Painful Knives (continued)

So my surgeon tells me that those big lumps of clotted blood in my wounds just wouldn't do; it was off to the operating room to open up the surgical wounds then clean them out with the medical version of a squirt gun filled with "bug juice" or antibiotic-laced sterile water. I reported to the hospital like the dutiful little patient I am, got an IV started (eventually-my nurse wasn't so good at this task) then went to sleep anticipating another day of post-surgical mental haziness.

Morning came and I went to the OR as planned. The surgical wound-cleaning went well and soon I was back in my hospital bed feeling like shit. I had a PCA pump filled with dilaudid running, IV fluids flowing in, I couldn't pee, and my legs hurt. A PCA (patient controlled analgesia) pump has a large syringe of pain medicine hooked directly up to an IV line. Every time the patient presses the control button a small dose of pain medicine squirts into his veins. Now, I barf when I take two Vicodin and dilaudid is much more powerful. I had the nurse cut the dose I was getting in half hoping not to puke. No such luck; I puked like a champion anyway. I struggled with a urinal for hours trying to pee. Success finally came and I was a bit happier. If I couldn't pee within six hours or so post-op I might have had to had a catheter inserted and I sure didn't want that. The leg pain wasn't too bad but it was still there. Anyway, the night just seemed to last forever. I just couldn't get to sleep and my nausea wouldn't go away. I took some anti-nausea medicine but it didn't help. I just laid there all night writhing around trying to get comfortable without success.

Finally I fell asleep around 6:00 am. At 7:15 am the doctors woke me up to see if I were still alive. I found that they had left the leg wounds open with a full roll of kerlix soaked in bug juice stuffed inside the wound to keep it moist. A roll of kerlix is about the size of a roll of toilet paper that is 1/3 gone so they must have really had to jam that stuff into the wound to let it all fit. The plan was to leave the kerlix in for two days to let the swelling go down and the bleeding to stop then pull it out. By that time it would be fairly dry and probably stuck to my abused calf muscles and wound tissue. Getting it out promised to be pretty brutal.

I spent the next two days laying around in bed doing nothing. It truly sucked. The same crappy TV channels, the same crappy hospital food, the same crappy hospital bed. Fast forward past the boredom two days and one of the surgical interns comes by in the morning. He'll be returning soon with another intern and the attending surgeon (the guy I saw in the office and basically the big cheese.) He had the nurse give me five mg of valium to help out with the procedure and promised to make sure I got some pain medicine just before the kerlix came out. A half-hour later the trio of vascular surgeons reappear. The chief surgeon tells me that the interns are going to remove the kerlix and he was going to keep out of reach because "After this I won't be your friend anymore."

Though my legs look filthy, its just bruising and iodine staining the skin.

The interns unwrap the dressing on my legs and I start to feel like a mouse being played with by a particularly sadistic cat. They yank out the dried-up dressings and I'm feeling pretty miserable. I don't actually holler but If I had less pride I might have. For the next couple of days they nurses just pack in wet gauze to keep the wound from drying out then I go back to the OR to get the legs closed up for good.

The wound closing goes well and I'm discharged the next day with puffy, stitched-up legs. Hopefully they heal well and I'll be running in no time.

Painful running leads to painful knives

One day while sniveling to an orthopedic surgeon about how my calves would begin to tighten up progressing rapidly to excruciating pain and numbness after about five minutes of rugby or 1/2 mile of running I learned about Chronic Compartment Syndrome. He hooked me up with a local vascular surgeon who is an internationally recognized expert on this malady.

When I arrived in his office he took my history, asked questions; the usual thing. Then he brought out a little pressure meter with a big needle. He stuck the pointy end of the needle into the muscle on the front of the calf on each side and read off the internal pressures to the nurse assisting him. After a bit of discussion we set up a surgical date to repair the problem since the pressures were way out of line.

The day of surgery arrived and eventually I entered the oblivion that midazolam and fentanyl bring on. I awoke with sore calves and bandages from toes to knees. The surgeon had created a slit about four inches long running up and down on my calves then removed an oval piece of the fascia (inflexible connective tissue covering muscles) about that size. He then pried up the skin above and below that hole and gave the fascia a slit about 1-2 inches as well. Pretty straightforward. Another hole was created above the incision and a long drain tube was inserted into each wound running its entire length. The drain was connected to a little bulb to help pull out the inevitable post-op bleeding. I got a bottle of Vicodin, some dressing supplies, some care instructions, and an appointment to return to the clinic in a few days. Pretty old hat since I've been a nurse about twelve years now.

This is pretty uncomplicated surgery but its bugbear is bleeding. The surgeon told my family that the calves looked terrible; lots of inflammation, adhesions, etc. and that I had really needed this surgery years ago. Sure enough, my wounds just kept bleeding and hematomas (think big chunk of clotted blood) developed inside the wounds. The hematomas would eventually become scar tissue which would leave me worse off than before. I had to go back to the operating room for a little tune-up surgery. (to be continued)

Spending time in the hospital

I've been away from the console for some time now, spending some time in the hospital. What was supposed to be a quick 1/2 day outpatient surgery turned into a week in the hospital and three trips to the operating room. Stay tuned for some stories from The Wrong Side of the Hospital Bed.