10:19am June 3, 2013

Dermatillomania and the hospital

I think I can tell how sick I am in the hospital by whether I still pick my ear or not. For some reason I’m always getting hardened bits of skin on my ear that I can pick off, and once that happens it can take months to heal because I’m always picking the skin, even unconsciously.

But it often heals in the hospital. Because when I am sufficiently ill, I don’t pick. And have no urge to pick. I don’t know why. Maybe lack of energy.

But this time, despite being exhausted because they didn’t give me any Mestinon, I wasn’t so exhausted that I couldn’t pick. Which is probably a good thing in the scheme of things even though it isn’t good that I am picking. I was however so exhausted that I found it hard to sit up in bed. Fortunately I wasn’t tube feeding so I could get away with lying down. You can’t lie down while tube feeding or you can aspirate, and with other aspiration problems from reflux it’s just bad for me to lie flat any longer than I have to.

(Why on earth is the operating table in Interventional Radiology flat? In real operating rooms they always sit me up to prevent reflux, but IR refuses to do that. They say they can’t do it, actually, like it isn’t physically possible with their table. Fortunately they can usually drain my stomach before the procedure starts, either with an NG tube or by suctioning my g tube, so it is less of an issue. But still.)

And wow the propofol really messed up my brain this time. Last time I felt just fine instantly. This time I couldn’t even type. Maybe it was the propofol combined with the lack of eating for days. I don’t know. I just know that shortly after I woke up I lost the ability to type for a while. I’d been able to and then suddenly all I could do was picture symbols. Which happens, but it’s more likely with general anesthesia to do things like that to me than with heavy sedation under propofol.

This time I’m not sure if I was totally out or not, but I certainly didn’t feel the procedure. I think the anesthesiologist may not have been quite as skilled, that may have been part of it. I have learned that the best anesthesiologist will never promise you that you won’t feel anything. This one did promise me. The best ones know that even under general anesthesia they can’t totally guarantee you’ll be unconscious, because consciousness is a slippery concept that’s hard to define or control. Some anesthesiologist even end up consulting philosophers to learn more about it. So I’m starting to learn how to tell the great ones from the good ones from the mediocre ones. I think this one was decent but certainly not great.

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