27 February, 2010

My plan of care anxiety relieved - Joe Theismann and Vampires

I had surgery on my blown knee this past Wednesday. Let me say that I was happy with the progression of my care. Friday, I hurt the knee. I was able to get in and see my primary care physician with-in 40 minutes and have a plan of attack sketched out that afternoon.
I got an appointment with an orthopedic surgeon for Monday and had the surgery scheduled for Wednesday morning.
I'm not sure how other folks insurance companies and health care options work, but I could not believe how well my schedule moved forward.

While I'm super happy with my case progression, I learned how much of a wuss I am. Now post-op, I know that there was not much to worry about from the actual procedure. I had way more anxiety due to my wild imagination than anything else. In general, there are two things that I can't stand seeing on TV - knee injuries and neck injuries. Can't stand them. It's hard not to feel the injury on myself! I have turn away, try to change the channel right away and control the nausea. The knee injuries - I'm not sure why I have that issue, but I remember seeing Joe Theisman's football game where his leg was shattered. It was too much for me. As for the neck - I've always been afraid of vampires. As a kid, I couldn't sleep with my neck exposed to the air. It was too creepy.

Anyhow, wussiness aside - this is what my days looked like from day of injury to immediately post-op.

Friday-Monday - I actually didn't have too much pain. The original injury was more of a shock than painful. The dislocation of my patella was fricking painful, but again, that was the initial injury. The bruising around my knee was disgusting. Otherwise, I was sitting on my couch or my bed with my leg up in the air. I've never had any other knee injury, and don't wish one again, but a severed patella tendon is weird. Your quadricep flexes and pulls on the patellar tendon, which in turn pulls on the shin, which pulls and controls your lower leg. With out that connection, my leg was a ton of dead weight. I could stand straight up with my legs locked, but nothing else. It was awkward.

Monday - Met with the orthopod. Before we even saw him, he was able to see my x-rays and read my history and physical and scheduled my procedure for Wednesday morning. He did a couple tests on my leg and gave a very detailed picture of the surgery. It was during this description that my choice to be a pharmacist and not a nurse or physician was validated. And of course, the detailed description made me want to puke.

Tuesday - Waited around a lot. I had periods of anxiousness just thinkng about the surgery. I'm sure my BP was up there.

Wednesday - Day of surgery. The procedure was scheduled for 10:45. I was due into the outpatient surgery center at 8:30. My prep was promptly started at 9:00. Line placement was the worst. The nurse couldn't get a line placed on the first try. It was line in the hand. Unfortunately the nurse had to describe everything she was doing and I realized that the thought of a piece of metal sliding through my blood vessels was added to my list of anxiety creators. Todd Smith, the orthopod came in and again described exactly what he was going to do. I had to cut him short and explain to him that my anxiety was running high. Checking my blood pressure showed a systolic of 150's and diastolic of 100's. Wow.
A little fentanyl and versed and I was happy and anxiety free.
After that, I don't remember much.
The anesthesia was a combination of a femoral nerve block plus general anesthesia. The nerve block places medication at a specific nerve that would block any sensation at the location of the surgery. It helps keep the amount of narcotics and sedation that is given to the patient and quickens the recovery from anesthesia. It also provides some pain control for about 18 hours post procedure.
I remember slowly waking up in the PACU (post anesthesia care unit). I was transferred to a chair and then sent home.
All in all - one hour prep, one and a half hour surgery and one and a half hours in recovery.

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Attention Deficit Dad with as many interests as days in the year. You can't hold me back and you can only hope to contain me!
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