Writing about surgery has been my most difficult post thus far. It was an insanely emotional ride. I was also heavily sedated for four days after my surgery and have many blind spots of my immediate recovery as a result. I enlisted Patrick to help write this to help fill in the holes. More so, I want our girls to understand that their Daddy is my hero ….….and I have no idea what to say to finish this paragraph. Instead, picture me at the island of my kitchen, at 11:53 p.m. on a Friday night, bawling my eyes out as I empathize with what he went through those four days. I am not sure if I would have made it if the roles were reversed.
Here is Patrick’s perspective on my surgery:
The alarm sounded. I had slept hard through the night which I thought was odd knowing the day we had ahead of us. Honestly, at this point in the game Jamie and I were so mentally and physically exhausted that we were walking zombies. My body and my mind were in shock. We had just driven to a hospital on the other side of the country to have brain surgery. (Still hard to believe one year later)
I showered, got ready for the day,and chose to wear my Do Better. Be Better shirt. We said our goodbyes to family at hours of the morning that are intended for sleep. We traveled down the flight of stairs to our rental car and I directed us from Scottsdale to downtown Phoenix.
I remember two things in our drive very distinctly. One: It as a Friday morning and the traffic in the Phoenix metro area was intense at the time we were driving into the hospital. Two: I remember turning to Jamie and expressing to her, “You are having brain surgery today”. It was so surreal to hear that come from my mouth.
We arrived at the hospital parking ramp and proceeded into the pre-op area. I remember how full the area was and how the board on the wall showed all of the surgeries for the day. I glanced at it during our wait. Jamie’s surgery was to take 8 to 10 hours, certainly Dr. Spetzler would not have anything else scheduled for the day right? Wrong. The good doctor had 2 other surgeries on the docket for the same day. I couldn’t believe it, but knew that he had his support teams around him and he was probably only going to be in Jamie’s surgery for a small yet critical portion of time.
We were escorted back to our waiting area. Jamie and I snapped a few pictures with our Do Better. Be Better shirts on. We made small talk during the anxious time of nurses, doctors, and staff coming and going. We anxiously awaited Jamie’s family to join us. Upon their arrival, we continued to take pictures and converse trying our best to avoid what I knew was to come. The moment I was dreading.
The time was near. We knew only a few more medical professionals would be by to prep Jamie for the surgery. The anesthesiologist was the most critical of everyone. He explained some significant details as to what his role was in the surgery. At this point in the game, I was numb, scared, and simply did not want my wife to leave my side. It was time, time for Jamie to leave for her surgery….for brain surgery.
Jamies parents (Bill and Mavis), brother (Nathan), and best friend (Angie) said their “See you laters” (not goodbyes) to Jamie. It was my turn. We snapped a quick selfie to remember the moment and the anesthesiologist administered the sedation drugs to relax Jamie prior to wheeling her back. I gave her a kiss and started to walk with her back to the “Can not go Beyond” doors. Jamie’s hand relaxed, her speech slurred, and as I looked into her eyes they faded. The drugs were working, she was headed off to surgery. I walked with her as far as the medical staff would allow me to. I kissed her forehead and watched her go through the doors.
It was at that moment in time I had a flashback to being twelve years old watching my mother go through similar operation doors to have her right breast removed to stymie the cancer. I literally lost it. I couldn’t hold it in anymore. I could not hold back the emotion: the worry, the stress, and the pure and significant amount of fear that I had. I knew that I could not let the others with us see me, so I literally ducked into an unused pre-op area to try and hide my emotion. I doubled over sobbing. I lost every ounce of composure that I pretended to have. It felt like minutes went by, but in reality it was probably only seconds, until Nathan and Angie came to my side to help me regain my composure. I had to do everything I could to stay strong and hold it together for Bill and Mavis. The thought of watching one of my own girls fight for their life is gut wrenching and they were living it in real life.
We gathered our belongings from the pre-op area and headed to the surgical waiting area. This would be our home for the next 8 to 10 hours. We were one of the first families to arrive in the waiting room. We set up camp in one of the corners of the waiting room that had a circular table and enough chairs that we all could comfortably sit around it. I looked around the area and it seemed more like an airport than surgical waiting area. It had a huge monitor at one end of the room that showed patient number and status of that specific patient's surgery. It was 9AM.
Nathan and Angie offered to go and get some breakfast for everyone and I knew that I had to get some air so I tagged along. Bill and Mavis stayed back to watch our belongings. We found an amazing little diner across the street from the hospital called, “First Watch”. You could tell that a lot of their business came directly from hospital staff as many of the customers were in scrubs of some sort. We ordered, we ate, and I remember thinking to myself how surreal this whole experience was. My body was in full blown shock.
We arrived back at the waiting room with food for Bill and Mavis. I noticed that I had left my phone in the waiting room while we were gone to eat. (I must have been in shock, because when do I ever leave that thing behind?) I picked up my phone to a mass barrage of messages. I had hundreds of messages on that phone. My tears fell. Text messages from friends near and far, emails from co-workers/clients, and Facebook posts that would have taken me a year to respond to all of them. The amount of support, prayers, good vibes...selfishly, it was what I needed. We were an army of 5 in foreign land and simply knowing that we had so much support coming from back home….it meant everything.
It is fair to say I was a nervous nelly. I was at my wits end. The littlest of things would get to me. I needed my alone time and I needed to find my place. I left the others behind in the waiting room and said I was going for a walk. I knew exactly where I was headed; the Chapel. St. Joseph’s hospital had one of the most beautiful hospital chapels that I had seen. The chairs were wooden with maroon padding. I sat quietly and peacefully reciting the Our Father, Hail Mary, and Glory Be. I stared ahead at the large archway that held the altar and crucifix clutching my hands in prayer as hard as I could clasp them. I called upon my Mom as I tend to do in time of need. This was undoubtedly the hardest time I have ever called on her.
My nerves seemed to settle. I had seen a sign for a ‘healing garden’ on my way from the waiting room to the chapel, I thought it might be a nice place to go check out. The sun was warm to my skin and certainly a welcome feeling coming from the Iowa winter we had just left four days earlier. The healing garden was an outside area filled with trees, rock gardens, water fountains, and benches. I did not realize it at first sight, but this would be my go to place for the next ten days. It was so peaceful and inviting. A place that you could come visit to let all your worries vanish into the Arizona sky.
The timing of the day is a blur. At this point it was probably close to noon. I returned to the waiting room much more like the version of Patrick that I aim to be rather than the one that left a couple hours earlier. A card game that the Garbes family enjoys to play is Pepper. The five of us pulled out the deck of cards and pretended to the best of our capabilities that we were not in a surgical waiting, but in a living room in Dunkerton playing cards like we so often do.
The card game allowed a portion of the afternoon to pass. One or two of us would come and go as we pleased. Taking walks around the medical facility, visiting the cafeteria/Starbucks on the main floor, and checking out the gift store as well. Just yesterday sitting in church with Myah I opened up a pocket of my UNI coat (that I had not wore in quite some time) to find a guardian angel pin that Angie had bought for all of us. It was more than just a simple pin, it was a symbol of hope.
Throughout the day the surgical waiting room grew in attendance. There was a mixture of tears, sadness, fear, and for some, happiness. I remember very vividly a family going to the counseling room to meet with their physician. They came out so happy and cheerful to what I would assume was the news they had all been hoping and praying for. A part of me was mad, did that family not have enough respect to know that others in the room were still in the state of fear/sadness that they were just relieved of? The other part of me was envious. Will that be us coming out of the counseling room with smiles and joy?
The waiting room had what I would call a surgical liaison that would come and update you with any information that she had available. She would come over and say, “Yep, she is still in surgery, everything is going fine” or “Just went back, all is looking good”. She knew that every time she came up to our family that we all sat at attention and begged for any glimmer of hope/information. We had to look like a hungry chocolate lab eagerly awaiting her treat (Molly, our dog niece ; ).
The time was close to 3:30 in the afternoon Arizona time. Jamie had been back in surgery for over six and half hours. The little waiting room liaison approached our table and instead of the simple everything is, “going ok” blurb that we got all afternoon she gave me the, “Hold tight and don’t go anywhere.” Then she walked to another part of the waiting room to speak to a different family. I legitimately lost it. I popped up from my seat, raced to catch up with her and dropped an f-bomb. I was beyond fired up-- my wife has been in brain surgery all day and you walk by us and tell us to hold tight? What does that mean? What happened? Why did you not give us information right away instead of walking to a different family? It was a perfect case of an employee losing touch with how important of a role she played in the livelihood of other humans. Should I have done what I did? Absolutely not. When she finally calmed me down she expressed that Dr. Spetzler was done with his portion of the surgery and he would be in shortly to speak with us. That is all she wanted to let us know….
The time was close to 3:30 in the afternoon Arizona time. Jamie had been back in surgery for over six and half hours. The little waiting room liaison approached our table and instead of the simple everything is, “going ok” blurb that we got all afternoon she gave me the, “Hold tight and don’t go anywhere.” Then she walked to another part of the waiting room to speak to a different family. I legitimately lost it. I popped up from my seat, raced to catch up with her and dropped an f-bomb. I was beyond fired up-- my wife has been in brain surgery all day and you walk by us and tell us to hold tight? What does that mean? What happened? Why did you not give us information right away instead of walking to a different family? It was a perfect case of an employee losing touch with how important of a role she played in the livelihood of other humans. Should I have done what I did? Absolutely not. When she finally calmed me down she expressed that Dr. Spetzler was done with his portion of the surgery and he would be in shortly to speak with us. That is all she wanted to let us know….
I returned to my seat with a blood pressure that had to be 220 over 120. My face was red and my ears were burning. I explained to the family that Dr. Spetzler would be out to consult with us soon. Everyone checked their watches and started to calculate in their heads how long she had been back there. Six and a half hours which was earlier than we thought. Millions of questions started to go through my head. Were they able to get to the malformation? Did something occur during surgery that caused them to turn back? It was very challenging for me to not think of the worse.
Minutes went by, they felt like hours, and finally we all were escorted back to the briefing room that we had seen so many other families go back towards throughout the day. As we walked in Dr. Spetzler was already there. I introduced Bill, Mavis, Angie, and Nathan and sat there awaiting the words that could sway our lives forever. He and his staff were very calculated and guarded when speaking about the outcome of the surgery. I would imagine from a legality standpoint they were not wanting to promise or guarantee anything with this type of a surgery. They advised us that it went as planned. Time would tell and a post surgical MRI would be necessary to measure how successful the procedure was. All five of us drilled them with questions and their answers were like broken records. “Time will tell.” “One step at a time”. It was not the guarantee or the rush of joy and excitement that I was so desperately yearning to hear. I thanked the Dr. as I thought it would be the last time I saw him for a week. He was off to Hawaii for vacation. We were informed that Jamie should be “closed” up within the hour and we would possibly get to see her by 5:30.
We all walked out of the briefing room. I didn't know how to feel. Was what we just heard good news? We sat down at our table and looking at everyone’s reaction, we all were beaten down. If it wasn’t for Nathan, I would have remained beaten. He brought the positives directly in front of my face. The worries I had before had been laid to rest. They were able to get to the CM, they were able to remove it to the best of their capabilities. We had to view the surgery a success until we knew differently. We had to take a breath.
The hour came and went. I anxiously awaited the beeper in front of me to buzz telling me Jamie was being wheeled back to recovery. I glanced up to the airport board to see if her status would change from, “OR In Room” to “In PACU”. Soon it was 5pm and the waiting room liaison that I verbally gave a bashing to was about to leave. She came over and gave us her best and advised us a student worker would take us from there. The waiting room was nearly empty. We were one of the first ones in this room eight hours ago and now would be one of the last ones to leave. She gave us the last update stating that they were still closing Jamie’s wound. The hour that Dr Spetzler gave us was not the most accurate of timeframes. It was dinner time and everyone was hungry, so I advised the others to go get some food. I would hang tight to wait for Jamie to get moved to recovery.
Everyone headed to a pizza place close to the hospital for dinner. I had stayed back huddled in the corner of the waiting room. I scrolled through Facebook to pass the time. I had completely forgotten that my alma mater, Turkey Valley, was playing in the state basketball championship game. One of the Facebook posts I saw was a link to the game. I uploaded the link and there I sat in a hospital waiting room watching the Lady Trojans. They were down big when I started to watch, kinda had one of those moments where I said to myself, “At least they made it this far”. Slowly but surely they started to chip away at the lead. I can’t remember the specifics. They were down close to 20 points and the next thing I knew they were winning late in the fourth quarter. I was so engrossed in the game that the buzz of the pager they gave me frightened me when it went off, “Patient Going To Recovery”. Finally, I was getting closer to seeing her. It was 7:30pm.
I stepped out into the hallway to stretch my legs. A person I recognized walked by me, it took a minute to put two and two together. It was Jamie's anesthesiologist! What do you suppose i did, you bet your ass, I chased him down the hall and stopped him. How did surgery go? How is she doing? Did she bite her tongue like you said could happen during the surgery? I bombarded the poor guy with 20 questions before he could answer one of them. He walked me back to the waiting area and we sat down to discuss the procedure. He assured me that she was a trooper and that the surgery was very successful. At this point, I took a deeper breath.
The young student waiting room attendant walked over shortly after the anesthesiologist left. She said, “Mr. Smith? They are ready for you back in the recovery area.” FINALLY, I was going to get to see Jamie. I walked back with her to the recovery area. She told me to wait here and she would go to check and confirm they were ready for me. She came out a very short time later and escorted me back to the recovery area. I remember lots of cubicle-ish pods that had walls on three sides and a curtain on the front. She pulled the curtain back and kind of gave me the “Ta-Da” look. There in the recovery room was a lady that I didn’t recognize, didnt even know who she was….it was not Jamie. I turned to the young 20ish old and said, “That is not my wife”. As you can imagine, I was swiftly escorted back to the waiting area and apologized up and down to. All I wanted to do was see her.
Time continued on - Bill, Mavis, Angie, and Nate arrived back from the pizza parlor. I scarfed down a slice of pizza faster than Rafael, Donnatello, Michaelago, and Leonardo could. Once again the young lady came over to me and said, “NOW, they are really ready for you.” It was time, finally time!
We walked the same path back as we did before. This time there was no waiting, she took me directly back, and introduced me to Jamie’s recovery nurse. She stated that Jamie was doing well, but she had some vomiting episodes that they needed to have under control prior to bringing me back. I wanted to say, “enough already with the chit chat, let me see her.” They opened the curtain and there she was. Resting. Peaceful. As I walked up to give her a hug, she started vomiting again. Fierce and violent thrusts as she vomited into her oxygen mask prior to the nurse removing it and providing a pan. It was all so much to comprehend and all so much to view at once. She was not intubated like they all had stated she would be. She had all of her hair-- I thought for certain they would be shaving a portion of her head to get to the incision site. For all things considered she looked….amazing. I hugged her, kissed her forehead, and thanked God for helping her through the surgery. Minutes went by and I knew the others waited anxiously. I returned to the waiting room to allow Bill and Mavis to go back.
With each of our support crew that went in, they all came back with the same marvel that she looked wonderful. We all knew it was going to be an intense battle to get her back to 100%, but the first step, the largest step, was complete.
As we waited for Jamie to be placed into an ICU room, I noticed Dr. Spetzlers right-hand man walk by the waiting room. I once again showed my 34 year old quickness and tracked him down in the hall. He recognized me and said of course I was just coming to brief you. This doctor was with Jamie from start to finish. He opened up the site and closed it down as well. The five of us met with him in the briefing room. Once again, questions upon questions were being asked. Many of them were by me and many of them may have been the same I asked Spetzler earlier in the day. He had much more time to answer them. He went into far more detail than anyone had done before. Almost every answer involved the post-surgical MRI. “We will know more once we have the MRI back”, “That can be answered with the post-surgical MRI”, “We will know if we got it all after viewing the post surgical MRI”.
The one comment he made that I will never forget was, “Dr. Spetzler has done this surgery over 500 times. He knows the difference between healthy brain stem that is blood stained and cavernous malformation which needs to be removed. Once you remove healthy brain stem, you can not put it back”. Holy meatballs, did he just say that!
After every question was exhausted, we let the doctor go, after all it was close to 9pm on a Friday night. He was finishing his studies under Dr. Spetzler and in June he would “graduate” and head back to home in Buffalo, New York.
We gathered our items from the surgical waiting room and headed up to the ICU. There was strict rules to follow regarding the ICU. No more than two people could go back to see Jamie at a time. The rest of us stayed out in the ICU waiting room with other families. There were couches and chairs to rest in and a television to watch to pass the time.
I went back first to see Jamie. She had her very own room and her very own nurse assigned to her. The nurse had a station set up directly outside of her room. In the room was a small couch, rest room, and obviously Jamie’s hospital bed. It would be our home until Jamie was well enough to move to the surgical recovery floor.
As I returned from the ICU room, Bill and Mavis went back to see Jamie. When they returned Angie and Nate took their turn. It is hard to recall all that happened during this span of time. All I remember was being exhausted.
As the other four decided to head back to the condo to get some rest, I returned to Jamie’s side. I was rubbing her head and sitting by her side when she narrowly opened her eyes to me and gave me the sign language sign for I love you with her right hand. It took everything that she had to open her eyes for a few seconds and lift her hand enough for me to notice what she was trying to say. With that she closed her eyes, March 4th, 2016 was over and will go down as a day we will never forget.
I took to Facebook to update everyone of Jamie’s status. Below is my post from that night.
March 4th-
“Today my wife had brain surgery”. As many times as I say that in my head I still don’t believe the day we just had. I remember turning to Jamie this morning on our way to the hospital saying that very same thing, “You are having brain surgery today,” as we both just looked at each other in disbelief.
If I had to describe the day we just had well…..IT. WAS. LONG. It started with pre-op check in, difficult conversations with doctors dealing with exactly what they were going to do, and of course the challenging hugs and kisses prior to surgery. Then came what I would expect to be the longest hours of my life. The wait…..no words. I am so thankful for Jamie’s parents, her best friend, and her brother for being here. I wouldn’t had stayed sane if it was not for them….and all of you - the messages - the prayers- they were tremendous.
As for our current state - Jamie is resting peacefully in her ICU bed as I lay next to her on a cot made for umpa-lumpas (seriously my feet are hanging over the cot by a foot). I am thankful, I am beyond thankful….its deja vu for me as I flashback to Iowa City 2.5 years ago. I have not been able to carry on a full conversation with Jamie as she is still heavily sedated, but about 5 mins ago she gave me the, “Smith Family Secret I Love You” sign, it brought tears to my eyes. The plan is for her to rest and let the anesthesia wear off. Some time tomorrow they will conduct another MRI of the impacted area. As I have said before, she will get worse before she gets better. The surgery acts almost as if another bleed occurred. We are aware of this challenge and we are ready to battle together, “Step by Step.”
At this point, I honestly am so exhausted that I don’t know if this post will make sense, but I will leave you with this.
Today is the only day of the year that tells you to do something, March Forth is exactly what my GSD/DBBB wife did.
Tomorrow we will be better than today. God Bless!
It was 12:47am on March 5th. I had survived the longest day of my life.
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