Three faces of worry

My anxiety makes worry a regular guest in my skull, yet on the eve of my surgery I was calm. In the weeks leading up to it I hadn’t worried either. I thought I’d be bored in the days after the surgery. In America I’d have been sent home the same day but in Japan, where I live, I’d be kept in hospital for five days. 

Dressed my hospital gown, waiting to be escorted to the operating theater where I’d soon be put under general anesthesia to undergo laparoscopic surgery, I fell asleep where I sat.

When asked, on the walk to surgery , if I was concerned I just shrugged. It’s something that needed to be done. I knew the risks.  Mine were low due to many factors. Everything about the surgery got put into a file in my brain labeled “big thing, needs to happen, worrying won’t help” and I didn’t. I’d finished everything I could control.

I called worry a guest in my skull but that’s not accurate. He’s not a guest. He has his own key. He lets himself in without invitation. He’s there most of the time. I’ve learned his patterns and mannerisms and in doing so I’ve grown accustomed to his presence. I give him his space and try, with all I’ve gleaned, to not let him disturb my life unduly.

Everything I know about him informed how I prepared for the steps leading up to my surgery.

When I started worrying about what was going on with my body I told a friend who I knew would tell me “uhhhhh. Go see your fucking doctor.” and question me until I did. Knowing my brain starts dropping facts when I’m stressed I wrote everything in my bullet journal. I asked for a recommended specialist once my clinic doctor couldn’t do anything more. I  didn’t leave that clinic until staff helped me arrange the hospital consultation. 

It soon became clear that my worry wasn’t disproportionate or uncalled for. This was an Important Thing with Real Consequences. What I was about to go through was going to involve my health, my emotions, a hospital stay, cutting into my body, and red tape from work and the insurance system I’m part of.  

I’m sure my anxiety pack knows this feeling. When we lift our noses and can smell large problems with actual risks and our body just smooths itself. All the usual ripples that fan out across our mind at smaller triggers calm. We stand up straighter. This, our bodies say, is what we’ve been training for. This is real.

I created plans of attack for every stress  I might face: red tape in a second language has always been difficult for me. I have no idea how many times I broke down in tears in a bank, a city hall, or a post office my first decade in Japan. I’m not great at bureaucracy in my first language and adding a second language give me ample chances to feel like I’m failing what should be an easy task. In my moments of calm I know that bureaucracy served the system, not the individuals who must endure it…but when I panic I lose sight of that. What I was facing was important and I didn’t want to waste my precious energy feeling fucked around.

I asked for help with everything I thought might be outside of my abilities. I asked doctors to slow down or provide me with Japanese notes and illustrations when needed even when they looked frustrated at the extra work. I eliminated distractions and avoided multitasking when stressed.  When faced with a huge folder of hospital papers to translate I set a schedule to tackle them bit by bit to avoid overload. 

When  I was all checked in at the hospital, I let go.

My mind was quiet as I was walked to the operating room. 

I lay on the narrow bed and the head surgeon made English small talk with me, the first time anyone in the hospital had used English with me. I laughed at the familiar questions. I’m American. Wisconsin. Cheese and beer. Yes, I like natto….yes I’ll breathe deep…

I was out.Worry and I woke together. He was screaming and stomping.

There was no ignoring him. I looked for reasons in an attempt to deal with whatever was triggering him.

There are generally patterns to his distress.

I say generally because I’m now on medication for generalized anxiety. I (mostly) only feel him when there’s a perceivable reason to. Off medication I have days and weeks where my whole body is flooded with adrenaline and stress for no actual reason. I chase every possible solution to might reduce my stress no to avail. I upturn everything.

Nowadays there’s usually a cause for stress. My stress might be disproportionate to the cause but there's usually a reason for the reaction. I wanted, needed, to know what was setting my anxiety off.

My body crackled with adrenaline. Every nerve and emotion I had was on fire.

When general anesthesia wears off enough that a patient can breathe unaided, the staff removes the intubation tube from their throat. I’d been warned that it would be painful, that my throat would hurt for a while, and that I might have waves of nausea.

To my knowledge I hadn’t been told about the mucus, maybe I had been.

Your body produces more mucus to combat the irritation of having a tube down your throat. When the tube is out you’ll need to cough out all that extra phlegm with your sore throat. Coughing will remind you that many of the muscles you use to cough have been literally cut into.

The pain in my abdominal region was unbearable but understandable. I had a frame work for it. The mucus terrified me.

As I desperately tried to find a reason for my terror I latched onto a few explanations in quick succession. They were understandable. They were also wrong.

I have asthma. It’s not major but it was enough of a concern that I’d been put through some lung capacity tests in preparation for my surgery.

My asthma manifests as phlemy coughing fits wherein I can’t catch my breath.

My brain put all this together and I reasoned that I was having an asthma attack. I croaked this at my nurse.

 She placed the breathing mask over my mouth and nose again and tried to calm me. She explained that what I was experiencing was normal. I needed to cough out more phlegm and as the anesthesia wore off I’d be able to breath deeper.

Asthma attacks are scary. True. I wasn’t having an asthma attack. I believed my nurse. Ok.

Worry was still a siren. I was still ablaze. I latched onto a second explanation.

There are a few nebulizers and inhalers that trigger my anxiety as a side effect. Once I nearly melted down while teaching kids how to make paper airplanes and another time I hyperventilated until I blacked out three times in a row. After the cause was located my medication was changed. I’ve been on them a few times since when alternatives were not available but even knowing the issue doesn’t fully mitigate it.

An ex-boyfriend of mine once had to talk me out of ripping out an IV and checking myself out of a hospital when an anti-nausea medication we’d been warned “in rare cases can cause anxiety” did just that. I recall how sure I was that the best thing for me was to pull the needle out of my vein and collect my clothing.

Now I was freaking out with a breathing apparatus over my mouth and nose. 

I tried to explain my new fear to the nurse, that I was being given a nebulizer or aerosolized medication that was causing me to freak out. This time my words were hampered by the fact my brain wouldn’t give me the Japanese word for nebulizer or the Japanese brand name of the ingredients that trigger me. 

More miscommunication and more panic on my part. 

At last the nurse understood my confusion and explained that the mask was giving me oxygen. Only oxygen. It wasn’t a nebulizer. There were no other ingredients. Nothing I was breathing could possibly be creating my panic.

Then it clicked.

I was panicking because I was scared and confused. Period. 

I was safe. Disoriented, in severe pain, barely able to talk or cough , but I was safe.

There wasn’t a damned thing I needed to fix. I was ok. I needed to breathe.

I was still electric with anxiety. To settle myself I reviewed the facts.

I am not having an asthma attack. Fact

Breathe in.

My breathing apparatus is providing me with oxygen, nothing more. Fact

Hold that breath.

Pain and confusion is reasonable after a surgery and coming out of anesthesia. Fact

Breathe out.

Feeling pain after my body has been cut into, filled with gas, and items have been removed is normal. Fact.

Breathe in.

Heavy duty pain medication has been shoved up my ass and will soon help. Surprising delivery but a fact.

Hold that breath.

There is nothing else I can do. I just have to ride this out. Fact.

Breathe out.

Sleep. Quiet. Silence.

12 hours had passed, maybe 20. 

In that time, at regular intervals, a nurse came to check my IV , blood pressure, blood oxygen, and my temperature. She’d pull up my shirt to check my wounds and then rip away the tear-apart diaper that covered my catheter to check that. I’d be swaddled again, perhaps given medication and I’d sleep more. I’d been given the option of taking my pain medication  in my arm.

Dignity had left my body, thankfully taking embarrassment with it.  I was in a stage of numb acceptance. 

Eventually my catheter was removed. I was back in my big girl panties and shorts. A nurse was present for my first walk to and from the bathroom (don’t lock the door!) before I was given permission to take myself to the toilet unsupervised.

The checklist for my nurses decreased. They now checked only my IV, blood pressure, blood oxygen, temperature and bandages.

Then my bandages were ready to be changed.

For the laparoscopic surgery my navel was opened and they made three incisions, like a connect-the-dots smile, near the crest of my pelvis. My bellybutton was covered with a convex bandage with clear tape after the surgery. Occasionally the nurses would draw markings on it with a permanent marker. From the tits down I was a cyclops with a wonky smile.

I lay in bed as the nurse removed my navel bandage to apply a clean one. I strained to get my first look at it and was shocked. 

It was then anxiety reappeared.

I couldn’t see it clearly but what I glimpsed terrified me.

I could make out two or three pinkish protrusions, each the size of a kidney bean and seemingly the texture of goose flesh, where I expected my navel to be. It was as if my navel had prolapsed and spilled forth from my body only to be hastily tucked back in, I thought. I am a horror show, I thought.

Then the miasma of numb acceptance rolled back over me. I relaxed my neck as the nurse taped down a new bandage. I slept.

Occasionally I would wake up and attempt to walk the one hallway the Covid precautions allowed me to roam. I texted friends, checked my social media and watched movies.I napped a lot.

At some point I remembered and started googling things like “navel after laparoscopic surgery” and “outie bellybutton laparoscopic” and found nothing that fit what I saw.  I checked Google images, never a wise option when learning about surgery or ailments, still nothing.

I thought about what my friends had told me about their own surgeries. I’d been given some mysterious advice, like being told a pillow would be my best friend, that I hadn’t yet come to understand*..but there’d  been nothing about my navel.

I had no answers but was still within numb acceptance. I’d worn myself and my worry out.

Eventually I asked a nurse what my bellybutton would look like. She said only a doctor could give me that information. 

I explained that I perform and teach dance, belly dance, and that my midriff is in plain sight when I do that. She again told me to save those questions for my doctor.

I wasn’t specific about my worry when I asked. I didn’t want to put it into words. I especially didn’t want to put it into my second language. I knew what a mess I’d sound like.

“I saw my navel. It is like pink bean shapes now. Beans outside my stomach. Is this normal? I worry.”

My sense of embarrassment and the desire for dignity was returning.

Another night passed.

At this point I was walking unassisted and sitting up. Desperate to put a dent in my shoulder pain (a common side effect of the surgery) I’d found some yoga-after laparoscopic surgery routines on YouTube and had been doing them on my bed.

Best of all I’d purchased some unapproved vending machine coffee to take the edge of my headache and pain. My attention span was returning and with it my sense of self.

I was sure I had lumps of flesh where my navel had been but I didn’t worry about it. I’m not sure why.either I was too tired to worry or I realized that worrying wouldn’t change anything. 

I was allowed to shower for 30 minutes. Again I was forbidden to lock the room, in case  I needed help. This was my first time getting to see my naked body in a mirror.

The incisions were only covered with clear tape. My navel still had gauze and tape with strange markings. My abdomen was surprisingly free of bruises. My skin is a pale white, a hue usually reserved for boring appliances and Steve Martin, so bruises show easily.

The pain had withdrawn to a point where I could touch my abdomen, which I did cautiously. Above the skin around the incision on my left side I felt a thick lump that my center and right incision lacked. That’s where the most work had been done. Then I gingerly touched the gauze.

I could feel the bandage against my fingers. The muscles around my bandage could feel the movement. Yet I couldn’t feel the pressure of my fingers from the other side of the bandage. I couldn’t feel my touch. What I was pressing didn’t have nerve endings. It wasn’t part of my body. There was something between my bandage and the nerve endings of my navel.

Whatever I had seen, it was not me.

I finished toweling myself off, getting dressed, and I returned to my room.

I touched my bandage again. No change. Not my own flesh.

I thought. 

A hypothesis glimmered.

I googled again: laparoscopic surgery navel packed gauze.

I felt myself relax as whatever muscle I’d unknowingly hidden my anxiety in unclenched.

That was it. My navel had been stitched up and then it had been packed with tightly wrapped gauze. My bandage had been secured over that gauze. The odd markings on the final bandage recorded any fresh staining.

The gauze, of course, had absorbed blood from the wound until it was redish-pink. When they’d changed my bandage they kept the gauze in place. I’d seen the oddly textured nubbins of bloody gauze protruding from my body and had assumed I was only seeing my own body.

When a nurse came next I asked, “Is there gauze in my navel?”

Yes, there was gauze in my navel.

YAY!

I did not explain why I was happy about this fact. Neither of us would have been better off after my Japanese explanation:

“I thought my navel became three pink beans, like skin! Hahaha. Not skin, my mistake. There is gauze in my navel! We laugh, don’t we？＂

I lay back down. Soon, I would be home again. I’d return to my own bed and shower. I’d have other causes for anxiety. Until then I was in the hospital. My only immediate responsibility was to rest and to heal. I closed my eyes and slept.