On surviving yet again

Miscellaneous experiences and reflections

Three shoulder surgeries in 25 months. If you don’t think that sounds like fun, you really ought to try it sometime. This was my first joint replacement though, and recovery should be easier because less soft tissue was involved, and it’s soft tissue that takes forever to heal.

I remember getting a nerve block just before they rolled me into the O.R. at 7:30 Friday morning, but the O.R. anesthesiologist must have cold-cocked me the minute I arrived because I don’t remember anything after my gurney hit the swinging doors. I don’t even remember waking up in recovery or being rolled upstairs to my room.

Because I’ve lived on narcotics for so long, they no longer work well, so my first night in the hospital was hell. I had a PCA (Patient Controlled Anesthesia) pump that injected a xylocaine-like drug into my neck, but when the main block wore off in the middle of the night, the PCA didn’t touch my pain, so I was given intravenous morphine, Dilaudid, and oxycodone, all within ninety minutes and all without effect. Nurse Jen then called Mark (my surgeon) and he told her to double the Dilaudid, but even that didn’t help.

Jen then said “I don’t mind waking doctors up in the middle of the night, so if you think of something else that might help your pain, you tell me.” It soon hit me that I needed Neurontin along with the Dilaudid, so Nurse Jen woke Mark up a second time and got me a prescription for 900 mgs of Neurontin, and the two drugs together enabled me to sleep three hours for a two night total of seven hours. (Mark hates the drug, and he knows that I know this, so I laughed about him being awakened in the middle of the night to prescribe it.) As you might imagine, Saturday sucked, yet if I hadn’t suggested the Neurontin, no one else would have thought of it, and I wouldn’t have gotten any sleep.

Thirty-six hours after surgery, I could barely walk 200 feet, and I needed Peggy’s assistance to go that far. Twenty hours later, I came home and walked 2,000 feet all by myself. Today—three days post-op, I walked a mile.

I won’t take a medicine unless I know what it’s for, and this meant that I sometimes turned down medicines while I was in the hospital. If I asked a nurse what XXX was for, and she said, “I don’t know, but it’s on your schedule, so you need to take it,” I didn’t take it.

After I was put into a room, I was surrounded by seven machines of one kind or another, and I was hooked up to four of them around the clock. I literally couldn’t stand up to use my urinal without a lot of wires and tubes becoming entangled. Also, some of these machines had alarms that kept going off for no good reason. I finally insisted that the worst offender be disconnected, and after three hours of serious bitching on my part, it was.

My main physical therapist was an Aussie guy who didn't want to talk about anything but his diabetes and his desire to move back to Australia for the government run healthcare. I kept thinking: “I wish you were there now, dude; I wish you were there now.” If I had it to do over I would have asked for another therapist, but all it takes is a moment of weakness, and some selfish bastard will steamroll you every time. I’ll still complain about him, but doing so after the fact will be less satisfying.

I think that most nurses and doctors respect a patient more—and treat him better—when he’s not mindlessly compliant. As for the ones who are bothered by it, I assume they’re on a power trip, or else they’re so lazy that they resent being forced to actually think for a change.

I had my yearly physical just before my surgery, and, just for the hell of it, I called my internist “Doctor Kirk” (Kirk is his first name). I hadn’t called him by his title since I started going to him 21 years ago, and he looked flabbergasted. I interpret an insistence on being addressed by a title as indicative of a need to have people brown-nose you, so I guess it’s just as well that I’ll never meet the queen.

The anesthesiologist who performed my nerve block was so concerned because I’m “not narcotic naïve” (meaning that I take a lot of narcotics) that he came by twice on his days off to check on my pain level. I wanted to leap out of bed and kiss him. Doctors like that are to die for.

I’m pretty sure that a nurse stole some of my Dilaudid, but I believe you should be 99% sure before you formally complain about such a thing, and I was only at 98.5% (although I did mention my suspicions to her).

I’m sure that some of you wonder if I’m ever tempted to pray given that I’m in chronic pain and have had numerous surgeries. No, I’m not. When someone tells me that their oncologist had “given up” on their Aunt Matilda, but that god dropped by and healed her cancer, I think about how much more impressed I would be had god re-grown her missing leg, or eye—or even her missing toenail. Funny how religious people only pray for things that might happen anyway. Why is this, religious people? Why not ask god to raise the dead or at least re-grow teeth? I mean, jeez, how difficult could a bicuspid be?

Finally—and for the hundredth time—allow me to warn you against ever allowing yourself to be intimidated by a lot of diplomas and certificates, or by a bigger than life personality. I promise you, you will occasionally have an idea that is so brilliant yet so seemingly obvious that you will be appalled that the experts overlooked it. Yet, they did because even the most brilliant, caring, and educated people suffer from the all too human tendency of falling into a rut.

41 comments:

CreekHiker / HollysFolly said...

I hope this surgery does the trick! Feel better Snow!

Stafford Ray said...

Snow, I seriously sympathise and am praying for your quick recovery.
Haha, just leave it!
And I must say I am impressed that your sense of humour is intact, viz, "Doctors like that are to die for."

Just_because_today said...

You are right, last paragraph is so right.

I found the PAC to be a joke. You can press it a million times and it only delivers a tiny little bit of pain killer that doesn't kill the pain. I hope you recover soon and that you are done with surgeries.

Snowbrush said...

Thanks, Creekhiker. You're a nice reader unlike that horrid Stafford who responded right after you did.

Stafford, my head is spinning round and round and green projectile vomit is flying continuously from my mouth before splatting onto all four walls, and I'm sitting here with only one arm to clean it up with, you horrid Aussie you.

Snowbrush said...

Stafford, because you're from Australia, your visit reminded me of something I left out:

"My main physical therapist was an Aussie guy who didn't want to talk about anything but his diabetes and his desire to move back to Australia for the government run healthcare. I kept thinking: “I wish you were there now, dude; I wish you were there now.” If I had it to do over I would have asked for another therapist, but all it takes is a moment of weakness, and some selfish bastard will run over you every time. I’ll still complain about him, but doing so after the fact will be less satisfying."

Snowbrush said...

Just because said: "I found the PAC to be a joke."

Peggy says that they don't use them much anymore at her hospital. When I first heard about them, they sounded like a great idea, but of course, one obvious problem that you run into right away is that they lock you out for 20 minutes after each dosage, yet you have no way of knowing when the twenty minutes are up. (Well, you could watch the clock, of course, but just try remembering your start time when you're in horrible pain.)

The Elephant's Child said...

Thanks for letting us know how you are. So, so happy that you are home again. And from the sound of it, going gangbusters. A mile three days after surgery is truly impressive.
And I am with you big time about refusing to respect a position or a title. In my book respect is earned and it may or may not have a piece of paper (framed or not) to go with it. Hope the pain settles quickly. And even more I hope it settles to levels you have only been dreaming of pre surgery.

The Blog Fodder said...

Welcome back. Hope you heal rapidly and can be in a little less pain.

Natalie said...

The nerve of Stafford the Aussie, to PRAY for you.!!! Doesn't he KNOW that is too scary to contemplate????
Thinking of you, and I am impressed with the mile walk. GO YOU.xx♥

River said...

This sounds so bad to me that I'm now glad my surgeon decided I didn't need the repair to my shoulder tendon as it wasn't fully torn and exercise had restored almost the full range of movement. he said there was no point in putting pain back where there wasn't any and immobilising the arm causing further stiffness with long term physio in my future. I'm back at work now, pain free and managing well.

If gods could regrow teeth I'd be praying ten times a day....

Elisabeth said...

Ah snow. What a saga, and all that pain. It sounds worse than childbirth and that's saying something, a extended never ending labour, I might add because it seems your pain never really goes away.

My commiserations - no prayers, I don't know how any more, just admiration and empathy.

Snowbrush said...

Child, I'm impressed to with my progress. I didn't know I had it in me. I did notice that my surgeon acted a lot more casually in regard to this surgery, and that alone gave me hope that it wouldn't be so bad as I had feared, although it certainly sounded gruesome enough. That I had the courage to lie down on that gurney was really something just in itself.

Fodder, thank you so much, my Ukranian/Canadian buddy.

Natalie said: "The nerve of Stafford the Aussie, to PRAY for you.!!! Doesn't he KNOW that is too scary to contemplate????"

That's why he did it. He's both a thrill-seeker and a reprobate. Truly,
Stafford Ray is one of the worst men who ever lived, though not even in the same league with the worst of women, and it's his knowledge of the latter that's like a burr under his saddle. He strives to be worse than he can be, but his limits are low given his maleness, and his frustration makes me fear for his sanity.

River, there are different stages of tendon tears. Stage one can be treated non-surgically. Stage two and up cannot. I would say you were lucky to address the problem in time. I sure wish I had. Since most problems get better on their own, I thought that my sore shoulders would too.

Elisabeth said: "I might add because it seems your pain never really goes away."

This is true. You grow up expecting wounds to heal, but from some things, you never heal, which is why I turn to such gruesome and violent measures as orthopedic surgery. ON the bright side, my pain is gone on my left side, although the stiffness is alarming, and I will be largely incapacitated for a long, long time.

Phoenix said...

Great post, as always, Snow, and as usual I have a dozen or so thoughts running through my head by the time I'm finished reading because your writing is always so thought provoking.

I feel like I've got a healthy mix of ego and humility, in that I'm good at being respectful of others (if they've earned it) but I consider myself an expert on myself. As you pointed out, walls full of diplomas and certificates can be intimidating, but at the end of the day I still feel like my input on what's going on with me is just as (if not more) valid than medical opinions that treat me like a lab rat.

I have a feeling that my experience with doctors will end up being similar to the experiences I had with my teachers in high school and college. Those who loved their job and enjoyed being challenged by their students liked me quite a bit - and those teachers who hated their jobs and just wished that every student was a mindless little robot learned to loathe the very sight of me. :)

Snowbrush said...

A friend marveled that I wrote such a long post with one hand. I only type with one hand when I have little to say. When I have a lot to say, I lay my left arm on a pillow. As long as the shoulder bears NO burden, I can do what I want with my hand. That's about the only upside of shoulder surgery. I'm not supposed to lift so much as a feather, but I can use my hand.

Snowbrush said...

Phoenix said: "Those who loved their job and enjoyed being challenged by their students liked me quite a bit - and those teachers who hated their jobs and just wished that every student was a mindless little robot learned to loathe the very sight of me. :)"

Phoenix, you expressed my own outlook perfectly. What a great way we've found to weed out the half-asses!

Robert the Skeptic said...

I need to jot down these pain drugs you mentioned, I only had oxy-whatever or morphine squirted into my IV.

Surgery and hospitals really are the pits!!!

Snowbrush said...

Robert, I know of others, but of the most commonly prescribed narcotics , hydrocodone (the active ingredient in Vicodin and Norco) is the weakest. Oxycodone (the active ingredient in Percocet and Oxycontin) is the next strongest, and hydromorphone (the active ingredient in Dilaudid) is the strongest of all. Nurse Jen saId that hydromorphone is stronger than morphine, and it sure seemed so to me. Yet, dosage plays a big role as does the way a drug is administered.

All Consuming said...

“Nurse Jen then said “I don’t mind waking doctors up in the middle of the night, so if you think of something else that might help your pain, you tell me.” - I envy this enormously. Hubby had to put out a mantrap and stalk a dr for three days before we could catch one to come and see me.

“If I ask a nurse what XXX is for, and she says, “I don’t know, but it’s on your schedule, so you need to take it,” I’m not inspired to fall into line.” - Absolutely, my experience is that they'll give you drugs that actually harm you or cause more pain if they're dim enough not to know what it does in the first place!

“I think that most nurses and doctors respect a patient more—and treat him better—when he’s not mindlessly compliant. As for the ones who are bothered by it, I assume they’re on a power trip, or else they’re so lazy that they resent being forced to actually think for a change.” -it's like I wrote this myself.

This post makes me so happy. Not you being in pain of course, but the subsequent recovery is all but marvellous to hear! Keep complaining, it's only folks like me and you who irritate staff enough repeatedly that get them to change their policies and behaviour towards patients when they can't stand another word out of our mouths and just want us the hell off their back. No back pun intended there my natural wit has no bounds. Big ole bear hug to you mister. x

kylie said...

aussies arent coming up so well here, snow :)
i'm happy you seem to be doing well
xo

Snowbrush said...

Kylie, dear, as I saw it, his Aussiness was incidental to his half-assedness, so don't take my criticism as indicative of any suspicion of Aussies in general. I just figure that people are the same the world over, with half being below average at their jobs and half above average.

All Con, thank you so much, Sweetie. I took your letter to the hospital with me for comfort. Such things don't help the pain a damn bit, but then that would be a bit too much to expect from a letter, eh? I'm very glad I took it, and I'm very glad the work on your place is finally underway, so you can resume life in better surroundings--even if they running the wiring across the ceilings and walls instead of inside them.

Marion said...

Well, Snow, I'm just glad you made it through okay. Hospitals are known to kill people and it sounds like, overall, you had a pretty good group of professionals. My husband is a retirned nurse. He said that nurse probably DID steal your meds and that he saw more addict nurses than you can shake a stick at in his 25 years in nursing.

Take good care of yourself. I'm glad it's over and I hope you'll be pitching baseballs really soon.

Love & Blessings,
Marion

Marion said...

A great post and comments! I'm so glad your recovery is underway, Snow...walking a mile after surgery 3 days ago is truly fantastic! xo

Crazed Nitwit said...

I'm totally LOL about you wishing the Aussie therapist was back in Australia too! Glad you had a rocking' gas passer.

Stafford Ray said...

Many Aussies overseas are a pain in the arse. We can’t spell either!
One correction. Our health service is not ‘government run’. It is government (taxpayer) funded.
It is run by medical practitioners who negotiate their basic fees and generally offer services at that fee.
Public hospitals treat all comers for any ailment free, but the wait for non-urgent treatment can be long. For your shoulder surgery you might have had to wait a year, but for a modest amount (for me $130 per month) you have immediate access to a private hospital where any (scheduled procedure) is covered by the insurance. That would include your shoulder. I am also covered for about 40% of optical, dental and many other costs.
The Public System costs the community less per head than US citizens pay for their medicine mainly because even the best specialists must negotiate their scheduled fees with a statutory authority. They can charge what they like above that fee, but the public knows the fees and ‘shops’ accordingly. Maybe the US could do worse than to have a look at how it works here.

But then while I contemplate the likelihood of that, I have a vision of a perfect day in Florida.
Then, into the frame comes a flock of pigs is flying over a multi-million dollar yacht.
On the foredeck is the glued-on blonde while on the flybridge, decorated with medical degrees, is a white clad, cigar puffing medical specialist twice her age pushing both throttles to full plane, hoping the wind will blow her top off, burning a hundred gallons of fuel per hour just because he can.

I am so glad my prayers helped in your speedy recovery!

Snowbrush said...

Marion said: "He said that nurse probably DID steal your meds"

Hello, Louisiana Marion! Peggy gets the Oregon Nurse's Association journal, and every issue has two solids pages containing the names of nurses who got into trouble with the law, nearly all of them for drug-related offenses. I probably will complain because while I wouldn't want to see her fired based upon my experience, I would like to see her watched because of my experience.

Hello, Canuck Marion!

Hello, Washington Nitwit!

Stafford said: "the wait for non-urgent treatment can be long. For your shoulder surgery you might have had to wait a year, but for a modest amount (for me $130 per month) you have immediate access to a private hospital"

Modest for you or modest for anyone? (I really don't know.) My computer is a Mac. When I took it in for servicing, I was given the option of waiting in line like everyone else or paying $50 to be bumped to the front of the line. Your healthcare system reminds me of that. I could truthfully say that, for me, $50 is a modest amount, but it's not the money but the principal of the thing. Say I were standing in long theatre line, and the theatre manager (I'm spelling theatre the way you spell it in a shameless attempt to brown-nose you and my other Aussie--and English--readers) went down the line offering to sell places at the front of the line for $1.00, would the cheapness of the charge be adequate reason for me to take the place of all those people who got there ahead of me? I'm far from arguing for my own system--which stinks to the heavens--I'm just saying that I wonder if healthcare shouldn't be a matter of first come, first serve.

Stafford said: "I am so glad my prayers helped in your speedy recovery!"

I think you must be praying for the wrong body part, Stafford, you moron (I quickly tire of brown-nosing, which is why I was fired from all 413 of my advertising and public relations jobs), because every time you tell me you were praying for me at such-and-such an hour, I'll invariably recall that my room was flooded with a blinding light at that very moment, and that the light was followed by a clap of thunder, but when the pyrotechnics were over, I had a sleepy jaw combined with new fillings in all my molars, so I'm wondering if maybe you got shoulders and molars mixed up. In any event, my dentist is accusing me of infidelity, so I really need you to do something different here.

Stafford Ray said...

OK, so I goofed. You didn't say which joint as far as I remember, but it must have been someting to do with walking, so it was a knee or a hip!
I will now say a hundred our fatheres and two hundred hail marys.
And you can put the previous comment aside until it does apply.

I have been following your contretemps for some time and sincerely sympathise, particfularly the bits about pain!

Yes, the problem of how to provide a system that is equitable, efficient and doesn't break the bank is difficult if not impossible.

Nevertheless, I have never heard of auctioning or scalping in a medical queue! But having said that, the fact I can avoid waiting by taking out medical insurance is an 'auction' of sorts.

Snowbrush said...

Stafford, I talked to god this morning (I call him Big J), and he said for me to tell you that it don't matter none how many "to hell with Marys" you say cause he don't like you the way he likes me. However, he also said for me to tell you that if you will send me $600 a year--that's if paid monthly--or else $595 if paid all at once, he will set things up with his front office so that I can intercede on your behalf with him, and that, if you will do this, he will forgive you for your country of origin. But, wait, there's more. You will also receive a bucketful of twenties for every dollar you donate to my minstry (and remember, Stafford, those dollars go straight to my orphanage in Belgium--or maybe it's in Belarus; something like that--plus perfect health and good looks for the next hundred years. Now, I know you're a sensible, practical, and well-educated person, so if I were you, I would go ahead and send me your bank account information TODAY because this offer could be withdrawn at any time. Now, that's not me talking here; you know that. I'm just passing on what I was told.

Lorraina said...

I was so happy to read Snow that you are safe at home now. best wishes for a continued speedy recovery

Hilary Melton-Butcher said...

Hi Snowbrush .. just glad you're through it & I hope it heals and relieves some of the pain ..

Thank goodness you had your wits about you ..

All the best - Hilary

Strayer said...

Glad you didn't get some horrible infection in the hospital. Hope that artificial shoulder serves you well. Hope the green vomit stops. Hope the whining aussie guy somehow can be deported in an INS mistake even if he has a green card. Let's turn him in!

Vagabonde said...

It is great that you could walk so far so quickly. I have not been in hospital for a long time and hope I won’t have to go for another long while. I hope that you’ll keep getting better and better. This is a short comment, but I wrote a long one on your last post…

dana said...

Oh Snow. I'm so happy for your mile walk. Just stop trying to outdo yourself!! I'm proud!! I'm thrilled!!

And I've always been angered when people claim a healing, or worse, God heard their prayers and didn't let them die (when everyone else on the train died...I guess they weren't praying as good as the blessed one) and there's NEVER been a prosthetic leg, a glass eyeball, or a wig left on the altar after a healing service.

Yay for YOU and your rare piece of good fortune!! WAY overdue!!

RNSANE said...

Well, you've survived your surgery. I hope you continue to make the best progress possible and I wish some magic fairy could make you pain free. We both know, however, that isn't going to ever happen. You are so incredible, though, Snow - you do better with pain than anyone and, somehow, keep a pretty upbeat attitude through it all.

diane b said...

It looks like it might be Aussie bashing day so I had better be careful what I say. I'm glad you are home and a mile walk is impressive. The pain management in the hospital sounded a saga. At the risk of getting a serve from you, I must agree with your Physio Therapist when it comes to our health system.

Putz said...

well the thing that i am struck by the most is how uneducated i am about drugs<><><>how you can just casually ask for diproathon or zinconhtilite so knowledgablly

Snowbrush said...

Thanks, Lorraina.

Thanks, Hilary.

Thanks, Strayer.

Thanks, RNSane. I wish I felt that I do well with pain. It's really hard (for me) to compare people that way since there are so many variables. My main advantage is that I have Peggy. If I had no one to support me emotionally, and if I had no one who needed me in their life, I think I might have killed myself before now. As it is, I can always see that my assets exceed my liabilities. Even when I'm walking the floor at night in pain, I think of Peggy asleep in her bed, and my heart is filled with love and even joy.

Diane said: "It looks like it might be Aussie bashing day..."

Well, that hurts a little. My main thought about that therapist was to wonder how he could be such a jerk when every other Aussie I've known was a sweetheart. Of course, I know that Aussies are simply people like you find everywhere, but my experiences with them have been entirely positive except in this one instance.

Putz, I've relied on drugs and surgeries for years now. If you were in my situation, I should hope you would spend time learning about them too if for no other reason than that you can't trust a doctor to make good decisions about your care simply because he has a medical degree.

RNSANE said...

I don't have a partner. Until my sons were grown, I knew I had to be there for them as I had no child support so I was both mom and dad. I was so fortunate to have the excellent nursing position that I did, with the extra call, that gave me a more than decent income and I was so passionate about forensic nursing, I ignored the fatigue. My sons were very good and really caused me little grief, even in their adolescent years.

I am blessed with friends who are most supportive but, at times, I am in so much pain, I find myself thinking, "Why can't I just go to bed and die peacefully in my sleep?" I don't want to suffer, I don't want my kids to have to suffer...but, then, we seldom get what we really want.

I have always admired you, Snow, and your ability to write so well about you adversities an suffering. I keep thinking somewhere there are miracles and I wish you one!

The-Fire-Olympus said...

I hope you recover safely

Lydia said...

Your comment about never meeting the queen just cracked me up. And since it has been proven that laughter has healing qualities I feel just great. Wish I could return the favor!

nollyposh said...

"I think that most nurses and doctors respect a patient more—and treat him better—when he’s not mindlessly compliant" ...i have come to understand this too... Just the other day i had a CT & before they stuck me with the intravenous contrast i said that i didn't feel that i should this time given my body's delicate state at the moment... The nurse said to me later that she thought that i did the right thing sticking up for what i thought was right for me... (Even though it would make the Doc work a little harder comparing the scans)...

So i have to say i think you are right about keeping the doc's on their toes... Otherwise you end up paying your (in my case) $110 a visit with the doc & walking away with simply a confirmation of what you had already worked out for yourself... My doc has a paging system & i use it where once i would have thought that i was being annoying to do so!

amanda said...

Good luck to you, I hope your suffering ends soon.