Tuesday, October 1, 2013

My 39th Surgery

I've waited to write about my latest surgery until all the facts were in since this has been such a confusing case with different opinions and different diagnoses.  So I got referred over to another doctor weeks ago from the one doctor who was giving me cortisone shots.  Since the cortisone shots weren't working and he didn't have a lot of expertise in shoulders, he referred me over to a different doctor.  When I saw the new doctor, he decided surgery was the next logical step since the cortisone shots weren't helping.  I was a little nervous about doing the surgery here because they don't know burns here and they don't know me here like they know me in Portland at Legacy Emanuel.  But, there didn't seem to be any other option so I decided to go ahead with it.  The surgery was going to be minor - arthroscopic surgery. I had to see my Orthopedic surgeon again cause here in LG, you have to have seen your surgeon within 30 days of the surgery and the appointment I had with him where we decided on surgery was outside of those 30 days.  I also learned that my Orthopedic surgeon was going to be leaving right after my surgery so on my next appointment I would also be meeting the doctor that was taking his place and who would be sitting in on my surgery since I would become his patient after the surgery.  

I had my appointment with the two surgeons and was even more nervous about doing this surgery but for new reasons to add to the other reasons.  The new reasons were that the surgeons themselves were a little nervous about operating on me because they don't know burns and they're nervous about the scar tissue and contractures that they might find in there.  So them being nervous about the operation made me more nervous than I already was.  I got to meet the new Orthopedic doctor who would be taking over my case and he did a few tests on me himself to get more acquainted with my problem.

My surgery was September 25th at 9:30 AM.  I had to check in at admitting at 7:30 AM.  So after checking in, I made my way to the surgicenter where I would be prepped for surgery.  I was placed in room A-2.  After getting my gown on, my brother (the pharmacist at Grande Ronde Hospital now) came in with an intern to check my medication list and when I last had everything.  It was cool seeing my brother in action be the boss in a high class career that he loves.  After my nurse and another nurse who came in to help tried putting in my IV without success and hurting me pretty bad, the anesthesiologist came in to talk to me.  I told him that I was a burn survivor and had had 38 previous surgeries and was difficult to intubate.  I also told him what intubation method was used on me successfully and his response to me was rather brash and snotty.  He just simply said, "No.  I can't do that."  There was no kind of, "thank you for the information," or "Ok, great, thanks."  Just, "No.  I can't do that."  After he left, I suddenly got very panicky feeling and started to have a bit of a panic attack.  I was bothered with how the nurses tried to get my IV and how much they hurt me and I was bothered by the anesthesiologist.  I added on that the surgeons were also nervous about operating on a burn patient.  I started to cry a bit and hyperventilate.  My mother hugged me and wiped my tears, told me everything would be OK.  It was just a rough start.  I wiped my tears the best I could cause they just slowly kept coming, and soon the Orthopedic surgeon was in to talk to me and mark my shoulder.  After he talked to me, he calmed me down and I felt better.

The anesthesiologist was soon back in to try and get an IV in me and I got a little panicky again because of my previous experience with the nurses trying to get an IV in me and how bad they hurt me.  But he did very well and didn't hurt me.  My brother came back in to see me for a bit.  That also helped calm me down just having him there.

Soon it was time to head in to the operating room.  I got in the operating room and the nurses were very kind to me.  Giving me extra blankets since it's always much colder in the operating room and stroking my arm as I breathed in the oxygen to prep me for the anesthesia.  I didn't like that my the anesthesiologist didn't let me know he was pumping the anesthesia into my IV to warn me like the anesthesiologists always do in Portland.  I just hate this part of surgery so much that I like to be talked to throughout it, letting me know what they're doing.  So suddenly I felt the hot sting of the anesthesia in my IV site and I knew I had only a few more seconds before I was out.

Next thing I knew I was waking up in the recovery area.  They gave me some pain meds and some time to wake up so they knew I was OK and then I was being wheeled back into my room.  When I got back into my room my mother greeted me and I asked for my usual post surgery snack - coffee and tomato soup (I always crave tomato soup after surgery.  Always.)  I recovered in my room for about an hour and a half before I was ready to get dressed and go home.  With my arm in a sling, I was wheeled out in a wheelchair to the car.

The surgery went well.  We got two conflicting reports as to what was actually done in surgery so I waited to write about it until today when I went to see the doctor for a post-op appointment.  When they got in to my shoulder using arthroscopy they discovered that the longhead of my biceps tendon was being "frayed" and "torn" by a contracture that was rubbing up against it.  It was also very red and inflamed.  The contracture had caused up to 50% of damage to the tendon and the surgeons felt the only way to fix this without cutting open my skin to do another alternative surgery was to cut the longhead biceps tendon completely.  This is not uncommon.  He said there was a lot of scar tissue and contractures in my shoulder hindering better mobility but aside from that tendon that was being "frayed," everything else in my shoulder looked good.  He also said my chances are 50/50 that I may get the mobility back that I had before but I did not need to go through physical therapy.  He gave me some exercises that I could do on my own at home.

So it looks like they found a cause for my agony and loss of range of motion these past 7 months and hopefully a solution to the problem.  I have three little wounds where they cut me open to insert the arthroscope and I go back in another week to get the stitches out.  I was in quite a bit of pain after the surgery for a couple days and handicapped since it was my right shoulder and I'm right handed so I had to have help eating (cutting my food, etc) and even going to the bathroom was difficult.  But things are getting easier and the pain is getting less though I'm still pretty sore inside my shoulder.  But hopefully the pain will soon cease all together and I won't be in agony anymore and I can work on getting mobility back.