My First Surgery
Failure of surgery
My first surgery was a few weeks ago. Patients often forget that the doctors treating them are also human and subject to the same physical ailments as others; sometimes the doctors seem to forget that, too. For the past four months I have been having “back pain.” It would come, I would stretch and it would go. I would get massages at every opportunity, take Motrin and bumble along.Six weeks ago, I went to my doctor for my annual physical, and a routine test showed blood in my urine. Just microscopic amounts, but that is enough to start the wheels of modern medicine churning.
My visit to the urologist was followed by a CT scan with contrast. Intravenous contrast is a material injected into the veins that is visible in an X-ray or CT scan. The contrast goes through the body to the kidneys and comes out in your urine, so you can see the inside of the kidneys and the ureter and bladder all lit up. The test showed two large stones in my right kidney; large means 2 cm or so in diameter. A large kidney stone cannot pass down the ureter, so I was destined for surgery.
For smaller stones, urologists typically use the ultrasonic lithotripsy machine. The patient is placed in a bathtub or gel cushion under general anesthesia and the beams of the ultrasound are focused on the stone. The energy blasts the stones into smaller granules, which can then be passed in the urine.
My big stones needed a different procedure—a ureteroscopy, in which a camera is placed through the penis into the bladder, up the ureter and into the kidney followed by a laser that bursts the stones and turns them to dust, which you then pee out.
My surgeon could not get the scope up my ureter. I apparently was born with a narrower ureter on that side. The surgeon placed a stint, a thin metal-and-plastic tube, into the ureter to enlarge it over a few weeks, after which I would need a second surgery. My first surgery was a failure.
When a medical procedure or surgery, even a cosmetic plastic surgery procedure, fails, the patient quickly becomes despondent. Failure in modern medicine is a taboo subject in modern American culture with its peculiar need to assign blame and seek compensation for a result that did not turn out “as seen on TV.”
In my case, the blame lay not with the surgeon for failing to get the scope up but rather with my embryological development; did my mother drink alcohol during the pregnancy? Maybe she ate oysters. Something she did surely led to my mal-developed ureter. Or… maybe it was the surgeon after all. Maybe he didn’t try hard enough or was late for his office appointments and rushed through the surgery. Or was it the radiologist who interpreted the CT scan? Why had she not noticed my runt of a ureter and hence prevented the failure (which by now feels more like a catastrophe)? Someone is to blame, surely? NO.
The old adage of “once bitten twice shy” is never more true than with surgery. You have undergone the stress leading up to the surgery, suffered the pokes, prods, masks, nudity, chill and instant intimacy of total strangers on the hospital staff.
Now I knew I would have to suffer through all that again, and also through the “unknown.” That thing that gives fear to all patients. That not knowing what is going to happen, whether you are going to be fine, whether it will fail again… This is where your surgeon can make a difference. Mine did not. “It didn’t work—call my office to schedule another procedure in a few weeks.” Wait a minute… explanation?
After the initial recovery, which lasted 48 hours, I was resigned to my fate. Another procedure that would hopefully work this time. But questions lingered.
Should I change surgeons? Too late. Not worth it. Anyway, he’s doing it by the book.
How many days shall I take off work this time?
What if it doesn’t work?
The same questions that go through my cosmetic plastic surgery patients’ heads every day and that I only too well understand.