An anxious type's guide to surgery

Harried Healthseekers! Graham here.

So, yesterday I had my much-awaited vocal surgery. 

I’m currently still in the strict 24-hour vocal rest period, so I don’t even know what the outcome is yet. But! By the time I finish writing this I’ll be able to test my voice out. 

Oooooh the suspense.

Surgery is such a loaded, emotional experience - probably for everyone, but particularly for sensitive cats who maybe haven’t always felt super understood by the health system. So I thought I’d share a few semi-connected reflections from the vantage point of my post-general-anaesthetic haze…

The backstory 

I’ve been struggling with my voice for about two and a half years now. The short story: I got hit in the throat, then over time started losing my voice and experiencing pain while talking.

At first it was the loss of function that got me. I’m a singer and I couldn’t sing. Not even spontaneous love ballads to my dog.

(He’s noticed.)

I’m a podcaster and I couldn’t podcast - at least not without regular pain. 

But lately it's gotten worse. I’ve had about 30 mins of good voice a day, which I’ve needed to ration carefully.

It’s been lonely. And it’s been hard to feel ‘useful’ when my main skill (and joy) is ‘I’m pretty good at talking people through the hard stuff’.

All of which has provided a steady stream of solid material for those daily mid-afternoon ‘I’ll never be normal again’ doom spirals.

(Of course.)

It’s hard to trust the health system

Despite how desperate I was for a fix, I almost didn’t do the surgery.

I originally booked it for June last year, which was postponed by Melbourne’s second COVID wave. I then re-booked for November, which was postponed by a wave of… my own severe doubts. 

The thing is, it hasn’t been an open and shut medical case. For a long time the specialists didn’t really understand why I wasn’t getting better. 

Which happens to be a real soft spot for me. 

Because I’ve been in this situation before with health issues, more than once. Where the experts don't really have a clear answer.

In my early 20s, I lost my sense of time and space for months, and at times lost my ability to see altogether. Desperate for an answer, I saw multiple psychs and neurologists who essentially all said some version of the same thing. We don’t know what’s happening, sorry.

(Okay they didn’t all say ‘sorry’.)

Why don't you sing to me anymore Graham?'

The psychiatrist told me I had ‘brain damage, probably irreversible’, despite the neurologists telling me everything was fine and it was all in my head. 

Either way the subtext was clear. 

You’re on your own here, kid.

By contrast, when I started experiencing chronic nerve pain five years ago, this time the condition at least had a name, and even a world-leading specialist right here in Melbourne. But it turned out he too couldn’t help me, because my experience falls outside the usual parameters of the condition. (Most people’s pain stops on its own after two years. Mine, so far, has not.)

His advice? 

‘It could be worse. Just stop worrying about it.’*

(*At time of writing I have not yet figured out how to follow this advice?)

The temptation to go it alone

Health and mental health, often the same story. Unexplained pain. Promises of help that eventually become just another sign of what a lost cause you are. 

When your encounters with the health system leave you feeling less understood, you stop wanting to tell them what’s happening. You start to wish you just didn’t need them at all.

So when I canceled Surgery Attempt #2 in November, just days before I was due to go in, I felt a wave of giddiness. My voice had been inexplicably better for the previous two weeks, and I was filled with a sense of possibility. 

‘What if I can figure this out myself…?’

I felt I had to give myself that chance. And within a month my voice was worse than ever. 

The next available surgery spot was months away.

I felt like a total idiot.

What sticks with you

My experiences with healthcare haven’t all been frustrating.

Through my life I’ve had many reasons to marvel at the wonders of modern medical science - most of which I’ll never even know about. Diseases never caught thanks to the wonders of vaccination, for instance. And this past year has shown just how incredible the health system can be - for those of us lucky enough to live in countries with adequate public health funding.

I’ve also encountered many empathetic health practitioners who - even when they can’t ‘help’ - at least know how to listen.

But those aren’t the experiences that stick with me when I’m back in that vulnerable place of needing help. Because they aren’t the experiences that hurt.

Surgery Attempt #3

I book the procedure for the third time, and the surgeon’s receptionist almost puts me off completely. He's not overtly impolite, but I suspect my last-minute cancellation of Surgery Attempt #2 had put him out, so maybe he's twisting the knife just a little when he says…

‘Well Mr Panther, the thing is if you’d kept your last appointment you’d be done by now...’

I want to scream. 

(But of course, that would hurt my voice.)

And above all I want to explain. ‘Buddy, I’m not trying to be annoying! I just find this whole process very hard - especially when there’s no real promise that this is even the right thing to do... Also it's not covered by my insurance and there *is* a pandemic on, so it's a pretty major decision on multiple fronts y'know??’

But even if I had the voice to say all this, I still wouldn’t. It all feels too personal, too gooey and intimate for a largely transactional healthcare conversation. 

So instead I say nothing. I suck it up. I book Surgery Attempt #3. 

I sit through Christmas and New Year’s barely able to say a word without pain, all the while nervously watching Melbourne’s COVID case count tick back up. 

Praying my procedure won’t be postponed again. Knowing it will be entirely my fault if it is.

The leap of (informed) faith

I somehow find time to waver some more. I see another specialist - this one very much outside the mainstream health system - to help me decide whether to go through with the surgery.

And eventually I decide to do it. Largely out of desperation. Partly because I don’t want to piss off that receptionist any further. And partly with a curious question in mind. . . 

What if this is an opportunity for growth? 

I’ve had good reasons to be wary of mainstream health services. But what if this is a chance to challenge that script? 

The procedure is low risk. The specialists are lately more confident than ever that this will, in fact, fix the problem. What if this is a chance to place my trust in them - not blindly, but deliberately, purposefully? 

A leap of ‘as-informed-as-possible’ faith, if there is such a thing?

‘Your turn’

A few days before the procedure, I’m pacing the block with Bodie, working out the nervous energy. We’re listening to Alan Watts. 

(Well I’m listening to Alan Watts. Bodie is mostly just staring into the distance at anything that might, conceivably, be a cat.)

Alan is talking about a certain attitude one can take toward the world. 

There’s the usual, default setting most of us have: ‘the world is a threat’. But then there’s the antidote to this feeling, Alan Watts says. The curious conviction that just maybe the world is actually on our side. That we don’t always have to be in control of every little thing in order to be safe. 

I’ve heard him say this countless times before, and I can't say I'm convinced. 'Sure, that would be a nice way to live', I think, 'but how do you ever really give up control?' Then another intriguing thought appears. Maybe giving up control is not something you *do*, and that's the whole point? Maybe it just happens, every now and then, when you need a break from being in charge of everything?

In his beguiling British voice, Alan suggests a phrase to offer the world in these moments: ‘Your turn.’ As in, ‘alright, your turn. Let’s see what you’ve got for me next.’

I say this to myself repeatedly, in the days leading up to the surgery. Mentally whispering it to the surgeon and his team.

‘Alright then. Your turn.’

The big day

The day of the procedure goes remarkably smoothly. 

I encounter multiple people who seem warm and caring - starting with the taxi driver who ferries me there at the crack of dawn, wishing me well.

It helps that I feel so prepared. 

I feel emboldened to ask questions that I would usually be too shy to ask. Each person I encounter, the receptionist, the nurse, the anaesthetist, when they're done with me I say, ‘thanks, and can you now tell me exactly what happens next?’

Maybe it's because I’ve done so much ‘pre-worrying’. Maybe it's because I’ve really ‘made’ this decision, rather than just let it happen. Maybe all that indecision was a perfectly valid part of my process to reach this point?

Deciding what to take from the experience

As they wheel me into the theatre, my zen feeling (I'm wearing robes, after all) jumps to a sudden spike of fear.

I tell the nurse this, and she has the perfect response. ‘I had surgery myself recently, and I thought I’d be totally fine. But I panicked at this bit too. It’s normal.’

And of course, not quite everything goes to plan. As I wake up from the general anaesthetic, a nurse makes me talk to answer her questions, despite clear instructions from the doctor not to speak for 24 hours (lest I undo the effects of the surgery). 

I frantically mime to her that I need a pen and paper, but she makes me talk anyway. (‘Ah that old feeling that health professionals don’t get me…’) Later the doctor confirms this definitely shouldn’t have happened.

But I try to remind myself this is just one issue amidst a carefully choreographed production of supportive, attentive staff.

Those of us with mental health histories don’t always have such rosy experiences of hospital trips, to say the least. Nor do we always have this level of autonomy when it comes to health responses, even for physical issues. So as I sit there in the recovery bed snacking on hospital cliches (orange jello!) surrounded by attentive strangers, I decide to actively cherish it.

All part of the growth experience.

Surprisingly tasty! Or maybe it was just the drugs...

So… how’s my voice???

I am literally finishing writing this as the hour approaches for me to finally test drive my voice. I am suitably nervous, but I give it a go.

It feels… okay? Sore? Look I actually can’t really tell. 

I sound like Tom Waits after a big night. Probably to be expected after surgery and 24 hours of silence? But there’s also a resonance there that I’m keen to explore further. 

In truth, I probably won't really know the final outcome for a few weeks (yay). But right now I'm reminding myself that the experience itself has had value. I have actively tried to meet my needs as well as I can, despite never feeling I could possibly have enough information.

And I’ve been (mostly) pretty understanding with myself regarding the fact that, for me, this process of meeting my needs is not always a straightforward one.

Right now that feels like growth to me, whatever happens next.

Let me know what you think?

As usual, I’m keen to hear your thoughts on this issue. 

Also I’d love to know, how does being a sensitive cat affect your experience of seeking help with physical health issues? 

Click this here pink button to share your thoughts with me:

Big things afoot. . .(!)

Aussie readers can see my Big Feels co-pilot Honor Eastly on The Project tonight, talking about the future of our mental health system. Also check out this brilliant article about her in The Age today.

Why the media blitz?

For the past two years Honor has been toiling away as part of the Royal Commission into Victoria's Mental Health System, which releases its much-awaited findings this morning.

As you read this, Honor and I will be at the special parliament sitting where they are tabling the final report. (I'll be doing my best impression of someone with a functioning voice, at least for the 'networking with politicians' part. Sensitive cats represent!)

This Commission really is a once-in-a-generation chance to build a mental health system that actually makes sense. We can do so much better for people in distress, and now is our chance to do it. 

We'll have more to say about the findings of the Commission soon, and what they mean for sensitive cats not just in Victoria but (potentially) across Australia. Meanwhile if you're a keen bean, you can read what we told the Commission here, and if you want to spread the word, share that article from the Age. You can tag Honor in anything you share, she'll be making a rare appearance back on social media for the next little bit :)