Tales of Blood and Guts Mucus

Featuring nasal slings, partial nudity, heavy drug use and boring personal details. Not for the squeamish or faint of heart.

I don't know at this point if I'm Academy Award-winning actor Kevin Spacey or George Jetson's boss Mr. Spacely or some amorphous, hallucinatory amalgam of the two of them, but I can say for sure right now that I'm not myself, and haven't been for a while. Not since last Thursday afternoon, anyway. Whether I'll ever return to normal (as defined by my previous incarnation, pre-Thursday afternoon) or not remains to be seen, but at the moment, I'm betting the under.

The problem originates with sleep apnea, a condition with which I've suffered virtually all of my adult life. I'm an Apneist, from the Apnean Way. Because I don't get my full rest at night, I fall asleep all day long, any time, anywhere -- meetings, rock concerts, movies, driving, anywhere. I snore, heroically -- seriously, I clear rooms, I move mountains -- and, worse, I stop breathing for long periods of time while I'm asleep. (When attending a long-weekend offsite with a couple of related departments in my company a few years ago up at Granlibakken at Tahoe, I shared a room with five other guys the first night. The second night, and all subsequent nights, I had the place to myself.) I know this to be a fact; my wife has told me, my friends have told me, I have woken myself up on innumerable occasions from my snoring and/or gasping for air. Finally, about six months ago, I underwent a sleep study to determine what I already knew to be true. The results were no surprise: I got approximately 80% or less of the oxygen I should have been getting in my lungs throughout any given night. Something had to be done.

During the sleep study, I was fitted with what most doctors like to recommend (probably because none of them have ever had to wear one or rely on it regularly), an instrument known as a CPAP machine. This torture device -- which is so heinous in its function and construction that even Torquemada Dick Cheney refused to argue for its use by the CIA -- is constructed of a loud fan in a box that gets plugged in somewhere near the sleeper's head, a tube to deliver five or six G-forces of oxygen to the wearer and some sort of mask or other instrument to strap onto the victim's apnea-sufferer's head or face to deliver the oxygen. Some of the machines feature various face-masks that fit over the nose or mouth or both, making the wearer look a bit like Tom Cruise from Top Gun without the Thetan-free smile, ready to shoot down MIGs in his or her sleep. Others have inserts that go directly into the nostrils, up through the nasal passages, and then, as far as I could tell, actually inject pure oxygen directly into the brain itself. It may not help open the air passages, but it sure gives you something to think about.

So the CPAP machine was not a viable option, not in my book. That left as one other option diet and exercise (and a near-complete cessation of alcohol, at least in the "five or six hours before [I was] planning on going to sleep" -- right, Doc, I'll only drink from 11 in the morning until 4 in the afternoon), and I already knew that wasn't the answer, because I had suffered the same symptoms even back when I'd been a young man in my fighting trim. And the last option was surgery, which I was told could be very painful and had about a 60% chance of being successful.

Guess which one I went for.

Lest you think I went rashly into this decision, understand that I discussed it thoroughly beforehand with my regular doctor, the sleep study doctor and the doctor who was to perform the surgery. After examining my nose and throat, that doctor told me I was actually a very good candidate for it, and that he thought there was a much better than average chance of it being successful. It wasn't just my weight or my alcohol intake that was causing me problems; there were actual physical reasons why I have never been able to breathe properly while I'm asleep. Surgery of the type that he performs on a regular basis could very well correct that.

So there I was last Thursday, at the California Pacific surgery center on Clay at Buchanan in San Francisco. It was a lovely day outside; the rain had finally subsided, the sky was clean and blue and the air was crisp without being too cold. First thing they did was strip me of my dignity by taking my clothes and fitting me with one of those big hospital gowns that shows -- no, announces -- your ass to everyone behind you. Worse, the nurse immediately grabbed a larger size than the one she had already laid out for me once I showed up. The doctor had four separate procedures he was going to perform on me while I was blissfully anesthetized; they included taking my tonsils out, reducing the size and shape of my uvula and soft palate and straightening out what he had discovered was a very crooked septum.

The gas doctor lied to me, telling me she was only giving me some pure oxygen for a few minutes before she gave me the gas when she plopped the mask on my face. "Think of where you want to dream about being," she said after a few seconds. I immediately imagined Hawai'i. "Okay," she said, "think about Hawai'i." How did she know? I started to say something about that, but then I noticed that I wasn't getting oxygen any more.

"I can't breathe," I said. "I can't breathe." That was the last thing I knew. No counting backwards from 100, nothing. Just, "I can't breathe," and then, gone.

Mrs. G wanted to take a picture of me when she finally came up to my room after it was over. (Why? To scare the horses, frighten little children?) My face and throat were swollen, distended and bruised, my hair was predictably wild, the pupils in my eyes were dilated down to the size of pin-heads that even angels couldn't dance on and there was blood around my nose. My nose was what was giving me the most discomfort. It was packed full of something, some kind of plastic device in both nostrils pushing it up and splaying it out like a hog at the fair, with holes in it (barely) allowing for the passage of air back and forth, but also oozing blood and mucus. To collect all those semi-precious bodily-fluids, a great piece of rolled-up gauze known as a nasal sling was tied around my face, with a bow worthy of a dentist's office scene in one of the Our Gang comedies atop my head. That was what Mrs. G found so amusing, and wanted to record for posterity, but my baleful look when she suggested it convinced her otherwise almost immediately.

The doctor came in and said something, spoke for ten or fifteen minutes, I don't know, then the various nurses and nurse's aides came in and told me things I didn't understand, and on it went like that through much of the night. I could barely move, hadn't eaten anything since the evening before (and wasn't in the least bit hungry anyway), and spent most of that time finding new ways to moan and new pains to moan about.

The one thing I consistently understood was painkillers. "Do you want more morphine? Do you want more Vicodin? Do you want both? You can have both!" Here's a hint -- always, always take the painkillers when the staff offers, even if you think you don't need them right then. Always.

At one point, one of my nurses gave me a shot of morphine and then, apparently forgetting that she had just administered one to me five minutes before, came back in my room and said she was going to give me a shot of morphine. Thumbs up, honey.

The morphine was administered through the already-established IVs in my left arm, so it wasn't like I was getting a new needle with with each shot. (When they first put the two cannullas in and taped up my arm, I held it up for Mrs. G to see. "Look," I said. "I've been assimilated. I'm the Borg.") The Vicodin, on the other hand, they had to crush up and give me with a spoonful of applesauce, and you don't know what nasty is until you've swallowed a spoonful of applesauce and not-very-finely crushed Vicodin. After the first couple times, they would just crush up the pills and let me spoon in the applesauce and do the mixing myself. It didn't matter; it was still nasty as all get-out.

I tried to sleep through the night as best I could, but it was pretty much an exercise in futility. People were in and out of my room all night -- and that's not to mention all the people attending to my roommate, and his wife, who slept in the same room with the two of us, both of them separated from me only by a flimsy curtain -- giving me meds, taking my temperature and blood pressure, even doing a new sleep study on me from midnight to six. (In that one, I was drawing about 95-96% oxygen, much better than in my previous study, even with all the swelling and junk packed into my nasal passages.) Before the sleep study started, they had defied the Geneva Conventions by strapping me to a CPAP machine for a few hours in an effort to break my will ensure that I was getting enough oxygen in me if I happened to fall asleep. Fat chance.

Also useless to me was the view out my 5th floor window. I could see Alta Plaza, California Street looking west, the dome on the Palace of Fine Arts, the Golden Gate Bridge and Sausalito. It was a breathtaking, beautiful view. I didn't give a skinny rat's ass about it once.

Not having eaten or drunk much of anything for 24 hours, I didn't have much urge to use the bathroom facilities, though they did encourage me in that direction numerous times. Finally, about 2 or 3 in the morning, I felt the urge to urinate. Because I was hooked up to an IV, a heart monitor and an oxygen monitor, I wasn't going anywhere without assistance. So I grabbed the plastic urinal that had been on my table and managed to stand up, sort of, with my back braced against the bed. I held the urinal up to myself with one hand, and pulled up the voluminous hospital gown with the other. Finall, after standing like this for what seemed to be twenty minutes or more, I was able to get a small trickle out. At that moment, the nurse's aide to the man in the bed behind the curtain next to me pulled my curtain open and looked at me. She seemed uncomprehending for a few moments, a dumb look on her face. Then her eyes brightened, her face lit up, she pointed to my crotch and said, "Oh! Good!"

She was happy I was peeing.

"Go away!" I explained to her.

Maybe the worst part of all of it, though, was the nasal sling. It looked for all the world like I had a giant tampon strapped across the middle of my face. Really, I don't know how else to describe it. Picture a lengthy roll of gauze, wrapped up in the size and shape of a kielbasa, with knots at either end and enough gauze streaming from those knots to wrap around your head and tie behind your ears. Then imagine wearing one 24 hours a day, collecting all the oozing blood and snot coming out of your nose after major surgery for the next five days. At least they gave me some fresh ones when I left the hospital. You should have seen the looks of the people on the sidewalk when I got out of the cab at my building.

At home, my sleep was still not much better. I was no longer getting pumped full of morphine, but I did have a giant economy-sized bottle of Vicodin (with a refill) to pop like M&Ms, not to mention a couple bottles of viscous Lidocaine to swish around my mouth every couple hours and a regimen of antibiotics "just in case." When I first saw the bottle of Vicodin, I thought, there's no way I'll get through all these, much less need a refill. Now I'm thinking I might need another refill after that. But regular sleep...? Eh, not so much. I nodded here and there, especially if I took more than one Vicodin every four hours, but rarely for more than ten or fifteen minutes at a time. I tried to keep to a regular schedule, but if I got in bed at 10, I was sure to be awake and up again by 2 or 2:30

Now here it is Tuesday, and the pain just isn't subsiding much. Well, it is, sort of, sometimes, but Jiminey flippin' Christmas, I'm here to tell you that having the back of your throat feel like it's full of broken razor blades every time you swallow is no picnic, no day at the beach. Or night at the Ritz. It's not even as much fun as that scary, gang-graffitied Motel 6 Mrs. G and I foolishly spent the night at in Joliet, Illinois, back in the early '90s. In fact, it pretty much... what's the word? Sucks. Yeah, that's it. It sucks.

Yesterday, Monday, I did get some measure of relief, though. I went to the doctor's office, where he told me he was going to unpack my nose. I didn't realize just how literally he meant that until he started. First, he pulled out the two-pronged inserts that had been shoved up my nostrils to hold everything else behind them in, and allegedly allowed some air passage in while letting the blood and mucus drain out into my face tampons nasal slings. I thought maybe that was all there was, or, if there was more, it was just some gauze packing behind it. Oh no. Suddenly, my nose was a cornucopia, a clown car emptying its contents in the center ring. He started pulling things out of my sinuses that I wouldn't have thought possible to fit in my mouth, much less my nose. (And in doing so, I was reminded of my good friend Scott's regular captioning line: "This came outta ME?!?") He pulled out tongue depressors, cardboard collar inserts, air baffles, pennywhistles, old Cracker Jack prizes. He pulled out volumes G through N of the Encyclopedia Britannica. He pulled out the tailfins to a '56 Cadillac. Then he looked inside my nose and said that it was good.

And my god, I could breathe. I could breathe through those nasal passages like I've never been able to breathe through them before in my life. I could feel air, real, cold air, coming from outside my body straight though my sinuses and into my lungs. I had never experienced that before yesterday.

It began to close up a bit as the evening went on, though, and now today, my nose is somewhat stuffy, what with all the blood still in there and the mucus and such. But it still works better now than it ever had before. As for my throat, water or broth is about all I can handle at this point -- I've tried small amounts of Jello and pudding and yogurt and applesauce and juice, and all of them are too much for me right now -- and though it still feels like every sip is spiked with shards of glass, it does seem like it's going to get better soon. Like in the next few days or so. By next week, for sure. Because ultimately I'm an optimist, and I believe I did the right thing in the long run. I may not be able to ingest anything but clear liquid right now -- and I may have to put up with the evil Mrs. G constantly reminding me of that fact by having the temerity to eat real food right in front of me without contorting every muscle in her body and screaming in pain with each swallow -- but I know someday I'll be better. And it's not as if I can't stand to live off the fat of the land for a while anyway. Not that I'd recommend this as a dieting strategy to anyone, but, hey, you take your opportunities where and when you get them.

Meanwhile, I think it's time for some more Vicodin.