The Day of Surgery: Fearless Goodbyes, Painful Hellos

Saying goodbye to your family as you’re being rolled away on a gurney into surgery is an emotional experience, especially when it’s brain surgery.  Three weeks ago, I was saying my goodbyes to my family before having a craniotomy.  My family was nervous and teary-eyed, but I was fearless and excited.  It’s not because I’m a strong person or even brave.  It’s because this surgery was my chance to live life again.


I was having microvascular decompression (MVD) on my right trigeminal nerve to correct trigeminal neuralgia (TN).  The short-term pain of having a surgeon drill into my skull and cut through my brain didn’t scare me nearly as much as the thought of living with TN for the rest of my life.


The anesthesiologist, the neurosurgeon resident and the medical student rolled me into the operating room.  The room was a stark white, and bright lights shone over the operating table.  This was the room where my life could change forevermore.  Needless to say, it was an overwhelming moment for me.


As I lay on the operating table, the anesthesiologist tried to put in a line for the anesthesia.  He went from one arm to the other, one hand to the other, in hopes of finding a vein.  One needle after the next.  One stick after another.  No success.  “Where are your veins, Ariella?”  –“I don’t have any.  I’m a miracle of life,” I said.  The medical student laughed, but the anesthesiologist didn’t.  Apparently, he wanted me to literally answer him.  So, I gave him a recommendation for a place to look in my left arm.  No luck.


I just lay there looking in the opposite direction of each stick, taking notice of all the massive and, frankly, frightening equipment in the room.  With a needle in my left arm, I noticed on the other side of the room an oversized version of the portion of my brain scan that depicted the blood vessel compressing the trigeminal nerve.  There it was…looking right at me.  Bastard.


After no success, the anesthesiologist took out ultrasound equipment to find a vein.  “We’re taking out the fancy equipment for you, Ariella,” he said.  “Do I have to be special at everything?” I thought.

Hoping to distract me from the pain of being a human pincushion, the medical student, a fellow American, tried to make small talk, but I wasn’t in the mood.  I’m generally not a good conversationalist when someone is digging around in my arm with a needle.

I felt cold alcohol pour over my arms, a small device roll along the inside of my elbow, and then a stick.  He moved the needle in and out, left and right, round and round, but to no avail.  He couldn’t get a line to put me under.


“What I’m going to have to do to get a line is going to hurt a lot, and I don’t want to torture you.  So, I’m going to give you gas, and that will put you to sleep, okay?  It’s going to make you laugh, and you’ll think everything is funny.”


The idea of my body soon being tortured was not funny at all.  Laughing gas or not, I was not laughing.  After two breaths of the gas, it felt like the mask was suffocating me with fumes.  But, within seconds, I felt high, and, a second later, I was asleep.


Six hours later, the surgeon informed my mother that the surgery went well and without any complications.  He explained that once he was inside the brain, he found that I had multiple veins, which were not just compressing the nerve, but wrapped around it like a web.   While he has had more success with arteries than veins, he was hopeful that the surgery would be a success.


Now that I was breathing on my own and off the ventilator, I was on my way to have a brain CT to ensure that there was no bleeding, and then my mom would be able to see me.  “I helped her get on and off the CT machine before the surgery.  Should I go with her now to help since she can’t walk?” my mom asked the surgeon.  “No one walks after a craniotomy,” he answered compassionately, being careful not to make fun of her for what she now realizes was a ridiculous question.  At least for once, I was on an even playing field!


I don’t remember waking up, but the way my mother describes it, I looked like road-kill.  Behind my right ear was an 8 inch long, 3 inch wide section of hair that had been shaven, inside of which was an 8 inch long incision.  The incision was nicely stitched with blue plastic stitching and was covered by a bandage, which had been stapled to my head.  Surrounding the incision was red and purple bruising, which went into my right ear.   The expression on my face screamed pain.


My hair was covered in a wax-like substance and was pushed to the left side of my head.  Traces of red marker were on my forehead, face and hair.  And, blood was on and inside my nose.


I had an oxygen mask on my face and IV fluids going into my right arm.  My legs were inside an apparatus, which squeezed them every few seconds to prevent blood clots.  And, I was connected to a machine, which monitored my heart.


I had six ports located in my arms, hands and my left foot.  Where each port was located, I was covered in bright purple bruises – no doubt, the evidence of the “torture” the anesthesiologist promised would ensue after the laughing gas.  Underneath my left wrist was a bruise 3 inches long and what appeared to be multiple paper-cuts   My arms looked simply mutilated.


“Can she hear me?” my mom asked the nurse, disturbed by how terrible I appeared.  –Hi, Mom.  “Hi, baby.  I love you.”  — I love you too.   She told me of all my friends who called to check on me and tell me they loved me.  But, moments later, I began to cry from pain.

I was fearless going into the surgery, but no longer.  This was frightening.


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