Monday, January 16, 2006

In-Depth Details About the Shoulder Surgery, Part Two: The Surgery

Part Two: The Surgery

Arthroscopic surgery is a 90-minute out-patient procedure.

I had mine done at UCLA's Ambulatory Surgery Center in Westwood.

I got there at 6:30am Monday morning, two hours before the scheduled surgery time. They asked the usual questions about three different times. I met about four different doctors, two anestheticians, and two nurses (one of which was very cute I'm happy to report).

They had me write "Yes" on the arm that was to be operated on. A wise procedure, I think.

They hooked me up to an IV and gave me an optional nerve block. The nerve block completely numbs your entire arm. It sucked getting it in though. They numbed the area between my neck and my traps a bit and then began digging around with a needle/electrode. It was damn uncomfortable though not quite as painful as it sounds.

The electrode is positioned near the nerve trunk that serves your arm. They then send test pulses down the electrode to make the nerve fire. Depending on where the electrode is placed, different arm muscles twitch violently. It kind of hurt to have my muscles fire so suddenly and repetitively. The whole thing took about two minutes but it basically sucked the entire time.

Once they find the right spot on the nerve trunk they inject an anesthetic directly to the nerves, thereby knocking them out for 8-12 hours.

I was then put under general anesthesia.

The next thing I remember was coming out of the general anesthesia violently dry heaving - over and over and over again. I didn't wake up and then dry heave, the dry heaving is what shook me out of the anesthesia. They injected me with some anti-nausea drug and the dry heaving subsided.

I was completely woozy and totally freezing. Felt like I was lying naked on a breezy 45 degree day. And still nauseaus but no longer heaving. At least I wasn't in any pain.

After 15 minutes my head started to clear up. The nurse had me hooked up to a saline bag and said that the liquid would help fight off the nausea. My mouth was dry but she wouldn't let me drink anything - she said it would just cause me to heave again.

The worst part though was the nerve block on my arm. I couldn't feel anything at all in that entire arm. And certainly couldn't move it. I had a very, very hard time coping with that psychologically. It just completely freaked me out. I wanted to rest and sleep but I couldn't. I just kept thinking about how my hand was missing and I had to keep fighting off the irrational panic that caused.

It helped a little bit to hold my "missing" hand with my left hand, but even then my brain was still in total freak-out mode. And holding your own hand while you can't feel it is... shudder... just gross. It's just this warm piece of meat with dry skin. I would have definitely preferred to feel pain rather than this psychological torture.

My surgeon was already in another surgery so I didn't get a chance to talk to him to find out how it all went.

They released me about an hour later. The arm was already in a sling and my sister was there to take me home. The effects of the anesthesia kept wearing off and I was okay to walk around, talk, etc.

Halfway back to my apartment though I had to have my sister pull over as the nausea returned. A few more dry heaves and I was good to go (the part where they tell you not to eat or drink from midnight the night before is definitely wise!).

At home I tried to rest but the missing arm still bothered me too much to sleep. After a few hours I started walking around more, pacing the room. I figured the nerve block would wear off faster if I got my heart rate up. I had a little sensation near my wrist so I'd just massage that to reassure my brain.

After an hour I could feel a little sensation in my thumb. Two hours later I had a little feeling in my fingers. By about 6pm I think I could just manage to twitch my finger digits.

I slowly tried to drink a bit of water. Then a piece of bread. As the nerve block started to wear off I figured I should take a painkiller (they prescribed hydrocodone for me). The 6-hr painkiller seemed to work fine as the nerve block subsided but it did make me nauseas again. The piece of bread made its way back up.

By the end of the night my appetite was back and I had a small regular meal. I took another dose of hydrocodone on a full(er) stomach and that helped.

I slept in my roommate's recliner - the bit of elevation made a world of difference in comfort. Lying on my back just wasn't an option.

There was a little discomfort in the shoulder but no pain. By then I could make a weak fist with my hand so the psychological issues had mostly subsided. My hand was a bit swollen though.

Aside from the nausea and the brain-freak from the nerve block the whole experience really wasn't too bad.

Next: The Results


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