POEM surgery detailed

Mostly for the benefit of future Achalasia patients considering the trip to Strasbourg for the POEM surgery, I thought I would detail my 30 hours at the hospital so you can understand a little of what to expect.

5 am. Awake after falling asleep at 2 am.

6 am. We were taken in a taxi from the hotel to the hospital where Dr. Swanstrom greeted us in the lobby and showed us up to the admissions area where I put on a gown, said goodbye to Kelly and relaxed in bed.

630 am. I was rolled in my bed down the hallway into an elevator down another hallway into a large empty staging room and left to rest again, soon there were many others brought into the room and it was obvious we were the surgical patients for the morning.

720 am. A gaggle of giggling french nurses ( expectation realized ;)) arrived to sort and export. They seemed to enjoy the fact I only spoke English and took the opportunity to practice the language. Hello. What is your name? How are you? Where do you come from? All with much laughter and discussion in their native tongue regarding my rugged good looks and handsome physique (approximate interpretation).

I transferred to an operating table from the rolling bed just outside the operating room and successfully kept all my parts inside the gown during the process. Hurray. I was rolled into the OR which looked very sophisticated with many large flat screen monitors, huge cool looking operating lights, some other equipment and a handful of folks prepping for surgery. Dr. Perretta was there and put her hand on my chest and consoled me while I explained my concerns of aspirating when they put me to sleep. She has the skill and professionalism of the highly trained surgeon she is while at the same time the genuine heart of the kindest nurse. A rare combination. The anesthesiologist said she would be putting me to sleep now so I tried to stay awake for as long as possible when I felt the slightest hint of drowsiness because It seemed like a pretty fun thing to do at the time. 1 second.

8 - 830 am operation begins.

1030 am. I awake (do not recall).

1031 am. Dr. S. called Kelly and reported all went well, I had a super tight sphincter
and he expected a full recovery with great results and a small chance of reflux.

1130 am. I awake in a large room filled with lights, people, desks, more lights chapstick and some lights. Retreat.

1140 am. Arrived in a regular hospital room with apologies for the need to share it with another patient. No worries.

1141 am. Kelly says hi kisses me on the cheek, lovingly caresses me for a while then quickly realizes I will be no sort of entertainment anytime soon and leaves me to sleep it off.

1200 pm. My first french lesson. My bunk mate's nurse is using the word catastrophique repeatedly. Loosely translated this means your bunk mate has loose stools which have run all over his half of the room and this room will be uninhabitable in 4 seconds. catastrophique

1200 and 10 seconds pm. Freaking out.

1205 pm. Moved to own room. Much sleeping. No pain. I don't remember much of the afternoon but I know Kelly and Joelle came and visited several times into the evening. Modern, clean, basic hospital room with what I swear is the most comfortable mattress I have ever been on. Very comfortable.

?? pm. Dr. Perretta arrived. We chatted and I took notes which seemed like a good idea. The answers I wrote down were:

2nd poem surgery at ircad

No h20 until friday.

No

Probably soft/liquid until sunday

No

Will see Dr. S. saturday

Maybe walk 4-5 pm no need to tell nurse

Surg. went well woke up well

I need to ask her about the two questions which correspond to the two NO answers to see if any apologies are in order. I was pretty intoxicated.

300 pm hot hot. Push button for nurse to take my temperature because i have internal bleeding, infections, almost drowned in a tsunami and will soon die. Temperature confirmed 37.1 which I gather is pretty good based on the smile on the nurses face.

430 pm. Walked around the hallways for 10 minutes.

Afternoon and evening. Periodic temp and blood pressure checks. I connect faces to the nurses which speak some english, a little english and no english. Mostly no english which leaves more time for resting. If I push the red button I know a nurse will show up with which I can communicate reasonably well.

As far as I know I was on I. V. meds for nausea and mild pain along with sugary saline solutions for hydration and some energy. No drinking until friday (surgery was thursday) according to my notes.

700 pm. Walking

800pm. Nurse says goodnight see you at 2 am and 5 am.

900 pm. Nurse walking in hallway singing a lovely french song. Serious.

1000 pm. Walking

Pretty good sleeping very comfortable.

400 am. Mild chest pain. Push red button and she tells me she will mix something up for me. Returns with small I. V. bag which she connects to my system of bags and tubes. No narcotics needed I am pretty sure. All of the pain was very mild and I asked lots of questions about what was in the I. V. Bags.

405 am. Walking the halls.

Sleep

830 am Kelly arrived.

930 am. Dr. Perretta arrived for a check up and to let me know that if the swallowing X-ray was acceptable I could eat, drink and leave that afternoon as planned

1000 am. Prof. Marascaux arrived to introduce himself and wish me good luck.

1230 pm. Taken to radiology.

1240 pm. Radiologist looks at first X-ray and no kidding he turns to me and says this grapefruit sized gray area in your abdomen is not normal, not something he has seen before. Catastrophique I think. I had my initial swallowing X-ray done in Medford and they were a little confused so there was not a previous abdominal X-ray to compare to. He continued with the swallowing part of the procedure. This was my first chance to swallow since my surgery and I had no idea what to expect. It was beautiful!! Awful toxic tasting liquid but beautiful man oh man it slid down so easy, way better than I had ever remembered. Short lived glory because I had a tumor the size of a grapefruit in my chest.

130 pm. Dr. Perretta arrived, had reviewed the X-rays and assured me that what the radiologist saw was the CO2 gas bubble they used to inflate something or other inside my abdomen to allow easier access for the surgery. This is a new technique for them and the radiologist had not seen it before. She said the swallowing looked fantastic and I could have some water and soup which arrived in seconds from somewhere. Released.

I was given some Tylenol, nausea meds and 15 days worth of Nexium.

230 pm. taxi to hotel, sleep, eat yoghurt, drink water, yoghurt, juice etc. pretty tired.

I experienced mild esophageal pain friday and saturday which was completely controlled with tylenol. No nausea ever. Today is sunday and the pain is basically gone and I feel very normal as you can tell by the length and spunk of this blog post.

Today is post op day 3 and even if there were no further improvement in pain and ease of swallowing ( which there will be as swelling and irritation subsides over the next many days) I would rate my POEM surgery a 100% SUCCESS. What a relief.

Food introduction timeline:

Surgery day. No food or water.

1st day post op. Yoghurt, soup and juice.

2nd day. Scrambled eggs, goat cheese, crepe with 3 cheeses, foie gras, fried potatoes, mushroom gravy, creme brûlée. Small bites chew a long time.

3rd day. Added firm cheese, lox, soft pretzel, liver pate, prosciutto and cookies.

My goal before we leave Alsace, France is Choucroute. Not charcuterie. Google it.

We are back at Joelle and Claude's

Happy