Saturday, October 18, 2008


Okay. Now that I'm coherent enough to write, here goes.

I'm currently at a 2-3/10 for pain at the surgery site in my left leg. Since I got home yesterday I've been gobbling Percocet like they are SweetTarts (I'm also able to take Aleve now and I think that is doing more good than the Percs) and for a while last night I thought I was going to have send my wife out to the garage for the chain saw so that I could amputate just below the knee - the block (I'll explain shortly) wore off and I was at a 10/10. All of that said, I am feeling a little better now as I don't feel the need for amputation anymore...

The process yesterday was really pretty fascinating. Considering the last surgery I had was my tonsils at age 12, other than when I was in Paramedic school looking for intubations I'd never had the need to be in an Operating Room. Everything started when I got there at 9:15 yesterday morning. I forgot to mention that my scheduled time got moved twice in two days, which I was pretty unhappy about, but ultimately everything worked out okay. When I got there I was shown to the changing area where I had to put on that fashionable gown ubiquiteously found in any medical setting as well as one grippy sock - I had to take off the boot as it wasn't going back on after the procedure. But more on that later also.

Once I got put into a pre-op room, they started the prep. The first nurse I encountered was Mary - probably in her early-mid 50's, very nice person. Hell, all of the staff people I met at the BASC were wonderful, really friendly, really helpful. And I made their job a little easier because I wasn't ignorant on unhelpful on my end of this, either, simply because I couldn't be. I think, also, that when I was able to answer questions somewhat intelligently they figured out that I wasn't just a tool of some sort.

After I got done with Mary doing her pre-op checks (and I signed more forms than when I bought my first house) the Anesthesiologist came in to see me. Michael Natale, MD - different doc than whom I met Monday, but just as good. He and I had some banter going on during the process of him getting me set up, and he did the following things: he started my IV's (was only supposed to be one but he had trouble with a valve in my hand so I got a second start), put a Popliteal block into my left leg - at the area of the Popliteal artery there is a nerve bundle that is the tail end of the sciatic nerve, which is where he put the block in, and ultimately took care of my anesthesia needs in the OR. He wasn't actually in for the procedure, I don't think - I had Barry, CRNA, taking care of business at my head during the surgery. He was pretty cool, too; after I woke up enough to be coherent we talked for a while. Really good guy, and incredibly competent.

When they put the block into my leg, I got 4mg of Versed before they started. I'll tell you, milligram for milligram Versed is an awesome drug; it is really effective as everyone says it is, and I don't remember rolling from my stomach onto my back after the block was in. Dr. Natale also used a nerve stimulator to find the bundle. That was freaky, as I had been sedated when he was looking for the nerves and I remember my leg jumping around. Vaguely, but I do remember it.

Probably 20 minutes later, the surgeon came in to talk with me. Doug Goumas, MD, was the Orthopedic surgeon who did the work. Very personable, really easy to talk with and ask questions of. Shortly thereafter they wheeled me to the OR.

I was expecting to be totally knocked down and have my airway managed by an LMA, but Dr. Natale has suggested a spinal block, which I hadn't considered prior to that. I opted to go down that road as it meant that I would be at least only lightly sedated and I wouldn't have to have an adjunct put in place. So once we got to the OR, they sat me upright and placed the spinal approximately in the area of my 7th or 8th thoracic vertebrae. Once they did that, they rolled me onto the table, I got 2mg more of Versed, and away they went.

The procedure took about an hour, and I vaguely remember hearing bits and pieces of conversation during that time, but I couldn't feel a thing because of the spinal. It was a bizarre sensation, unlike anything I have ever experienced before. From what I was told, I also got some Propofol (one of my favorite drugs to see work - I've talked about the "Milk of Amnesia" in past posts) and I also got some Fentanyl as well. I don't remember actually being wheeled into the PACU, and apparently it is just as well because with all of the drugs on board my pressure dropped and I guess made for a bit of an exciting time all around. Once that issue was resolved I started to wake up a little bit at a time - I was in the PACU for about 4 hours, mostly because it took that long for the spinal to wear off. Dr. Goumas did not put my boot back on; I have a cast on my leg up to just under the knee, fully fitted, because I am not able to put weight on my leg for any reason. It makes going to the bathroom a chore, even more than before the surgery. And I'm stuck with this until a week from Tuesday when I'll have the stitches removed and get further instructions on where to go from here (and hopefully, the boot).

I have to say that the staff at the BASC were absolutely awesome. They did everything to make me as comfortable as possible and were able to answer all of my questions. The level of care was superb. And if I ever have to go through anything like this again, I would do it there.

So now I'm housebound until then. Probably not a good idea to drive with pain medication on board, so I'm going to wait this out. And I'm feeling a touch drowsy as I finish this post up. More later on....

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