by Cameron Gearen
There was a time, during my breast cancer treatment, when I went through surgery with some regularity. In one year, four times.
Once I was declared cancer-free, I tried to forget those difficult days on the gurney and in the recovery room when everything seemed splashed with danger and it was hard to convey what I needed.
That was six years ago. This winter, after an unexplained episode of bleeding, my doctors decided they needed to "take a look," as they said — which would involve anesthesia and the OR for me.
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As a trauma survivor, I have some special needs regarding surgery, and the experience tends to go better if I make those needs known and advocate like crazy — in a nice way — for myself. July 11 was bearing down on me like a Mack truck in the passing lane, but I was doing my best to keep this procedure at the back of my mind. I read the giant folder the hospital sent me entitled "Your Surgery," chucked it across the room, and then proceeded with my busy life.
That's how I found myself at my nearest Walgreen's at 6 a.m. on the morning of my surgery, scanning the frozen cases for lemonade popsicles. All I saw was dairy, and I was hungry and thirsty but past the hour when I could have food or dairy.
It's an annoying predicament for anyone, but, for a trauma survivor, feeling deprived can be a trigger that sets off the bath of cortisol in one's brain telling us "Threat! Threat!" Once it's flowing, it can take days to reabsorb. In the meantime, PTSD. I was hoping to trick myself into "eating" something clear and frozen to nip this rising feeling of deprivation in the bud.
Since they had no popsicles and I wasn't willing to actually go to the grocery store, I bought several dazzling varieties of special (clear) teas and seltzers. They occupied me for the next few hours.
There was still plenty of advocating to come, though. Hospital teams are very well-meaning but often not trained in specific techniques for how to treat trauma survivors. I've learned to explain my situation to everyone on my team, one by one as they introduce themselves, and in as simple and brief a manner as possible.
I started with Cynthia, the nurse who took my vitals. As she wrapped my arm in a cuff, I said, "I'm a trauma survivor so I need some extra care as we go into this procedure." She wanted to know what would help and I told her the thing that helps me most: a feeling of control.
Or you can say it the opposite way: when I feel that my control is stripped from me, the cortisol bath begins. That's the thing about surgery. In order to be safe and efficient, doctors and nurses don't necessarily ask each patient if they want a chocolate Pop-tart. They have protocols which they use to keep the procedure safe and sanitary. Many patients believe that these protocols are ironclad, but I have found that not to be true.
I handed Cynthia my purse and even my clothes, but asked to keep my phone. Unless you are having an MRI or another magnetic procedure, there is usually no harm in keeping your phone. In preparation for the day, I had loaded mine up with fresh podcasts and meditations: the best shot I had at distracting myself while waiting.
Cynthia said she didn't see anything wrong with it. She checked with a doctor who okayed it, and the phone eventually went into the OR with me. I "fell asleep" listening to Ira Glass.
One by one, those on my team came to say hello. Each time, I told them the briefest version of my story and what I needed. They all completely got it and, maybe, put me in a different category in their mind: this one needs a little extra care.
When I met the anesthesiologist, Tom, he showed me pictures of dogs and parrots on his phone to make me laugh. He told me how his parrot is fiercely loyal to only him and will charge Tom's wife if he (the parrot) has to. Regarding my requests for TLC, Tom said, "No problem! We'll do what we do for the little kids!" He meant he would get my IV in once he had me in a twilight state, since my veins weren't cooperating due to dehydration.
From my gurney in my stupid hospital gown, with my hair bunched into a blue shower cap, I said,
"Yes! If you all just treat me like I'm three, that will be exactly right!"
And later, when I was slipping away thanks to the gas, I said again: "Remember, I'm three."
I'm not sure that, besides the phone in the OR, I really got any special treatment at all. For a trauma survivor like me, maybe 75 percent of the issue is just being able to ask for it: to say what you need, know that someone hears you and cares and will attempt to deliver that. Whether or not they actually deliver it is almost beside the point. At least for me, I'm looking for the humanity, the empathy, and the guarantee that caring is present.
Unfortunately, in recovery, I was with a whole new team whom I hadn't given my spiel to; optimal would be having the pre-surgery team communicate a patient's special needs to the post-surgery team. Even so, my new nurse, Phyllis, was kind and responsive.
I woke up in a sort of scream-cry which has happened to me before, post-anesthetic. In fact, I had warned the team that it might happen. It's about cortisol again, and my defenses being not yet back in place. She popped two pills in my mouth (she probably told me what they were but I don't recall) and I was calm the rest of the day and evening. The next day felt better. Thanks to all that preparation and advocating, I was not awash in cortisol once I got home and I could go on with my life.
Tips for Trauma Survivors Facing Surgery:
● Really know yourself. You need to know enough about yourself to know what does trigger you, and then be confident enough to state it calmly and more than once. For example, if you know you would like to have a friend stay with you in pre-op, ask to have one come in. If you think a friend will increase your nerves, gently tell your beloved friend to wait in the waiting room.
● Maintain control in any areas where possible. If you prefer your own clean socks to the hospital issue ones, bring them and ask to wear them.
● Distract yourself as much as possible. This may mean planning ahead and using a smart phone, even on the operating table.
● Be creative around issues of deprivation, or whatever your biggest triggers are. If you can't have coffee or food after a certain hour, by all means get yourself a lemon popsicle or 12 and eat them.
● Line up treats. If your 4-year-old child were going through this, you would make sure she had her favorite things before and after. Treat yourself the same way. I always schedule a massage for two days out and get a pedicure beforehand — to relax me and to let me know that good things are coming my way.
● Advocate, advocate, advocate. They can't read your mind and they just met you. I have found that doctors and nurses are delighted if you can share your inner experience with them and tell them how to help. They have a bigger problem if they are treating someone who has a negative response and they haven't been briefed about the potential for it. Never, ever feel bad for asking for what you need. It will make the whole thing go lots better for everyone involved.
Cameron Gearen's book of poems, Some Perfect Year, came out in early 2016 from Shearsman Press. Her short fiction and nonfiction is up at The Easy Chair podcast. She recently launched a project, #onmyown, on her blog: text and photos celebrating solitude and singlehood. You can read it at camazon.tumblr.com. She works as a freelance writer and college counselor in the Chicago area, where she lives with her two teenaged daughters and her dog, Roxy. Her YA novel is currently with an agent.