The steroid injection seems to have worked reasonably well so far, and Ive been able to sit at my desk for long enough periods to actually do some writing including this overlong post.. Also, the procedure happened far enough back for me to make fun of it, and so here goes. Although the following chronicle is based on true events, I have been know to exaggerate (lie?). Lying is good practice for me. I write fiction even when Im writing non-fiction. Despite how this account might sound, Im not opposed to assembly-line medical procedures. I understand the need for some efficiency in a process that basically doesnt require a doctor to exercise bed-side manner and also optimize his patient load. Background: two+ months of sciatica. Stayed mobile. Found sitting for any length of time set me back. Couldnt put on my right sock. Finally sought rehab because my own exercises werent working (Okay, so I didnt really hurt badly enough to exercise true diligence). Two weeks of my first experience with a chiropractor and he brings in a pain specialist. The specialist interviews me and wants to know whether I want to tutor his child in 5th grad math.I expected a simple steroid in the butt. I decline the offer to tutor. Ive spent forty years teaching college mathematics, and the only thing I know about the 5th grade math curriculum is that it is not calculus. He seemed disappointed. I told him Im a writer now. I no longer attempt to distribute mathematics to a classroom full of antagonistic students. Instead I write without worrying what curriculum nonsense the state legislature will impose. As, I left the examination room, the physician says in a voice so low that I barely hear, Youll have to go to the outpatient surgery for the procedure. What? I say. Procedure? The receptionist will schedule you for next week. He disappears down the hall. Confused, I ask the girl at the computer, What procedure? Youll have to ask the doctor. She says. She hands me a blue sheet of instructions. You may be able to refuse the anesthesia at the outpatient clinic. How about Tuesday at 12:00? Anesthesia? I can always cancel, and so I agree and go home to look up possible procedures on the internet. One is an epidural. I dont want an epidural. Spinal fluid can start leaking from the puncture, and then they have to try a blood patch to seal it. I really need to keep my spinal fluid inside my spine. I see the chiropractor two days later. Is your hip tender? he asks. Did you get a cortisone shot?. No. Im scheduled for a procedure. I dont know what the procedure is, but I suspect an epidural. I expected a shot in the hip. Ive had a lot worse sciatica than this without any treatment except exercise. An epidural seems like overkill to me. Do you know what he plans? Yeah, an epidural seems like too much to me too. I expected a shot in the hip just to kill the inflammation hot spots. Ill call his office and find out. Do your exercises. When I see you Monday, Ill know what the procedure is. Depending on how youre doing we can always cancel. I do my exercises. They hurt. I feel pretty good after the exercises, but everything quickly tightens up. By Monday, Im improved, but now I suspect that the pain specialist has made a good diagnosis. The chiropractor confirms that the pain specialist believes that he has to get to the root of the problem, and that is in the spine. So we dont cancel the epidural date. The instructions tell me not to eat or drink on the day of the procedure. I stop eating and drinking at 10:00PM the previous night. The instructions are vague about arrival time: either Im supposed to be there a half hour before, an hour before, or an hour and a half before my appointment. Layne drives me because the instructions say I must have a driver. We arrive at 11:00 AM. I expect that I have to be there early for paperwork--although I filled out a lot of paperwork in the doctors office--and for procedure prep. The waiting room is packed. The receptionist at the outpatient procedure unit gives me paperwork. She takes my insurance card and ID. Filling the forms takes five minutes. I return the paperwork and get back my cards. I am number 39. The receptionist tells me that the doctor will not arrive until 1:00PM. Its not 11:15AM yet. Well, I guess, that they will call me in at my appointment time of 12:00 PM so that they have plenty of time for prep before the doctor arrives. Thats okay. Before I can sit, they call number 38. Good, Im thinking. Despite the crowded waiting room, these folks are moving along. Anticipating a quick call, I dont pick up a magazine. Then they call number 20. Opps! Maybe I need something to read after all. For the next two hours they call people in, but not me. At 1:30PM I ask the receptionist if the doctor has arrived yet? They seem unsure. Finally someone in the office indicates they saw him go into the procedure room. I get my call after 2:30 PM. I havent had anything to eat or drink since 11:00 PM the previous night. I have a growing fear of the side-effect of that fast. I go into the assembly line prep area. The first nurse to greet me asks who I am and what I am here for. Good. She asks if I have a driver. Good. I thank her because one of the dangers of being in an assembly line is that I might get another persons procedure. I know who I am at that point, so that poses little problem. If I had not gone online and asked the chiropractor to check, I would not have known what procedure I was scheduled to have. How long would it have taken for the doctor to explain that he thought I should have a steroid epidural at L3 and 4 in order to take out the inflammation at the root? Not as long as me explaining why I dont tutor fifth grade mathematics. I thank the nurse for questioning me to be sure I got properly queued. She gives me a patient bracelet and a procedure gown. I suit up and they put me on a bed/cart. The next nurse comes in and asks me questions that include my name and procedure and a lot of other stuff that Ive already filled out for the doctor. She asks if I have a driver. I thank her for verifying my proper place in the queue again and remark that it would be nice if patient data were in a large shared database so that it didnt have to be re- entered so often. Yes, she said. Thank you for that. Under allergies, I explain that I once has a reaction to anesthesia, but the hospital records were handwritten so that no one knows what the drug was. Since that time, Ive had a procedure using happy juice and that seemed to cause no problem. She confirms that happy juice is their sedative of choice. For some reason this makes me happy. The next nurse comes in the start an IV. Heres what Ive dreaded. I usually pack in a lot of water before I have blood drawn otherwise only experts can find my veins. Sure enough, when the nurse sticks the back of my hand, my veins take evasive action, and she moves the needle around thrusting and jabbing like a musketeer. When she stabs a vein it ruptures and she starts again. It hurts a lot. She withdraws and apologizes and tries again, entreating me to relax. I try to relax, but it really hurts. She gives up and calls another nurse who takes my other hand. She also fails and apologizes. She promises to go get their expert sticker, but that nurse is assisting in the procedure room. Eventually, the other nurse comes running out, ignores the back of my hand and looks at my forearm. Lots of possibilities here, she says. I hardly feel the stick and my IV is in. She leaves the second nurse to tape things in place and hurries back to the procedure room. I hope she can get some rest before I get there. A nurse wheels me from the prep area to the assembly line hall. She ask me the same questions about who I am and what procedure I should be getting. Do I have a driver? I thank her for her efforts. She give me a walki-talki to call a nurse in case I need to get up. A doctor comes out of the procedure room. I dont recognize him when he passes. I look again. Its my doctor. Hes shaved his head. Why did he shave his head? Did he lose a bet, or is he so depressed he could no longer comb his hair? Its getting late in the day. He looks tired. How fresh can he be? Mistakes are more likely when youre tired. A few minutes later they wheel out a woman who is obviously still enjoying her happy juice. Then, the anesthesiologist comes out to my cart. He asks me the standard questions again. I explain my anesthesia reaction. He assures me they only use happy juice for this procedure, but do I have a driver? I thank him and he wheels me into the procedure room. I check my watch to begin a game I like to play: how much of what happens before the procedure will I be able to remember? Its about 3:00PM. The nurse who did my IV is in the room. She asks who I am and the procedure again. Do I have a driver? I thank her for checking. She opens an intercom to the doctor, and they discuss who I am and why Im there. The anesthesiologist gets me ready, all the time explaining the process to me. The nurse joins him. Why did the doctor shave his head? I ask. She shrugs. No one seems to know. I am not reassured. The doctor comes in. Says hi to me and asks who referred me. I remind him, and he indicates that he remembers who I am. Okay so far. The anesthesiologist says, Im giving you some happy juice. You may feel a cold or burning in your vein. You might taste something bitter. I feel the cold, but I cant remember the rest. I wake up to the command of wake up. Im in the recovery area. Its after 3:30. Another nurse comes through asking me how I feel. She asks if my driver is in the waiting area. All the nurses have been very nice, and took great care to make sure I was the correct person in the correct position of the assembly line. The waiting time was unpleasant but I suppose thats part of the overhead for assembly line medicine. I dont really blame the nurses for the failed first attempts at IVs because I know how my veins are. The anesthesiologist passes by and asks if I had a nice sleep. I did. He asks if I have allergies. I have allergies and sinus drainage. Did I cough a lot? Yes. I also take lisinopril. Its worse depending on my angle of inclination. Ah, sinus and lisinopril. That will do it. They usher in my love, wife and driver--yes they are all the same person,Layne otherwise we would not all fit into the car. They tell her to bring the car around while I finish dressing. The site of the injection hurts. For the next two days, it is more painful than my sciatica. They give me a form with the phone number in case I need a follow-up injection. I pledge diligence for my rehab in the hopes that Ill not need another. When we leave in the car, its 3:50PM. Now I know why such operations are called day-surgeries. Its not just that you dont stay overnight, it also measures the length of time you are there.
Posted on: Sat, 27 Sep 2014 18:21:50 +0000
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