Two Showers, No Shampoo

The last time I had major surgery was 1991. Pre-operative guidelines have changed since then, most likely based on public health studies showing improved outcomes following increased cleanliness of the patient’s body. To wit: If you are going to have surgery, you will be instructed to shower the night before and the morning of your surgery. Some patients will also be given a special antibacterial cleanser, but others are allowed to use their own products. You are not allowed to apply lotion, haircare products, perfume, makeup, nail polish, or any of the other good-smelling, good-looking stuff. Makes sense.

I had a problem or two with this instruction. First off, that’s like an entire week’s worth of showering in less than twelve hours! Don’t get me wrong; I like to be clean and all. But that meant that I had to get up at 4:45 a.m. to do so. Secondly, I have a congenital skin condition known as ichthyosis wherein I’m missing a layer of skin that helps retain moisture, so basically I have chronically dry skin all over and if I don’t put on lotion after getting wet, I’ll start to flake up and itch in just a few minutes. Fortunately, after some negotiating with the surgical nurse, I was allowed to use lotion, since they would be operating on my head anyway, not my limbs or torso.

And then there was a communication breakdown.

In order to get the proper coordinates to drill in my skull, I had to get a “stealth MRI” the day before surgery. Other than my appointment time, I was given no other instructions.

The weekend before my surgery, my husband’s parents celebrated their 50^th wedding anniversary in Illinois. (Side note: I discovered that not one but TWO of my husband’s relatives also have meningiomas! One of them was just diagnosed this year after she fell on some ice getting out of a car. That’s a typical meningioma diagnosis story: discovered by accident while looking for something else.) I showered on Sunday before we slowly made our way back to Minnesota (we visited family in Wisconsin along the way). As I was very busy that Monday (midterm project for my graduate creative writing class) and had airport duty for some other relatives, I decided to forego a Monday shower. I’d be showering Tuesday night and Wednesday morning, so why overdo it?

Tuesday afternoon, I’m getting prepped for the stealth MRI (so called because of the stealth MRI machine used in the operating room, not because of ninjas—I asked). Oddly, I had a moment of near-fainting. I’ve had MRIs with/without contrast before, obviously, so I’m used to the flush of saline at the back of the throat when they start the IV line. For some reason I started getting faint, perhaps because instead of being in the dimly lit MRI room, I was in a room like a phlebotomy lab: brightly lit, straight-backed chairs, lots of tubes and vials and needles. Or, more likely, the hyper-medical setting and medicinal taste in my throat meant that Shit Was Gettin’ Real. Then the technician walked in with a pair of clippers, some sticky doo-hickies, and a Sharpie. He shaved off a couple small spots on the back of my head and started applying the stickers. Then he used the Sharpie to mark the center point of each sticker.

“Okay, these need to stay on. If they should fall off, it’s not a huge problem because I’ve marked the center point, but if the stickers and the ink comes off, we have to do it all again. So you can’t wash your hair.”

Me, spluttering: “But… but I’m supposed to shower tonight and tomorrow morning!”

Tech, who doesn’t have a cosmetology license (I asked): “You can shower, you just can’t get your hair wet. No shampooing!”

So there I was, hair already lank from not having been washed since Sunday. The one part of my body that they’d be operating on was the dirtiest part of my body. Gross. It would have been nice to know. Fortunately, it was Halloween, so I added some Frankenstein bolts to my head for the trick-or-treaters, threw on my skull-pirate t-shirt, and let that ride.

Are the bolts medically necessary?

Lesson for future craniotomates: Shampoo before your final MRI even if it may seem excessive!