Surgery/Home

Sedation starting 8:00 ish am Monday Dec 9.

Anesthesiologist is adorable and too young.
Uses ultrasound to find the nerves and I'm having fun watching the Vastus Medialis line up against Sartorius.   He uses a purple pen to pinpoint where he will inject a 'caine' kind of neural block at the Saphenous nerve, inner thigh above the knee, and Sciatic nerve through popliteal fossa, lateral thigh,
after I am out.

Dr. Scerpella meets briefly with me to reiterate where he will cut and some options on keeping the bones together.  He is a little disgusted that he cannot make the correction on the work order but has to hand it to a nurse to have it rewritten - they have omitted any reference to the 4th metatarsal, the most shattered bone.

I wake at 2 pm.

Six hours of sedation and surgery.

Nerve blocks inhibit all pain and external sensory sensation.  I can not feel my toes or feel my hands on my calf or toes.  But it's not pleasant.  The sense of tingling and fear that something is happening that I can't feel is ominous.

Surgeon did a tremendous amount of repair. 

Screw at first metatarsal tarsal joint space.

Plates and screws at 2nd and 3rd metatarsals

Screws at fifth metatarsal proximal to joint and through 4th.
Plates and pin in fourth bc so comminuted and did not want to take bone pieces out and remove muscle.

He looked at fracture in anterior calcaneus and opted not to do screw.
Surgeon notes said to get me off the table.  Notes indicate exsanguinated for 60 min, 40 min, and 43 minutes, with 15 minute releases of the tourniquet between bloodletting.

Four incisions. Over 1st, 3rd, and lateral to 5th, and little entrance inferior to the latter.  But I am casted and cannot see them.

They move me to the overnight room in this Outpatient Clinic about 7 pm, after everyone else clears out.  The nurses assure me that security will come through and make sure no one else is in the building and that we are there, and then they will lock down.  If we have any issues, St. Mary's is just across the street.  The MOthership.  It is not comforting to be in lock-down with two young women in a building full of drugs and shiny high-speed drills and I can't get out of bed by myself.  Well I can, but they have sent my crutches home so I need the nurses to help me transfer to a wheelchair to do anything.

Blocks inhibit all pain and external sensory sensation.  I can not feel my toes or feel my hands on my calf or toes.  But it's not pleasant.  The sense of tingling and fear that something is happening that I can't feel is ominous.

There is a welt in the back of my head.  Nurses have no idea what.  Actually I'm not even sure those girls that stay over night in outpatient surgery are even nurses.  I lie there freaking that there is an aneurism under the skin. When I turn my head to the right I feel cool water running down the left side of my nose.  Not.  I have been dizzy since emergency room, 12 days ago.  Chalked it up to dehydration and low blood pressure and not being used to lying around so much.  But now I wonder if something is really wrong.

I think they dropped me in OR.  Left ass hurts.  Think I was on gluteus medius for most of the trip.  (I will find out from the surgeon notes a few days later that indeed they "put a bump under her right hip and buttock").

 Arms hurt like holy hell from the crucifix position all that time. 

Blocks started receding at 4:15 am.
Nurse-girls say to take ibuprofen.  This is dead wrong.  They say it again, say it helps reduce swelling.  Yes that's true but it's highly contraindicated for bone union and healing.  Who are they?

Tyrodol (sp?) pain-med by IV just before IV was taken out at 5:15 am.

Discharged 5:45 am.  

23 hours and 59 minutes 

Confluence of Medicare regulations in and Outpatient Building and insurance parameters.  This was not outpatient surgery.  But they didn't have OR open until next Friday.  

1 degree above zero.  8 inches of snow the weekend before and still dicey driving.

First Percocet at 3:15 on Tuesday, December 10.

Clinic calls about 4 pm to see if I've gotten home alright.

I'm out.