To know one life has breathed easier because you have lived. That is to have succeeded. - RW Emerson

Sunday, April 29, 2012

Surgery, Smurgery

My surgery is done, and I am alive!

On Friday afternoon, I arrived at the hospital at 11 am and by 12:45 I was in the block room with a lovely anesthetist who did the popiteal block (a nerve block that is done behind the knee to freeze both the sural and peroneal nerves, thus numbing everything below the knee) on my leg before the surgery. She was incredibly nice, actually talked to me like a human being and reassured me that I will get into a medical school in Canada because (and these are her words) I am reasonably smart, I will probably do reasonably well on the MCATs, I can talk to people and I have a good story. Its always nice to get a reassuring pep talk from a doctor. After she did the block on my leg, she let me see the ultrasound of where tibial nerve divides into the the sural and peroneal nerves...which was pretty amazing! I love learning things when I go into the hospital, its like getting a sticker after a shot when you are a kid. This anesthetists even called me this morning to see how I was doing (unfortunately it was at 7 am and my phone was off) and left a message with her phone number to call her if I have any questions or concerns. Who does that? She is awesome! Is there a new doctor that I want to be like? Yup, I think so!

Anyway, after the block I was wheeled to the OR, where a resident anesthetists took over. I asked him which kind of intubation he was going to use, and he showed me the two different kinds and explained why he was going to use the tracheal one. It was cool, to finally be able to ask questions and have them answered like I was an intelligent adult, and not just a silly patient.

I threw up a bit after the anesthetic when I woke up in recovery, but it was all settled with some Maxeran.

After that I dressed myself (which according the the nurse was quite impressive) and was out of there by 5:30! The surgeon recommend (or agreed to my suggestion) that we start driving home right after the surgery in order to milk the nerve block for all its worth. So we made it to Kamloops and stayed overnight there. I expected to wake up at 1 am in severe pain from the block wearing off, but I didn't. In fact, when I woke up at 5:30 am I still couldn't feel my foot or move it in anyway...such an odd feeling trying to wiggle your toes but nothing happens. Seeing as it was still numb, we hit the road and I didn't start to have any pain until 2.5hrs from home! That anesthetist did a darn good block! It wore off completely sometime last night, so now I'm in pain.

The doctor gave me Oxycodone (whoohoo) but I am slightly allergic to it, so I have to take benadryll which makes me even more sleepy. Oxycodone doesn't work so well for nerve pain, but it does make it so I don't care that I'm in pain...

The surgeon said that both the proximal end of the nerve (the one that was implanted in my muscle) and the distal end (the end near my foot that is only an axon not attached to a cell body) both had sprouts growing off it. So he removed those from the proximal end, crushed the nerve and put it into a 5mm drill hole in my fibula. The distal end is another story. Not only did it have sprouts growing off of it, but it also had grown an entirely new branch...this is pretty much impossible according to what we know about neurophysiology. The distal end was not attached to anything (the proximal end is still fully intact with a cell body somewhere in my spinal cord), so the distal end would not be receiving any nutrition or regulation from the cell body, yet it still managed to grow an entirely new branch. I apparently have an unbelievable ability to regenerate nerves (which is unfortunate in my case), so lets hope I can translate that biological ability into the ability to do so in a lab!

Alright, time to go back into an oxycodone stupor. Sorry for all the spelling mistakes...its not me, its the drugs.

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