Post 28 — Dances With Surgeons

A sizable chunk of my life as a parent has been devoted to giving my younger, ‘explosive’ son a drug-free childhood at a moment in history when similar kids are medicated early, dangerously, and unnecessarily.

But my hesitation with all things medical and pharmaceutical arrived far earlier than with this son’s developmental issues. Back in my twenties I refused conventional interventions that my peers happily submitted to, and I took alternate routes that were commonly viewed as nutty.

So by the time I chose midwives over doctors for my pregnancies and births; and a homeopath, chiropractor, and acupuncturist over MDs and often-unnecessary pharmaceuticals for my kids’ health, I had already worn in an alternative path for myself for decades previous. I’m not a Luddite or a crank, and I have agreed to some conventional measures over the years. Some I’m fine with, some I accept as having been absolutely necessary, and some I deeply regret.

So, a largely necessary outpatient surgical procedure for my other son was a difficult, stressful — yet interesting — exercise in dealing with The Medical System that I otherwise avoid…like The Black Plague.

My older son was born with a small bump under an eyebrow. I discovered that it was called a dermoid cyst and was a painless and benign mass of tissue often seen under the end of an eyebrow. Uncommon but far from rare. It wasn’t disfiguring or bothersome, except that it starts to pose an issue if it gets hit, as it once did during karate. These little bumps can become inflamed, they probably eventually droop with gravity, and over time people would simply rather not have them.

I always knew that we were going to have to have it excised but I dreaded having to deal with doctors and, worst of all, surgeons. I began strategizing early on. I was told that my son would require general anesthetic to have it removed, which seemed like a ridiculous intervention for the removal of a bit of benign tissue. People vastly underestimate the dangers and toxicity of general anesthetic. I once had a little thing like this removed from my torso with local anesthetic, and general anesthetic made no sense from a patient-health perspective.

So I waited until I felt a case could be made for a local anesthetic (based on my son’s age, calm nature, and maturity), and then agreed to a consult with an ophthalmic surgeon. I don’t like surgeons. They represent a type I don’t like. They’re very often hyper-arrogant, poor communicators, obnoxious, [paradoxically] careless, and pushy. Sometimes they’re better than this; and sometimes they’re even worse.

We landed a young woman who, correct to type, was super-confident and a bit of a show-off. She would do this-and-that, she said, and then this-and-then-that. She repeated a couple of worn, infantilizing generalizations about the safety of this-and-that and about her choices, ostensibly to raise our confidence in her and her procedures, and sent us away.

I had been hoping that we might hit the entire process during a sweet spot of my son’s age: young enough to be processed through our local children’s hospital, yet old enough that he could be considered a candidate for a local anesthetic, which required greater self-control and maturity on the part of the child (and trust on the part of the surgeon). A children’s hospital accepts that pesky parents are an inevitable part of the process, and I wanted full advantage of that so that my son could feel protected and also safe enough to learn as much as possible.

I also wanted this procedure done while he was a minor in Canada. Woe be anyone who has to deal with the American system of care; and even the European systems can be sketchy and certainly even more paternalistic than here. And who knows where my son will go to school, or work, or beyond?

[I wanted to avoid general anesthetic because some family members and myself have had poor reactions to the drugs; because the drugs are unhealthy; because a general anesthetic was in this case functionally unnecessary and far more dangerous than the eye procedure itself; and because my son had only recently healed from a period of extreme eczema and didn’t need another assault to his system.]

I did some homework on her ‘thises’ and ‘thats’, and pushed back in carefully worded, ultra-polite emails. I didn’t want the brain scan she wanted in order to see exactly how deep the dermoid cyst was placed. The information wouldn’t radically change her surgery or the outcome, and studies now show that too many kids are receiving too many of these possibly harmful scans. I didn’t want the general anesthetic. And I didn’t want the incision where she preferred to make it. Her choice was based on her idea of cosmetics, which didn’t jibe with our own choices. Some back-and-forths took a few months, and we had a couple more consults with her.

To my surprise, she came to agree with everything we wanted, though the anesthetic issue was the trickiest. Surgeons and anesthesiologists like to knock everyone out; it makes the surgery simpler and quicker. But not necessarily so simple for people recovering from those powerful drugs.

The moment of outpatient day-surgery came. We were processed, prepped, and questioned. The hospital anesthesiologist was a young, bombastic, very unpleasant man who appeared to resent our presumption of agency; but he somehow agreed as well. My teen was going into an eye [area] surgery with local anesthetic after all! I suspect that while surgical pros don’t like to be questioned, they also don’t like to be seen to refuse what they perceive as a challenge. It’s in their nature to be competitive and to show off. In this case, that trait worked in our favour.

Contrary to what you would imagine a children’s hospital would try to do, the pre-surgery area atmosphere was at a fever pitch, a cross between a war zone and a circus. Nerve-wracked parents sat with unhappy children amidst construction-volume noise (hospital machinery plus blaring kiddie TV), creating a place of pure chaos. My son was a frozen ball of anxiety; my nerves were shredded. A nurse plied my son pointlessly with Tylenol (research indicates that these drugs are far from benign and helpful). It was a horrible moment.

I was soothed to hear after the surgery that the cacophony and fervour ended the moment he moved through the doors of the next hallway that led into the operating rooms. He reported an atmosphere of pure calm and quiet.

As planned, my son was asked during the procedure on his level of discomfort at every point, so that more local anesthetic was administered and the surgeon could continue. She indicated beforehand that the procedure using local anesthetic would be lengthier than if we agreed to general anesthetic, and it was.

Afterwards, she indicated how everything had gone, and that she was impressed by my son’s self-control, calm, and ability to communicate his needs. (Contrary to the reported statistics, she learned that a teenage boy can indeed remain calm throughout a surgical procedure.) Having not had information from a brain scan didn’t change anything, and he was rolled into the post-operative area awake and calm. At home, we began a disciplined regimen of healthful ‘alternative’, or Integrative remedies, to reduce swelling, pain, and keep the area clean. We used no conventional cremes, ointments, or pain relievers. The site healed beautifully under a regimen of botanicals, vitamins, supplements, a careful diet, and lots of rest.

My son went along with everything I wanted; and indicated before, during, and after that he was happy with my/his/our decisions. He’s a kid and I’ll be interested to canvass his impressions when he’s a bit older and has some distance from the events.

I’m recounting this story on this blog because the awareness I tried to bring to my son’s minor surgery was the same awareness I have tried to bring to my other son’s developmental issues. This issues are all the same: of listening to myself and not ‘experts’ or white-coated medical professionals; of doing what I believe to be the best in the long term for my child; of advocating for my children because they lack the ability to do so for themselves.

In not drugging my younger son I try and teach him age-appropriate self-awareness, behaviour-awareness, and self-responsibility. Drugging him in order to control him won’t teach him anything about himself and carries negative consequences (known and unknown, since long-term affects of these psych drugs are unknown).

His older brother learned about patient advocacy, about being responsible for his own health, and not abdicating that responsibility to strangers. He learned the importance of doing your own research and not leaving it to supposed experts (all of whom will have competing views of their facts). He learned that the doctors and hospitals don’t necessarily know best on surgery methods, medications, recovery, pain management, and wound healing. He learned that he has a right to argue for himself and his needs with a surgeon, which is something most people never learn in a lifetime. And he had the opportunity to face his own fears of being awake and aware in an operating room.

You don’t often have the opportunity to teach a child all this under semi-controlled circumstances. Most of our hospital experiences happen in emergencies, and patients have no time or opportunity to think, consider, or advocate. I had the opportunity this time and leapt at it for my child’s present and future.

 

 

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2 thoughts on “Post 28 — Dances With Surgeons

  1. Evie

    This was nice to read. The difference for your son, in not being exposed to general anesthesia, the scan, or (if I read correctly) the Tylenol, compared to if he had submitted to all three, is probably tremendous. Luckily, he doesn’t know what he missed.

    I imagine some readers would think you’re a crackpot for speaking ill of Tylenol. I don’t. I couldn’t take it in when studies about 7-8 years ago showed that research subjects who had taken Tylenol were less [something…maybe emotional] than those who hadn’t, but there’s been more since then.

    It’s a crying shame that aspirin ceded the space to Tylenol. I’ve never trusted it; I always liked that aspirin was derived from tree bark and had stood the test of time. I read some fascinating stuff by a doctor who play a small role in linking aspirin to Reyes syndrome. He now believes that the vaccine/autism link is real, and that when Tylenol is offered to a child for pain at the injection site (wussies), it interferes with the usual ways that any metals in the vaccine are metabolized and rendered harmless. That’s too simple and probably stated incorrectly. The point is that he thinks Tylenol is the “third variable” in the putative vaccine/autism connection. Exposure in utero has effects, but ingestion as a small child has worse ones. Ugh.

    PS You left a comment on my blog, formerly called Evidencer.org. I re-branded. It’s ExaminingMedicine.com now. The link I put in the web site field to make this comment is to a collection of materials I posted on autism and acetaminophen, including the words of the doctor I referred to above. (By the way, he did inform the FDA…guess how they responded.)

    Reply
  2. Liz Sydney Post author

    Evie, Thanks again for reading and commenting. I don’t even give my kids pharma pain relievers anymore. At this point I’ve read too much, and any garbage pumped out of pharma labs scares the crap out of me. We use a host of ‘alternative’ supplements like ice (carefully), arnica, mustard, deep breathing, lavender oil, bromelain, Zyflamend (sadly bought by Proctor & Gamble, but I cross my fingers that the products haven’t been completely ruined), and turmeric. No easy feat since my younger son is hypersensitive to the slightest injury and does a great impression of World Cup soccer players who throw themselves to the ground and writhe in agony after having been elbowed by an opponent.

    Reply

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