Stool softeners, Zofran, and other remembrances of loves past

This week was weird, even for me. On Monday I had knee surgery. It is the kind of knee surgery that’s so routine that the surgeon feels pretty blasé about telling you he does 15-20 of them a day. But there is no routine surgery when you’re the patient, and in my case, there is nothing so simple and straightforward that I cannot make a convoluted harangue out of it. 

It actually started before the surgery, when my psyche visited a cancer spider surgery dream upon me. This set the stage nicely, as it signaled to me that surgery – even a type utterly removed from cancer or Nina’s treatment – was going to be a trigger. 

Well, it turned out to be not so much a trigger as a bizarre trip down bad memory lane. The day of the surgery I took the prescribed opioids, but wound up with sudden onsets of nausea. I tried not taking the opioids. This resulted in me getting behind the pain curve and not sleeping for two nights. I went back on the opioids, this time with Zofran – the anti-nausea medication which handily enough I still have in my medicine cabinet from Nina’s last prescription. The Zofran did the trick – no more nausea – but then I remembered the downside to opioids and Zofran, which I’d also learned through Nina’s experience – massive constipation.

So back to the medicine cabinet I went for the bottle of stool softeners that have been there since Nina died. Her pain and bowel management legacy, it seems, is replete. It was an odd way to confront or revisit these issues. First, it’s just intrinsically odd to be filled with the desire to tweet “I pooped!” after your longest bout of constipation ever (because I am discreet and value privacy, rather than tweeting I texted my sister – who says decorum is dead?). But also, I ought to have remembered the lessons of pain meds and this was my first real encounter with an invasive medical procedure since Nina died. 

Fittingly, my experience was sort of the diminutive version of the kinds of things Nina went through – a friend who messaged to check in on me after surgery hit the nail precisely on the head when she asked if I were really in serious pain or just suffering from Male Pattern Wimpiness. 

But the connection to Nina’s course of disease was striking and direct. I have never been a good patient. My threshold for discomfort is startlingly low, let alone actual pain. It embarrasses me now, but I remembered when I went to have my knee examined recently that I had knee issues in 2016, too, while Nina was metastatic but not yet end-stage. I remember having great trouble getting up and down the stairs of our house. What must she have thought as she heard me groaning my way through the morning, with her metal vertebrae and Fentanyl patches? 

Here is the actual knee, with its two TINY sutures. Don't let the looks deceive you: a cushy recovery was needed. 

Actually I know exactly what she thought. Nina was pretty direct about things like that. But, though I never became even a half-decent patient, I learned to be a good caregiver to Nina. I remembered when she took her meds, reminded her about anti-nausea or anti-anxiety options, helped her track her pain levels so we knew when to ask for bigger pain patches. It was not only necessary, but that level of caregiving was my way of staying close to her, feeling necessary and vital to Nina as she got closer to dying and I faced down the idea of life without her. 

I had lots of help this week (I know Hilary Clinton meant it about childhood, but it will take a village to raise me until the day I'm lowered into the ground), but it’s weird doing the caregiver-patient dynamic alone. Not only is it an added reminder of loss, it involved so many of the instruments of Nina’s illness it was hard not to feel a kind of flashback sensation. It was so striking that at one point in my opiate induced haze I wondered if I had cooked the whole thing up subconsciously, maneuvered myself into surgery as some sort of weird grief pathology. Like I needed to go through it at some level. I am reassured by the orthopedist’s notes indicated my meniscus was in tatters, but part of me still wonders if some of this isn’t too coincidental to be purely happenstance. 

Whatever the precise etiology of my knee injury – grief neuropathology or just aging jogger syndrome -- there’s no question I did it to myself. And there’s also no question that it has already taken me longer to be ambulatory than it took Nina after they grafted a metal cage into her spine – she stood and walked the next day; I’m still using crutches. Make of that what you will. I don’t think there’s any connection, personally.