Sunday, August 30, 2009

-ectomy

Up until a week ago, when I had my tonsils scooped out of my throat while I was unconscious, I was sort of proud of having really, really big tonsils. I would show them to people and they were virtually always impressed. "Wow," they would say. "Those really are big." I would nod and say something final, like "Yep. They've been big since I was a little kid."

When I was six, my family doc told me I had the tonsils of a thirteen-year-old. As a short, skinny "late bloomer"--I wrestled in the 75 pound weight class in eight grade and I only had to worry once about not making weight--I held onto those words well past my thirteenth birthday. When I was fourteen, I imagined I must have tonsils the size of someone in his twenties. This was consoling. I didn't really start growing toward my current height of 6' 2" until the summer before my senior year in high school. There wasn't much that was impressive about me: I was smaller than average, had below-average grades, didn't have any discernible musical talents, didn't have a car, didn't play on any of the sports teams, and wasn't stunningly attractive. I was "cute," in the way little brothers are cute. So, my tonsils were one of my only real assets, and I would show them off in times of insecurity.

Even into adulthood, my tonsils had remained an asset. Sometimes, if I liked someone and thought they were good friend material, I would tilt back my head, or, as the case may be, squat down frog-like and tilt back my head, and open my mouth and perform a sort of exaggerated, prolonged yawn while they inspected the large bulbs of lymph tissue at the back of my mouth. They would usually peer in cautiously, move their heads right and left pigeon-like, and then their eyes would widen, and they would say "Golly, those really are big."

But now they are gone. A lot of people get their tonsils out because of frequent infections, tonsillitis and the like, but I haven't had much trouble in that area. I used to get yearly bouts of strep throat, but that ended when I was about 19. For the most part, my tonsils treated me pretty well. We had a relationship of mutual respect. Except, of course, that they sort of obstructed my airway all the time, made it hard for me to swallow sometimes (and sometimes got food stuck in them that formed these funky-smelling little white balls that I would cough up about once a month--I called them "pearls," but Elizabeth didn't agree), made me snore with ever-increasingl intensity, and caused me to breathe badly while I slept. But I didn't really fault them for this. It wasn't like they were being malicious. They were just being their big selves. It's just that they were standing right in the doorway of a rather important passage.

So I went to my local family doc and asked him about them. He said, "Those are pretty big. They should come out." He didn't really hmm and haw about it like he does about most everything else. And then I went in for a consult with the Ear, Nose and Throat doc. He said, "You should probably have those removed. Having a tonsillectomy will likely help you snore less or not at all, and will probably make you breathe better at night." In the back of my mind, I kept asking myself Why, for the last three decades, when they look in my mouth and smash my tongue with a giant Popsicle stick, did other doctors not immediately exclaim, "Let's cut those things out of there!" But there was no use asking such a question now.

Because of my marvelously loud snoring, Elizabeth and I have been sleeping farther and farther apart. She was wearing earplugs, which helped, but I was waking the baby up and, even with Elizabeth wearing earplugs, my snoring was loud enough to keep her, and sometimes the baby, from going back to sleep. Besides wanting my wife not to rue the moment I entered the bedroom, I was also hoping that a tonsillectomy would help me sleep better, which would cause me to wake up with energy and vigor in the morning, which would in turn cause me to have more motivation, stamina, insight, and talent. So, I went in for the surgery.

Things went pretty well in the hospital. About seven different women in scrubs made rotating visits. I couldn't keep straight who was from the lab, who was from the pharmacy, who was just an assistant, who was my nurse now, who would be my nurse later, who would be my nurse during surgery, who was my nurse anesthetist who would be shoving a tube down my throat, etc. But they were all friendly and didn't mind that I had confused one for another and forgotten their names. Finally, one of these women pumped some stuff into my IV line and told me, "Teenagers love this stuff. They always ask me if it is for sale somewhere. But it's not for sale. For some reason, they just laugh and laugh and laugh." I asked her what this stuff was for and she said, "to help you feel okay about surgery." I thought that it was probably a little late not to be okay with surgery, but didn't tell her this. Instead, I let the artificial feeling of euphoria invade my body and enjoyed the gurney ride down the hallway, though I didn't feel any uncontrollable urges to giggle. I remember greeting my doc, all decked out in surgical scrubs, and then my pre-surgery memories stop.

When I came to, or rather, when my brain began coherently recording memories again after I came to, I was chatting it up in German with a nurse from Germany. She had been in the U.S. for the last twenty years, but I must have recognized her accent and we played get-to-know-you in German in the recovery room. When she departed she told me my German was good, which pleased me, but the ironic thing is that it couldn't have been that good because MY UVULA IS MISSING.

You see, to roll the German "R" properly, one needs to get the uvula and other loose soft-palate materials jumping around in the back of one's throat. It's not like the Spanish R, which is rolled with the tip of the tongue on the hard palate.

I made the discovery of the snipped uvula a couple of days after my surgery. My curiosity got the best of me and I wanted to see what this bundle of horrible pain looked like (this has been painful, very painful, and nauseating, but enough bellyaching), so, standing before a mirror, I gingerly spread my mouth wider and wider until I could see back there. Sure enough, my big, fluted, fleshy tonsils were gone, replaced by white scabs over inflamed red throat skin. But to my astonishment, the white scabs continued above my tonsil-holes, up along my soft palate right up to where my uvula used to hang. Now it just forms a rather shallow V.

I didn't realize it until then, but I was also sort of fond of my uvula. It fit. It dangled there between my giant tonsils sort of like the buddy who is always brought along as the third wheel because he is good at helping the conversation along at awkward moments. Actually, more often than not, it didn't hang freely, but was sort of stuck to one tonsil or the other. But my uvula was never a problem. I had never even thought of cutting it off; it looked so harmless and good-natured. And apparently, besides my uvula, my doctor felt like digging out some of my soft palate as well. Unexpectedly losing some extra skin while I was anesthetized was sort of shocking and a little dismaying.

In a way, I feel as if I've been circumcised again, and, once again, nobody asked me if that was okay. It's not okay, just so you know.

I've been doing a little research and, apparently, uvulectomies (a word I never knew existed) and trimming off a little extra soft palate tissue are often done to try to help people with sleep apnea. When I had my consult with the ENT doc, I mentioned that I stop breathing at regular intervals throughout the night and could possibly have sleep apnea, so maybe he took that as the green light. I'm not sure. I have an appointment with him in a couple of days and I'm going to ask.

But the damage is done. He's not going to sew anything back on (and I don't get to keep my tonsils in formaldehyde either--I had to sign a release saying I agree to this). Perhaps my new and improved mouth/throat will work wonders for me. Apparently I snore no more, not even a little bit, which keeps things peaceful in bed. I have yet to reap the rewards of extra energy, motivation, talent, and insight, but it's only been a week. Maybe those will come. And, after a few more times waking up to discover that I have not unexpectedly lost a little body part while I was unconscious, I'll probably feel safe again. And the pain will eventually go away.

I'm going to miss my tonsils, and my uvula, and my soft palate tissue, and I will have to find new ways to show my friends I love them and make myself feel special, but eventually, I am sure, I'll be glad to have had my elective tonsillectomy and my involuntary uvulectomy. It was all just useless tissue anyway, right?

6 comments:

lazyeye said...

A timely experience given the raging debate on health care reform (whatever "reform" means). I think it is an interesting reference to the president's overly simplistic description of the "system" with tonsillectomy as the prime example. Still mulling over what it all means. Sorry to hear about the uvulectomy, he was a good uvula...I guess. Maybe you should have had them throw some hardware on that shoulder while you were out so we can ride mountain bikes again.

Joal said...

Good idea about the shoulder. While I'm under, they might as well fix everything, eh? Though I'm not sure how good of a job the ENT doc would have done. He's kinda quirky. I met with him yesterday and he said my uvula was so long it touched the back of my tongue, so he "trimmed it." He said I'll still have some uvula when all is said and done. I guess I can live without it. Perhaps it was also interfering with my breathing. Who knows?

By the way, I can ride now. My shoulder still hurts some, but E and I went for a ride about a week ago and it was fine. I would just need to be a little more careful than usual. However, I am pitifully out of shape after a summer of medical recovery. You would end up riding alone up any hill. But I'd be game for a ride anyway.

Anonymous said...

What about your possible future as a uvula model? Ruined! Those doctors need to learn not to mess with people's body parts without permission. Luckily, you have that teaching/writing career to fall back on. I say sue them for lost income and deflated self-esteem.

Joal said...

It's true. I was getting quite good at posing my uvula (how do you think I won over Elizabeth?), and it was really opening up doors of opportunity for me. But I'll have to stick with my day job...for now.

Actually, now that I'm mostly recovered, I mind the un-permissioned loss of throat flesh less and less. It might have done some good, and this way I don't ever have to go back and have it done in the future. I just wish he had mentioned it before doing it, you know, as a courtesy or something.

By the way, who are you?

the child family said...

Ack! They took your uvula? Without asking? That's terrible! Unless it makes you more talented, etc and then I guess it's terrible with a good turnout. I read your latest post too - Elizabeth is definitely a good woman. Hope you're soft tissues are mending well!

Anonymous said...

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