgery, s/he is the best person to do it.  S/he is not necessarily.  The GYN who did my first surgery left several sites in place because she was not skilled enough to remove them.  My next surgery was with a doctor who had made his name as a fertility specialist/surgeon.  Much better results in surgery and much better at diagnosing and treating endo than the generic GYN.  (addition):  I’ve had some luck by cross referencing google scholar searches (in this case, for recent articles on endo and laparoscopic surgery) for authors with my home state’s affiliation.  Yes, lots of false hits but it’s a decent way to get a sense of what doctor or group of doctors close to you are working on what you’ve got.  I also have had good luck asking around. This works best if you are asking people who have what you have.  My New England Outback doc was a double hit – recommended by a friend with endo and who also happened to be someone I had found via the internet search I described above.

2.  Even if the doc says you don’t need to do it, do a bowel prep before surgery.  I didn’t before surgery 1, nor did I get stool softeners.   Oh my god did  I regret this.  This most recent surgery, I decided I didn’t have time to do a prep and since my intestine has a pretty quick transit time these days, I figured I wouldn’t need it.  I was wrong.  General anesthesia, people fiddling around with your intestine, and narcotic pain meds will slow your bowel down to a standstill.  Do a mini-prep.  You can ask your doctor or (probably better) the nurse at your doc’s office for a recommendation.  This is not the huge colonoscopy prep!  You don’t want that, no one wants that.  This is just something to make sure you’re not holding a full bowel going into surgery.  And take the colace/stool softener afterwards and if they don’t offer it, ask for it.  Straining to go after abdominal surgery is a horrible thing that can be avoided or at least lessened if you prep and if you take the stool softeners.

3.  They will tell you, or they may tell you, that you can use a heating pad for comfort post op.  I and a friend who also recently had a hysterectomy both found that ice was better, at least initially.  Not long periods, and not everywhere.  But for that one super sore spot (for me, just under the incision at my navel), ice was my friend.  Heat was good later, after a few days.  When I strained myself though, I still found ice was good.

4.  Don’t strain yourself.  Stupid little things like reaching down to pick up something off the floor or turning to get something off the end table while I was sitting on the couch did me in.  You do not have the flexibility you are used to.  Memorize that and turn your full body, not just your top half, when reaching for something.  Don’t bend or lean down or you may regret it.  And definitely do not plunge the toilet.  No, that’s a big fat no-no (it probably goes without saying but since I was stupid and prideful enough to have done it rather than ask my husband for help, I figured I’d mention it).

5.  Plan rest breaks.  Even if you think your activity level is still low, for that first week to two post op, plan to just stop and lay down for a while every couple of hours.  If you don’t, your body will force you to later.

6.  Drink a lot of fluids.

7.  Medicate and write down your doses and times in a notebook so you will know when it’s time to medicate again.  For the first week or so, I found it was crucial to stay ahead of the pain.  You can play stoic later and try to wean yourself down by extending your time between doses or cutting the dose down, but for the first week or so, please just take the meds.

8.  Set boundaries on visitors and well wishers.  People may want to help out, and that’s great.  If you’re lucky enough to have close friends and family who want to show their support and love, tell them that they can bring over food, go grocery shopping for you, bring you reusable hot/cold packs, get you a gift certificate to Audible.com or Amazon, pay for a month of netflix (watch instant rules!), be available to take you to the doctor if you need it, ferry books and videos to and from the local public library for you, or let you borrow their iPad/iPod or other very portable electronic device.  They are not to come over for prolonged visits though.  Hosting, even hosting from the couch, takes energy and that’s energy you need for you.

Relatedly…

8b.  The couch is YOURS.  No one else’s.  You do not need to share.  For your mental health sake, you need to NOT be confined to bed, which means you need to have access to the couch (or a recliner) and the bed so you can get a change of scenery in those first few very low activity days.

9. Do not be shy about calling your doctor.  If you feel funny, if you feel better then much worse, if you have a question, call.

10.  When you’re ready to shower, I do not recommend trying to wash your hair at least for the first few days post-op.  If you have bars or a shower chair, you might try it with some degree of safety.  The reason for this caution is that when you close your eyes and tip your head back, you may suddenly discover just how unsteady you are.  The environment of a soapy, slippery shower stall or tub is not a good place to discover this.

purulent

An unlikely favorite word, made so for the personal history with it.  And currently, I am.  Or more precisely, one of my incisions is.  There’s always one.  So off I go back to the surgeon (the fellow to be precise) at B.A.T.H. to have it “cleaned up” and probably to start an oral antibiotic.  Oh my poor intestine.