The day we both had been preparing for had finally come. I had spent the previous evening reviewing Jesse's tests and CT scans. Her's was the first surgery on the board for this morning, so I knew she would be at the clinic at approximately the same time as myself. First, I wanted to meet with the anesthesiologist, and the rest of the surgical team, making sure we were ready. Then I headed to the pre-op area to see how Jesse and her family were doing. As I entered, I was greeted with Jesse's smiling face. Well, good morning, I said. Hi, Dr. Jen, Jesse answered. This is my mom, Julie, and my little sister, Terry. Hi, it's nice the meet you, I said as I extened my hand to each of them. Oh, it's so good to meet you, Dr. Jen, Julie answered. Jesse has been struggling with this awful thing for so long. And she sure has a lot of faith in you, said Terry. Well, I really feel like after all we've put her through, we're on the right track to help her now. So how are you feeling this morning, I asked her. Really good, Jesse answered. I'm all ready for this. I smiled and agreed. I know you are. I slipped my badge into the monitor and logged in to look at everything in Jesse's file on the computer. I wanted to make absolutely sure nothing had been overlooked, especially today. Are you comfortable, I asked her. Oh yes, this suit thing is really toasty warm. She was referring to the warming suit she was wearing that was hooked to an airhose in the pre-op room that kept the patient from becoming chilled before surgery. Additionally, a screen behind her continually monitored her heart rate, oxygen level, and blood pressure. A pole with an IV line and extra ports and a bag of saline also stood behind her. Lastly, a large syringe laid on the desk. It was a dose of antibiotic that Jesse would be given following the surgery to prevent infection.
Just then, Kelly, a doctor of anesthesiology and a good friend of mine, joined us in the small pre-op room. I'm sorry to ask, Kelly said after introductions were done, but since this is a small room, could you say your best wishes now and Jesse will see you later? Oh, yes, of course, Mom and sister said, and after hugs and kisses, they left and a nurse escorted them to a surgical waiting area. I stepped closer to Jesse's side and Kelly began to put an IV in her right hand. So, do you have any questions now about the procedure or what will happen afterward? Now that you've had more time to think about everything? Not really, she answered. But you will do an extra exploratory thing to be sure it's all gone, right? Oh yes. We won't leave anything, believe me. Very soon now, this will be all over for you. We smiled and looked into each others eyes. Ok, Kelly said. We're ready. I'll let the surgical nurses know. Thanks, Kelly. And she was gone, leaving just Jesse and I in the small room.
What happens after this is really all over, Jesse asked. You'll feel a whole lot better so you can go on with your life. But, without you? And she took my hand, causing me to give a short gasp. Again, our eyes met. I bent closer to her and said, we'll have to see about that I guess. She gave me her trademark nod and, to my surprise, I leaned even closer and kissed her softly. Okay, Jesse, let's go. We heard a surg nurse arrive and release the wheels on the gurney to take her to the OR. And I need to go to scrub in, I announced, so I will see you all there! The two nurses with Jesse headed one way while I headed out a different door. And as I slipped the mask up over my face and began to scrub my hands and arms, the thought of what had just happened swirled in my mind. Four months ago, this incredible young woman came to me for help, and today, we would take this important step together to make her life all that it should be. And . . . I was crazy in love.
I stepped into the OR and one of the surgical nurses stepped up and slipped a gown over my outstretched arms, tying it in the back, and then slid gloves onto my hands. I walked towards to table. Jesse had been transferred and the proper draping was in place. A nurse was scrubbing her belly with beta dine and my assistant surgeon, Dr. Jill, was going over the instruments with the surg tech. What kind of music do you like, Jesse, Kelly asked. Jesse chuckled and said, oh, light country I guess. Yes, I shouted. The music of Carrie Underwood came on in the OR, and I looked at each member of the team as they each gave me a nod or a thumbs up. I looked at Jesse, we both smiled and nodded at each other, and Kelly slipped a mask over her face and said, ok, Jesse, count to four for me. I scratched a small spot on her belly and Kelly said, go, letting me know Jesse was asleep and not feeling any discomfort. And our new lives began.
Dr. Jill handed me a scalpel and I located the spot by Jesse's navel to make my first cut. I worked my scalpel through the muscle into her abdominal cavity, then introduced the first laparoscope. Dr. Jill now was making her first incision to the right of mine and inserting a cannula. She filled Jesse's abdomen with fluid and then replaced the cannula with a second scope. The video technician had a clear picture on the screen for us to begin our exploratory surgery. Jesse's condition was a difficult case, as her endometriosis was deep in her pelvis. We would no doubt have to insert additional scopes to secure her organs away from the area of surgery so as not to damage them. We used the laparoscopes to carefully move the uterus, ureters, ovaries and locate the areas of endometrial disease. We made two more incisions to the left of our original cuts to stitch and secure those organs and keep them away from where we would be cutting. We now began to slowly cut and pull the extensive diseased tissue away from other areas in her abdomen. It was a slow and lengthy procedure, but when we were very sure that we had located and detached all of the tissue, Dr. Jill reinserted the cannula and placed a sterile surgical bag into Jesse's abdominal cavity. We used this to collect the endometrial tissue and then remove it through the cannula. When we were sure that the tissue was all removed, Dr. Jill used suction to clean the fluid from the belly, and we released and examined the organs we had secured first. Lastly, a different cannula was used to spray sterile saline in the cavity to help reduce inflammation and make the patient more comfortable as she healed. The four wounds were easily closed with surgical tape.
I had a large sigh of relief. Everything had gone very well. Jesse was already waking up and talking to Kelly. From the corner of my eye, I saw her feet move up and down. And the fingers on her hands. A very good sign. Jesse was transferred from the operating table to a hospital bed and taken to the recovery area. I scrubbed my hands and arms again, quickly changed my clothes for clean scrubs, and headed to the family waiting area. Julie and Terry were anxiously waiting for me and news on Jesse's procedure. I could not conceal my own relief and happiness that the surgery was over and everything had gone so well, and the surgical team and I were confident that she was going to feel much better very soon. But what would happen, and where we would all go from here, I could only hope as I thought about that soft kiss in the small room.
(To be continued. Please stay tuned. Thank you.)