Signs of lightness

Over the last few days, I’ve been watching my pee carefully.  In keeping with recent trends, I would have expected it to become lighter in color and look normal again.  This is not what happened.  If anything, it’s been getting darker.  My skin also changed back to the healthy look of the recently tanned, which is apparently not healthy at all.  The whites of my eyes are quite yellow.  It’s quite obvious that the bilirubin values have gone up again and likely that the other liver markers have followed suit.

The first three days of the week, I attended a workshop on collaborations, teamwork and negotiation.  Going in it, I was rather skeptical.  The language around it, starting with the title, was just a bit too pompous for my taste.  The workshop turned out much better than I had expected, with a clear message, simple techniques to not only to improve one’s value to teams but also one’s enjoyment of teamwork, and deep insights into behavior and people’s interactions with others.

The downside to all this was that the course was intense.  It took all day, each day.  Staring at a screen with considerable focus for three days in a row was exhausting.  At night, I tried to catch up on the most important ones of the work emails I had ignored all day long.  There was also homework to do.  I didn’t think much about bilirubin, but on the third day, I took a coffee break as an opportunity to call the hospital about it.

A few hours later, my doctor called me back.  He didn’t sound concerned but told me that I would get an appointment for a little operation to implant a stent into the bile duct.  This will secure free passage for the bile and prevent bilirubin and Co. from showing up in blood and urine.  A few more hours later, I got another call.  Please report to the hospital tomorrow at 10, the woman said.  Your surgery will be on Friday.  You should be back home by Saturday.

It is reassuring that an operation that doesn’t seem particularly urgent can be scheduled at such short notice.  Switzerland is in a self-inflicted mess of extremely high corona numbers without even the slightest idea of how to get out of it.  But it seems the country can still handle the situation.  No one talks about the excess deaths, mostly old people with preexisting conditions.  They have no voice.

This morning, I went up to the hospital.  I was placed in a room with a view, up on the 11^th floor.  The nurse insisted that the Alps are visible in the early mornings, before low clouds and fog turn everything into a white-out.  The ground is covered in snow.  I checked in with joy.  The liver values have been a nuisance for too long.  Bilirubin causes no pain but is an irritant to certain parts of my body.  Let’s fix this.

Placing a stent inside a vessel that is maybe a few millimeters across sounds like tricky business, even when you have direct access through a gaping hole in the belly (at least to someone unskilled and untrained like me).  But it must be routine.  To increase the challenge a little, the surgeon decided to do away with the cut.  In the spirit of minimal invasiveness, he will use existing openings and passages only.

Put it simply, the surgery will be conducted endoscopically.  The doctor will insert a miniature video camera, a light and a remote-controlled robotic arm into my mouth and lower it through esophagus and stomach into the small intestine, down to the point where it meets the bile duct.  The equipment then has to take a tight turn and investigate the bile duct for the best place to put the stent.  I’m glad I’m the patient and not the surgeon.

Without any cuts to heal, I could probably leave the hospital a few hours after the intervention.  I’m allowed to eat two hours after it.  The doctors are keeping me for a night to see whether anything didn’t go completely according to plan, but on Saturday I should be home for lunch.  After that, I’ll keep watching my pee for signs of lightness and thus success of the operation.