Milestone: I can smell again!

It has been 10 days since my surgery and while I had the packing removed from my nose after the second day, I had no sense of smell until about 2 days ago. Sadly, all I smelled at the time was ammonia. It was fairly strong and followed me everywhere I went. When it occurred, I just took note of it. I didn't think there was anything I could do about it and since I had other issues, this was the least of my concerns. When I awoke this morning, I smelled breakfast, the bacon and eggs. What a relief! I still smell a hint of ammonia but either I'm getting used to it or it's fading on its own. My taste buds seem to be coming back as well. It feels different, almost like they have changed also but at least they are coming back.

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Milestone: No pain meds

Well, today marks another important milestone for me. Despite my other adventures, I did not need to take any pain meds today. My activity level was light, all in all a good day for pain. To contrast, yesterday my neck pain was exceptional yet again and so was the headache after about mid-day. By evening it was time for some relief. But not today.

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1st week Post Op issues

If anyone attempts to allude to Endoscopic Transphenoidal surgery as being anything other than brain surgery or even "minimally invasive", don't buy it. Make no mistake, this is brain surgery and it is invasive. There is a reason that a neurosurgeon is performing the operation and he has a team of specialists assisting him. I guess in some respects I convinced myself that this was less than what it really was. The risks are many, the complications are great and it involves the neurological system which we really don't know much about. Consider the complexity of the pituitary gland and how easy an imbalance occurs. Our bodies and how it regulates itself is miraculous by design. A man with specialized training had to go in there, remove this thing which insisted on growing and somehow not disturb anything. How realistic is that??? As I mentioned previously, my symptoms prior to surgery were minimal. Here is the list if issues 1 week post op in order of observation:

• Headache/head pressure
• Extreme neck/muscle pain
• Pervasive ammonia or no sense of smell
• Distorted voice/sounds
• Stabbing pain in left ribcage

It took a day or two before I began discerning the different things I was feeling. The first day felt more like one big train wreck. I hadn't taken inventory, heck, I didn't even know I needed to take inventory of what worked and what didn't. As the days passed, I learned to distinguish between the head pressure, the nose pain, the neck pain, the soreness from the lumbar drain, the discomfort of the urethral catheter, and sleep deprivation.

First on the list was the headache and/or head pressure. This was to be expected and it supposedly will pass. My nose it tender at the location of the surgery but it rather blends in with the pain around my forehead. It can be described as an extreme headache but isn't localized to just the area of surgery. The pressure seems to encompass my entire head. The upside is that you have at your disposal a variety of drugs to control the "comfort".

Next is the neck pain. It reared it's ugly head on the very first day and is above everything else, the thing I feel the most. The only relief is to lay down and not move. Turning to one side or the other doesn't help. It's best to just lie still, face up. No amount of drugs contains it. If I lie still and try to rest, the intensity does pass. My doctor ordered an MRI of my spine to see if there something visibly wrong. In terms of pain or discomfort, I was well enough to go home as long as I remained laying down. Upon sitting up, however, the pain becomes overwhelming after about 5 mins.

Next is my sense of smell. My ENT came in 2 days after my surgery to remove the "packing" in my nose. Up to that point, I could not breathe through my nose. When he removed these gargantuan cylindrical gauze pads, it was like two large wind tunnels were opened up that led straight to the my throat. Never have I been able to breathe so freely through my nose before (or since). The removal of the pads themselves were uncomfortable but it went quickly and I think I had enough pain meds in me to take the sting out of any direct pain. Despite the ability to breathe freely, I did not notice any particular smell. In fact, it wasn't until well over a week later that I began to smell anything at all. And when I did begin, the smell was ammonia. I'm not sure what to make of it but I have other more pressing things to worry about.

Next is the distorted voices. I noticed this, mostly coming from the TV, during my stay in the hospital. It's subtle and I didn't think much of it at first. In fact, I rather dismissed it as possibly a defective speaker in the hospitals TV speaker. Upon returning home, it continued and I've asked others if they hear the same distortion but they do not. It sounds very similar to a distorted computer voice. I'm sure if I revisited computer movies made back in the 80's I could find the voice. There was one with Matthew Broderick where a computer wants to "play a game". That's the voice, it mostly comes from the TV but sometimes I'll hear it in my wife and kids voices.

Last on the list is a stabbing pain in my left ribcage which started the day after coming home from the hospital. I don't know what to make of this yet and I haven't had an opportunity to talk to my doctor about it. It it precisely located underneath my arm, about even with my nipple, and it is sensitive to direct pressure. The weight of my chest when I walk aggrivates it and I seem to able to avoid the pain by just supporting my left pectorial with my hand.

Well, that's it. During my recovery, the nurses made sure to check that I had my strength and sensation in my both my arms and legs (which I do). I can hear from both ears evenly(?), I can see directly and peripherally and my eyes dialate when light is introduced. I'm urinating the correct amount of volume so diabetes is no longer a topic of concern, my bowels are working (albeit stubbornly). I'm eating and sleeping.

Just taking this simple inventory, I'm again reminded that there are so many functions that our bodies perform naturally by miraculous design. I'm watching the Beijing Olympics and I'm observing these highly tuned, trained athletes. Talk about perfection, talk about ochestrating perfect harmony, talk about miraculous design. As I said before, our bodies are highly complex and as an engineer, I wish we were given the devine blueprints. That would eliminate a lot of the guesswork and I am convinced more than ever that our doctors are employing nothing more than educated guesswork.

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Acromegaly: the day of surgery

The day of surgery and the those leading up to it took on a life of its own. The momentum after the decision and surgery was scheduled, it was all I could do to just keep pace with it. A new job, a new car, my kids football practices, coaches meetings, perpare for surgery, it was a whirlwind. And the thing that kept going through my head was, am I even going to be here after Aug 12? The surgery was scheduled for 7:30am so I had to be there by 5:30am. I knew that once I went to sleep the night before, there was no turning back. Trying to align the schedules of 3 very busy doctors was hard enough the first time. Was I prepared? Well, yes, I guess. But I still had no idea what to expect. I arrived on time. Hospital activity was light as one would expect at 5:30am. Parking was easily available. To my surprise, nurses were waiting for my arrival once I reached neurosurgery. They take your vitals, weigh you in and give you a bag for your personal effects. They provide you with a nicely folded gown, still warm to the touch, and gave me instructions on how to put on the gown and compression socks. "The openning should be at your back and the hole at the end of the socks is for the balls of your feet, not your toes." Got it. Everyone you make contact with will want to know your birthday and if you've eaten in the last 12 hours. I had fun saying it backwards and forwards and forwards and backwards. Despite the time, everyone seemed to be in fairly good spirits. This was in contrast to my feelings of impending doom. The anesthesiologist was the last guy I remember. He was very friendly and assured me that he would be with me the entire time, monitoring my breathing, checking my vitals and if there is any evidence of pain, he would quickly remedy it. The "evidence" as he called it was an increase in breathing. I guess it's a sign that I'm recovering at some level so he makes sure that I remain "comfortable". The time before surgery went pretty quickly. I was wheeled into the operating room at percisely 7:30am and it was as sterile as one would imagine. The table and trays are all purposeful looking, there is nothing there that isn't needed. I chose not to allow my eyes to linger too much on all the instruments. My mind has a way of empathizing their many uses. It was also very cold in the room. I mentioned it to someone and within seconds I had another pre-warmed blanket on top of me. I will say this, the Scripps Green Hospital in La Jolla is top notch! I must have shown signs of nervousness because my anesthesiologist came into view and asked me how I was doing. I said I was doing okay but the nervous tap my hand was doing on my thigh was telling a different story. He said he'd give me something to help me relax. And sadly, that was it. I was planning on counting backwards indefinitely, I practiced all morning on my birthdate. But it was not to be... I was out cold with a simple sedative. I woke up around 12pm as I was being wheeled into my recovery room. I heard someone say room 427 as I awoke. They asked me if I knew what day it was. It was Aug 12, 2008, Tues. They asked me if I knew where I was and I said room 427. They laughed. Do you know why you're here? To remove a tumor... Yes, Mr. Del Rio, welcome back. I was glad to be back and I felt pretty good. I was a little tired but otherwise none too worse for wear. I didn't feel any pain but I did feel a lot of pressure, mostly in my nose, but otherwise I didn't feel a whole lot of anything. By 2pm I was starting to feel stuff, though it was very general and I wasn't sure what I was feeling to be honest, I was definitley beginning to feel things as the medication began to wear off. The pressure in my head was most prevalent and my nurse would come in periodically to ask if I needed anything. I would just shrug and say I was okay. "Do you want any morphine?" Do what? Are you kidding? I must have declined the morphine request at least a half-dozen times but by 3:30pm, I was starting to feel things, bad things, pain and lots of it. I called the nurse and she said, okay, why don't we give it another 30 mins. Oh, okay. It was okay when you wanted to push it but now that I'm requesting it, it's best to wait??? 4pm came and so did my shot of morphine. Another nurse came in at the same time and upon hearing that I was feeling "pain", suggested that there was no need for me to feel uncomfortable so if this shot of morphine didn't work, they'd be happy to give me another. My mind quickly started racing about the condition I would be leaving the hospital and whether or not I'd have to battle a mophine addiction in addition to acromegaly. I must confess to my ignorance and potential pharma-phobic tendencies. I never understood drugs and their propensity to create problems rather than actually fix anything. And I will never understand how the pharmaceutical companies "push" their cocktails of drugs while down-playing all the side effects and warnings. But I digress... They assured me that there was no chance for me to develop an addiction and it was merely to allow me to feel comfortable enough to allow the healing process to begin. Ah, well that's different. Fire away. Within 30 mins, 4:30pm, I had my 3rd shot of mophine. The first 2 were 1mg while the 3rd was 2mg's, and while this seemed like a lot, I really didn't feel anything. I wasn't sure what to expect or even what to feel. For some reason I was expecting some sort of euphoric feeling but that wasn't the case. It was a case of simply feeling nothing to the extent that I questioned whether or not I was receiving a placebo. They assured me I was not... :) All I remember about the rest of the evening was Agnes, my evening nurse (with a strong accent). Every hour, on the hour, I'd hear, "Hello, it's Agnes... Hello? I have to check your vitals, how are you feeling? Hello? It's Agnes. I have to take your BP, can you open your eyes and lift your tongue? Hello? It's Agnes..." At 9pm, at 10pm, at 11pm, at 12am, ... by 3am I thought the evening would never end, then 4am, then 5am, then 6am, then ... Beth! It was 7am and Beth was back! Oh Beth, why did you ever leave me... I kept having this horrible dream...

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