It's been a week since I last posted about my new face, and a bunch of stuff has happened.
Last week on Tuesday (the day after I wrote my previous post) I went to California Pacific Medical Center - Pacific (at Clay & Webster) and got surgery. The way it was supposed to work was that I was supposed to fast from midnight Monday until the next morning, and I was supposed to check in at 6:45 AM for a surgery at 8:45 AM. The original goal was that after surgery I'd spend a few hours in the hospital chilling and recovering, and then go home later in the day.
I got almost no sleep that night, and got up at 5:30 AM to get ready to leave for the hospital. I did all that and checked in at the hospital shortly after 6:30 AM. I changed out of all my clothes and got ready. They put an IV in me and took some blood samples, and then told me to wait and eventually someone would come get me and take me up to the OR area to talk to an anaesthesiologist. I waited and 8:45 came and passed and no one came for me. At around 10:00 AM I asked one of the nurses what the deal was, and she eventually found the head nurse who called my doctor. The nurse said that my doctor was "on his way" to the hospital but didn't have an ETA for me.
I took a nap and woke up around noon. Still no doctor, no one told me what was going on, etc. Again I ask what's going on, and the head nurse comes back and tells me they reached someone from his office who is going to come in and explain the situation. One of the assistant doctors (?) from his office comes in and explains that Dr. Miranda got called into an emergency surgery situation, and that I have to wait until that surgery is done. At around 1:00 PM they come around and tell me that that surgery is ending, and the doctor himself comes and talks to me at around 1:30 PM to explain the situation and apologize. They took me up to the OR area at around 2:00 PM and then after talking to the anaesthesiologist and whatnot my surgery began some time after 3:00 PM I believe, almost five hours late.
I was under complete general anaesthesia for about three hours while they opened up my eye socket and maxillary zygoma (cheek bone) and did reconstructive surgery on both of them. I'm not sure exactly what they did still, but they said after that the damage to the cheek area was a lot more extensive than they had thought from the CT scans. I believe that I have a bunch of metal and screws in my face now where they reconstructed my eye orbit and my new cheekbone. When I woke up I had stitches in three different places around my eye (including stitches sealing part of my eyelid shut!) and stitches in my upper gum area inside my mouth where they accessed my cheekbone.
I came up at around 6:00 PM or 6:30 PM and under the doctor's recommendation, spent the night in ICU.
ICU in a major SF hospital like this is crazy. I have so many ICU stories for another day. I was in a room with the weirdest eccentric mega-millionaire Marin county retireee ever who was actually also in on a biking injury (old guy who was doing an overhaul of one of his roadbikes, tried to take it up a huge hill and then allegedly the chain snapped as he mounted at the top and he fell and broke his hip; although I have some doubts about certain aspects of the story).
The tl;dr though is that ICU really sucks. On the one hand it's cool becasue I was conected via IV to a hydrocodone drip, and I could get more painkillers at any time by pressing a button. On the other hand it really sucks because you're connected by the IV to a saline drip that you can't control. The saline drip is meant to keep your electrolytes and whatnot at the right levels, but it also makes you need to pee every hour or two. Since you're connected to an IV, you can't go pee on your own. You need to call a nurse in to disconnect you from the IV. Same with when you're done in the bathroom---a nurse needs to come reconnect you to the IV. Also only nurses are allowed to come connect or disconnect you, not the nurses assistants, so I spent a ton of time buzzing the thing to have someone go find someone else who could come over to let me use the bathroom. In general it's crazy because ICU is way understaffed, so it's this constant no-sleep cycle of going to the bathroom, getting disconnected or reconnected to the IV, having a flobotomist come by regularly to record your vitals, having medicine/food administered, etc.
The most bizarre part of ICU was my release. They had faxed in an order for all of my medication except the painkillers to the Walgreens near my house the night before my surgery. Only no one told me they had done that. Once they found out I didn't have any of my medication, they didn't want to release me since I guess a lot of people are like "fuck that shit" when they get released, go home without any medicine, and then end up in an even worse situation and end up in the ER/OR/ICU again a few days later. So after the most beauracratic process I've ever witnessed they get the drugs switched from the Walgreens near my house to the Walgreens attached to the hospital, and are arranging for someone to come up from that Walgreens and deliver the medicine to me bedside in ICU. Sounds great. I get a phone call from Walgreens while I'm still in my bed, connected to the IV, and they go over the order with me and talk about which medicine my insurance didn't cover (eye drops and some other eye ointment) and do I still want to pay for those things out of pocket (yes). Then they ask me how I'm going to pay, cash or credit? I say credit. They're like OK, we need your credit card information before we can send up the order. I try explaining them I have an IV in my arm, and they're asking me to get up, find my backpack out of the closet, find my wallet within my backpack, and then read off all of the information over the phone to them. The lady is like yes, that's what we need you to do before you can get the medication you need to have before you can be released.
While they're going over the discharge information, I learn a few things:
- I'm going to be on a liquid only diet for at least 2 weeks if not more
- I have the most crazy regimen of eye drops and anti-bacterial ointment and some third kind of ointment ever.
- I can't brush my teeth or use normal oral hygiene products for 4 weeks; instead I'm on this weird Rx anti-bacterial mouthwash which is the only approved way for me to clean my mouth.
A few hours after I got home and was trying to sleep (again---since I hadn't slept at all in more than 24 hours at that point) and I started getting a fever and felt swelling in my sinuses. Then blood started coming out of my nose. I freaked out because they told me that if I get a fever or bloody anything it could be a sign of an infection, and that I should go back to ER immediately. I have my friends help me get to the ER of the same hopsital I was operated at (in Pacific Heights), and by the time we get there my temperature is normal, I've stopped the bleeding from my nose, and things seem OK. The doctor there told me that bloody discharge is normal on the first day after surgery since there was entrapped blood in my sinuses from the surgery. Specifically the way it came out with me (watery bloody discharge at first that then gets thicker) is indicative of a normal situation. Thanks for not telling me that when I was released from the hospital.
I spent most of the last week in an opiate binge constantly sleeping and iceing my face. The first 72 hours after the surgery I was on a "clear liquids only" diet which basically means clear juices (e.g. grape juice) and Jello only. This sucks a lot because it's a calorie negative diet and I had been fasting for nearly 24 hours before it, so it makes you feel really woozy and tired all of the time, a feeling which is aided by the constant administration of narcotics.
I started to feel a lot better on Saturday except my eye had a bunch of gross discharge that kind of mixed with my sutures to seal my eye shut. I spent a bunch of the day on Saturday and Sunday just trying to keep my eye clean and lubricated with eye drops, since they told me that if it didn't stay properly lubricated I was at risk to get corneal abrasions if my eye got too dry.
Today (Monday) I saw my doctor again for the first time since the operation and he removed most of my sutures. The result is that now I can sort of open my left eye about halfway, and I can finally wear glasses again and have binocular vision. Even though it's still really swollen and bruised, and my eye still won't fully open, my vision is a lot better than with just one eye, and it's a lot easier to use a computer now. I'm also off my painkillers now which means that I can stay up for more than a couple of hours at a time.
Until I see my doctor again on November 5 I have to stay on a completely liquid diet. After that, if my healing is satisfactory to him I can start eating really soft foods like mashed potatoes and overcooked pasta.
I should be able to return to work on my weird liquid-only diet tomorrow.