I’ve been out of touch for shoulder replacement surgery - and some weird side effects. At this point, 3rd day, there has been no pain, despite the somewhat fearsome reputation of the surgery. None whatsoever beyond a needle prick that immediately was followed by numbness, unless you count setting up the IV which preceded it, but that was just normal, as far as my many experiences go.…
There was a lot of paperwork to sign, the usual permissions required for many procedures in a non-emergency basis. I got another one to sign, preceded by a fairly detailed explanation. This goes down through the top of the shoulder to be replaced by metal and plastic. It is a nerve block, or rather a 3-nerve block. So far that is fairly standard, though in no way replacing deep anesthesia requiring lots of monitoring including ventilation. They warn you there might be a sore throat after that. I had none, though I do have a memory of first awareness of waking, being moved by four people all telling me I needed to breathe and pronouncing it good when I apparently resumed on my own, but that was several hours later.
The IV port supplied fentanyl before the block started, not that I could tell it even went in. I was distracted by the rest of it. A large screen - to me anyway - ultrasound was on one side of my bed with one nurse managing controls to give the field covered the right depth. It was adjusted 3 times until the doctor anesthesiologist pronounced it perfect. My view was lots of slightly wiggly white lines going across the screen. These were in part my nerves. I felt a pin prick - actually a long needle - and saw it as a brighter white line sliding down the middle of one of them, which was when I decided a different view was in order. I figured I’d seen enough to satisfy curiosity.There were to be three of those (brachial?) nerves to be treated, but since I wasn’t feeling a thing, I had enough of that experience. If I kept watching I might feel it happening? Imagine it, perhaps. Not necessary.
We discussed ahead of time what was being used, and I got the actual name later: liposomal bupivacaine. Think novocaine that works immediately and lasts 4 days, ideally, as a complete nerve block. It’s fairly new, and I had to sign my permission for them to use it. The alternative standard only lasts a bit after the surgery does. No question there for me. The worst of the procedure pain should be over before the block ends. A worst case is the block lasts a lot longer.
The side effect started a few minutes later. I believe asomatognosia about covers it. I tried describing it to my medical team, not having the jargon, and came up with body dysphoria, to mixed reviews.
I had been covered over by one of those delightful Bair Huggers which kept me cozily warm, giving me no view of my body nor need of one. I quickly lost movement in my fingers on that side, totally expected, aside from being able to curl them, no lifting any finger. The rest of my arm had no movement, no lifting the hand. I tried. The thing was, as it slowly dawned on me, that I couldn’t see the movement I actually could make under my covering. The arm was bent at the elbow and had been draped across my chest. I looked for it, feeling with the other hand, and it simply wasn’t there where I knew it was. My chest hadn’t been numbed and it knew exactly where my arm rested, except….
Somebody came into test for how the block was working, and lifted my arm into view… straight out down along my side and just between the mattress and the bed rails, safely tucked where moving my bed down the hall wouldn’t snag it. When they put it back down, my fingers now identified what they had been feeling as the binding on the mattress, while my chest and brain insisted it was “again” draped across my chest!
Every conscious awareness for the rest of that day and into the next insisted that was my arm’s location! It never was. Post surgery, with my bed now raised at the head, I could see it wasn’t there but body and brain continued to disagree. I kept trying to put things into that hand… that wasn’t there! Once I did have a chance to touch the numbed hand with the normal one, it was a useless series of misses and failures to register by the numbed one, none of which dissuaded my brain from trying.
Before I even woke up the entire arm was encased firmly in what the staff referred to as a sling. I call it a contraption, composed of rigid padding, belts and buckles, not allowing any movement whatever.
The fingers stayed curlable. Next day I started being able to uncurl them on purpose, later move my wrist. Third day my hand was back, all the way past the elbow with feeling of itself and motion to the limits of the contraption, still with no pain whatsoever.
I got sent home with a selection of good pain meds and others for when I need them. Maybe tomorrow. No point wasting any.
It’s good to know where my arm is again. For a while it was puzzling, frustrating, annoying, and ultimately hilarious! I’ll trade all of it again for avoiding the notorious pain, at least for a few days. The slow progress back to feeling and motion is encouraging.
Now I get to spend the next six weeks learning how to live with effectively one hand. Putting food from a box into the microwave isn’t hard, but for some reason I need Steve to push the numbers. I must have used the other hand for that, though I’m puzzled why I can’t switch. The wrong arm has to reach for the phone now, from the shoulder that isn’t fixed. It’s an uncomfortable stretch. My laptop won’t sit on my lap these days so it’s over on a table and the chair height is weird. Can you pull your pants on/off without using both hands? In time? This first draft had a typo about every third letter because my fingers operate the keyboard from muscle memory, but now it’s hunt and peck, wincingly wondering what on earth I was trying to say in that spot and why this line got inserted way over there in the middle of that word?
I have lots of help at home when I need it. Some skills are improving - I did think out lots of potential issues ahead of time and work on solutions… with both hands of course. I had no idea of a not-hand, just an immobilized one.
Odd things are happening, no direct relation to the surgery, exactly. My pacemaker clinic called. They can’t prove my battery still has a charge, though it might be a false result. It was a known possibility going in. So I have an appointment to go in for a check, though no opening for two weeks. But if I feel faint meanwhile, call 911 for an ambo to the local hospital with a call out to Boston Scientific for a technician to race me there, relevant phone numbers on the calendar.
I feel fine, all things considering.
The second weird event I think was a scam. “Sara” called, informing me I was behind in keeping up with my medical testing, and it could make a difference in what my insurance would cover.
Are you shitting me? All the medical stuffI’ve been through the last 5 months, everything one needs before this surgery? I tried to interrupt “Sara” to ask this impossibly cheerful voice just exactly what tests “she” thought I needed but the voice wouldn’t slow to answer a question. I got a bit rude, loudly repeating “Whoa!” about a dozen times without a breath, which changed her schpeil long enough to get her to change tack. The voice, which I now decided was likely AI, came back with “I see you have a lot on your plate, would you like me to call back later ?”
How irrelevant can you get? just answer a simple question! Obviously a badly programmed AI. I returned with, “No, I’m all caught up on my medical stuff, GOOD BYE!!!”
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