Tuesday, January 02, 2007

The Big Ouch: What Happened Part Three

"Go towards the light," said the voice.
I could see the light, beckoning, calling.
I have not had any surgery or anesthesia since having my tonsils removed as a child. I have no recollection of being under.
"Go towards the light."
Sometimes things go wrong in surgery. You don't wake up. Could this be happening now? Could the surgery have gone horribly wrong and now I was to find out the answers to the ultimate question of life, the universe and everything?
"Go towards the light."
Or was something else happening?


1:15 am.
The nurse comes by and offers me a drink of water. It will be my last drink before surgery. She asks when the last time was that I went to the washroom. It's been hours, so she suggests that I go.
She helps me out of bed, and I stagger along the floor, my busted left arm and shoulder in a sling, my right arm dragging my IV rack. I make it out of my little area, but I have no idea where the washroom is.
"Which way?" I ask.
She points to my left. A door is open, with a light shining behind it.
"Go towards the light."
"A fine thing to say to a person hours before surgery," I harrumph.
"Oh great," she mumbles, "it's going to be one of those nights."

It's amazing how much your life can change in an instant. This morning, I was dreaming of an 18' kayak. Now, after tumbling off my bike, I'm wondering if I can go to the bathroom without screaming.
Kayaking is a distant memory.

There was no screaming. In fact, the entire process was mostly painless. I return to bed, and sleep in fits and starts. I awake around 7, about 45 minutes before surgery. Breakfast arrives for the other patients, but not for me. The nurse warns me that should a breakfast accidentally arrive for me, I shouldn't eat it. I haven't eaten in 18 hours now, but I'm not hungry. In fact, I will go about 30 hours between meals. I was never hungry.

The nurse returns to explain the procedure. Around 7:45, the anesthesiologist will come and sedate me. (This never happens.) They will wheel me into the waiting area, then the operating room. The anesthesiologist will then inject something into my IV and put me out, and from my point of view, I will wake up right away in the recovery room. No time will pass for me. I may be a little disoriented, but it should pass quickly. No dreams.
The anesthesiologist does arrive, with questions for me, plus papers for me to sign. Then an orderly comes and wheels me into PreOp.
I don't give it a lot of thought, but it does occur to me that I may be facing my last conscious moments. Mistakes do happen. Things sometimes go wrong. But I'm resigned to my fate. It's in the lap of the gods.
I'm wheeled into the orthopedic surgical room. The operating table is narrower than I thought it would be and there's some discussion of how to transfer me from my bed to the table. Finally, I say that I will walk over to the table. Someone helps me up and off the bed, and I cross over to the table and lie down.
It hurts, of course. Lying down on my back is the most painful position. Someone calls for "shoulder extensions"; the bed is so narrow that my shoulders hang off the sides, and for my mangled left shoulder, this isn't helping.
I'm not aware that the shoulder extensions ever arrive, and now the anesthesiologist has my attention. He explains that during surgery, they will be freezing the areas they operate on. This will reduce the pain when I come around. I'm all for that.
He starts by poking something between my left shoulder blade and neck. He's trying to find a certain nerve or muscle group, I guess. He wants me to tell him when I feel a tingling like a mild electric shock.
"Feel anything?"
"No."
"Feel anything?"
"No."
"Feel anything?"
"No."
"Feel anything?"
"No. Wait. There's a bit of tingle. By the shoulder blade."
"Okay, good. That tells that I'm in the right area--"

Then I open my eyes.
Which is odd because I do not remember closing them.
But my first sensation is a good one. My left arm, even though it feels sore and swollen, also feels attached and whole again.
I focus on a clock on the wall. It's almost noon. Four hours have passed in a blink.
There's a machine beside me automatically checking my vitals. I can feel it inflating to check my blood pressure.
I glance over at my left arm. I have a long bandage stretching from above my shoulder to half-way down my arm.
A nurse appears. She says everything went well, but the surgery was four hours, not the planned two and a half. They found additional damage in my shoulder to repair. They kept re-locating my shoulder and it kept falling out. So in addition to screws and a plate in my arm, they also performed a Bankart Repair. This is a procedure that ties a strip of muscle across the joint to hold the arm in place in the shoulder socket. I don't know it at the time, but this will slow down my recovery, and probaly permanently decrease my range of motion.
The nurse leaves as she tries to find a bed for me; they did the surgery even though they did not have a room to put me in afterwards.

What else did they do to me? They put in a plate and screws to fix my arm. They repaired a small break in the shoulder socket; unfortunately it was where some tendons and ligaments were attached so they had to be repaired. Also, a lot of muscle had to be re-attached as it had come away from the bone. Here's what my shoulder looks like now:


Yes, the plate and pins are permanent. I will never have an MRI and I will beep at airports.

The nurse returns, they found a bed for me. I ask for a drink of water. My throat is killing me -- it's raw from the breathing tube they had down it.
I'm wheeled to my room, pumped full of antibiotics and morphine. I'm tired and I feel like sleeping, yet I also don't want to sleep. Mostly, I just sit dazed, occasionally nodding off.
Karl will visit me around 5:00 PM -- I spent more of his visit asleep than awake. Others will visit me. Louise, Brenda, my niece Kai all stop by. Paula and Bernie visit. For some perverse reason, Bernie is mostly concerned that my right hand still works. Paula thinks I look like I've been hit in the face with a sledge hammer. Not that there's anything wrong with my face, but because the shock of this life-altering moment is still sinking in.
Dinner arrives around the same time Karl does. It's a fish patty thing, which wasn't very good. The mashed potatoes are excellent. The nurse tells me to go easy -- it's my first meal in 30 hours. I nibble at it.
Details are a blur, but I am constantly poked, prodded and checked by nurses. Everything seems to be normal.

I'm sharing my room with three other patients. Across from me is a young guy who's here for the long haul. He's just ordered a tv. He knows all the nurses by their first names. They are asking him for advice on his course of treatment. I'm guessing dialysis.
Beside me is an old lady. I'm never sure what is wrong with her, but she seems to have all sorts of ailments. She is constantly being taken out for tests.
The third roommate is an older man who's left left hand got into a fight with a table saw. I give the victory to the man only because all his fingers are still attached.

Afternoon fades into evening, and into night. It's early in the morning now. And I need to pee. There's no nurse around, so I slowly sit up. My back is killing me. I carefully stand and walk to the washroom, dragging my IV rack. A nurse has already helped me do this a couple of times, so I already got the hang of it. When I return, I stop at the window and look out. I can't see much -- most of the view is blocked by the roof of another part of the hospital. But I can see the tops of some trees, some streetlights, and clouds.
I miss being outside.
And it will be along time before life becomes normal again.
I carefully climb back into bed.
Sleep eludes me.

In the morning, I go down for x-rays. It is there that I see for the first time the steel and pins that are now part of my arm.
Holy jeez. I'm bionic or something.
The rest of thr day is a blur. More drugs, more pills. More blood tests. They want me out -- they need the bed. In mid-afternoon, I get the word. I can go home.
My long recovery begins.

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