My Crappy-Turned-Happy Lap Appy



My Crappy-Turned-Happy Lap Appy
A transsexual laparoscopic appendectomy adventure
By Calvin Neufeld

Last weekend my appendix decided it was no longer happy in its 31-year-old home.

The whole story began on Friday night. A great sweeping pain across my abdomen. Gas, I think. Big bad gas. Must be the garlic scapes I had for the first time, three nights in a row; no other change in my diet leaves me with no other sensible diagnosis. “I bet it’s appendicitis,” says my wife. What does she know? “It’s not appendicitis!” I reply firmly. Many times that evening. She keeps giving me the “you’ll see I’m right” eyes which I keep ignoring as any husband eventually learns to do.

When I find I can’t eat my dinner – and more serious, when I find I can’t drink my wine – I know this is no simple case of angry flatus. I go to bed at 9 p.m. and lie there wishing away the pain and willing sleep for the next five hours. When I wake in the morning, surprised at having fallen asleep, the pain is still there. Only it has moved. To the lower right abdomen. Dammit, I think, at the double-barrelled realization that not only do I likely have appendicitis, but I will also have to tell Sharon that she was right. She has eyes for that too.

But the pain has happily eased into a stubborn discomfort. This means I can still work. Out I go to my potatoes. I have a cheap bag of old seed potatoes – 45 pounds of them – and they are eager to see soil. And I am eager, as I always am, to see how much food I can produce in my little suburbanish space, and I’m especially addicted to homegrown potatoes. Tomatoes too – I stopped counting at 60 or 70 plants – and beans – hundreds of plants – and squash and broccoli and garlic and peas and onions and raspberries and everything else I can get my hands on. But potatoes – these are my precious.

So out I go in search of spaces in my already-planted backyard, in each of my gardens, and in the neighbour’s garden, potatoes in every spare space. 186 plants in total, I keep count. Tomorrow I must find places to plant the other 30 pounds of seed potatoes.

By the end of the day I feel tired and sore and the pain is still there. My wife asks if I’m going to have it checked out. She’s been Googling. I whine about not wanting to. She says to me, “Well don’t go if you think you don’t need to go, but don’t not go just because you don’t want to be sitting in the hospital.”

It’s after 6 p.m. I want to start dinner. I had an early lunch, I’ve worked hard, I’m hungry and thirsty. But I can’t think of a reason for not going that she hasn’t just ruled out. So I walk to the hospital, only two blocks away, nursing a small grief in anticipation of how unpleasurable my evening is going to be.

And I wonder when I’m going to get my dinner.

At the hospital, I’m asked at check-in for a urine sample. I went just before leaving and have nothing to offer. And I haven’t had anything to drink, nothing to encourage results. So the sample bottle waits with me in the waiting room. An hour later I am triaged by a nurse, she asks me to pee, and I manage enough at least to be analyzed. And then I’m sent back to the waiting room.

Another hour later, after three very bad TV shows that I intently ignore with Sudoku, I’m called back to “emerg.” A term that I will hear many times in the coming hours.

I am happy to stand up. Sitting for two hours in an awkward waiting room chair has made my cramp worse. Standing feels lovely. And walking. By the time I see the doctor, I feel better than I’ve felt in ages. I wonder if maybe I am suddenly cured, as I so often am in a doctor’s presence.

I wonder if I will look like a hypochondriac.

So when the doctor presses into my abdomen and it hurts, I am relieved. Does this hurt? (Pressing in.) Yes. (Mixed feelings.) Now pay attention! (She’s that friendly-authoritative type, which I like.) Does this hurt more? (Suddenly withdrawing her fingers.) Yes! (My goodness.)

She tells me to press my knee against her hand – Does this hurt? No. She twists my leg to the side – Does this hurt? Yes! To the other side – This? Yes!

Okay. You’re going to have to go to Kingston. We can’t do a cat scan here until Tuesday. You could have waited until Tuesday?

Oh, and she asks me if I have pain in my testicles. No.

Should I tell her that I don’t have any? It doesn’t seem the time or the place. (My wife later disagrees with me.) I don’t bother to tell her. For me, it’s just a funny moment, one of many that will crop up before my adventure is through. I store it for later retelling to Sharon when I get home.

It’s 9 p.m., then 10 p.m. They send me for X-rays. A woman comes up with a wheelchair for me. I feel just fine, it seems absurd. I ask the nurse, the nurse asks the doctor, can I just walk? The doctor – Doctor Anna, whose last name I heard a million times but can’t remember, Sarkarovich or something – says no way. In the wheelchair.

The woman wheels me to a curtained changing space and says that she assumes she doesn’t have to accompany me in there. I tell her she assumes right. I change into one of many nighties that night. Silly things. My hospital roommate would later comment that for all their progress, no one has come up with a nightie that does the trick and leaves you with dignity. Good point.

I stride out in my nightie, trying to appear casual. She’s talking, we’re joking, it’s fun. But strange as I get puppeted into position for three shots. X-rays doing their thing.

Then she wheels me back to my bed in emerg where the other nurse, Chris, is ready to take blood. Many vials of it.

And while they’ve got the needle in there they put me on a drip. A sugar-salt-water cocktail. If I might be needing surgery, I can’t risk eating or drinking. No dinner for me, no sirree, not for a while. And Doctor Anna won’t risk me dehydrating.

This is starting to feel like a bit much. Even the doctor says to me, Look, it could be a poop or it could be appendicitis. I think maybe a poop. But could be appendicitis. So you have to go to Kingston for a cat scan. I’ve called them, they agree, everything’s set up and waiting.

She is going to send me by ambulance but settles on letting Sharon drive me. By now it’s after 11 p.m., I’ve been five hours in hospital. I am hungry and thirsty (actually the drip does help) and tired and want my dinner. But you do what Doctor Anna tells you to do. So Sharon and I drive an hour to Kingston, park in a parking garage that looks like the one in the horror movie about someone trapped in a parking garage, and waddle to emerg. The pain is getting angry. Crankier at least. And I still have the needle thing in my arm – not an actual needle, but a tube going into the vein, uncomfortable but not exactly dangerous. It’s a plug that can be reused, and will be, many times. And it’s a plug that leaked!

Three times it leaked. First, when nurse Chris put it in. It’s my veins, you see, they amused her. When she came to take blood, I rolled up my sleeve and Chris cries out “Oh my goodness I love you! I love you!” Apparently my veins are a nurse’s dream. She says, “You have no idea how many times a day you have people insist that they simply have no veins, and you’d almost think they were right because you can never find them! Yours you could find with your eyes closed in the dark!” The doctor walks by, Chris tells her, “You should see his veins!” “Are they good?” “You could see them with one eye closed in the dark and the other eye not seeing very well.” “Ooh, can I try?”

She doesn’t try, of course, but it’s funny.

Nurse Chris ties the cord around my arm and I start pumping my fist like you’re supposed to for a needle. Nurse Chris laughs at me, “Oh you don’t have to pump your fist honey, trust me, you don’t have to. Not with those veins.”

So I guess it’s my veins showing off when they get blood to spurt before the attachment thingy connects completely. She stops it in a second but a lot of blood can show off in a second and stain the bed. I feel bad for that. But still I brag that my veins are showing off and we laugh.

In Kingston, the needle plug thing leaks a second time, as the radiologist prepares me for my cat scan.

Cat scan. I’ve never had one, so exciting. The radiologist explains everything to me. They inject radioactive dye. Yes. Which the scans pick up better. Possible side effects, such and such, none of which are very likely with me. It will make me feel warm head to toe and it will make me feel like I’ve peed. But I won’t have peed.

Wowza, what an intro.

So he hooks the IV up to my arm needle thingy and sets the machine to go. He steps into the other room to watch and monitor. I am conveyed, lying down, arms back, into the loop that forms the cat scanner. That’s when I notice that my needle thing is leaking, again. Onto my pillow. I signal the guy, he comes and fixes it, and my cat scan continues.

It’s amazing. A voice and little lit-up faces tell you when to breathe in, when to hold, when to exhale and breathe normally. The lit-up face telling you to breathe is a green side-angle Pacman with a big open breathing smile. The lit-up face telling you to hold your breath is an orange puff-cheeked distressed side-angle Pacman. I find this amusing.

And meanwhile, the scanner is spinning, sometimes slow, sometimes at blur speed, doing goodness knows what. I learn later that it’s taking pictures of my body, slicing it in minute detail, to create a complete and minutely dissected 3-D image of me.

It’s done in no time. I’m returned to my wheelchair – even here I’m not allowed to walk, but I admit it’s nice being strolled around from time to time – and I’m dropped off in the waiting room, back at Sharon’s side. Sharon at least had dinner. But she’s exhausted and I can’t help but think how she’s being a better sport than I might have been in her place.

At 2 a.m., I am brought back to an emerg bed. Curtains all around it, 10 or so beds similarly curtained in this ward. A nurse does the same checks Doctor Anna did. She says a surgical resident will be in to talk to me. Sharon joins me and we wait, tiredly and hungrily and thirstily – though Sharon has a water bottle – until 6 a.m., when the surgical resident comes to tell me that yes, it is my appendix, and I am booked for an 8 a.m. surgery. By then I’m relieved, an end is in sight, and at least my long night’s plight won’t have been in vain. That would have been a tragedy, a dinner missed for nothing. For some bad cat-scan-worthy scapes.

Actually, the surgical resident had been to see me once before during that long night’s wait, about 4 a.m. This was after I’d grown a wee bit terrified of meeting him.

I will make this abundantly clear: at all times he acted professionally and did his job well. Even so, it unfolded that the woman in the curtained-off bed beside me was in with a host of problems that included something to do with her bowels. I can’t think of anything I’d less rather have to be in hospital for.

She’s a character. An old woman, from what I can hear, and with a sense of humour that leaves me never knowing whether to feel sorry for her or go hug her for being so darn funny. She fell asleep in the night, and this surgical resident wakes her up to perform a test. She doesn’t wake up easily, she clearly wants to sleep. But he gets her attention and says, “Mrs. So-and-so, do you mind if I perform a rectal exam?” She says, “What? Of course I mind!” He explains why he has to, there’s an exchange of funny/not funny comments as they get her on her side, and then “OH! OW! What, you wake up a person to do that? Jesus, Mary, and whoever else!”

After he leaves, she continues to remark “Geez, that hurt!”

This is still ringing in my ear when he comes to introduce himself to me. But of course he isn’t the big bad midnight finger monster, he’s just your average surgical resident guy. And I’m not here for my bowels, thank goodness. I’m just here for a silly old appendix and I’m being a big hungry thirsty tired baby about it.

He asks me a few questions, allergies? No. Symptoms? Yadda yadda. Medications? None. To this, my wife gives me a look like I’m leaving something out, which I don’t think I am. Surgeries?

Oh dear. Yes. Despite my hungry thirsty tired state I’m going to have to name and explain the surgeries I’ve had. I’m not thinking clearly and lamely strategize a way out, “Well, I have had surgeries…but they weren’t related to bad health.” Now I’ve confused him. I’ve confused myself. My wife saves the day, as she tends to do. “He’s transgender, he’s had a mastectomy and hysterectomy. Oh, and he takes testosterone.” She gives me her look, “No medications?” she says, “Testosterone!”

My excuse that I didn’t think that counts as medication doesn’t fly. And I look silly for having chickened out on the surgeries question.

He just says “Oh” and asks about the hysto, yes it was laparoscopically done. The appendectomy will also be laparoscopically done. Been there done that, I’m ready.

Of course in my compromised state of mind I have a moment’s panic about what opening they’ll be pulling my appendix out of. I know where they pulled the uterus for my hysto…but that wouldn’t make sense for an appendix. I never took Biology but I can figure that much.

(Still, I don’t know where they did pull the appendix out. I have three little laparoscopic cuts, one in my bellybutton. Did they pull my appendix out my bellybutton? I never got a chance to ask that. A week later and my bellybutton’s still sore. But barely.)

Now that my surgery has been announced, a new nurse comes to say that she will be my nurse for the next 10 minutes, preparing me. The doctors want an ECG so she’s brought the ECG machine. It looks like the world’s first laptop. In shape and age. I tell her it looks like something out of the ‘80s and she agrees, “I keep telling people, sometime in my lifetime I will see ECG scanners that you just bloop bloop then you’re done. Instead I have to hook up all these electrode things.” (I may be paraphrasing all that.)

She sticks electrode stickers on my legs, on my belly, and lifts my shirt to put them on my chest. “Oh, you’ve had surgery!” She looks at me, concerned. I say, “Oh, right, well I’m trans, so I’ve had a mastectomy, and a hysterectomy, which was laparoscopic.” She says, “Oh, I’m sorry, no one told me!” But of course there’s nothing to be sorry for, and I tell her so, and that’s why I’ve got these big-ass scars.

She’s actually cheerier from then on. It must be a lot to process, if I think about it, no wonder people tend to perk up.

Then I’m wheeled up to the OR prep room, where Phase Two of my adventure – the happy part – is about to begin.

The Appendectomy

It begins in the OR prep room. Or is it a curtained hallway? I don’t know, I’m tired and hungry and thirsty, though less thirsty now that I’m on a drip (where there had been a third leakage incident, quickly remedied).

The surgeon comes to see me. He’s the one Doctor Anna was speaking to on the phone at 8 p.m. last night. Last night? Between then and now for me are unbroken hours. But it’s 12 hours later, now he’s signing into work fresh, still in his civvies, reviewing my file with me. He’s so nice and friendly I couldn’t be more confident in the procedure, I’m not even thinking about it, I just can’t wait to get it over with, get back home, have a proper dinner.

But one thing is weighing on my mind now: the dawning realization that surgery is imminent, which means that in moments I’m going to be sprawled out nude in front of who knows who. Uh-oh.

I say to the surgeon, “You know that I’m trans right?” He says yes, casually and without performance, as if I’d asked whether he knew about the abdominal pain. I say, “Okay, I just wanted to make sure you don’t find yourself surprised in there when you see my scars…and stuff.” He assures me no problem. It really is nothing.

It amuses me that it’s nothing. It’s awesome.

He goes off to get into gear, and after him comes the anaesthesiologist. We go over all the same questions, allergies, symptoms, have I had surgeries before and what kind? He’s flipping through his papers and I offer a weary but by-now-amused “Well, it’s funny, I’ve had a hysterectomy…” Without batting an eye he says, “Well that doesn’t make any sense.”

I laugh and explain. He says, “Whoa! You’d never know it! I bet you have all kinds of interesting conversations in a place like this!” We have a laugh over it and I tell him about Doctor Anna asking if I had pain in my testicles.

Someone wheels me into the operating room. It’s huge. At least from where I’m lying. Clean, white, blue, bright. Steel. There are at least five people in there. Thank goodness the surgeon knows, I think. If anyone here doesn’t know he’ll explain it to them. That’s all the reassurance I need.

The anaesthesiologist is ready with the oxygen mask and the anaesthetic drip. He asks me if I have any last questions before they begin. I say no, then “Wait, yes, after this do I get to eat?”

He says, “The only thing standing between you and a meal is this operation.”

I say, “Then let’s get the show on the road.”

The oxygen mask descends, I breathe deep and eager, and suddenly things go woozy and the anaesthnolgst…says that in 30 seconds I’ll be out. I’m amused by the way my eyes are independently drifting and then I wake up in recovery.

Another nurse, a new nurse, young, asking me if I am in pain. Or if I feel alright. Or something. She’s nice. But there is pain, lots of it, so I tell her. She says she’s giving me hydromorphone, which is stronger than morphine. Lovely, I think, and say. She uses my arm needle thing to inject it, and I notice it’s been replaced with a clean new arm needle thing. The other one wasn’t looking so nice with blood and cat scan and drip stuff on it. They must have changed it while I was out. It looks much nicer now.

The pain isn’t going away. I tell her (I don’t want to know how pathetic I sound) and she brings me another shot, this time morphine. Lovely, I think, and say. But again the pain stays. Or maybe I sleep a bit. But at some point there is plenty of pain and I tell her. She brings me two Tylenol. I swallow them, and shortly after feel just right again. A little sore, but utterly comfortable. She found the perfect mix.

At some point they wake me to bring me to my room. I might have been in the recovery room an hour, maybe two, I don’t recall. But I wave at everyone as they wheel me out, goodbye and thank you!

I love being wheeled around after surgery. I want to watch everything and everyone around me, my head is never on the pillow. Perhaps it’s the drugs, or just the effect of a bit of excitement. A whole new perspective, watching hospital lights sweep over you and doorways and people clearing an elevator just so that you can get on. The post-surgery gurney ride only lasts moments but they’re moments I always remember.

They wheel me to my room. I’m sharing it with a man I can’t yet see, on the window side, behind a dividing curtain. They ask if I need help walking to my bed but of course I’m just fine. I sit up, cautiously, walk to my bed and get in all comfortable. The nurse says, “You don’t look like someone who’s just had surgery!” I hadn’t thought about that, I was just enjoying myself.

They settle me in, probably explain a few things, nurse Sarah introduces herself as my nurse, and she says that she knows how important food is to me and there will be a meal soon. Wonderful news. And then I think to remind (or inform) her that I’m vegan. She says, “Oh, no problem, I’ll let them know. But…I’m worried they might only have something like a hummus for you.” I say that’s no problem, I’ll survive – meaning, secretly, I’ll eat whatever vegan scraps I can get and they’ll be exquisite.

I lay there taking in my new environs for a while before falling asleep. I wake up a short while later and next to me is food on a tray. Oh happy day! It sounds hokey but that’s just how it felt. I sweep the tray to me and say out loud to no one “Lunch!” and survey what’s before me.

No hummus. A beautiful big round tray with an Indian chickpea curry and rice and broccoli and on the side a fruit salad and tomato rice soup and best of all, TEA. Tea, a black plastic mug of hot water, beside it a Red Rose teabag, a packet of sugar, and a little Tupper of soy milk. My goodness. There are words for happiness like this, but I can’t find them.

The nurse walks in and tells me she knows I’m eager but go easy, take it slow. I try. I compromise by eating half of it in the first few seconds, and then waiting several minutes for a second tea before devouring the second half. There’s even a little margarine, unaccompanied by bread, that I spread over the curry and dip in the tomato soup. I’m hungry. And it’s delicious.

The tea is so good that I refill my mug four times before stealing it when I check out. I think I should send the hospital an apology with a few bucks to cover it, but it was worth it. Maybe it was the drugs, but it was the perfect little mug, lightweight, unbreakable, and we had grown emotionally attached, it goes where I go. Good tea.

Back to my story. After eating, I’m left nursing my teas, watching the clock in silence as hours go by. The hours are not without entertainment. My roommate, John is his name, is called out for a cat scan. I wonder if he’ll feel like he’s peed.

He is helped out of his bed by his nurse – not my nurse – and as he walks to the gurney there’s his bum peeking out of his nightie. He makes no effort to cover it. I look at my tea.

It wasn’t the only time his bum showed up. It walked to the bathroom a few times. And he was brought back unsuccessful from the first cat scan attempt, because they just couldn’t find a vein. The nurses, the doctors, the technicians all tried, he just had no veins. So until they could tap into him, the cat scan had to wait. The second time they tried, a few hours later, they were resorting to special methods. He came back successful this time, bare bummed and with his own arm needle reusable plug.

Meanwhile, I’m watching the clock, thinking about how much fun I’m having, thinking about how good that meal was, and the tea, and how I’m going to get the rest of my potatoes planted. Serves me right for waiting until July, every day counts for those potatoes.

I also get to peek at my tummy. They’ve shaved it, bellybutton-down, which looks funny on a hairy guy. And it’s covered with red dye, or is that to sterilize? And three neat little bandages where the laparoscopes went. It’s a strange sight. And there’s barely any pain thanks to a job well done and the perfect mix of drugs.

I’m eager to go home but I’m told that I must meet three criteria to leave: I must be able to eat a full meal without nausea, walk without feeling dizzy, and pass gas.

So I set to my tasks. I’ve missed one good evening’s meal, I have no intention of missing another. I am having a nice dinner at home tonight.

Clearly I’ve proven that I can eat a meal with ease. Gusto even. So I set about walking. Up and down the corridor, squeaking my wheelie drip stand along beside me, like walking arm over shoulder with a friend. I wander, smile at nurses, who usually have something funny to say, and repeat a few times before settling back into bed.

My parents come to visit. We have a great chat, I tell them it’s silly for them to drive all this way just for an appendix. Is this a big deal? To me it’s just an annoying interruption to my potato planting, and it’ll be a short one. But they were sweet to visit and I think John must have been entertained by the kinds of things my parents and I get to chatting about.

After they leave, Sharon arrives, having caught up on a bit of sleep and taking care of our pugs and cat to whom dinnertime is also very important.

It’s about 6 p.m. and I’m calculating time needed to get home and make and eat a nice dinner. By now I have passed gas twice, most happily and discretely. I tell the nurse so and she praises me. She says, “This is the only time people will applaud you for that.”

And there is dinner. This time, a beautiful big round tray with a lentil dahl and rice and broccoli and tomato rice soup (which Sharon eats, among other things on the tray). The dahl is delicious. The nurse is astounded at my meals. She says she never knew they were on the menu, she’s going to have to try them, they look and smell so good. I tell her about my friend who always orders the vegan meal on airplanes because they make them custom and in smaller numbers, so they’re always fresher and tastier. Same with hospital food, apparently.

Lovely dinner. But to me, a mere appetizer. A tide-me-over. I will have my dinner tonight.

The nurse is as convinced as I am that I’m ready to go – she keeps telling me I don’t look like someone who’s just had surgery – but it’s after 8 p.m. when I finally get the doctor’s release. A trauma elsewhere delays him for a while. Again I’m reminded that I’ve had a fairytale time here compared to most.

Even John, my roomie. After three days here, he’s still in pain, both in the arm that had surgery and in his arthritic body generally. He’s barely middle-aged. It’s only as I’m leaving that I speak to him for the first time. He’s very nice, he’s funny, he’s got a ceramic hip and he’s upbeat for a guy in his situation. I myself would have been cranky after three days here, however much fun it may be.

I comment on his veins, so they eventually found one? Yes, he says, and shows me his arm needle thingy. I tell him my vein story, about finding them with one eye closed in the dark and the other eye not seeing very well. And how my veins showed off by leaking. And how she joked that most people swear they have no veins. We laughed because he’s one of them. And he joked about these damn nighties, despite all their progress all these decades, no one’s come up with a nightie that does the job and leaves you with some dignity. Good point.

A new nurse comes in with the papers to sign me out. There’s been a shift change. I didn’t get to say goodbye to my nurse but when my new nurse walks in, as I’m talking to John, the first thing she says to me is, “Well you’re the happiest person I’ve seen all day, that just makes my day!” Which of course makes my day. She’s the one who explains to me that they call what I had a Lap Appy. Which I think sounds like a French restaurant.

It’s been fun but I’m so happy to be leaving. I do the math: 8:30, get home 9:30, be eating some dinner by 10 p.m., I can do that, easy. It’ll be late but I don’t think I’ll be falling asleep early tonight, too many experiences to absorb. The testicle story. The big-ass scars. The Jesus, Mary and whoever else. My vain veins. Feeling like I’d peed. The tea. The meals. The passing flatus (in the release form’s words). And not once feeling weird for not having a penis and testicles. I’ve had fun. Despite a hell of a beginning, I now regret having only one appendix to give.

My late Sunday dinner ended up being just soy chicken nuggets from the freezer, but they were exquisite. And I’m happy to report that, a week later, I have planted the remaining potatoes, 314 in neighbouring farm space, for a grand total of 500 potato plants. It’ll be a good year.

Appendix

I return several weeks later for my post-surgery check-up with the surgeon. I hardly recognize him, with his face showing. He asks me questions, pokes my scars, they feel fine. It’s a short appointment, he moves at a fast pace, but before he leaves I can’t resist asking him if he took my appendix out my bellybutton. He answers Yes, with a look on his face that suggests Of course. Then, unexpectedly, he continues:

“You see you get it such and such way to come out through the bellybutton, then you take a little bag, like a Glad bag, grab it, and wiggle it, wiggle it out and into the bag.”

I find this funny. “Do you find that gross?” I ask.

“Oh no, I love my job!” he says. “And anyway, I’ve done much grosser things…”

On that note, we shake hands and part, laughing.