4:55am April 4, 2013

On the surgery itself and the anesthesia screwups

Damn I am in so much pain and nausea I don’t know if I can even type this but I’m trying to distract myself despite distraction seeming to prove pointless.

So before the procedure I discussed and discussed and discussed the kind of anesthesia I needed, using the words heavy sedation. That’s a medical term. It means basically being asleep but breathing on your own. Sort of. You don’t remember much if anything of the procedure and it feels much like general anesthesia.

I described it in detail. Was told in detail that yes this was what they were providing. Was told the names of some meds that I didn’t really understand. One was Fentanyl the other was I don’t know what. I don’t know what they use in heavy sedation. So I figured they were talking about the same thing we’d just discussed the effects of, in detail. I was told things like, they’ll take the nasogastric tube out while you’re still asleep. So they were telling me to prepare for being asleep.

I’m certain I told them it takes more lidocaine than usual to even close to put a dent in sensations for me a lot of the time. Because I was remembering a drug used in heavy sedation and how they hadn’t listened to me during an endoscopy. And had not numbed up my veins and the drug burned going in. So I told them it takes a lot for it to work if it works at all. A lot. A ton. This is common in people with hypermobility syndrome. It’s why digging PICC lines is often so painful for me.

When I got into the radiology room itself they started talking differently. They said I might go to sleep. Might. But that I definitely wouldn’t remember anything later.

They gave me a whole lot of Fentanyl and some kind of thing they compared to Ativan. As in, they thought they could fool me into thinking that heavy sedation, instead of being a technical term that I noted I was using as technical term several times in the conversation, was just another term for using a whole lot of a light sedative. They used enough until it began impairing my breathing and stopped. Which fine. That works. For what it is. I don’t want to stop breathing. But I wouldn’t have had breathing problems with real heavy sedation which I’ve had before.

Using the word heavy sedation to mean lots of a relatively minor sedative, is like using the word major tranquilizer to mean a high dose of a minor tranquilizer. These are specialized terms with meanings that were clearly understood and ignored.

Anyway then they started telling me that I wasn’t falling asleep but that I wouldn’t remember a thing the next day. I remember it all. All of it. As well as I remember any event.

With the lidocaine. I kept screaming ow, ow, ow, as they did things. They didn’t stop the procedure to give me more until I was numb. I don’t even recall them checking to make sure I was numb. And they knew I was not numb because I was screaming and yelling ow ow ow ow ow and stuff. Which I’m not inclined to do for minor pain. Webmuskie and a friend were sitting outside the door and could hear the whole thing.

I could feel them poking or digging inside me and doing things I didn’t understand but could definitely feel. I felt all of it as far as I know. If there was any numbing at all it was minimal. And I don’t recall the pain getting worse consistent with numbing meds wearing off, so I think I felt most of it.

As this was happening, they just kept encouraging me to keep going. “just one more thing” “just a little more” things like that. And of course “Don’t worry you won’t remember this later it’s okay.”

Apparently my friends were yelling encouragement but I couldn’t hear them. They could hear me though.

So the pain has been pretty much out of control ever since. With brief windows of control only when I take such high doses of pain meds that it affects my breathing. So right now I’m awake typing after a big dose of opiates didn’t even touch the damn pain. Which has spread through my whole body through the wonders of neuropathy. And that’s why I’m typing this in the middle of the night instead of sleeping. I can barely bear to type it and I can barely bear not to type it so I’m typing it. I’m not sure if typing makes it worse or better or neither. I just know this is agony.

And another nurse just told me to start getting up and walking around tomorrow. Which would be interesting if I could walk further than the commode before the surgery. And would be interesting if I could do it without my pain hitting nine, even with other people holding onto me and supporting me. I’m sure my fellow patients don’t like the screaming. I swear that when I had a much more invasive abdominal surgery with proper anesthesia, it didn’t hurt anywhere near this bad. Until of course the pharmacy didnt fill my pain meds for hours and hours and hours and they totally wore off. Out of control pain is so much harder to treat than controlled pain well from the start. This is much more minor surgery than that but it hurts more because of the way things unfolded.

And that’s what I can remember right now – through a haze of really nasty pain that seems to fill the entire room – about how the anesthesia screwups went down.

Oh and ridiculous thing of ridiculous things? I referred to this as surgery recently and a doctor told me it wasn’t surgery. It may not have been done an operating room, but last I heard, punching holes in the digestive tract and threading tubes through them is surgery. If getting a tooth pulled is surgery, this has got to be surgery. It felt like he was just trying to show off that he knew more technical terms than I did. Or maybe there’s another motive. If they refer to this as surgery, then maybe they have to start taking my body’s responses to it as surgery seriously in a way they don’t want to. IDK. I hate this.

Notes: