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If I catch a cold—they'll cancel it
If I catch a coldthey‘ll cancel it Gerfrude M. Kohloff, RN
If I catch a cold, my surgery will be cancelled. This thought went through my mind as I sat with my family two days before scheduled surgery. We had experienced a sudden drop in temperature, as we waited to see the Fourth of July fireworks display, and everyone had cold symptoms - except me.
The cold would be an easy way out, but was that what I really wanted? I had given my decision too much thought during the past 17 years to back out now. While a student nurse, I often told myself “as soon as I graduate, I’ll have my nasal deformity corrected.” After graduation, there was one important excuse after another until I really wondered if I’d ever have the courage to carry out my plan. Then one day, while working in the operating room, I met a plastic surgeon on our consulting staff. I was very much impressed by his excellent Gertrude M. Kohloff, RN, is operating room supervisor a t North Ottawa Community Hospital in Grand Haven, Michigan. She received her R N from Mercy Central School of Nursing a t Grand Rapids, Michigan.
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surgery, as well as his quiet assuring manner. After we left the operating room, I mentioned my desire to have corrective nasal surgery. He took a few minutes to generally explain, with a pencil sketch, what he thought was possible; then advised me to think about it “for a month” and, depending on my decision, to make an appointment with his office. Suddenly, I had mixed emotions. This was as close as I ever came to my goal. My thoughts wandered back to the cause of my injury. That beautiful new red bike my older brother received as a birthday gift was a big boy’s bike and “a little girl could never learn to ride it,” according to my brother. Well, I’d show him. The more I thought about it, the more a challenge it became. So, while he was having lunch, I wheeled the bike to the front steps. He was right; it was big; but I climbed on and my toes barely reached the pedals. Away I went, down our drive and out into the street. I was actually riding the bike. It was exciting for a few minutes, but suddenly I realized I had a real prob-
AORN Journal
lem. How to turn around? How to stop? Along with these frightening thoughts came another problem. Our home was at the top of the hill, about a half mile from my father’s service station. It had always been fun running down the steep hill; but riding down on a bike was a different story. Below the hill and over a railroad track was our service station a t a busy junction of two state highways. Everything happened so fast. I didn’t have time to think of what my father would say and do when he saw me, alone, on that bike. Fortunately, no train was coming, but to avoid being hit by a car, I did the only thing I could think of at the time. I turned the bike in the direction of the gas pump; an object large enough to stop me that would not move. The next thing I remember was my father, speaking in an excitable Italian voice. I still wonder if he was praying for my safety or condemning my stupidity. He seemed relieved when I opened my eyes, which, incidentally, was the last time I opened them for the next week. I knew, almost instinctively, my nose would never be the same. Apparently my father thought I had learned a lesson since I was in worse condition than the bike. How I wished I had waited for proper instruction. How was I to know the bike had brakes? Back to reality; the plastic surgeon had said, “think about it for a month.” I had thought about it for years, and now was the time to make an appointment before I lost my courage. That evening, I had a discussion with my husband, and as a result of
November 1971
his encouragement I called for my appointment the next day. My physical exam revealed an “s” shaped septum resulting from the traumatic injury. It was obvious why I had such difficulty breathing; especially when I had a cold. A nasal spray had been my bedside requirement for years, and when going anywhere overnight, it was the first thing packed. The doctor gave a more detailed explanation of the surgery, warning that most people would not notice the change. He also described what I could expect to hear and feel under a local anaesthetic. His intent was not to discourage o r frighten me, but I could see where it may have if I was not so determined to accomplish my goal.
It was now only two days before my scheduled surgery. I had never realized the anxiety a patient undergoes while waiting for an operation. “Is it really necessary?” “I have lived with it this long.” Oh, how I tried to rationalize. It would show a lack of courage to call and cancel; but if I had a cold. . . . Driving to the hospital, I pretended being on my way to work. Arriving a t the registration desk, I found myself more talkative than usual. I was directed to the waiting area where at least a dozen other people were waiting for pre op admission. Sitting there, I noted the apprehension of the elderly lady next to me. She, too, was alone and obviously eager to talk to someone. I greeted her and, from her immediate response, could tell she was not very happy about being confined to a hospital bed and having to undergo an operation. Somehow, I forgot my reason for being there and, deeply involved in
75
conversation, soon acquired a new friend. As we went our separate ways she thanked me for relieving her anxieties, but she did not know that our little pre op visit was just what Z needed at that point. Following a stop a t the lab, I was escorted to a very comfortable hospital room. It was soon evening and my doctor arrived. The first question he asked was “Do you have a cold?” I quickly replied, “No,” before my imagination took over. Summer is the best season for a nose correction since there is less chance of catching cold, but with my recent exposure, I sincerely do not know how I avoided it. I asked several questions and also requested a cold steamer at my bedside upon return from surgery. I would have a nasal packing and mouth breathing would be easier if the moisture was available. The doctor promised my cold steamer and said he would order a sedative to help me get to sleep. I’m sure he could see through my false bravery. Morning came too soon. I jumped out of bed to brush my teeth and took a good look in the mirror at the reason I was now a hospital patient instead of being a hospital nurse. My humped nose and breathing problem were the two things I really wanted corrected, but I tried to imagine how I would look with the tip turned up (retrousser) . After receiving my pre med a t 6:30 am, I was on my way t o the OR; completely relaxed. I was not too sedated, however, to notice the company name of the stretcher that carried me and the type of operating light in use in the OR. They were
76
two of my most recent interests since we were about to make a decision on both for our new OR. Knowing how I would look post operatively with a swollen and discolored face, I was happy to have my surgery away from my own hospital. I was very pleased, however, to have one of my AORN friends circulating. How nice it was to see a familar face. Now I knew what a pre op visit must mean to our patients. It was difficult for me to believe Z was actually the patient. As my arms were tucked a t my side, the cool refreshing skin prep began. The moment I feared the most was soon to follow-the local anaesthetic. Somehow it did not seem as uncomfortable as I anticipated, and I was very thankful for my pre medication. It was interesting feeling the doctor work, but without discomfort, and listening to the bits of conversation as the surgery progressed. I wished i t was possible to see what was going on, but forced myself to be quiet so as not to distract the surgeon. I could hear and feel (psychologically) the bone being chipped away, just as the doctor had explained on my first visit to his office. Almost three rapidly passed hours later my surgery was completed. I could not remain quiet any longer. “Is the hump gone?” I asked. “It’s over in the bowl,” I was reassured. I cannot explain my immediate excitement about having attained something I looked forward to for so many years. It was 11 am when I returned to my room; nasal packing, nose cast and all. I had an “excitement” head-
AORN Journal
ache. With a feeling of satisfaction and an ice bag and my cold steamer, I was able to rest fairly comfortably that memorable day. The next morning I was awakened by taut dressings. I made the mistake of looking into the mirror and was happy about being where no one knew me. I don’t know why the surprise, since I know a swollen face was expected after the operation. It was noon before I had the courage to remove the drainage gauze taped across my packed nostrils. The dressing went back on as fast as it came off. The formally downwardtipped nose, now had an upward tilt. I was suddenly “not so sure” I had made the right decision, but with the cast and my swollen face, an honest opinion wasn’t possible. The week passed rapidly. I took advantage of my free time reading and completing an article that had been pending for a year. I was anxious for my doctor’s visit since my packing was going to be removed. The cast would be removed the next morning and then I would be going home. On my way to the hospital, I had purchased a pair of sun glasses, to cover my discolored eyes, when I returned to work. However, I was now informed that I was not to wear anything over the bridge of my nose for a few weeks. My appearance was far from attractive and I wondered how my children would react when they saw me. Suddenly, it was Sunday; the day of my cast removal. With the same quiet assuring manner I admired, my surgeon removed the cast. In my excitement, I don’t know where the hand mirror came from, but I was very pleased with my smooth nasal
November 1971
profile. A shadow of doubt still remained as I noted the upward tilt. I quietly reassured myself it was still too early to form an opinion. It is now one year later, and what an interesting year i t has been. I never realized how wonderful it was to be able to breath with a normal air passage and no longer have to depend on nasal sprays. It was difficult waiting for the swelling to subside. After it did, I was really able to appreciate my smooth profile, and was even able to tolerate my retrousser. Usually the discoloration disappears in ten days to two weeks though some slight swelling remains for three months and sometimes longer. I found myself noticing everyone’s nose, and even thinking that my own was more attractive. Thanks to my surgeon’s skill and artistry there is no visable sign of a scar or suture line. The result is an exciting, cleanly sculptured tip. Although many people did not notice the physical change I have experienced a tremendous sense of psychological relief. I would encourage anyone with a similar problem to have a surgical evaluation now and not continue to manufacture excuses as I had done. In July, on our way to the Independence Day fireworks display, I made a special stop to mail a “Thank You” note. I wanted my surgeon to know how much I appreciated my new nose on its first anniversary. As I watched the fireworks with my family this year, I couldn’t help remembering the previous year’s sudden drop in temperature and how I had foolishly wished, “If I catch a cold-they’ll cancel it.”
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If I catch a cold, my surgery will be cancelled. This thought went through my mind as I sat with my family two days before scheduled surgery. We had experienced a sudden drop in temperature, as we waited to see the Fourth of July fireworks display, and everyone had cold symptoms - except me.
The cold would be an easy way out, but was that what I really wanted? I had given my decision too much thought during the past 17 years to back out now. While a student nurse, I often told myself “as soon as I graduate, I’ll have my nasal deformity corrected.” After graduation, there was one important excuse after another until I really wondered if I’d ever have the courage to carry out my plan. Then one day, while working in the operating room, I met a plastic surgeon on our consulting staff. I was very much impressed by his excellent Gertrude M. Kohloff, RN, is operating room supervisor a t North Ottawa Community Hospital in Grand Haven, Michigan. She received her R N from Mercy Central School of Nursing a t Grand Rapids, Michigan.
74
surgery, as well as his quiet assuring manner. After we left the operating room, I mentioned my desire to have corrective nasal surgery. He took a few minutes to generally explain, with a pencil sketch, what he thought was possible; then advised me to think about it “for a month” and, depending on my decision, to make an appointment with his office. Suddenly, I had mixed emotions. This was as close as I ever came to my goal. My thoughts wandered back to the cause of my injury. That beautiful new red bike my older brother received as a birthday gift was a big boy’s bike and “a little girl could never learn to ride it,” according to my brother. Well, I’d show him. The more I thought about it, the more a challenge it became. So, while he was having lunch, I wheeled the bike to the front steps. He was right; it was big; but I climbed on and my toes barely reached the pedals. Away I went, down our drive and out into the street. I was actually riding the bike. It was exciting for a few minutes, but suddenly I realized I had a real prob-
AORN Journal
lem. How to turn around? How to stop? Along with these frightening thoughts came another problem. Our home was at the top of the hill, about a half mile from my father’s service station. It had always been fun running down the steep hill; but riding down on a bike was a different story. Below the hill and over a railroad track was our service station a t a busy junction of two state highways. Everything happened so fast. I didn’t have time to think of what my father would say and do when he saw me, alone, on that bike. Fortunately, no train was coming, but to avoid being hit by a car, I did the only thing I could think of at the time. I turned the bike in the direction of the gas pump; an object large enough to stop me that would not move. The next thing I remember was my father, speaking in an excitable Italian voice. I still wonder if he was praying for my safety or condemning my stupidity. He seemed relieved when I opened my eyes, which, incidentally, was the last time I opened them for the next week. I knew, almost instinctively, my nose would never be the same. Apparently my father thought I had learned a lesson since I was in worse condition than the bike. How I wished I had waited for proper instruction. How was I to know the bike had brakes? Back to reality; the plastic surgeon had said, “think about it for a month.” I had thought about it for years, and now was the time to make an appointment before I lost my courage. That evening, I had a discussion with my husband, and as a result of
November 1971
his encouragement I called for my appointment the next day. My physical exam revealed an “s” shaped septum resulting from the traumatic injury. It was obvious why I had such difficulty breathing; especially when I had a cold. A nasal spray had been my bedside requirement for years, and when going anywhere overnight, it was the first thing packed. The doctor gave a more detailed explanation of the surgery, warning that most people would not notice the change. He also described what I could expect to hear and feel under a local anaesthetic. His intent was not to discourage o r frighten me, but I could see where it may have if I was not so determined to accomplish my goal.
It was now only two days before my scheduled surgery. I had never realized the anxiety a patient undergoes while waiting for an operation. “Is it really necessary?” “I have lived with it this long.” Oh, how I tried to rationalize. It would show a lack of courage to call and cancel; but if I had a cold. . . . Driving to the hospital, I pretended being on my way to work. Arriving a t the registration desk, I found myself more talkative than usual. I was directed to the waiting area where at least a dozen other people were waiting for pre op admission. Sitting there, I noted the apprehension of the elderly lady next to me. She, too, was alone and obviously eager to talk to someone. I greeted her and, from her immediate response, could tell she was not very happy about being confined to a hospital bed and having to undergo an operation. Somehow, I forgot my reason for being there and, deeply involved in
75
conversation, soon acquired a new friend. As we went our separate ways she thanked me for relieving her anxieties, but she did not know that our little pre op visit was just what Z needed at that point. Following a stop a t the lab, I was escorted to a very comfortable hospital room. It was soon evening and my doctor arrived. The first question he asked was “Do you have a cold?” I quickly replied, “No,” before my imagination took over. Summer is the best season for a nose correction since there is less chance of catching cold, but with my recent exposure, I sincerely do not know how I avoided it. I asked several questions and also requested a cold steamer at my bedside upon return from surgery. I would have a nasal packing and mouth breathing would be easier if the moisture was available. The doctor promised my cold steamer and said he would order a sedative to help me get to sleep. I’m sure he could see through my false bravery. Morning came too soon. I jumped out of bed to brush my teeth and took a good look in the mirror at the reason I was now a hospital patient instead of being a hospital nurse. My humped nose and breathing problem were the two things I really wanted corrected, but I tried to imagine how I would look with the tip turned up (retrousser) . After receiving my pre med a t 6:30 am, I was on my way t o the OR; completely relaxed. I was not too sedated, however, to notice the company name of the stretcher that carried me and the type of operating light in use in the OR. They were
76
two of my most recent interests since we were about to make a decision on both for our new OR. Knowing how I would look post operatively with a swollen and discolored face, I was happy to have my surgery away from my own hospital. I was very pleased, however, to have one of my AORN friends circulating. How nice it was to see a familar face. Now I knew what a pre op visit must mean to our patients. It was difficult for me to believe Z was actually the patient. As my arms were tucked a t my side, the cool refreshing skin prep began. The moment I feared the most was soon to follow-the local anaesthetic. Somehow it did not seem as uncomfortable as I anticipated, and I was very thankful for my pre medication. It was interesting feeling the doctor work, but without discomfort, and listening to the bits of conversation as the surgery progressed. I wished i t was possible to see what was going on, but forced myself to be quiet so as not to distract the surgeon. I could hear and feel (psychologically) the bone being chipped away, just as the doctor had explained on my first visit to his office. Almost three rapidly passed hours later my surgery was completed. I could not remain quiet any longer. “Is the hump gone?” I asked. “It’s over in the bowl,” I was reassured. I cannot explain my immediate excitement about having attained something I looked forward to for so many years. It was 11 am when I returned to my room; nasal packing, nose cast and all. I had an “excitement” head-
AORN Journal
ache. With a feeling of satisfaction and an ice bag and my cold steamer, I was able to rest fairly comfortably that memorable day. The next morning I was awakened by taut dressings. I made the mistake of looking into the mirror and was happy about being where no one knew me. I don’t know why the surprise, since I know a swollen face was expected after the operation. It was noon before I had the courage to remove the drainage gauze taped across my packed nostrils. The dressing went back on as fast as it came off. The formally downwardtipped nose, now had an upward tilt. I was suddenly “not so sure” I had made the right decision, but with the cast and my swollen face, an honest opinion wasn’t possible. The week passed rapidly. I took advantage of my free time reading and completing an article that had been pending for a year. I was anxious for my doctor’s visit since my packing was going to be removed. The cast would be removed the next morning and then I would be going home. On my way to the hospital, I had purchased a pair of sun glasses, to cover my discolored eyes, when I returned to work. However, I was now informed that I was not to wear anything over the bridge of my nose for a few weeks. My appearance was far from attractive and I wondered how my children would react when they saw me. Suddenly, it was Sunday; the day of my cast removal. With the same quiet assuring manner I admired, my surgeon removed the cast. In my excitement, I don’t know where the hand mirror came from, but I was very pleased with my smooth nasal
November 1971
profile. A shadow of doubt still remained as I noted the upward tilt. I quietly reassured myself it was still too early to form an opinion. It is now one year later, and what an interesting year i t has been. I never realized how wonderful it was to be able to breath with a normal air passage and no longer have to depend on nasal sprays. It was difficult waiting for the swelling to subside. After it did, I was really able to appreciate my smooth profile, and was even able to tolerate my retrousser. Usually the discoloration disappears in ten days to two weeks though some slight swelling remains for three months and sometimes longer. I found myself noticing everyone’s nose, and even thinking that my own was more attractive. Thanks to my surgeon’s skill and artistry there is no visable sign of a scar or suture line. The result is an exciting, cleanly sculptured tip. Although many people did not notice the physical change I have experienced a tremendous sense of psychological relief. I would encourage anyone with a similar problem to have a surgical evaluation now and not continue to manufacture excuses as I had done. In July, on our way to the Independence Day fireworks display, I made a special stop to mail a “Thank You” note. I wanted my surgeon to know how much I appreciated my new nose on its first anniversary. As I watched the fireworks with my family this year, I couldn’t help remembering the previous year’s sudden drop in temperature and how I had foolishly wished, “If I catch a cold-they’ll cancel it.”
0 77