Family Webicine

By Rod Moser, PA, PhD

The morning of my recent surgery, I had to get up at 4 a.m. That was easy for me since I was too anxious to sleep, but my wife is well-known to push the clock to the last second. I had to be at the surgery center no later than 5:30 a.m. for a 7:30 a.m. procedure. I have only had four surgeries in my life, and three of them were this year. My elevated blood pressure also reflected my nervousness, and I was concerned that my surgery would be cancelled because of it, or we would be late.

I was the only patient in the surgery center at that time, so I was sent directly to registration. They checked and double-checked my identity and reason for my surgery – we don’t want them doing the wrong person or the wrong shoulder! I checked the identification bracelet for accuracy and immediately found an error. They had me listed as a female. Although I take pride in my sensitive, feminine side, a woman I am not.

The next step in the process was to get undressed. One must be near-naked to have shoulder surgery. Next: Sasquatch gets shaved. Hair was flying everywhere, not unlike the dog groomer.  This was followed by a pat-down with sticky tape to retrieve the copious loose hair.

The anesthesiologist appeared, somewhat concerned about my anxiety-driven blood pressure. I reassured him that this old body can handle it according to my recent cardiology clearance, and he felt better. He was going to do a nerve block on my arm (optional) to help my post-operative pain for the first night. He told me that the block will be painful and that my left hand and arm will be paralyzed, so I declined. I don’t think I could mentally handle even a temporarily paralyzed arm following surgery.

The surgeon appeared. He had forgotten to give me a prescription for pain medication, so I wanted it right away. He offered me a weak analgesic, which I declined. I know my pain intolerance from the ureter stone earlier in the year, and I wanted something strong. He looked at me like I was a drug addict, but maybe that was my imagination. I was given ample advice by several others who had this surgery, so I held my ground for some “big boy” pain meds. Pain (real pain) is notoriously under-treated in the U.S. because of prescription drug abuse, but I was not going to be held hostage over this issue.

My IV was flowing and the anesthesiologist quickly injected a drug. That was the last thing I remembered for the next four hours.

I woke up in the recovery area with severe eye pain. As soon as I became more conscious, I knew what probably happened. The anesthesiologist tapes the eyes closed, and he inadvertently scratched my cornea – a painful “paper cut” on my eyes. Nurses were scrambling around, but no one was prepared for this issue. There was no way for anyone to evaluate my eyes in an orthopedic surgery center. Someone offered to get me some sulfa eye drops, perhaps the most painful of all eye antibiotics. I refused, of course. As soon as I was released, I headed for my optometrist so that my eyes could be properly examined and treated.

Let me set this scene for you:  Red-eyed man still out of it from anesthesia, wearing a large, unbuttoned, flannel shirt over iodine-stained left arm in a sling; his now half-hairy chest fully exposed. This was not something my optometrist wanted to see, but he is an old patient of mine, so he understood. His examination confirmed a bilateral corneal abrasion. He gave me some antibiotic drops that I was allergic to, so I had to get it changed.

My wife dropped me off at home and went to the pharmacy to pick up the medications. This took over an hour because they forgot to fill the eye medications. When things start to go wrong, they tend to go wrong all day.

The first two nights spent sleeping (not really sleeping) in a reclining chair was miserable. I only slept a few minutes per hour, waking myself up by inadvertently moving my very painful arm. I had a huge dressing over my left scapula, giving me the humped appearance of Igor from Young Frankenstein. I could not get comfortable. The pain meds only helped a little. Any time that you are wrapped in a dressing, there will be itching – itching that you cannot reach. I even broke my back scratcher on a particularly-difficult-to-reach spot.

My wife has been unbelievably supportive. She makes sure I take my medication on time, fluffs my pillows, and helps me get dressed. My dogs have been tolerant even though I have stepped on a few tails on my way to the bathroom. Dogs are intuitive and seem to know that I am in pain. They stare at me with those sad-looking eyes and offer me their heads to pet.

I am on day three now and a bit better. I still have shoulder and arm pain, as you might imagine. Sleeping is still a problem, but I was actually able to sleep nearly two hours without waking up – a new record since the surgery.

It took me all day to punch out his blog, a letter at a time, but I did it!