Midnight Mutterings | Tech heaven

||| MIDNIGHT MUTTERINGS by JACKIE BATES |||

Having whined sufficiently about Tech Hell in my previous offering, I wanted to change the atmosphere at bit. But first, to Sadie’s point in her comment: Officer Francoise did lose his job. Was ‘terminated’ immediately, according to his supervisor, who phoned me several weeks after the event. He was ready to compensate me for my loss. I can’t remember the specific circumstances of the call, except that it occurred in the middle of the events I describe below, and I somehow missed his name and phone number. Anesthesia can do that. He hasn’t called back. One day, when I have a little more heart for the subject, I’ll try to contact him.

Now about Tech Heaven: This is about how technology benefited me greatly almost two months after the laptop theft. It wasn’t my use of tech, but others use of cutting edge technology that benefited me. I am a fairly private person in real life, but this was so extraordinary in my experience, I can’t keep it to myself.

On April 6, I went into surgery to have a malignant tumor removed from my left kidney. The operation is called a ‘robotically assisted laparoscopic retro-peritoneal partial nephrectomy.’ What that means is that the surgeon sits at a console and with an elaborate joystick-like set of controls, convinces a sort of multi-armed steel octopus-like robot use its slender, mult-jointed arms to access my kidney through a few tiny incisions. And then removes the small tumor. All with minimal blood loss in record time, without (in my case) any complications. Best of all, no pain to speak of afterwards. Slightly more than twenty four hours after I walked the hospital, I exited on my own feet, with a few Steri-strips on my side under my shirt. To invade my own privacy once more: I have had a number of surgeries, even one other one that was a robotically assisted laparoscopy, so I knew to expect: a quick,
almost painless recovery.

What made this one even more amazing? Well, two things. First, although there are a number of surgeons who do robotically-assisted laparoscopic partial nephrectomies, there is only one surgeon in the Seattle area who does a retro-peritoneal approach, which was what I needed due to the scarring from those previous abdominal procedures. Unfortunately, he is ‘out of network’ for my insurance, and I had to prove that I needed his expertise in order to get insurance coverage for an expensive procedure. That meant I had to get support from the surgeons IN my network to say that they do not, cannot do the approach I needed.

The theft of my laptop made all of that a lot harder. Nothing much is done by phone anymore, and my loss of names and passwords for a copious number of professionals and bureaucrats I needed to convince to communicate with each other during the pandemic. It was beyond maddening. To complicate things even more, my divine primary physician retired in the middle of my multi-year effort to coordinate everything, after the first damning Cat Scan. My then-primary’s ability to coordinate her colleagues on my behalf, explain to me the possible diagnoses and what my options were, came to a screeching halt with her exit. My new primary, clearly brilliant, kind and very hard working, doesn’t know me, her colleagues, the systems, and is just starting out with an overload (because she is highly recommended) of patients, all of whom are trying to figure out how to function in a pandemic. Think short-staffing, short tempers, new protocols, virtual and phone exams and conferences with strangers. And then the loss of my old MacAir (MacBrain).

After all that, my hero surgeon comes riding in on a silver octopus to fix my kidney. You can see his trusty steed HERE. Best of all, I got to see my exact surgery, by ‘my’ surgeon ahead of time through the wonders of YouTube. Because this surgeon developed the retro-peritoneal approach, many of his surgeries are filmed, with his narrative, for teaching purposes, with surgeons around the country/world watching, asking questions, etc.

To clarify, although the primary surgeon is sitting at a console, the OR is full of assistants, nurses, scribes, audio/video-photographers. In at least the video I watched, there was a human assistant doing the suctioning by hand. One thing the robot with its knives, scissors, scrapers, probes and camera did not do. With the robot’s lighting, the surgeon’s view of what is going on is far better than if he were peering into an incision with his own eyes. Also, risk of infection and trauma are much reduced with tiny incisions, precision instruments, sterile field, etc. Da Vinci robotic surgery is high art, like a ballet, with suturing as graceful as
Baryshnikov.

Two last things: First, I found this surgeon through an Orcas friend of a friend, who knew about him. Otherwise, I would never have found him in the fractured world of insurance networks and pandemic complications.

And second, although some people say ‘cancer is cancer’ with all the dire implications, that’s just not true in my experience. The one described here: Papillary Renal Cell Carcinoma, is slow growing and slow to metastasize, and usually needs no further treatment after surgery. So there is none of the pain, fear, uncertainty or crushing fatigue. Also, no visible disfigurement. Just a few tiny scars that have almost faded already.

So this is a time I was so well served by technology, by robotics inventors, by advanced imaging, by the internet with all its information (especially YouTube), and best of all, by the Orcas network when one person shares invaluable information with another person for a friend she has never met. None of these things (except the latter) was available more than twenty five years ago when I was diagnosed with breast cancer. That was a much more arduous, lonely, painful, physically exhausting time, even though my experience was much easier and with a better outcome than many.

I appreciate the advances in technology, and I plan to stop whining about tech hell really soon. After I retrieve a few more passwords.

One last tech thing: A few hours after the surgery, the surgeon appeared in my room to see how I was doing. He then showed me his phone on which he had a 3-D image of my kidney, somehow taken from the CT scan. It showed my kidney, tumor, aorta, arteries and veins, color coded, that he could rotate to show any aspect, including how it would look with the tumor removed. The surgeon was like a kid with a new toy to show off. I am jealous. If I had that on my phone, I’d show it to you now, whether you wanted to see it or not.