Is this where I come for a rhinoplasty? Tuesday, 18-Dec-2001 a little before 08:00, I arrived at the Outpatient Surgery building at Seton Medical Center. I was excited! It's finally happening. Surprisingly, once I was at the hospital, there was no worry, panic, or wondering if I were doing the right thing. My trust in Dr. Romano, and the clear resolve that I had made months ago, was staying with me.

Within minutes I was escorted to the prep area. I changed into a hospital gown, donned the medical center's socks, and stashed my clothes into an assigned locker. Oh boy, I even got to keep the red and black tweedy SMC logo'd socks as a souvenir. Now that I was suitably dressed for the occasion, the maîtresse de surgiprep directed me to climb onto a typical hospital bed. After getting under the covers, she mounded heated towels on me to keep me warm – nice touch!

I'm real a wimp when it comes to needles, so I wasn't looking forward to having an IV inserted. When the prep nurse inserted the IV, it was no more annoying than any other kind of needle shot.

Next, my anesthesiologist, Dr. Hulton, came by to verify my medical history. He was interested in any drug allergies, prior experience with anesthesia, and to make sure that I hadn't had anything to eat or drink since midnight. It was comforting talking to him. While chatting, he very nonchalantly added a sedative to the IV. I knew that the show was about to begin.

To ensure that everything was fine, Dr. Romano stopped by for a few minutes. Everything was A-OK. He did a brief rundown on what he was going to do – no surprises there. We had been over what would be done enough times, that I was beginning to feel as if we were well-rehearsed actors ready to play our parts in the operating theater. He assured me that everything was going to be fine, and that it would be over sooner than I knew it.

My anesthesiologist came by one more time, and that's all I remember before surgery. I never felt any of the sensations that some people mention when being sedated. There was no mild burning in my veins or metallic taste in my mouth. I quickly went from a little drowsy to totally out. I was expecting to be somewhat awake when being rolled into surgery, but I faded off to never-never land while lounging about on the hospital bed. What a disappointment, I wanted to be wheeled through the operating rooms doors, hear them slam shut behind me, check out the equipment, then be put under.

Getting Hosed

If catheterization is done, it happens after you're already under anesthesia, so you're unaware that it's being done – you might never know that it even happened! For women, I don't think that there are usually any after effects. For men, occasionally there is slight discomfort during urination for up to a couple of days afterward. Men are more likely to experience after effects because the tube has a longer route to travel. I can't remember for sure, but the male urinary tract might also have a smaller diameter (at least closer to the point of egress) to complicate matters.

The first post-op memory I have was when I was about to be moved to the recovery room. I remember my eyes opening to just a slit... I'm still in a reclining position, probably on a gurney. I'm still wearing Seton's Medical Center's latest surgical fashion. But wait, something is going on down there... My privates are exposed! I'm catheterized! I'm being decatheterized! The small tube is being pulled out from my privates! The tube was out, and so was I once again. I was conscious just long enough to record that experience. Sometimes, I just end up with the strangest timing. It turned out that my blood pressure was quite low and the catheter was left in place longer than normal to be on the safe side.

I had a very slight discomfort for a of couple days after being catheterized, but it really was not a big deal. I find the thought of having a needle stuck in my arm for an IV much more disturbing than the after effects of being catheterized.

Dr. Romano had a few interesting points to make about the technical aspects and etiquette of catheterization:

• Catheterization is most important not only for the issue of having to "void" as it is politely put in medicalese, but also to prevent the occurrence of high blood pressure, of which men have a tendency. Should a patient wake up with a full bladder, the blood pressure could rise and potentially "spring a leak" in a blood vessel. This leak might cause a hematoma to develop. Catheterization is a precautionary measure largely for this reason.
• Dr. Romano has found that giving generous amounts of IV fluid (especially because a patient will have had no fluids since midnight) is an important factor in decreasing the risk of nausea postoperatively. With extra fluid being administered, there is a greater need for a catheter.
• Although I'm not at at all sensitive about such issues, Dr. Romano exercises utmost discretion when a catheter is inserted and removed. The patient is always unconscious during the process. For male patients, the doctor performs the task in privacy. For female patients, a female nurse performs the task in privacy. Apparently, most patients are comfortable with this arrangement. This etiquette is totally wasted on me, and its need is somewhat beyond my comprehension, but for people that are sensitive to this issue, fear not, you are always treated with respect and assumed to be of a very modest nature.

Immediate Recovery Period

I have perfect memory of all of my pre-surgery preparations, speaking with Dr. Romano, Dr. Hulton, and my nurse. Immediately coming out of anesthesia, however, I only have memory fragments. I've been told that I was answering questions just fine, and I could walk with some assistance. Despite all of that apparent lucidity, I only remember snippets of those conversations and actions. My partner told me that I was just a little silly when a 4-day Scopalomine patch was placed on my neck. I tried to tell the nurse that I didn't smoke, and that I shouldn't have the patch. Duh, Scopolomine is for motion sickness, not quitting cigarette smoking – the brain was still on holiday.

I didn't have any feelings of nausea that occasionally happen with general anesthesia. My anesthesiologist whips up his own private brew to mitigate any after effects, and few patients experience nausea. Having the Scopolomine patch might have helped as well. Although I was nausea free, I wasn't stable on my feet for a few hours. It felt like being a wee bit drunk and tired.

Going Home

	Wake me when we get there, zzzzz

The beginning of my normal memory resumed while reading the highway signs on the drive home. I was bundled up in the back seat of my partner's Saab, with my just-in-case never-to-used sealable barf bucket at the ready. When I woke up to true consciousness in the car, there were only three exits to go until home.

Immediately after walking through the door, the first thing I did was head for the bathroom mirror. With a plaster splint, nasal packing, and a drip pad in place, there wasn't a whole lot to see. However, I could tell that the dorsum had been reduced, the tip deprojected, and the tethering reduced. There was just a little bruising under each eye. These were all good signs.

With a quick flirt with the mirror dismissed, I crawled into bed and slept most of the time until the next morning. I woke up every hour or so due to dry mouth, and would have a drink of water. Of course, when drinking that much water, there were additional bathroom trips. Getting "cotton mouth" during the night, was the worst thing about having a rhinoplasty. Even with the humidifier set to "rain forest", my mouth would dry out within an hour. I can't imagine what it would be like without a humidifier.