Showing posts with label ankle surgery. Show all posts
Showing posts with label ankle surgery. Show all posts

Tuesday, October 4, 2011

General, or spinal?

"So I wondering if you want general anesthesia or a spinal?"

It's the morning after my big break and the Korean anesthesiologist has come to call. I'll call him Dr. Lee. He's mostly hidden by his paper surgery hat, gown, glasses. If something goes wrong, I think, I'll never be able to pick him out of a line-up.

I consider his question. My mother had slept through childbirth five different times while blanketed by the bliss of general anesthesia. I'm thinking that sounds good, but hey, he's the expert.

"Which do you suggest?"

"General anesthesia good, very good, you fall asleep, wake up, all over. But sometimes side effects not so good. With spinal you feel nothing, you wake up. Either one good."

I'd had general anesthesia before for other procedures, and had never suffered side effects. I'd had a spinal for my C-section—an injection of opiates right into the spinal fluid. I remembered lying on my side, "curled into a ball" to the extent that a nine-month pregnancy allows, trying to heed the warning to lie still lest the doctor nick something he shouldn't with that needle, even while my entire mid-section was wracked with contractions.

Now my brain was addled with trauma, lack of sleep, no food or water, and pain meds. I simply wanted this show on the road, in the least dangerous way. "I'll have the general," I said.

"Hmm. You sure? Spinal really very good. Also it last beyond when you wake up, which help with pain."

"So you're recommending the spinal?"

"No, no, general very good also. You fall right asleep, no problem."

Dr. Lee would be no help at all. But sleep? That sounded like the antidote I'd needed all night. I craved it. I settled on the general anesthesia.

Take two. Later that afternoon, another guy in scrubs came in. He strode in, shook my hand, introduced himself. I'll call him Dan. He had a red beard and mustache and the kind of stocky build and fresh face that suggested he'd been bow-hunting in the woods earlier that day. Thanks to a scheduling change, he would be my anesthesiologist.

"We're going to be taking you down for surgery soon but I wanted to meet with you first. I understand you want general?"

"Yes." With my work life blown to Hades, my loved ones scattered, and my ankle lying in pieces, it felt so good to feel confident about something.

"No you don't," Dan said. "Believe me, you want a spinal."

"I do?"

"No doubt about it." Dan smiled. "We'll take you into the O.R. and give you a little juice to relax you. We'll have you sit on the edge of the bed, bent over, and you'll feel one little pinprick for the injection. Next thing you know, the surgery will be behind you. Added bonus: complete pain relief for another few hours. Sound good?"

I'm not sure if it was his targeted argument or the thought of Dan out there in those woods, bow in hand, but something gave me faith in his aim. I said, "Where do I sign?"

I was alone when they came to get me for surgery. My mother hadn't come—while she was able to get me the help I shouted for when I fell out on that rainy hill, her grief over my father's recent death and her memory issues had made the struggles of daily life enough for her to worry about. A neighbor was looking in on her. Dave had left Pennsylvania that morning and was on his way. On the ride to the operating suite, as ceiling tiles flew past, I took deep breaths and tried to relax, hoping I wouldn't flinch when the needle went in and inadvertently cause my own paralysis.

They parked my bed next to the operating table and I inched from one to the other. I remember seeing Dr. Luc Perrier, my straight-from-the-pages-of-a-romance-novel surgeon, tying on his mask. Dan said, "Here comes the feel good juice" and I recognized the heat going into my arm...

"Mrs. Craft? Mrs. Craft?" It sounded like someone was speaking to me through a long tube. "The operation is over. How are you feeling?"

All I could think was, How many operating nurses does it take to balance a patient on the edge of a table if she's completely passed out? Memories of half-carrying wasted friends home from college parties came to mind. Maybe I should have told them that when two aspirin are suggested I can sometimes get by with a half.

Oh well. It was over. And Dan was right about the added bonus: then, and for a few additional, blessed hours, I felt nothing but relief from all that had plagued me. I'd had a great nap. They brought me a tray of food that I was able to enjoy with no distraction from pain, and a full pitcher of water. Dave arrived from Pennsylvania and I was no longer alone.

On my left ankle I sported a new wrap made of felt-like material bound with Ace bandages. Hidden within, my new permanent hardware:




























That night, my post-trauma flashbacks would recur. But there was a difference in my reaction to them: with respite from the pain, some heavy-duty stainless steel on the inside, and my husband by my side, I now had resources to help hold me together.

Tomorrow: my hospital roommate's secret to happiness.

Monday, October 3, 2011

Awaiting surgery

I can fall asleep for only a few minutes at a time. Then I hit the mud, slide, hear my bones breaking...and wake up crying out. To try to outrun my repeat fate I have pressed my broken ankle into its stack of pillows, and it is now on fire with pain.

And heat.

The posterior leg splint (right) the orthopedic surgeon made for me in the ER—bent to suit my ankle and strapped onto my broken yet realigned bones with Ace bandages—is curing. It heats up to do so. Every single thing I know about first aid injury treatment says this heat is my enemy. Time's a-wasting; my foot is swelling out of control but no one seems terribly concerned about this. My foot structure (narrow heel, high arch, small bones) never handled well my active life; it turns easily and I have sprained each ankle at least eight times. Experience tells me that the immediate application of ice can be the difference between walking and not.

I ask for ice. My nurse says she'll check my orders. Ice isn't listed, so I can't have it. It amazes me that ice can't be administered unless it's prescribed by a doctor.

What the hell. Guess I'm not walking anywhere soon.

They give me pain meds every four hours but as the interior pressure builds they only take the edge off for three. The last hour is a killer.

It's the middle of the night. I'm in a double but do not yet have a roommate. A hundred cable channels and nothing to watch but zumba routines I won't be able to dance and exercise machines I won't be able to use. I try, again, to sleep. Almost there... I hit the mud. Slip and roll. My bones snap and crunch. I wake mid-stride, ankle searing.

I've been panting. Mouth so dry. No water—can I have ice chips?

"I'll have to check your doctor's orders." I know where that will go.

Although my thirst cannot be slaked I'm hooked to plenty of IV fluids and I can feel them pumping, pumping into my swelling foot—then redistributing to my bladder. I have to get off the bed and onto the commode about every half hour. Lifting my leg from its pile of pillows is so painful as the tissue fluids redistribute, but that's nothing compared to the sensation of the broken bones shifting, and the hot knives that thrust into my ankle once my leg is dangling off the edge of the bed. Thanks to the efficiency of movement conveyed by a previous life as a dancer, I can get from bed to commode in one graceful pirouette (one must take one's small victories).

As I perform this bravura feat my debonaire cavalier (okay, the nurse) holds the commode so it won't kick out from under me. "I'm sorry, you can't have the ice chips, you're scheduled for surgery."

I keep my eye on the prize—that more manageable post-surgery pain, which they promise like offering a horse a carrot, then yank away, time and again. They can't give me water because surgery will be later that morning. Then it won't be until early afternoon, I'm told, so sorry, you can't have breakfast. Looks like the surgery will be later this afternoon, so you can't have lunch. Good news! We've heard from your surgeon, he'll be over after his office hours, so your surgery will be this evening.

I was glad I'd taken the sandwich offered the night before in the ER; I hadn't eaten since noon that day. (Then again, the offered sandwich was ham. I was thirsty.) The night before, when they'd come to the ER to take me up to my room, I'd instinctively wanted to wrap the uneaten half and take it along like some hoarder in a nursing home but they took it away, saying there'd be more of the same up on my floor. No such luck.

Luckily, dawn brought the distraction of my anesthesiologist comedy team—and a roommate who held a small key to happiness. More on that tomorrow.