On the day of the surgery

Trigger warnings –  trypanophobia (needles, cannulas, surgery) & emetophobia (vomit)
(But to be fair, what else would you expect from a surgery-themed blog post?

The surgery was taking place in a hospital not far from my home. I had to be on the ward at the hospital by 7 AM. Being the usual anxious person I am, we got the bus very early and arrived at 6:30. This cause a slight problem because inside hospital was ridiculously hot, (Why on earth did I end up having elective surgery on the one day that there was a heatwave?!) and there wasn’t really anywhere else to wait, or so we thought. There’s actually a lovely little community garden provided by the friends of hospital which was a nice place to wait while I was busy panicking about the upcoming surgery. There was nobody else around so I could just sit and panic quietly with my partner.

The hospital garden

The hospital garden

The day was beautifully sunny and the weather did ease my anxiety a little.

Dead on 7AM the ward opened and I was taken into the seating area and instructed to wait. I was only there for maybe 5 min. before I was called into the preparation ward.

WP_20150630_06_57_40_Pro

My very own little waiting station!

I was told I was first in the lists however this can change depending on the order the surgeons want to do the surgeries in, but my preoperative checks were done quickly including diabetes checks, blood pressure and heart rate and other things such as pregnancy tests. They all came back fine and I’ll talk to settle in for the wait. Thankfully the area I was waiting in was actually quite nice; there was a TV with Freeview and a comfy chair for me to wait in.

I was visited by the doctor who had referred me for the surgery in Fracture Clinic (still no sign of my consultant!!) and an anaesthetist. I expressed my concerns about being awake for the surgery due to my fear of needles (or anything piercing my skin for that matter) am I worried the local anaesthetics may not work me due to my HMS. Beneath that is reassured me that he could sedate me enough that I wouldn’t notice what was going on, and that he would test the anaesthetic effect before anybody was allowed to go near me with anything sharp. I admit I did panic quite badly, and how to a bit of a cry, but I think that’s understandable under the circumstances.

WP_20150630_14_50_27_Pro

Hospital socks!

I was told to change into a gown, and was given some snazzy socks (with tote grips on both the tops and the bottoms) to wear to keep my feet warm. The anaesthetist begged me to sit on my hands to keep them warm because I have dreadful circulation. I did this and wiggled my hands regularly, and to my surprise some veins actually did show up.

I think I was taken in for surgery at about 9:30AM, leaving my partner behind. You actually walk through from the prep ward to the anaesthetic area and are put on a reclining bed. (For the procedure, your arm needs to be in a dropped position) On this short walk through very cold corridor, all my veins promptly disappeared. The anaesthetist was very nice, he was there with a trainee, and he really tried hard to get everything done first time. Unfortunately this didn’t happen, my cannula went in incorrectly the first time which is horrifically painful, but the second time round it went in fine. I was quite surprised that I was actually okay with the cannula because it’s flexible, so I wasn’t worried about it breaking. I was given something to make me drowsy, I’m assuming it was a sedative. After this point everything becomes a little bit fuzzy(!)

I was given the spinal nerve block which is a local anaesthetic affecting vertebrae in your neck. It consists of several injections to various places within your neck however they put one needle in and then move it around while inside your neck, assisted by ultrasound to see the tissues. This is one of the weirdest compliment I’ve ever had. The anaesthetist said “You’ve got really beautiful tissues, it’s fairly common in patients with EDS, but yours have a real flow.” Odd right?!

Anyway, the nerve block was injected and my hand started to feel tingly, then it felt heavy, then the sedatives really started kicking in. I should point out I’ve never been drunk in my life but I’m fairly certain that’s what it feels like. The whole world was moving slowly and my body was less responsive, my voice sounded different and they started making fun of me because I became really Bristolian. The anaesthetist stood to my side and told me to give him a high five with my right hand (the non-anaesthetised one) which I could do. He then told me to repeat this with my left hand. That was actually impossible. I could just about wiggle my fingers, but that was all.

They waited maybe 5 min. for the nerve block to take effect fully, by which point in time I was pretty damn doped. This is where my consultant showed up – I have never seen him before in my life – he showed up and said “Hi I’m Mr. *name redacted* and will consultant but I’m sure we’ve met before”. I responded “I’ve never seen you before, I’ve always seen junior doctors, I’ve been wondering if you even existed.” He chuckled at me, I hoped he thought it was funny because otherwise I could’ve ended up with some serious scars in stupid places. He went to go set up and the nice anaesthetist came back and wheeled me into the operating theatre.

All the theatres at this hospital were recently refurbished, and I have to admit they were actually very nice. I expected them to be really scary that they were just rooms. There was a lot of people and a lot of equipment, but the sedative meant I didn’t really register any of it at the time. I had oxygen mask put on me, and they painted my shoulder to my elbow with iodine to disinfect it for surgery. This felt really bizarre because I could see it happening but couldn’t feel it. As I have stated I didn’t want to see the surgery happening, they took my glasses off me and put up a sheet to obscure my vision. That’s the last thing I remember.

I came to on the way to recovery at about 11:30AM, and was only in there for maybe 5 min. until I was awake and talking, then I was moved to the orthopedics ward. When I got the ward they started doing observations on me every half hour, and requested that I drink things and try to relax. Trying to coordinate your hands when you’ve been sedated is very very tricky and the nurses had to help me drink for the first half hour or so. At about 1 PM lunch arrived – unfortunately nobody had told anybody that I was supposed to be there for lunch so I was given cheese sandwiches and ice cream. This was fine but a bit of an odd combination.

I have to admit these first four hours after surgery were magical, I was in absolutely no pain for the first time in about 15 years. Looking back at this is quite depressing, because I didn’t realize how huge a part of my life pain has become, but I’m glad I did get to experience it even if it’s just for a short time.

The physiotherapist visited me on the ward and showed me how to put on this fancy immobilizing sling and what I was allowed to do as far as exercise was concerned (not a lot!!). Technically after this (and having made a trip to the bathroom, because them’s the rules with surgeries!) I should have been allowed to go home. One of the nurses phoned my partner at about 2 PM to tell him that I would shortly be able to be released. He spent the rest of this saga sat next to my bed, being very patient but very bored and quite hungry.

Sling back

Sling back

Sling front

Sling front

This is where the problems started…

My pulse rate was registering 112 BPM. This is technically tachycardic. The nurse wasn’t happy that my pulse rate wasn’t lowering even several hours after surgery so she alerted the doctor on site at about 4 PM.

My pulse rate is high naturally, I’m not sure if this is an HMS thing or fibromyalgia thing, or simply an anxiety thing but my resting pulse rate is usually about 85-90. For those who don’t know about pulse rates this is pretty damn high for a young person, especially since my blood pressure is neither high nor low.

I was pleased that they were being cautious however I was also really bored and wants to get home before the real pain kicked in (or rather the real painkillers ran out). The doctor came and checked me over at about 5:30PM and decided he wanted to do blood tests. This is tricky because most of the back of my right hand was taken up from bruises from the cannula(s) and my left hand was now in a sling. My elbows are pretty damn bad for finding veins as they lie very deep. He decided to take the blood from a vein going down the side of my wrist with my thumb. It turns out this is a really painful place have blood drawn from and it bruises like hell (photos will be provided!!).

There was a small problem here because the on-site testing had closed for the night so my sample had to be sent elsewhere. This seems a little bit stupid but I appreciate that this hospital tends to be mostly for outpatients or chronic long-term patients so I can see why the cost-cutting measure has been undertaken. Either way I was sat there waiting for my blood sample to be analysed and to be cleared to leave until somewhere around 10 PM. At this point I started to get a temperature, and the nurse who was taking my observations said that she was a bit concerned about this. Thankfully the doctor came along and signed the discharge forms before he could see the temperature, and I simply didn’t mention it.
All this time I was provided with ibuprofen & paracetamol, however I believe the painkillers used during surgery had not fully worn off yet. The pain started to rise around 11 PM once I got a taxi home. I’ve been given tramadol, ibuprofen and paracetamol as my painkillers for my aftercare. I had stated that tramadol gives me extreme nausea and vomiting, so I was also given ondansetron which is a strong anti-emetic.

Because we arrived home really late, I didn’t even eat dinner. We scaffolded up the bed with pillows and I fell asleep pretty promptly from exhaustion. As such I didn’t get chance to take the painkillers. I woke up early the next day, at about 7 AM and took ibuprofen & paracetamol, for the first few doses to assess how bad the pain actually was. Sleeping proved to make the pain worse so I decided to take tramadol at night. This was a really bad idea because I don’t know if any of you have ever tried to balance on hypermobile feet and knees with one arm in a sling while trying to throw up while high on tramadol but is pretty difficult! This is even with the ondansetron, rather than preventing the emetic effect it simply delayed by four hours.

I was promised a phone call from the ward to discuss pain relief “a few days after surgery”. I had assumed this would be 2 to 3 days after surgery. I waited for this rather than bothering my GP or the emergency care provision. This was quite stupid as the call actually happened 10 days post-surgery. In the end I yielded four days after surgery and went to the emergency clinic in the city centre to discuss pain medication, and they suggested that the only viable medication for me would be over the counter codeine. This has kind of worked, but not brilliantly and definitely didn’t work very well for the first few days. I was taking an awful lot of medication as you can see from the recycling pile that was accruing in him wastepaper basket. (Even with all the pain, I still recycled!)

WP_20150716_13_21_53_Pro

I have my stitches removed one week after surgery, and my sling removed four weeks after surgery. I ended up signed off for four weeks, however I am still not back on campus working due to an error in the dictation software I need as I cannot type with both hands still. This has been driving me a little bit insane, because I have had to physically restrict what I do in my everyday life generally I define myself quite a lot by the job I do. Not being up to do this has made me feel a bit of a failure – even though I expected it. This was a bit of a surprise to me.

I think that’s all I’m going to tell you all tonight, I’ve been recording everything with photos – so there will be scars and bruises in the next post, but there’s nothing too gross – it has healed well, but I have a highly limited range of movement and lots of pain. Oh, and forgive spelling errors – blame Dragon Dictate!

Sleepy time now,

Hypermobile (although less so now) Hobbit!!
xx