Wednesday, June 8, 2011

Day 2 - Reflections (LONG!)

It's Wednesday evening and I'm home and I can't believe how good I feel.  I'm not in any pain from my nose.  My pain is mainly referred pain which is yet to be dealt with and with the headaches related to the sinus component of the op.

Now that I'm totally lucid I have been able to reflect on everything that happened yesterday.  I need to write it down if I even need a GA again. I was so confused yesterday.  Everything seemed to go wrong from the minute we arrived at the hospital.

Anyway here is the whole story so either close this post or get comfy!

We arrived at the hospital just a few minutes later than we were told (got there around 6:50am) but reception was full and the receptionist was lovely and said she needed to rush us through.

Over an hour later we were still sitting in reception and were one of the last to be called in.  Riiiiight!

I was shown into a 2 bed room.  No private rooms left but one might become available later.

The anaesthetist showed up and was not the same guy my surgeon carefully chose for me based on my situation.  I could have cried!  Firstly he said he had never done ENT surgeries under a local and he's done many of them.  It's totally possible.  My surgeon gave me a handout saying it's possible!

Anyway besides this the anaesthetist was very nice and patient and asked me exactly which parts worried me.  He did agree not to use the mask with gas and knock me out only thru the IV since I have a fear of things being held over my face.

I also think he grossly underestimated my ability to cope with pain and surgical instruments.  I wish I remebered to tell him my egg pick up for IVF was done with NO anaesthetic!  I had just one injection of fentanyl but I asked for that for my very sore wrist. Anyway...

Eventually the nurse went through the questionnaire with me and she was so sweet and lovely too. She even let me keep my own undies on and not use those awful gigantic mesh granny pants ones.

I think nerves got the better of me combined with dehydration from not drinking for hours and I was possesively clutching my vommy bag when at about 9:30am I was eventually collected by a rather dishy theatre nurse.  I wasn't thrilled to have to walk to theatre in my shaky state but by that stage I was practically incoherent with terror.

I sat in a chair in the pre-theatre area and my surgeon turned up.  Finally a familiar face!  He was very nice about me being scared and then I saw he was clutching one of those small bottles with a long nozzle and that meant only one thing.  SPRAY ON local anaesthetic.  The same stuff I had when  got the camera up my nose treatment.

This stuff is so awful...bitter and vile and when I;m already trying not to vomit it was the last straw.  He must have put in about 20 sprays in each side!  he sat with me and I asked him about the ear pain I had been having.  he examined my jaw and said it needs fixing asap and said he'd refer me to someone.

I was gutted.  I've had a problem with the left side of my jaw all my life but never mentioned it to a doc because I don't want anyone operating on my facial bones.

Then he put in what felt like another 20 sprays in each nostril and trotted off to scrub up and the anaesthetic nurse when over all the checks.  I suspected she was Russian and I found out later she was.

She explained the local would make me feel like I was unable to swallow even tho I would be able to and I could already see what she meant.  I didn;t like it.

We went into theatre and I hopped up on the bed.  She started asking me about my last name and said she went to school with a girl with the same name and I explained it was my husbands and I'm actually first generation Ukrainian etc.

The anaesthetist turned up and started helping himself to my LEFT hand.  I advised against it due to the amount of surgical scarring and he said he saw a decent vein and it was easier for him if it wasn't painful for me.  I agreed and pointed out which areas to avoid if he didn't want to hit metal.

He asked who my surgeon was and said he went to med school with him and he knew he'd be a surgeon because of his meticulous knowledge of anatomy which point he tries to flex my wrist to bring the vein to the surface. Of course nothing happened because it's FUSED.  Seriously, Dude...which part of fused don't you understand???  I can see why he chose anaesthetics over surgery!!

So I'm having 2 conversations between him and his nurse which was hard to maintain at once but in retrospect I think they were trying to distract me but they were all very nice.

He reminded everyone in the room not to use the mask and I was very grateful.  he said I'd wake up with a soft tube in my mouth which I could pull out myself.  This wasn't part of the deal!!!!

Anyways he shoots up my IV at about 10am and I started feeling woozy and I was out.

I can't say the next thing I remember was waking up because it wasn't.  I was having some sort of dream then woke up.  Someone grabbed the tube out of my mouth and it wasn't uncomfortable.

The first thing I demanded to know (after checking they didn't give me any blood) was how long I was out for.  They said the op lasted about 35 mins but this was not what I was asking.  I felt like I'd been out for a couple of hours.  It was exactly like when I sleep...I'm not conscious but I have a sensation of time passing.  My sister and the anaesthetist both promised me I wouldn't have concept of time.

Eventually I asked what time it was and they said around 11:45am!  There was a whole hour unaccounted for and this is exactly what bothers me about being unconscious.  I need to be able to account for every minute.  Basically I was in recovery for over an hour before i came to.  Is that normal???

After a about 30 seconds I notice my nose is pain free but my head...I have the most excruciating headache I've ever had and could barely tell them about it because my upper mouth and back of throat were so numb.  I'm not sure if this is from the spray or whether I got more local when I was out.

They quickly gave me some fentanyl in my IV and from previous experience it starts working in less than a minute and increases its effect quickly.  i felt nothing.  they gave me more.  Still nothing.  I felt panicky.  My head was going to explode and they said I needed to wait before I could have more.

I felt fluid in my lungs and started to cough.  My oxygen mask filled with blood and the patients on the other side of the room looked somewhat concerned.  They pulled off the mask and suctioned my mouth and gave me a tissue.  I kept trying to cough up the blood because it was uncomfortable.

My surgeon quickly appears and they're all telling me not to cough because it's making the bleeding from my nose worse.  At this point I couldn't care less.  I felt fluid in my lungs and wanted it gone so I kept hacking it up into tissues.

They kept trying to force an icypole onto me.  I didn't want it but apparently it helps slow the bleeding so I lost the battle.  I stuck the lemonade flavoured icypole in my mouth and pulled it out again.  My mouth was too numb to suck properly and the icypole was covered in blood.  Do they seriously expect me to put it back in after that?  Apparently so!

Eventually it softens a little and I manage to suck it but I couldn't swallow. It just flowed out of my mouth, got spat into the ever growing pile of blood stained tissues.

After a while I managed to swallow something and finished the icypole and after every bite kept asking whether someone could call Andrew.  The dishy theatre nurse must have gone out and checked cos he came back and told me Andrew was waiting in the room and was told I was awake.

Meanwhile head still on the verge of exploding.  I noticed the recovery room was totally empty and they ask me if I feel ready to go back to the ward!  NO WAY!  They give me the last of my fentanyl and start muttering about pethidine but I explained early on i didn;t like it.

I couldn't remember whether they gave it to me or not  I asked for ice packs on my head and they said they wouldn't help!  I think I know what will help and what wont!

I can't describe how strange I felt.  My body felt heavy and slow and woozy but my mind seemed fully awake.  I wasn;t very coherent but I didn't feel sleepy at all which everyone said I would.

They brought me back to the ward and my lovely nurse was there and I explained about the pain and she fetched some panadeine forte.  It kind of took the edge off the pain but didn't last long.  I asked for ice packs and she fetched me one no questions asked and what do you made me feel better!

My headache was still pretty bad and I could tell it was on the verge of a migraine so I was stressing out.  If the pain isn't controlled fast, it would be impossible to control once it was a full on migraine.

she offered pethidine and I declined and I'm not sure how or when it happened but she must have called up the anaesthetist to get a phone order for endone.  Finally a drug I was sure would work and in combination with the panadeine and ice it did.  The headache didn't leave completely but it was so much better.

My nose still wasn;t sore but was bleeding a lot and the bolster underneath needed frequent changing.

My sister turned up with Maxie and I was so glad to see them.  I had got up and gone to the toilet and started to feel more human.  Strangely, the massive cocktails of painkillers didn't make me at all sleepy.

A few hours later, Andrew took Max and my sister home.

I wanted more endone since it seemed to be the only thing helping.  I was starting to feel immense pressure in my ears and my jaw and temples.  My eardrums felt like bursting ans swallowing was becoming very painful.

One nurse said it was just a one-off order since it wasn't on my chart. I started getting stressed again.

I had a cup of tea and it helped a little so my nurse suggested heat packs on my temples which I thought was a good idea and she left to get them she came back with endone instead!

She didn;t want to give me heat since I was still bleeding quite a lot and turned out the endone order was written up somewhere else.

My surgeon turned up to check on my and discharge my roomate at around 6pm.  He said he'd be back in the morning and I'd go home then.

I actually felt OK with that since my pain was finally under was all but gone!  I still didn;t want to eat but I felt well enough to have a shower. My wonderful nurse had gone home and another one came on duty.  She wanted me to avoid my head and neck area in the shower!

I told her I wanted to wash my hair, clean my face, brush teeth etc and she agreed provided the water was not too hot.

The shower was wonderful!  The hot water felt amazing on my sore still shoulders, temples, head, jaw etc...and the bleeding didn;t really increase much as a result.

I put on my own pyjamas and felt like a totally new person.  The problem was I was totally not sleepy and I had no idea how I'd manage to sleep anyway!

Eventually around 1:30am I tried to sleep and lasted about 30 mins  I woke just before my 2am obs.  It seems that lying down makes the fluid pour out faster from my nose.  By this time it wasn't pure blood coming out but more like bloody discharge of varying degrees of intensity and I rarely coughed up any blood.

I watched TV for a few more hours since I didn;t feel sleepy and at about 4am I fell asleep again waking in time for my 6am obs.

My room was around the corner from Hudson;s Coffee on the hospital ground floor and finally I could stomach the thought of coffee which I hadn't had in 2 days!

On the knock of 7am I bravely left my room in my pyjamas and bulky nose nappy and ordered the biggest macchiato they had.

I was more embarrassed sporting the huge nose nappy in the hospital reception than the fact I waltzed in in my pyjamas. Bumped into Dishy Theatre Nurse on the way back to my room.  he remembered me and asked how I was feeling.  Nice!!

The coffee finally returned the last of my humanity!  I was lucid!

Then I found out the doc wasn't coming because he was on his way somewhere else and discharged me by phone.  I was stressed because I needed to ask him about lots of stuff and the silly nurse I had in the morning was telling me something different to everybody else and none of it made any sense!

I took matters into my own hands and phoned the doctors main rooms.  They said he was consulting today near my house!  He is there once a week usually and they said they'd email the rooms and let them know I was turning up.  How lovely!  I felt so much better.

They gave me all my discharge meds (no endone tho) and what I suspected was a grossly inadequate supply of nose nappies.

DH picked me up and we drove to see the doc who answered all my questions and gave me the name of an oral specialist who not only deals with jaws but could help with other problems I have.  Doc said I could always get a script for endone later if I really needed it but honestly I felt so good I was pretty sure I wouldn't.

My nose was really not painful unless I touched it and the pain meds I've been taking are mainly for pain I have swallowing.  Very strange!  I never expected the post-op pain to be from all these other sources!

I tried to sleep when we got home since I got about 2-3 hours sleep on each of the two preceeding nights.  Sleep isn't fun because the nose leakage increases and my mouth is dryer than usual when I wake up.

I did feel better after a sleep and a shower...and besides the leak in my nose I really felt fantastic!  Very strange!

As for the general anaesthetic...while some aspects weren't as bad as I thought the rest were...and I still feel kind of tricked into having it because I couldn't discuss the alternatives with the anaesthetist I was originally going to have.

Given the op was so quick I think I could easily have coped with staying awake and I could have dealt with the headache as soon as it came on rather than waking up with it.

The fact is that I'm not bothered by tugging and hammering sensations and the sound effects of orthopaedic surgery are about as bad as you can get so if I can cope with that, then just about everything else is a piece of cake.

As for keeping still?  I kept motionless during my IVF egg pickup.  I felt everything and still didn't jump around on the table.

I know this sounds very strange to most of you but it's just how I am.  It's how I cope with these things.

Day 3 Thursday 9 June

I slept 5 hours in a row and got up to help Andrew get Max off to school but felt shaky with a very sore, dry throat.  Painkillers and bed after they left!

Woke up again 5 hours later feeling much the same.  One nostril is drying up a little and mu nose is starting to hurt a bit more to the touch but still still mild.

Throat is very sore especially on the left side where I've had more problems and more work done and where it's still bleeding.  I'm running out of these nose bolsters and chemists don't have them.

I tracked down a distributor and they're really expensive!  I think I'm going to have to put my sewing skills to good use and come up with a solution.

Taping gauze to my face is the most obvious but given how often I need to change these things I'll have no skin left!

My left hand is sore where the IV was.  Not the insertion point but where the plastic tube went and it's too close to the top of my fake joint for comfort.

It's strange but I feel worse today than I did yesterday.  Is that possible?

1 comment:

  1. you poor thing! so much went wrong i can't believe it!!!! you have a great attitude to be able to laugh at most of it though
    hope that soon you are feeling on the improve again