Straightened Out - Part 1

December 16, 2014

I started out the day of surgery expecting to go in pretty late in the day as per usual, as I had a scheduled time of 5:30pm, but the hospital did call me and ask that I get down there ASAP as they had a cancellation and wanted to get me into the OR at 1pm. Unfortunately as far away as we were, it still ended up being about 4pm before I was taken back to surgery. Getting the epidural was a bit of a challenge in itself as well as it seemed there was miscommunication between the pre-anesthesia screening call the day before and when I talked to the CRNA the day of surgery. But once the anesthesiologist and Dr. Z talked things over, they decided that we would go ahead with a spinal and a continuous infusion epidural rather than a general anesthesia. To be honest, that had me a little freaked out and I wasn't really cool with being "awake", but we were already so far behind schedule and it took so much just to get the epidural that I just went with it. I kissed and hugged my husband and MIL and got a good dose of versed before being wheeled into the cold halls of the OR maze. We entered my surgery suite and there was a host of people there with tons of equipment and I saw my surgeon who was waiting for me with a smile in his eyes. I also had two very kind circulating nurses ready to assist me while I was positioned for my epidural and they talked me through it and next thing I know I'm told that I should feel a nice warm and heavy sensation in my legs, which I did. As I was laid back on the OR table, my legs were last felt to be laid straight out in front of me yet when I was watching Dr. Z examine my ROM with his resident he had a pair of legs flinging around in the air doing all sorts of weird movements. Then I realized, they were my legs. Seriously, that is bizarre! A flurry of activity began from then on as my foley catheter was placed and then the sterile drapes were put over me and a clear plastic drape placed above my face. I listened to Dr. Z and the circulator do the "Time Out" where they state the name of the patient, the procedure, the correct side of procedure and antibiotic given, etc. Then it was go time. Suddenly I realized I was staring at Dr. Z through the clear drape and listening to him say "oh we have a loose body, please hand me _____ instrument " and I saw him switching out different scope instruments within my hip joint. Also I recall him having conversations with his staff during the scope. He also spoke to me saying that my hip had a loose body but he got it out and that the hip looked pretty good. Some parts of the femur were "scuffed" but not bad. As I answered him back it dawned on me that I was awake. That's when I looked at the anesthestist and said "I'm not going to be awake for the Osteotomies am I?!" She said no and patted my arm. The scope was over pretty quickly after that and I recall being transferred over to the fracture table and in my drugged up state I grabbed Dr. Zs arm and told him "thank you, you're doing such a good job" (doh!). He just smiled and squeezed my arm back. Then they situated me again with a blue drape over my face and this time it was totally lights out during surgery. All in all it was 3.5 hours of surgery. I was taken back to recovery after Dr. Z woke me up and said everything went really well and I had a beautifully straight leg, and a really healthy looking hip joint. I felt very calm but very shaky. The epidural wasn't set up to the continuous infusion yet so I had quite a lot of burning and searing pain in my thigh where the femoral osteotomy was done and my tibial osteotomy felt like it was that crushing/squeezing pain. It took the recovery nurses almost an hour to figure out how to get the epidural to work before it began to give me relief but they did allow me a PCA while they tried getting the epidural set up. I couldn't stop shaking and my sternum and shoulder blades burned with an icy hot sharpness that no one could figure out either. But my EKG was ok so no one was overly concerned and figured maybe the epidural went a little too high. Once the epidural boluses finally brought relief after two hours in recovery I was moved to my room on the orthopedic floor where I started out with my own room. It was a fairly decent first night except that my left foot just would not respond to any pain meds or interventions that we tried at all. I couldn't feel any pain in my hip or femur though which was great. My main concern was just not having a flare of CRPS in my right foot/ankle and spreading it to my left side and so far we seemed to have avoided that. But as the night progressed, my left foot became more and more worrisome and I was becoming more distraught. My nurse was very distracted and not able to attend to me as much as I needed her too either because the hosiptal had been hit with over 200-300 admissions alone that day/night for the flu and patients were filling every available space the hospital had, including areas of fresh post op spaces. Yep, there were 7 flu patients on my floor just a few doors down from me....but no worries, they were quarantined. So, although my left hip had responded nicely to the epidural, the rest of my lower body pretty much had full feeling. And that was just the beginning to my pain teams adventures.