Lone Star Posted August 28, 2010 Posted August 28, 2010 For those of y'all that know me, y'all know that I was wiped out on my motorcycle last November as I was on my way to a study group for my EMT-I finals. I spoke to the orthopedist that has been treating me since they found out that my right wrist was broken in 3 places (transecting fracture to the radial styloid, oblique fracture to the distal radius and and avulsed fracture to the ulna), and after steroid injections to the wrist didn't provide the intended results for the intended time, they're now talking about possibly doing arthroscopy on the wrist. I understand the concept of what they're proposing to do... a small incision and the insertion of a small camera and light to 'look around'. The concern I'm having is this: The last time I went in for a 'day procedure'...I ended up in ICU for 3 days with respiratory failure because when they removed the LMA they used, I ended up aspirating because the airway wasn't protected. I REALLY don't want to go through that again! Has anyone gone through this procedure? What can I expect (besides having another 'owie' to heal?
Richard B the EMT Posted August 28, 2010 Posted August 28, 2010 I had the LASER surgery for correcting a torn left knee meniscus, and it was a "local" anesthetic, numbed me totally below the ribcage. Although I was in a daze, I was awake throughout the procedure. Ask the surgeon, or preferably the anesthetist, of the possibility for a local versus a "general", or if the local is advised for the specifics of your case .
scubanurse Posted August 28, 2010 Posted August 28, 2010 You can talk to your surgeon and anesthesiologist about your concerns....having been through 7 orthopedic surgeries in under 5 years, I understand where you're coming from. You can also request to be awake during the surgery if it's going to be under an hour they'll sometimes do this...they do a scalene block to numb the nerves in the arm and keep you twilight sedated during the arthroscopy. I've never just had an arthroscopy though so not entirely sure. You can also request an ETT be used instead of an LMA due to your past history of airway complications. Good luck
emtannie Posted August 29, 2010 Posted August 29, 2010 I agree with the others who have posted so far - talk to your doc, the surgeon, and the anesthesiologist so they are aware of your concerns. I don't see why they wouldn't be able to do the surgery without putting you under a general anesthetic. I had 2 knee arthroscopies, and was awake through both. I was given a mild sedative, and an epidural (and probably other things too... it has been over 20 years since I had those surgeries). Especially given your hx, they should be looking at the alternatives to a general anesthetic anyways. When I requested to be awake, it was more of a curiousity issue for me - I wanted to see what they were doing, and watch the TV screen when they put the little camera in my knee... but then, I have always been the morbid curiousity child (I was the 8 year old who convinced the doc to save my tonsils in a jar for me so I could see them - and he did!). Maybe you could go with that route "I am a medic student, and want to see what happens during the procedure - it would be a good learning experience for me." Some docs like the chance to show off their skills, and to teach others, so maybe you could use that to your advantage too... Let us know how things go - and thoughts and prayers to you with your surgery.
mobey Posted August 29, 2010 Posted August 29, 2010 I have seen one done when I was on my OR rotation. They used a nerveblock procedure by placing a tourniquet on the upper arm, then injecting the arm full of lido and the pt was mildly sedated with benzo's, but used thier own airway. Might be something to discuss.
Lone Star Posted August 29, 2010 Author Posted August 29, 2010 Great advice y'all! I have an appointment with the 'hand doc' tomorrow afternoon, (curiously enough, only two blocks or so from where I got whacked). I'll be asking all sorts of questions and I will address my concerns before I agree to anything! IF general sedation will be used, I will have a nice long talk with the anesthesiologist before anything is done there too! I don't mean to be a 'pain' for them, but I do NOT want a 'repeat' of the ulnar nerve relocation incident! Annie-droid, I too have that 'morbid curiosity'...I wonder if they'll do some 'still images' from the procedure for me? I'd like to see what's going on inside my own body. It's probably a good thing that the torso doesn't have an 'access cover', because I'd probably be 'peeking' at my 'innards' every once in a while!! Hopefully I can remember what he says so that I can update y'all afterward. LS
Lone Star Posted September 2, 2010 Author Posted September 2, 2010 Well, after meeting with the new Doc today, it looks like the arthroscopy is out. Now they're talking about fusing at least two of the bones in the wrist. Also, I got to look at the xrays they took today, and it was pointed out that theres the formation of at least one cyst (indicating 'arthritic changes'). Then the doc decided to pump the wrist full of steroids again, (just had that done on the 27th of july). The anesthetic has worn off, and it's been aching for several hours now. Notified the lawyer about it, and he's not happy about this turn of events either.....
Richard B the EMT Posted September 2, 2010 Posted September 2, 2010 The human body DOES have an access cover: Skin. Good luck, Brother!
scubanurse Posted September 2, 2010 Posted September 2, 2010 Fusions aren't the end of the world... know a few people who have had it done, and I might be getting my left one completely fused... Good luck to you, and remember if you aren't confident in the doc, find another one.
Lone Star Posted September 3, 2010 Author Posted September 3, 2010 Fusions aren't the end of the world... know a few people who have had it done, and I might be getting my left one completely fused... Good luck to you, and remember if you aren't confident in the doc, find another one. Right now, it's not a matter of not feeling confident in the Doc. My biggest concern is how will bone fusion in the wrist affect my ability to perform the duties required by EMS? I know how 'limiting' it is not being able to bend your wrist, (I was in a cast during some EMT-I clinicals). If that's what is going to happen, then I may just have been spinning my wheels constructing an EMS based education. I'm not giving up yet... but that is the major 'concern' in the back of my mind.....
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