In the Cool of the Morning
By Bobby Neal Winters
I sat out on the drive way this morning in my undershirt. I had a cup of coffee in my hand and I was listening to Crosby, Stills, and Nash do The Southern Cross on my iPhone. I was in the shade and it was cool, but I looked at the sun play in the new leaves on the top of the oak Jean and I had planted. I followed it down and my eyes caught the peach tree she and I had planted to shade the hostas; it has grown enough that it now is now doing its job. Behind the hostas were the milkweed plants. Jean has hung strings from the gutters and is training the milkweeds to climb them. This is for the monarch butterflies that will come through later in the year.
One week ago I was sitting at KU Medical center having washer-like objects called fiducials put on my head. This was proceeding an MRI that would create a 3-dimensional map of my head. The 3D map was so that they would be able to perform surgery to remove a tumor that had grown over the last few decades on my pituitary gland.
I was calm because this was my second run at it. The week before they had attempted the surgery but had stopped because my blood pressure had jumped to 220/100, a new record for someone whose BP usually runs 125/80. My multidisciplinary team put their heads together, scratched their collective temple, and decided to reboot one week later.
One suspect in the mix is a product known over the counter as Afrin. The ENT (ear, nose, and throat) guys use it in surgery to control nasal bleeding. The ENT guys were a part of my multidisciplinary team because pituitary surgery usually proceeds through the nose these days. They put a tube up your nose, entering the sphenoid sinus and then crack into the sella turca (a bone shaped like a Turkish saddle—whatever the hell they are) on which the pituitary gland sits.
Afrin is shockingly dangerous stuff for something that available over the counter. The guys, using their collective wisdom, switched to an older product that is not available over the counter but is very much familiar to us in story and song: cocaine.
They used cocaine instead of Afrin, but they didn’t tell me this before surgery. I needed to be calm when I went under, and I was. Calmer than I had been the week before when we did our trial run.
The week before, I went under as they were rolling me off to prep me. They were making happy talk to me after they had put an “oxygen” mask over my face. I awoke after having noted zero passage of time and hearing the words “We didn’t do your procedure.”
In spite of not having had my procedure done, they had inserted a catheter and they had shaved my belly. If going in through the nose to get to a gland that hangs from the brain is confusing, then so is shaving a belly to the nth-degree.
They use a piece of abdominal fat to aid the healing process. They had prepped my tummy in order to remove it. Those of you who have seen me in person will remark to themselves that I have it to spare; everyone makes that joke. When I started to make it to my surgeon, she pre-empted me, having heard it too many times.
In any case, a lot had been done to me that I had not noticed. Time had passed in a darkness deeper than sleep.
It occurred to me that the happy talk I’d heard as I went under could’ve been the last words I’d heard on this earth. The nothingness was absolutely total.
It was calming.
That one week later--on the day of the real surgery—I was calm. I knew that my BP could spike dangerously, but I also knew they were ready for it this time. But even if not, I knew that if It happened, then I would never know.
My thoughts were all with my family. My family is strong because my wife Jean is strong. She would, herself, be supported by our girls who she has raised to be strong and by her mother, the one who raised her.
But I lived.
My surgeon, a woman who is famously meticulous among the hospital staff, spent the afternoon plucking a tumor the size of a black-eyed pea out from the middle of my head. She would take a bit, the BP would rise; she’d let the BP go down and then take a little more. It took hours to get the little son-of-a-bitch out.
When I awoke this time, they asked me how I felt and I knew the procedure had been done. I told them I felt like I’d been punched in the nose and cut in the gut. The two-inch incision where they’d taken the fat was on fire. My nose throbbed. They started putting the Vicodin (hydrocodone + acetomenaphine) to me and that made everything better.
We are now at surgery plus one week. I’ve spent a good deal of time napping in a Vicodin-induced haze, but over the last couple of days I’ve been weaning myself off of it. I will have plenty of time to sleep when I’m dead; that I know.
In the meantime, mornings like the one we had today are simply too rare. God is too good to us for us to ignore his grace.