Monday, October 13, 2008

It's A Go

As far as the surgery is concerned, it is definitely going to happen on Friday. I saw the Anesthesiologist today, and he checked out my airway. Definitely a Malampati 4. But just the same, there is a way that I'll be able to be able have the surgery done at the BASC - instead of positioning me prone, they will position me on my right side. That way my airway will be protected with an LMA rather than by intubation, where if I had to be on my stomach I would have to be intubated. That would mean surgery in a hospital OR, and frankly, I'm happy that isn't going to happen.

While I was at the BASC, I got my pre-surgery assessment done. I discovered that when I had my last labs drawn my Potassium level was only 3.4. That is just under the normal lab limit where the range is 3.5-5.3 milliequivalents/liter. That was surprising; it's not critically low, and they would have pushed the panic button there if it were below 3.0 and cancelled the surgery. The reason for that is simple: sodium and potassium are the two elements that control depolarization and repolarization of cardiac cells. Their respective numbers are relatively balanced with each other, and if there is any change in that balance there can be changes in cardiac rhythm, specifically with the electrical aspects of cardiac function. This could potentially be a bad thing - it can cause changes in the initiation of action potential, making cells fire early, potentially causing arrythmias.

The possible reasons for this are numerous: I may have been slightly dehydrated when the labs were drawn (bear in mind this was from labs drawn in June), possibly from excessive perspiration or insufficient hydration, or a combination of the two. Also, I take a thiazide diuretic to control my blood pressure, and one of the things thiazides cause the body to do is dump electrolytes through urination.

Am I worried about it? No. If there were a problem I think it would have manifested itself in some way by now. Besides, I eat tomatoes and bananas (both good sources of Potassium) like they go out of style.

In any case, I now have a clear view of the beginning of getting this fixed. I will not be a wuss or a slacker once I have the green light to start rehab, which unfortunately will be 4-5 weeks after the surgery. No weight bearing until I'm cleared for it, although I may be able to do some light movement after 2 weeks. I'm hopeful that I'll be able to work into a solid workout routine as part of the rehab that I will be able to carry over to when I'm fully functioning again.

They tell me the rehab for an injury like this is long - I am quite aware of this, and I will do my best to do everything right. I can't afford not to.

6 comments:

Gertrude said...

Sorry you've got a busted wheel! I know how much it sucks to be gimped up. Good luck with your surgery. Thanks for adding me to the roll!!

Walt Trachim said...

Thank YOU! I appreciate the kind words.....

Pete said...

Damn, Walt. That's a tough injury - the Achilles is certainly the bane of us middle-aged guys and it's bit you big time. I've had inflammation there and it was uncomfortable, but I know of 2 other gents that had a rupture and that is excruciatingly painful. Sounds like you've got your head in the game...surgery, rigorous rehab and patience! Don't skimp on the pain pills either, especially in the early days...you can be a tough guy once you start rehabbing. You're in for a long rehab, especially given your line of work, so keep the squash focused and healthy and the body will heal in time.
I'll light a candle for you at St. Elizabeth's in Bedford...good luck with the surgery and keep us updated.

Walt Trachim said...

Thank you, Pete. I especially appreciate the prayers.

The rehab forecast is between 4 and 6 months overall. As I said, I have to do this right because if I mess it up, I'm done. So I will be walking the line, in a manner of speaking.

As my wife says, I am no butterfly - when I made contact with the pavement I believe the impact could be felt from where I was in the Longwood area all the way out to Needham....

Pete said...

From what I read here, I sense your biggest problem will be patience...so, find it..embrace it and take one day at a time.

ps. be really nice to your wife...clearly she is saint-worthy.

HJSLT said...

Wishing you all the best tomorrow and lots of love from Halifax!!