Last Wednesday I went in for a procedure that was new to me, and quite frankly, I didn’t hold out much hope for as far as its success rate went. It was a transabdominal plane (TAP) block. My pain doc, who is fairly close to me in age, very serious, sober, and I suspect severely depressed, hoped this TAP would stop the nerve pain that I get as a result from the allergic reaction to the drainage catheter that winds around my abdominal area. He thought my pain was from my abdomen being cut so many times from all of my surgeries. I indulged him because quite frankly, I’ve got nothing better to do.
When I arrived at the outpatient surgical area, I changed into the ugliest shit brown gym shorts ever, and got a matching pair of shit brown hospital socks with rubber grips for fall prevention. No way would anyone willingly steal these digs (with the exception of one lovely elderly lady who declared them exceedingly comfortable, I was told). I had three nurses ranging in age between 50 and 68 (I’m guessing), all slightly fussy and calling me honey, and addressing me in a loud volume with small words as all surgical nurses are accustomed to doing when coaxing patients out of anesthesia. I was awake and responsive the whole time, but it’s hard to break a habit that takes decades to build.
We discussed all of the yellow on my chart – meaning all of my allergies. We settled on a chlorhexadine scrub rather than a betadine solution to prep my abdomen because of my allergy to shellfish. I watched as my doctor put a long sleeve on the ultrasound paddle that would help guide the needle that would deliver the meds, as he rolled it down and secured it with a rubber band, and I asked, “Oh, is that an elephant condom?” The nurses twittered and the doctor chuckled. Then the nurses got in on the game and tried naming a few other animals with especially big penises. Then we got serious again because it was time to stab me.
The doctor applied some ultrasound gel and pressed the paddle to my abdomen. The nurse at my head put her hand on my shoulder and I closed my eyes. My doc warned me that I would feel the poke and burn. I focused on my heartbeat and forcing it to beat slower, and as if from far away, I heard the nurse say close to my ear that I could squeeze her hand if I needed to. I whispered “No” and refocused again on my breathing. I could hear my heart on the monitor slow down. The doctor said something about enlarging the picture, then needing more “puffs,” and then he finally said he was done and he was going to withdraw the needle. I opened my eyes and my heartbeat increased again, and I saw him pull out a needle that was about four inches long that was attached to a wire.
We did it all over again on the other side: gel, paddle, breathe, focus, heart rate down, needle, pain, puffs, out. I had to have paper tape with gauze over the insertion points because I would have been allergic to what they usually use for gauze pads. The doctor told me afterwards that he had never seen anyone’s heart rate go down as he was inserting the needle and the meds – usually the opposite happened. I told him that I learned a few things from meditation.
I didn’t pay it much mind, but almost immediately, I had developed hives at my insertion sites. I was supposed to keep the gauze on for 24 hours so I didn’t see the hives until the next day. As far as pain relief goes, I didn’t feel any by the time I received a call at noon, but I noticed I had some at about 5:30 that night. However, by Saturday I was laid low by pain again. I emailed my doctor and his nurse to let him know about the hives as well as the ineffectiveness of the block. The hives did not appear across the entire area that they prepped so I know it’s not a reaction to the chlorhexidine – at least I still have that as an option.
If my doctor is depressed, I can understand why. I would feel the same way if I had patients like me.
And whatever this new allergy is, it’s really just another sign that I’m not a native to Earth and that I need to send a signal flare up to the mother ship to scoop me up.