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Chapter 2 | Part 1: A Regrettable Last Meal the Night Before Major Surgery

by Christopher Graham

My parents, sister, and my nephew came up a few days before the surgery. We had, essentially, a long weekend to visit and get ready for everything. The first few days they were here felt very surreal. We did normal things, like go to the zoo and out to eat. We tried to talk about “the usual” things, and not just obsess about the upcoming procedure. But the mood was largely sober. Everyone was thinking about the upcoming operation. I made a valiant effort to put it out of my mind, to try to enjoy the time I had with my family and with my as-yet unopened abdomen. But how could I? It was the only thing on my mind.

The night before the operation, I decided I was going to eat whatever I wanted. We had discussed going to a steak house, actually, but as the evening before surgery approached, I found myself just wanting to spend time with Nicole before the proverbial shit hit the fan. So, we picked up a pizza from one of the better local places that evening, and it was great. Well, as great as that type of evening can be, I suppose. Nicole and I spent the evening together, mostly just talking and watching movies. Yet again, we tried to make it as normal as possible. It wasn’t, of course, but oddly enough, I didn’t have that much trouble falling asleep the night before the surgery.

I think it was because, on some level, I thought I “knew” how things were going to go down. I “knew” it would hurt. But, I also “knew” that we were going to get through all of this. At that point in the treatment process, I was still naively optimistic that everything was going to go smoothly. We were going to go to surgery, get it all out, then start the intra-abdominal chemo, maybe even before I got discharged from the hospital. We were going to do all that, then Nicole and I were getting married and I was taking the board exam, and then after those things, we’d go to the next surgery. Then, I was going to be one of the people who lives for 15+ years after the diagnosis. In fact, we were just kicking the can down the road a bit until all this cool immunotherapy stuff people keep talking about catches up to peritoneal mesothelioma. It was going to be okay. Everything was going to go according to the plan.

I was completely wrong, of course, as you shall see. Just about nothing was going to go to plan. But we’ll get to all of that.

And before I knew it, it was the morning of surgery. They gave me this special disinfecting agent called hibiclens to use the night before and the morning of the surgery. So I stood in my shower trying to lather the surgical area with the cold and slimy “soap.” I stood under the warm water and just took a couple minutes to appreciate one of the last creature comforts I was going to have for quite some time. My next shower, such that it was, wouldn’t be for about a week. I dreaded getting out, because the next thing after that was to put on some clothes and head to the hospital. But – and this was going to be a common theme throughout the treatment process – I had no choice.

The other thing I noticed the morning of surgery was that I was pretty thirsty. I immediately regretted my choice of food the night before. It had been delicious, but also (apparently) salty, and I wanted a big glass of water rather badly. But, you can’t eat or drink anything after midnight on the day of surgery. Plus, I figured, I’d get an IV at the hospital and a bunch of fluid both before and during the surgery. All of that was true, and my urine output was good throughout the case, actually. But to this day, I’m still not sure whether or not I contributed to my kidney injury by being dehydrated on the morning of surgery. I am, however, very sure it didn’t help matters one bit. It’s hard to not be angry at myself for not thinking about how my choice of food might affect me, physiologically, right before a major surgical operation. I’m a doctor. I should have known better. But, as our friendly neighbors in the Great White North would say,

“Eh, that’s the way she goes, bubs.” Sometimes you screw up in life. It wasn’t the first time, and certainly wouldn’t be the last.

Continue reading in the next installment by Christopher Graham here: Chapter 2 | Part 2: Assuming the Role of Surgical Patient as a Doctor

If you missed chapter one of Christopher Graham’s story, click here to read it now.

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