Catching Up
The end of 2005 was quite a ride.
I had surgery on my hand the day before Thanksgiving. That in itself was an ordeal on many levels. The last I wrote about it, I was going for a surgical consult. First I learned that it was my thumb, not my wrist that was broken. The break was in two places at the base of my thumb, right at the joint. It was a bad break.
The consult was fine and I had some preadmission testing. The problem arose when I needed a surgical release from my primary-care physician. Everything was going fine and then he said, “I can’t give you clearance because you have asthma. You need to see a pulmonologist.” WHAT?! I was supposed to have the surgery the next day (two days before Thanksgiving). It wouldn’t have been that big a deal, but when you’re dealing with broken bones like this you only have a certain amount of time to properly set the bone before it starts healing the wrong way. The pulmonologist wild-card threw a wrench in the whole process.
My doctor tried to get a pulmonologist to see me that day, but was unsuccessful. Meanwhile, the surgeon was calling me saying they needed the clearance. I explained the situation. The surgeon called it “overkill.” My asthma is under control and I haven’t had a severe attack in a couple of years. In fact, since I’ve had this particular PCP I hadn’t had any problems with asthma at all. I’ve never been hospitalized (I’ve been to the ER and released) nor intubated for asthma.
At that point I was stressed beyond belief and angry. I tried to give my doc the benefit of the doubt. No one can fault the man for being too cautious. But when my brother — an internist — said seeing a pulmonologist was “crazy” and that he’d never required clearance from a pulmonologist for any of his patients with asthma — even those with severe asthma — I was livid. I talked to my doc and told him that he realized that because he wanted me to see a pulmonologist it would mean that I would not have my hand surgery done within the amount of time necessary to achieve the best outcome. He understood. I told him that this requirement could mean the difference between having a closed reduction (where they manipulate the bones without actual “surgery” — i.e., an incision) and an open reduction (where they put you under general anaesthesia and cut into your hand). He understood.
Fortunately, the surgeon understood, too. Although she didn’t end up actually doing the surgery, she spent a lot of time and energy to get things arranged so I could get my surgery done before Thanksgiving — and within the preferred amount of time. Without going into too much detail, I ended up at the ER and they had to admit me to do the surgery.
The surgery was successful, but they had to do an open reduction. I went under general anaesthesia. I came out fine.
I never saw a pulmonologist.
The problem with general anaesthesia is that it makes you nauseated. I woke up in pain and feeling sick. They gave me compozine for the nausea. It helped. They gave me morphine for the pain. That didn’t really help the pain, but it knocked me out. It also made me nauseated. So they gave me more compozine. With feeling less nauseated, I noticed the pain. They gave me more morphine.
By this time, I’d been in recovery for a couple of hours. I was zonked and nauseated and my hand hurt. But I decided it was time to move on. They took me back to my room where I tried to stop being dizzy and nauseated. I wanted to go home. Thanksgiving was the next day. In retrospect, I should have gone to sleep and gotten discharged on Thanksgiving (if I’d have been lucky enough to get a doc to discharge me on Thanksgiving!). But I soldiered on and got released.
I nearly puked on my way to the exit. Eric got me to the car and we went in search of a pharmacy to fill my painkiller prescription. We found one (24-hour Walgreen’s rock!). I got my Vicodin and we picked up some Emetrol for my intense nausea. Of course, I couldn’t take the Vicodin because that can make you nauseated. I went to bed.
When I woke up at about 4 in the morning, I wasn’t nauseated. So I ate some of a corn muffin, took half a Vicodin and went back to sleep.
Finally, I woke up mid-morning and I wasn’t sick, but my hand hurt like hell. It was the surgical incision that hurt more than anything. I had surgery when I was a kid. Heart surgery. I don’t remember this much pain. But I figured out that hands have a lot more nerve endings and that’s probably why it hurt so much.
But that’s not the end. Oh no!
I kept thinking that my cast was too tight. It felt tight. But I didn’t know it was too tight, I thought it was just me. My friend Melissa came out to visit (and bring me an incredibly delicious chocolate cheesecake that she made herself!) on Saturday. She took one look at my cast and said, “That’s too tight.” She ended up taking me to the ER to have it fixed. The fixing ended up being cutting a slit down the cast. Well, it wasn’t actually a cast. I should clarify. It was a plaster splint wrapped in gauze. So the bottom of the “cast” was like a cast, but the top was soft. The ER doc cut the top part.
A few days later they gave me a new splint/cast. Here I’ll take a moment to say that the docs at the Nassau University Medical Center Hand Clinic are great. My surgeon — Dr. Troy Callahan — is wonderful. He takes time to explain what’s going on and he explains things clearly. He’s knowledgeable, genuinely concerned, and down-to-earth (sometimes surgeons can leave a bit to be desired in the personality area). I like him.
I was originally supposed to have my pins removed before Christmas. But an x-ray and some discussion led them to stay in until January third. Six weeks with pins. Eight weeks with an immobile hand. I was amazed at how little I could do once the pins were out. Right now I’m in occupational therapy. My thumb is still swollen, though it does get better during some parts of the day. I do not have full range of motion and I might not ever have it. It hurts much of the time. The tendon along the back of my thumb is shortened, so I can’t bend my thumb all the way. I can’t bend the top joint on my thumb all the way either. The muscle at the base of my thumb on the palm is atrophed, which makes it crap up when I do my hand exercises. My grip strength is at 40lbs. About half what it should be.
This is not fun. I strongly recommend you not ever break a bone in your hand. Ever.
Oh, and did I mention this is my right hand? I’m right-handed.
If you’re interested in looking at pictures of the smashed-up car and of my hand (Warning: there are graphic pictures of pins in my hand at the bottom of the page I’m linking to, but there is a big red bar before you get to them), go here:
I’ll add more of my fun story later.
Mary