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specialmedicalcentre · 8 months ago

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Kezia's Anesthesia

The operating table was harder than she thought it would be. They look padded in the photos, Kezia thought.

She sat on the end of the black vinyl table, legs uncomfortably hanging over the edge. It was smaller than she imagined it would be, too. How was she going to fit? The gown they put her in was loosely draped over her, and she was acutely aware of it being open in the back. All she wore were her panties. The room smelled of…plastic? Maybe rubber. Everything felt alien to her.

"We're almost ready, Kezia," Nurse Farah touched her gently on the shoulder. "How are you doing?" She smiled. It was hard to see anything besides her eyes, as she was dressed for surgery with a mask and pink cap on.

Kezia shrugged her shoulders. "Okay, I guess." She tried to smile back, and her lip quivered a little. Her heart was pounding.

"Dr. Kim will be here any moment, and then we'll get started."

Kezia watched Nurse Farah continue to bustle around the room, getting things ready. She was gathering things that Kezia had no idea about. Despite the fact that it was all supposed to be for her comfort, Kezia felt nothing but anxiety at everything she saw. Wires, tubes, bags…ideas swirled in her head.

The other nurse - Kezia didn't know her name - turned on a machine up on a stand that had wires attached to it. It beeped and the nurse started typing things into it. She saw her name flash by.

Kezia L.; F, 25; 55kg; non-paced; Adult w/EKG…

She took a deep breath, and her body erupted in goosebumps.

"Yasmin?" Nurse Farah called quietly to the second nurse, and now Kezia knew her name. "Set up for SpO2 and BIS as well."

Nurse Yasmin nodded as she pressed buttons on the machine. "Got it, ok." Subtly, and for the briefest moment, Nurse Yasmin glanced over at Kezia.

Kezia was lost in her thoughts, watching Nurse Farah arranging a long, clear tube, when the door to the OR opened with a sudden sound. She turned to see a compact, slender woman enter dressed in green scrubs. Kezia was struck by how she immediately seemed to command the room. She strode right over to the table.

"Hello, Kezia," she said, but obviously didn't extend her gloved hand. "I'm Dr. Kim, and I'll be your anesthesiologist today. Ready to take a nap?" Her curt grin barely showed behind her mask. She had beautiful eyes; light brown, with long eyelashes.

"Hi." Kezia said. She had trouble getting anything else out. "…I…" She stammered.

"Don't be nervous, Kezia, we'll take great care of you. It'll be easy - all you have to do is sleep." Dr. Kim turned to Nurse Farah, briefly. "We ready?"

Farah nodded. "All set, Doctor."

"Great, let's go."

The room seemed to shift into action at Dr. Kim's word. Nurse Yasmin begain collecting wires and hoses near the machines and Nurse Farah came to Kezia. "Let's get you laying down, honey. Just scootch back a little…there, that's it. Now lay back - here, your head goes right on this cushion." Kezia, guided by Farah, found herself laying back on the operating table, her legs still dangling. The vinyl was a cold shock against her backside, which was bare except for her panties. She stirred in response. "Oh, is it cold?" Farah smiled. "It'll warm up quickly. Now your legs, here we go."

Before Kezia could respond, the nurse deftly adjusted something, and two padded legrests were swung into place. Oh, that's how that works, Kezia realized. They jutted out in slightly angled directions from the table, and were the same color as the table vinyl. Farah helped Kezia lift her legs and get them onto the rests. Soon Kezia was laid out flat, her legs slightly spread on the padded legrests. She was surprised - it wasn't as uncomfortable as it had been. Maybe it was meant to lie on, not sit on?

As Kezia was getting settled into place, Dr. Kim moved to the wall behind her where a touchscreen allowed her to bring up Kezia's case. "Okay, Kezia, so you're here because of persistent cholecystitis, is that right?"

Kezia was busying herself with trying to settle into position. She unsuccessfully tried to look up behind her, over her right shoulder. "Um…what?"

"You're having gall-bladder surgery today, is that right?" Dr. Kim clarified.

"Y-yes, that's right." Kezia spoke to the ceiling, unable to turn her head to see Dr. Kim. Her head was cradled in a weird little foam cushion. She felt awkward.

Kezia heard Dr. Kim tapping on the screen. "And how are you feeling today? Any discomfort, any issues?"

Kezia tried to think clearly. "No, but…I had pain yesterday. None today."

To the side, Kezia saw Nurse Yasmin approach her with a blue something in her hands. She spoke softly. "Hi, Kezia, I'm just going to put this cap on to keep your hair secure, ok? It might feel a bit crinkly." Yasmin stretched the elastic headband of the bouffant cap over Kezia's hair as Kezia shifted her head to let her fix it in place. The material crinkled audibly as she lowered her head back on the contoured head cushion. The look on Kezia's face caught Yasmin's attention. She smiled down at Kezia. "Oh, that’s just the cap making that sound, sweetie. You won't notice after a while."

The cap started out cool against Kezia's forehead but began to warm right away.

Dr. Kim continued. "Abdominal pain? Or, somewhere else? Any trouble breathing? " Her questions were rapid.

"No…uh, abdominal. Like, here," she touched her left side, under her breast. And no, breathing is…ok." Almost unconsciously, Kezia took a deep breath for effect. The cap crinkled in her ears.

"Mmm-hmm. Okay, no allergies to meds I can see…" Dr. Kim trailed off. "You've recently complained of intestinal discomfort, any diarrhea recently?"

Kezia blushed. God. "Oh. Ah, yesterday. Yeah, some…diarrhea." She didn't know where this was going, and she couldn't help blushing.

"Farah," Dr. Kim spoke in a different tone. "I think we should prep for flatus bag if we can do that."

As Farah spoke, Kezia turned her head to the left to see her. "Ok. Want to start without first?"

"Yes, that's fine." Kezia had no idea what they were talking about.

"Kezia," Dr. Kim leaned in enough for Kezia to see her directly overhead. "Do you have any questions for me?"

Kezia tried to clear her throat, and all she managed was a squeak. "I've…never…you know, gone under before. The, the mask, it's kinda - I dunno." Kezia heard the nurses moving around. "…needles make me really nervous." She managed, finally. Her heart was pounding, and she could swear they could hear it in her voice.

"I understand." Dr. Kim nodded, and looked up briefly at the nurses. We'll take this one step at a time, ok?" Kezia felt herself nodding. "Let’s start with something easy — let's get the pulseox on you so I can see your oxygen levels." Again, Dr. Kim looked up.

Kezia heard Nurse Farah. "Yas, go ahead and start." Nurse Yasmin was standing to Kezia's right side; behind her was an array of machines and readouts, all with wires and tubes attached.

"Kezia," Yasmin reached behind her, picking up a small something with a wire attached. Touching Kezia's hand, she said "I'm going to put this on your finger, ok? It doesn't hurt - just a little squeeze." Kezia held up her hand at Yasmin's gentle touch, and a white plastic clip squeezed her finger. It glowed with a weird red light. Just as she lowered her hand, a soft beeping sound came from somewhere to her right - it was in time with her pounding heart. And it sounded fast.

"98, HR 85." Yasmin said.

"Mm-hmm, thank you." Dr. Kim responded. Kezia heard her tapping on the touchscreen. "Can you also prep IV, please?"

Yasmin appeared to look over at Farah, who was on Kezia's other, left side. She looked back down at Kezia. "Kezia, sweetie, I'm going to get you set up with an IV. It'll be quick, ok?" Kezia nodded. "Okay. First I'm going to…"

"Gown first." Nurse Farah gently interrupted. "Kezia, let me get your arms out of this, okay, honey? That'll make tings easier. Here we go." Nurse Farah helped slip the gown off Kezia's arms, deftly unclipping and replacing the pulseox monitor. Instinctively, Kezia drew her hands in to cover her breasts. "Here, let's cover you for a bit." Nurse Farah arranged the gown as a sort of sheet, covering up Kezia's chest and leaving her arms free. "There we are."

Nurse Yasmin smiled; she had turned away from the table to grab a small tray. "Okay, right! First, just let me put this one here…" Awkwardly, Nurse Yasmin wrapped a soft blue strap around Kezia's right arm, tightening it uncomfortably. "Just want to find a vein, sweetie." She palpated Kezia's forearm a bit. Despite her fear, Kezia couldn't help but watch. "Great," Yasmin said, seemingly satisfied. "Now, I'm just going to swab you with alcohol first. A little cold." Yasmin pressed firmly on the skin of Kezia's arm, wiping several times. In her other hand, she held a long tube that Kezia couldn't see. "Okay, Kezia, just a little pinch now, okay? Here we go. Deep breath."

Kezia tried to look at the ceiling. There was a light there, and some other things hanging over the table…"Ow!" She yelped. She was surprised to find that she almost felt she was about to cry. There was a sharp pain and a longer, searing burn as Yasmin inserted the IV cannula.

"All done." Still pressing down on the site, Yasmin started to apply medical tape, securing a short tube to Kezia's arm. She covered the IV site with a clear bandage and connected a clear tube to it that dangled off the table. "Just leave this still, sweetie." Yasmin unstrapped the blue tourniquet from Kezia's arm and turned away, busying herself with something else. Kezia stared at the IV site, where a clear tube exited the tape, and several other thicker tubes of different colors dangled.

Nurse Farah saw her staring. "All good, Kezia?"

Kezia looked to her left, where Farah was standing. She had a blue package in her hand. "It's…it's my first IV. So weird."

Farah smiled. "I'm sure a lot of this is new, honey. You're doing great. Isn't she, Dr. Kim?" Farah looked up to the anesthesiologist, who was still tapping away on the digital chart.

"She certainly is." Dr. Kim didn't sound as enthusiastic as Nurse Farah, Kezia thought. Maybe she was in a hurry. "Farah, BP, please."

Farah moved toward Kezia. "Right here. Okay, Kezia, let me put this on you." She unrolled the package in her hand to reveal a bright blue long blood pressure duff attached to a hose. "You know this, right? Just a BP cuff. Here, lift your arm for me, honey." Farah deftly slipped the cuff under Kezia's arm and, pulling it snug, flattened the cuff to the velcro strip. She smoothed it firmly on Kezia's arm and routed the hose underneath. "There; just relax and let the cuff do the work." She smiled again. The cuff was a distinct feeling on her arm; odd, but not unfamiliar. She felt it brush against her breast. "Yas, could you…" Farah trailed off.

"Hmm?" Yasmin looked across Kezia at Farah. "Oh! Of course." Turning to the bright screen behind her, Yas touched part of it and the cuff stirred into life. With a distinct whirring from somewhere, Kezia felt the cuff tighten around her arm. She couldn't fight the urge to lift her arm up.

"Oh, honey, just relax it, ok?" Farah gently guided Kezia's arm back down onto the table as the cuff continued to inflate. "There."

"Mmph." Kezia grunted involuntarily. She could hear the velcro straining as the cuff reached its limit.

"Too tight?" Farah asked. Kezia nodded, staring at the distended cuff. Her arm felt swollen. "It might be the first time, honey. But you're a healthy girl and that should relax over time." The cuff began to deflate, in steps, clicking and hissing as it released her. She felt the blood rush back into her arm as something on her right beeeeeped. For the first time, Kezia saw her pulse jumping on the screen, a little blue line pulsing with every blip of the monitor. Below that line a pair of big numbers appeared.

"131/90." Farah said, out loud, to the room.

Kezia heard Dr. Kim from behind her. She was sitting down, now; her voice was closer to Kezia's head. "Let's give her a bit. Kezia, try to relax. Deep breaths. You're doing great. Farah, let's get the EKG going. Resp as well, please."

"On the way." Farah said, curtly. "Okay, Kezia, now we're going to get you set up on the EKG. Ever have one of those?" Kezia shook her head, her anxiety building. With the BP cuff, the IV, and the pulseox, she already felt like a medical experiment. She couldn't imagine any more. "Well, I'm going to place some stickers on your chest so we can see what your heart is doing. Okay? Just a few little pads. Now…I'm going to have to remove this for now, honey." Farah motioned to the hospital gown that was still partially covering Kezia's chest.

"Umm…why?" Kezia was getting a stomachache.

"Honey, the EKG goes on your chest. Don't worry, now, it's just for a minute, okay?" Farah touched Kezia on her bare shoulder.

"O…okay." Kezia managed. Farah gently lifted the gown, bundling it up as she lifted it off Kezia's body. Kezia felt the air of the OR wash over her chest and abdomen; as her toplessness flashed into view, she closed her eyes. She still had on the panties she dressed in this morning, but she felt completely exposed.

"Yas," Farah asked. "Can you hand me the EKG, please?" Kezia opened her eyes. Yasmin dangled a loose set of wires across Kezia's body. At the end of each wire was a white square patch. "These are the electrodes, honey." Farah held one up for Kezia to see: a soft square sticker with a wire snapped onto it. Kezia watched as Farah peeled the backing off one. "Here," she said. "I'm going to stick this one down on your shoulder." She pressed the electrode to the skin of Kezia's shoulder, just above the BP cuff. It was cold, almost as if it was wet - but it wasn't. It stuck there, Farah rubbing it down in brisk circles. It felt weird, and Kezia was keenly aware of the wire pulling against her skin as Farah arranged the rest of them.

In about a minute, Kezia had electrodes all across her chest, under her breast, and just above her pantyline. They felt like extra layers of skin, and she felt the cold wires draped across her body. She was almost too terrified to speak. "There we go, Kezia, you look great. See? You can watch your heart beat." Farah pointed across her body to the vitals monitor, where Yas was pressing buttons. Kezia saw three green lines jumping and pulsing across the screen; they made little spikes as the electronic sounds of her pulse echoed in the room.

It was fascinating. Just to punctuate the moment, the bp cuff whirred into life again, startling Kezia.

"It's okay, honey - it's going to do this every five minutes." Kezia audibly moaned as the cuff squeezed her. After an eternity, another beeeeep.

"There we go. 127/85." Farah said, the distinct sound of satisfaction in her voice. "Coming down."

"Good," Dr. Kim spoke up from behind Kezia. "How's her EKG?"

Farah rattled off numbers that made Kezia dizzy to listen to. “HR 82. No PVCs, looks good. ST segment normal, QT…360.”

"Ok, I think we're ready to go." Dr. Kim said, finally.

Kezia breathed carefully, feeling the electrodes tug at her skin all over. She was acutely aware of her body and the things that they had attached to her. "Am…I ok, Farah?" Her voice caught in her throat. She was embarrassed that a tear fell from the corner of her eye; she felt it roll back behind her neck, lost in the rustling plastic of the bouffant cap.

Farah leaned over and touched her arm, right where the BP cuff ended. Her hand was warm. "You're doing great. We're almost there." She winked, then looked across Kezia at Yasmin. "Hand me the BIS, would you, Yas?"

Nurse Yasmin produced another thing connected to a wire; this one looked like a long piece of thick tape with lines and shapes all over it. Farah peeled off the backing, and Kezia realized it was another thing they were going to stick on her. "What's that?" She asked. She held her body very still.

Farah held it up for her to see. "This is called the BIS sensor, honey. It tells us how deep you're sleeping." She moved towards Kezia's face. "I'm just going to press this riiiiight on your forehead." And she did, rubbing it lightly just above Kezia's brow. She could feel it when she wrinkled her nose, and the weirdness combined with the rustling of the bouffant cap, which was starting to feel warm and humid against the skin of her scalp.

Something beeped. "BIS 99." Farah said.

"Okay, Kezia," Dr. Kim spoke from Kezia's blind spot. "We're going to start with sedation now. Are you ready?"

Kezia could see Farah smiling at her. She took a deep breath, and after a moment's delay, she answered. "Okay…I'm ready."

"I'm going to put a mask over your nose and mouth, and this will just be some oxygen for now, ok?" Kezia saw Dr. Kim's hand lowering a black mask with a surprisingly thick hose attached. There was an overwhelming scent of rubber, and then the mask was on her before she could think of protesting. The edge was a soft seal against her face and a cool breeze seemed to fill her nose and mouth. It was utterly alien, and she could feel everything attached to her body. Just as a test, she wiggled her fingers and tensed her muscles. She felt the cuff, the electrodes, the wires…

"Breathe normally, honey," Farah said, watching the monitors. "Resps 20. Deep and slow, Kezia. You got this."

Kezia tried to slow her breathing. Something beeped to her right, and her cuff inflated again. "129/85." Farah said, when it was done.

"Still ok." Dr. Kim said. "Kezia, now we're going to put some medication into your IV, ok? Just something to make you feel relaxed. You might feel warm up your arm as it goes in." At her right, Kezia could see over the edge of the mask that Yasmin had a syringe of something. She felt the nurse press against her IV site, and then there was a burning feeling - but just for a moment. Her arm felt warm.

"It's warm." Kezia said, under the mask, but it came out almost unintelligible. Now her chest was warm, too.

"You're doing great, Kezia." Dr. Kim said. "BP, please." There was a beep and her cuff inflated again. Kezia felt weird, detached. The cuff wasn't as tight as it shoudl have been. She started to feel heavy.

"123/75." Someone said.

"That's the midazolam, we'll watch that. Fent is next. How are you doing, Kezia?" Was that Dr. Kim talking?

"…kaaaay. Mmm." The mask started to smell sweet. That was weird.

"Fent going in." Maybe that was Yasmin. Kezia felt a brisk cold rush in her arm, then her head spun. "Getting a BP." Whirr. Squeeze. Beeeep. "115/68 now."

"Ok, let's watch that. Should come up a bit." Then something she didn't really catch. "…okay, you can cath her now."

"Kezia, honey, I'm just going to remove your panties now, ok?" Farah was right at her left ear. Kezia felt like she was on the table with her, she sounded so close. "We need to put in a catheter to make you comfortable, ok?"

Kezia wasn't sure how to argue, she felt light-headed and she couldn't really focus. But she wanted to scream. She thought she shook her head but she wasn't sure. "ohhh…no, naaaa…" she trailed off.

"Just relax, Kezia, deep breaths." Dr. Kim was still there? Kezia felt the mask press a little firmer. Kezia's eyes swirled around the room.

From somewhere way below her, Kezia heard Farah. "Okay, Yas, Foley please? Thanks. Watch her legs." Louder, she said, "I'm removing them, honey, here we go." Kezia felt the cool room air on her crotch, and her panties slipping down her legs. She couldn't fight. Her legs were lifted slightly, the nurses bending them at the knees.

There was a shuffle of sensations connected only by the place they were occurring, just in the region of Kezia's pelvis. Cool wipes, soft fabric, gloved hands…then the abrupt piercing weirdness of something going inside her.

"Aaaaaa." Was all Kezia could manage.

"Almost there, Kezia, you're doing great." More quietly, "…okay, balloon up, we're in."

Kezia felt like she was peeing, and she moaned softly in sedated panic. The cuff again, and a beep.

"122/83. Looks great. BIS 71."

"Okay, last of the meds now, Kezia, you'll be sleeping soon." Someone touched her gently on the forehead, almost like they were brushing her eyelids. Were her eyes closed or open? She couldn't really tell.

"Prop going in - go slow, Yasmin." Kezia's ears started to ring, and she felt her cheeks flushing. She breathed slowly, methodically. The machines beeped and whirred, the cuff squeezed, and her pee ran down a tube and into a bag.

As she was winking out, she thought she heard one last thing. "…sanitary…rectal tube…okay, roll her…"

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