Random Conversations

Friend:  So how are you doing after surgery?
Me:  I'm good, just staying home, taking my pain meds.
Friend:  Can you move around and stuff?
Me:  Yeah but I won't leave the house too much...it's still pretty hard to get dressed and stuff.  I should just go commando.
Friend:  You should just wear a sheet like the Romans.

Me: That would be awesome!!!

Toga Mingle

Post-Op Day 2

Recovery is going well, I think.  

Yesterday my throat was really sore from the tracheal tube.  Now, I feel really bad for all the kids I've watched who needed a nasotracheal tube for induction (so the dentist can work on the teeth).  For a kid, it probably feels 10x worse.  

Yesterday, the recovery nurse gave me instructions for exercises that my doctor supposedly wanted me to start today, but when I looked over my pre-op instructions, the sheet my doctor gave me told me I wasn't supposed to do anything (except squeeze my little stress ball) until the doctor cleared me.  Good thing I called her office to clarify!  I was honestly scared to do anything with my arm, although today, I realized that if I angle my laptop just right, I can kind of type with my left hand - well, 3/5 of the fingers on my left hand.  It really does speed things up.  

Overall though, I'm still feelin' pretty fatigued.  Despite that, I still managed to type up board meeting minutes, which I volunteered to do for the ol' office over Skype a few weeks ago.  I'm not sure if my fatigue is from the surgery or from my Percocet prescription - probably the drugs, since I get suuuuper drowsy after an hour or two.  I took one pill before going to bed and woke up four hours later, just in time to take the next one.  Today, I tried pushing it to the five-hour mark - just in time too, if I waited any longer I might have actually felt pain instead of discomfort.  

Tomorrow, I get to take the giant dressing-pad they taped onto my shoulder. Woohoo! I've been wanting to see what the stitches look like.  I'll need to call the doctor's office again because I don't remember how and if I'm supposed to clean the wounds, but on a spur, I bought a box of Finding Nemo band-aids to cover them up.  

Post-Op

I'm home and it looks like surgery went well.  I arrived about 15 minutes late and felt really bad, because I know it can really mess up the flow of things, but that didn't seem to be the case today.  My pre-op nurse was really nice.  Her son and I went to the same high school but a year apart, so we talked about schools and college.  My procedure (Bankhart Repair) went well - she only needed to place two anchors, but she also said there was quite a bit of damage so she did some work on the ligaments as well, although I'm not sure which ones.

The whole procedure was about two hours.  It's interesting being on the patient bed this time around and watching people grab my arms/legs and lift up my gown to attach things while talking to me like were just hanging out in the lounge.  I don't remember falling asleep either.  The last thought I remember having was, "Is he giving me Sevo yet? This doesn't smell like Sev-ZZZZZZZZ"  My wake up wasn't too exciting either, only that each time they called my name, I kept thinking I should get up.

I'm home now, feeling perpetually groggy and trying to time my naps around the painkillers.  I have a little stress ball for my fingers so they don't get too swollen.

Tomorrow, I will be doing itty bitty exercises as per doc's orders:  letting the arm dangle outside of the sling and then doing finger exercises on the table.

Pre-Op

I met with my orthopedic surgeon on Wednesday to go over the procedure again.  I felt like I should have asked more questions, but I couldn't think of anything else to ask.  I even went home and looked up the procedure on YouTube to see what she'll be doing - that has to be a morbid pre-med trait.  I don't think any of my non-pre-health friends would YouTube their own surgery out of curiosity.

Even though I feel like I should prodded my doctor for more info, I like her and trust her to have explained the important details to me.  Her secretary, on the other hand, is like a chipmunk that talks a mile-a-minute.  Thank goodness she was only summarizing the consent forms.

I'll be going into the hospital on Wednesday at 6 am (ugggggggggggggh).  I will probably ask the anesthesiologist to hold off on giving me a nerve block for my arm.  Hopefully my post-anesthesia wake-up doesn't involve a lot of groggy thrashing.  Anesthesiologists are funny sometimes: a few of the ones I worked with had the "magic touch" and all of their kids would wake up perfectly calm, while the rest typically ran for the hills when the kid started waking up screaming.

I'm a little nervous.  It's weird that I am, since this is something I have been wanting for a while.  Then again, I have other issues if I actually feel excited.  If surgery goes well, I am looking forward to getting back some range of motion, but it will take time for me to actually feel mentally comfortable moving my left arm normally again.  Certain things have become habit now, like only sleeping on my back or right side, or not reaching back with my left arm.  With some good physical therapy and a good recovery, those things will be minor things to overcome.

Being a Patient is No Fun. Pt 2

A few weeks ago, I ended up in the E.R. with a dislocated shoulder due to a torn left labrum.  Anterior, I think.  I wasn't sure if describing my experience there constitutes whining, and I didn't really want to write a blog post chock-full of whining...but it was an interesting experience nonetheless and worth retelling if only so I remember it for myself later down the line.

Different E.R visits lead to different experiences based on several factors - understaffed/overloaded, number of patients and what their health issues are, the hospital's location, and the overall personality of the staff, just to name a few.

Regardless, being a patient sucks, and I can't imagine what it must be like for people with serious illnesses that need extended hospital care.  I felt powerless going into the E.R., even though I've been to one before (maybe it's because this time, I felt like it hurt a lot more).  I didn't want to be touched and I didn't want to be pitied either.  I felt the pressure of several years of guilt too - the knowledge that if I had quit wrestling at the first sign of trouble, maybe I wouldn't have had to gone through all this.  I felt anger - if the first specialist I went to had asked for an MRI, maybe I would have found out sooner how serious this was and quit.

I refused to let anyone help me out of my jacket - I did it myself, inch by inch.  She was nice and understanding about it, and I'm thankful she indulged me.  I fought the doc every step of the way though.  Something about her attitude or tone of voice rubbed me the wrong way.  I found her condescending and it made me feel like I was being treated like a kid who didn't want to go to school.  She planned to use the Stimson maneuver, which involves laying face down with the injured shoulder dangling perpendicular to the bed.  She would then attach four saline bags (roughly 10lbs) and let gravity do most of the work.  I know it's an accepted procedure that is coincidentally less violent than other methods, but it sounds ridiculous to this day.  I remember a previous dislocation where the doc and a med student used a combination of scapular manipulation external arm rotation (while I sat upright) to reduce the shoulder and it was totally, undeniably pain-free and took about 1 minute without any meds.  I tried to explain this to the doc, but for whatever reason - whether she was unfamiliar or uncomfortable with that method or if it posed a greater risk to me that she did not explain - she refused.

It took time for them to coax me into a prone position, and then another several minutes for a nurse to gently move my arm to a 90-degree forward flexion.  After that, they gave me an intramuscular shot of Ativan, which hurt AND didn't kick in until AFTER I left the E.R., and I was left to force myself to relax and spasm in pain until a P.A. came to manipulate the scapula.  Feeling your own shoulder slip into place is one part gross (listening to things slide into place) and one part relief.  Muscles that you didn't know were tensed suddenly relax and you can breathe.

I don't know if I was being a difficult patient or not.  IMO, I think the person two curtain-cubicles down was a difficult patient (until they restrained him).  Even though I was familiar with my condition, knew her treatment plan was going to work, and know what it's like to work with doctors, I still didn't want to trust her.  It's a very primal response, not subject to reason.  I'm just glad the doc went and found a nurse instead. The nurse was much nicer and more soothing.  She let me move at my own pace, which also helped.

I'll remember this incident as an important lesson in communication and patience. Someone who is sick or injured, in pain, and confused (and not under the influence of illegal substances) won't trust someone just because he/she has an M.D.  I'll try to remember it even when I'm underslept and overworked.

After that, I wasn't feeling tired and didn't want to go home just to mope around, so I asked my mom to drop me off at my friend's joint-sibling birthday party.   I wore a sling and was just starting to feel the Ativan kick in.  I have very vague memories of that night, because of the Ativan.  I remember sitting in her little brother's jumpy house, being bounced up and down while my friends jumped around and being very mellow.

Healthcare and It's Worries

Lately I've been feeling dejected because I've been counting all the times I've been to the E.R for sports-related injuries: 3 times for dislocated shoulder, once for a sprained ankle, another time for a relatively minor chest injury that involved a visit to the E.R. just to make sure nothing was broken. All but the sprained ankle were injuries that occurred during wrestling practices.

Now, all I think of when I recall those visits are the dollar signs. I wonder how expensive that chest x-ray or ankle x-ray was, how expensive my doctor's 10 minutes of consult was, how much goes to hospital admin fees, how much this silly cloth called a "sling" costs. I worry if my insurance will cover it, because everyone hears horror stories of perfectly good, hard-working people turned down for treatment for seemingly no good reason. I wonder how much it costs for a consult with the orthopedic surgeon, Dr. A - I should probably ask.

For the record, I'm not a klutz (or don't think I am), although I was pretty pissed off when I sprained my ankle on an uneven part of the sidewalk.

But still, my health worries are relatively minor in the bigger picture. I wonder how other people and families with serious, chronic illnesses deal with it. For one - cancer patients. Will their insurance cover all the drugs and treatments involved? What if it doesn't? How does a person worry about their life (or their loved one's life), if bills start coming in before the patient is considered "better"?

I'm currently reading The Healing of America by T.R. Reid because it seemed like a good starting point to learn about different healthcare systems.  I'm reading at a snail's pace, even though his book is really interesting and an "easy read."  Books like that, news articles, and the health professionals I have interacted with make me more aware of the current state of the healthcare, which is something I will have to deal with a lot more once I get past the training stages of medicine.

Being a Patient is No Fun Pt.1

I miss the simpler days when I only ever had to go to a pediatrician when I was sick. All I had to do was sit on the bed, let him examine my throat and ears and I was done and out the door with a nifty sticker.

I went to the ER today for a dislocated shoulder...As someone who is interested in becoming a doctor, I thought I should blog about it, even if it's only a reminder to my future self that hey, being a patient for any reason can be scary and frustrating. Before I explain the whole ER trip, here's some back-story on my recurring injury:

Due to being on the wrestling team, I tore my left labrum which I vaguely recall my doctor referring to as a Bankart Lesion. The first doctor I went to assumed I was just loose-jointed and needed time to grow out of it. We sought a second opinion. Dr. M informed us that I had a torn labrum and he recommended surgery.

My parents weren't too thrilled. They grew up with the mentality that surgery isn't always a solution and harbored the hope that I could live with the injury. They kept hoping (wrongly) that the tear would heal itself, or if we pursued alternative methods, we could strengthen the muscles and ligaments around the shoulder joint. I grew up in a very bicultural home, so I learned about the merits of Eastern Medicine, but I didn't think anything could be done for my shoulder short of surgery.

We argued about it constantly. When I turned 18, I chose not to pursue the surgery option behind their back. It seemed wrong to go behind my parents like that and I wanted their support (or my own job and my own insurance plan).

Finally, years years later, I found Dr. A who is an orthopedic surgeon and specializes in shoulders. I'm not sure why my parents finally made the turn around..it may have been that they finally realized my shoulder wasn't getting any better. In the years between meeting Dr. M and Dr. A, my shoulder would dislocated at the worst times, always when I'm doing something ridiculous and have my guard down: like taking off my jacket/closing the door with my left hand/ sleeping and unconsciously moving into a bad position.

I'm scheduled for surgery on Sept 7 at long last. Dr. A uses some type of plastic anchors instead of stainless steel (which my parents disliked). She's been very kind to explain AND diagram for me and my parents how the procedure would go.

Unfortunately, my shoulder couldn't wait another month and it dislocated itself today...ironically as I was taking my coat off. My next post on this topic will be about my adventures in and out of the ER :(