“I Had Some Help!”

Twilight- apparently that’s the term that is used for anesthesia when they do not give you enough sedation to actually lose consciousness. It’s how I would describe my mental state upon waking from surgery, even at the time I started typing these words. However, at around 7:35am this morning, that is not the type of anesthesia that I received.

I sat on the table talking with the OR staff and doctors, about country music, about my kids, and joking around with the 3rd year medical student that was there just to witness my surgery. “Nicholas, I’m counting on you to make sure they don’t do anything stupid.” I gave him a serious look and an eyebrow raise. A young Vietnamese man of perhaps 27 years of age, he had a kind face, and his brow fell, heavy with the weight of his new responsibility. Hopefully he realized I was kidding, but he looked down to shuffle his papers and decidedly backed away to safety. I heard the conversations between all the nurses in the background but found it hard to track them. They had me scoot into a seated position on the edge of the OR table, my legs dangling while the back of my gown flapped precariously behind me. I spoke to the nurse that was in charge of the OR, and she asked how old Bode and Scarlett were. Meanwhile her male subordinate grabbed a pillow and positioned it in front of my abdomen and chest. “Just go ahead and hug that” he told me. I did as I was told, and shivered as a gust entered my open gown from behind. Dr. Allison spoke next, “OK, I want you to mimic a Halloween cat and arch your back over that pillow.” I did my best to go through my digital catalog of Halloween cat images. I’m assuming she meant the classic black cat, back arched to the heavens with hips and shoulders pressed as low as they would go. I allowed my body to morph into my best interpretation. “That’s great!” Dr. Allison chimed. She was my anesthesiologist, a cheery and positive energy type of gal. On the short side even for a woman, she wore leopard rimmed spectacles that disappeared into her slightly graying espresso brown hair, pulled into a bun. She had a midwestern aura about her. I felt the moist area on my skin tighten after she was finished with her disinfectant routine. She gave the customary warning that a poke was imminent, one that I have heard so many times in the last few weeks. This one was for my thoracic epidural; it was a catheter inserted into my vertebral column and secured in place to keep a specific area of my torso numb, while the nerves were bathed in narcotic pain medications. The idea was to manage my pain after I woke from surgery, while the chest tube that protruded from my side drained the fluid from my chest cavity. Apparently without the pain intervention, it’s incredibly painful. I felt the prick on my skin directly centered on my spine, and grit my teeth slightly, eyes shut tight. It was temporary, but I didn’t have much time to think about it before another nurse put a face mask on me with some gas flowing, I assumed it was oxygen. Dr. Allison told me that she was giving something to relax, and she prepared a syringe that looked to be destined for my IV line. Meanwhile, the rest of the staff subtly maneuvered my body into a position where I was lying flat on my back. Dr. Allison must have pushed through the IV drugs, because I definitely felt relaxed. Maybe a little more than relaxed. I stared up at the ceiling of the Operating Room, noting the different stains and irregularities I could find. I heard people having conversations but could not identify any of the contents of their speech. What I did hear, was a song playing on the radio from the country playlist that I had requested. An upbeat duet between Post Malone and Morgan Wallen that I had heard before, and the chorus had started at the exact moment that it caught my attention; Morgan Wallen’s voice crying out with his signature country twang, “I had some help!” And I blacked out.

When I woke up, I was in the Twilight sleep that I described earlier, and I saw a nurse that I didn’t not recognize hovering over me, and then finally Mandi. Such a beautiful sight to see at any time, but even more so under the circumstances. I glanced at a clock hanging on the wall in my recovery room, as they pushed my bed into place. It was 10:30am. This is not a good sign, I thought to myself. I spoke my thoughts to Mandi who confirmed with words, and the look on her face, that it was not the outcome we wanted.

The surgeon had found that the tumor had spread into my pleural chest cavity, and into the sac of my heart, and all of the places that we do not want it to be. It completely stopped the surgery in its tracks. The only way to treat it is going to be systemic. Chemotherapy, radiation, immunotherapy. As of yet, we don’t know the exact course of action, but the surgeon was able to gain enough living tumor tissue to send to pathology for a definitive diagnosis. The news is a huge blow in the battle, and not what we wanted to hear, but I knew it was a possible outcome. The next steps are to meet with our oncologist, develop a plan to shrink the tumor or eliminate it, and possibly have a future surgery to resect the tumor at a later date.

It’s not possible to describe how I feel at exactly this moment. My mind is awash with scenarios that mostly depict the statistical reality of this news. After all, my survivability just took a major setback today. On the other hand, even as I write this I sit in a room filled with loved ones who have loved me my entire life, or at least most of it. Just above the foot of my bed, a collage sits on the recovery room wall that is a made entirely of photos of me, my closest family, my kids, my niece and nephew, and it reminds me that I have too much absolute beauty surrounding me to live in that darker place. I refuse to live my life in that place, as long as it is within my power to control. I ask God for the strength daily to live in a mental space of gratitude, and hope, and love; so far the well of strength has not run dry but instead overflows.

I am ready to fight the next battle. The war is not over. I have not given up the fight. And I have an army of supporters.

I love you all and will talk to you soon.