Saturday, December 8, 2007
Unscrewed! Dec 8
Yesterday, I had surgery to remove several screws in my leg. The three locking screws (the blue ones in the picture) were connecting my tibia to the rod. In theory, by removing them, it will "dynamize" the rod - meaning that there will be a little more play in the bone ends. Hopefully, this will stimulate bone growth. The other two screws were holding my tibia and fibula together. They actually had broken, so only the short heads of the screws came out. (We had been told that this might happen). Those screws had been put in place to stabilize my ankle. With them out, we are hoping that I will get more range of motion.
The orthopedist performed the surgery using general anesthesia. Back in August and early September, when I had a surgery nearly every other day, it seemed like no big deal to "go under." I was totally dependent on the medical teams, and it wasn't that hard to surrender my consciousness at times. This time felt harder. I am glad to be "unscrewed," but I wasn't keen on having general anesthesia. I found it unnerving to breathe deeply into the mask and inhale the artificial-smelling gas. Earlier, while sitting in the waiting room, I also thought about the range of caregivers that I had experienced during my stay in the hospital.
Some were excellent - in tune with what I needed. Others brought strange power struggles into the room. One nurse in Colorado helped out when Melissa was at her wit's end trying to negotiate with the company that rented wound vacuums. The nurse spent an hour on the phone convincing the company to deliver a portable version. Frank, the ICU nurse and Rob, the anesthesia PA came to visit me several times after I had left their unit in the CO hospital.
On the other hand, after my flap surgery, one nurse was terribly passive aggressive. My catheter was draining improperly, and I was swelling noticeably. However, she gave a variety of excuses that delayed its removal. The next nurse came on shift and removed it immediately. Another nurse delayed giving me the oral pain medication that I was taking (percocet) for almost an hour after I asked for it. When I complained that I was in significant pain, she entered with a loaded syringe saying, "I'm going to give you a shot of morphine." After I protested, she chided me that the oral medication wouldn't take effect for 20 minutes - exactly why I had requested it earlier!
One nurse finally encapsulated it for me. She said that more important than wound or pain management, her top priority was good patient advocacy. Hospitals are complex places, and patients need to be and to have good advocates. Yesterday, I asked to forego "Versed," a medication that commonly is used to diminish anxiety before surgery. However, a medical practitioner had told me that it is actually a diluted amnesia-inducer. The advice helped me self-advocate to skip that medication.
So now, with this surgery finished, I will spend the weekend in bed (not as glamorous as it sounds). Then, we begin to "mobilize" my ankle - starting at my PT appointment on Monday morning. I hope mightily that getting these screws out will accelerate my return to some sense of normal function and activity. I also hope that this surgery will do the trick - stimulating my bones to grow. There is nothing to do but be patient and diligent with optimism and physical therapy. As Melissa said, "I'm looking forward to this being your last surgery."