I only remember a few things from the next couple of days. I’m grateful for that because I understand that I looked terrible and must have felt terrible too but I was out like a light for most of it. I remember them removing the breathing tube and overhearing a conversation where my surgeon shared with my wife that my tumor had been so thin as to be transparent in places. He said he had held it up to the light and had seen right through it. This is apparently uncommon for Mesothelioma and a sign that mine was a somewhat unique situation. I remember feeling optimistic and then remember little else.

I am told that I was in ICQ for at least three days but I don’t remember much of that time or how long it actually was. My next recollection was being moved to TCU, the recovery area, where four patients share a room under the 24/7 care of an experienced nursing staff. They are supposed to carefully watch out for signs of co-morbidity, such as heart palpitations, heart stopping, fever, and urinary or bleeding problems. I don’t recall being in TCU for more than a half day and was then moved to a semi-private room on the thoracic surgery floor. This is where I can resume my story again.

My first strong recollection from the post-operative period was that I had no sensation in my chest. The entire area from my neck to my hip was numb and distant to the touch. It felt very much like I was touching a foreign object and not part of my own body. I found that this was because they were giving me a spinal block anesthetic in the middle of my back, which effectively stopped the nerves from below that point from transmitting pain signals to the brain.

I must say that this was quite effective. I had absolutely no pain during the early part of my recovery and this lasted until the spinal block catheter, a small plastic tube that had been inserted into my spine, slipped out while I was sleeping, soaking my sheets and restoring the sensation in my chest. The entire chest was heavily bandaged but I really couldn’t see any incision areas and I frankly didn’t have the fortitude to look. Besides, I was heavily distracted by the sloshing I heard whenever I turned over in my bed.

I could only lie on my back for so long and then I had to lie on my left side. Lying on my right side or on my face was out of the question because of the chest drain tube so I began to fidget back and forth between my back and left side. Every time I rolled over or sat up I could hear fluid gurgling and sloshing back and forth in my empty chest. It was bizarre, almost other worldly, as if it was someone else’s chest and not mine. The nurses told me that the body dislikes empty spaces and begins to fill all such cavities with lymphatic fluid. This process would go on for some time, they said, eventually congealing into a gelatin-like mass. The gurgling would then stop. I certainly hoped so. I could picture myself at Thanksgiving dinner, turning to my neighbor to pass the potatoes… gurgle, gurgle… Ouch. It was enough to turn one’s stomach.

Even before the spinal block popped out I began to notice how thirsty I was. I had been warned about this. Although I was on intravenous fluids for the first few days, the volume was highly controlled to reduce fluid retention. The biggest risk to a pneumonectomy patient is pneumonia in the remaining lung and the best way to prevent this is to "dry out" the patient to the point where fluid can’t collect in the lung. That was and still remains the primary procedure to protect the lung. Water was strictly controlled, no matter how much I begged.

Hydration was a significant problem that required careful management by the doctors and the nursing staff. The heated chemotherapy treatment had allowed a strong dose of toxic Cisplatinum to saturate the tissues of my chest and abdomen. Ultimately this toxin would find its way to the kidneys, whose job it was to process and dispose of the poison before it damaged the other organs. During the period immediately after surgery therefore, adequate fluids had to be given to allow the kidneys to do their job. The fluids then had to be cut back to prevent the remaining lung from getting too moist, and this is where the balancing act came in. After the saline drip was cut back, the thirst became unbearable and this torture went on for four days.

The nurses kept a control log of each ounce of water given and each ounce of urine that they collected. Unless you urinated you didn’t get to drink. The more you urinated the more fluid you were allowed. I seriously contemplated slipping my roommate twenty bucks to borrow a pint or two of his urine. I complained often enough that I was given the crushed ice and sponge treatment. The nurses would provide a few ounces of crushed ice every four hours and I would husband these precious fragments as long as I could. I began to dream about full glasses of cold refreshing water. I fantasized about falling into waterfalls and diving into bubbling mountain streams. Along with the crushed ice came a sponge on a stick that could be used to soak up a few drops of water to be sucked on. I never thought I would develop an aversion to sponges but ever since these rubbery lollypops served as my staple source of relief I cannot help but taste rubber in my mouth every time I touch a sponge. This was one of the many strange quirks I developed from my time in the hospital and from the chemotherapy. I’ll talk more about this later.

The spinal block took a day to wear off once the medication stopped flowing. The spinal block contained some form of opiate or was morphine based. While it was in place I was allowed to press a button to inject more painkiller if I needed it, but I found that the drug made me hallucinate and I found this unpleasant and frightening. I didn’t consider the pain so bad that I needed these extra drugs and so I made almost no use of this option. I convinced myself that I must have a higher tolerance for pain than the average person but this turned out to be a fallacy and caused me some self inflicted pain over the next few days.

Without the spinal block I was offered pain tablets by mouth and the nurses would ask every half shift if I needed anything for pain. The procedure for establishing pain is similar in almost all hospitals. You are asked, "on a scale of 1 to 10 with 10 being the worst, how would you rate your pain?" Now I don’t consider myself to be a fool but I honestly thought my pain was no worse than a 2 or a 3 and therefore I wouldn’t need pain medication. The nurses accepted this answer and left me alone.

Something strange was happening to me however. Although I was dead tired I found I couldn’t sleep. I would lie on my side, but twenty minutes later my side would be aching just enough to make me roll over onto my back. Another twenty minutes would pass and the throbbing would start on my back. I would roll over again onto my left side. Seeking relief from the pain caused me to sit up in bed and attempt to catch some shut-eye by propping myself up in an upright position on the bed tray table with pillows. Unfortunately this didn’t work either. Leaning forward compressed my diaphragm, newly fitted with its synthetic patch, and this made me damned uncomfortable too.

Nursing shifts came and went, and I paced my room, thrashed about in my bed, and tried to drape myself over my tray table in a vain attempt to sleep. I kept this up for over 36 hours without so much as an hour’s sleep. I frankly thought I was going mad. I was desperate for sleep and yet I couldn’t understand what was wrong with me. The nurses saw that I was perpetually awake and yet didn’t question me as to why. It took an overt act on my part to break this cycle and finally get me some relief. I asked the nursing supervisor whether what I was experiencing was normal. She asked me why I wasn’t taking pain medication and I told her that the opiates made me hallucinate. "Fine," she said. "We have other pain killers that will work". A couple of tablets later I discovered how blissful a good sleep could be when your sutures aren’t bugging you. I guess a 2 or a 3 was just annoying enough to keep me from sleeping. It was a lesson I learned at tremendous cost to myself and I hope no one else goes through the same experience.

The next thing I discovered was that hospital food sucks. Either that or chemotherapy and/or surgery destroys your taste buds. Perhaps both are true. A quick survey of the other inmates told me that the hospital food was probably more to blame than my taste buds. Even Dr. Jaklitsch admitted the kitchen could stand improvement. Once I reached home, however, I found there were certain foods that just lacked appeal, and some foods tasted awful. They certainly weren’t as tasty as I remembered them. Chemotherapy made this problem worse. Eating well and recovering from any surgery are closely connected things and this important topic will be reviewed again later.

My initial progress overall was outstanding. Once I got over the pain medication issue, I woke up full of energy and was always strolling around the floor, waiting for my visitors. A week after surgery they removed the catheter and chest drain, giving me a larger measure of freedom, even though I was still attached to a saline drip. This was progress, however, and progress gave me hope. I was soon well enough to venture off the floor with my saline bag on a dolly and my portable vital sign monitor strapped to my waist. I took the elevator to the Pike, the main corridor that runs between the different wings of BWH and so, hand in hand, my wife and I went to visit the thoracic surgery office on the ground floor of the hospital. While on my walk, I met my surgeon who marveled at my progress and said I looked like someone three weeks out of surgery, not one week after.