Shoulder Surgery, and an Unrelated Arm

My recent shoulder surgery brought to my awareness the difference that a small change in perception can make in everyday activities such as “looking at your arm.”

I was all set to go to St. Joseph’s hospital, downtown, at 2 pm to check-in for my 4 pm surgery when I called my doctor to make sure that:
a) he had gotten over his death-rattling flu (at least that’s what it sounded like to me) and that
b) the 10 days straight we had of rain was not going to prevent the staff from begging off for the weekend (this being Friday morning) and forgetting about my surgery.

He answered his cell, still sounding a bit under the weather, but assured me that yes, the surgery was still on, and that I should actually get to the hospital at 12 noon instead, and that I should make sure not to eat anything after a “big breakfast.”

I agreed, while mentally making a note not to get there until 12:30pm, smelling a rat… in any case, getting there that early just was “not on” as there was a small matter of moving a sofa to my living room, a move that had been delayed by the same rains. Our empty living room was about to filled with a nice cream colored sofa, and it was to be done without getting rain, mud or bird droppings on any part of it. Hence, it had to be moved when the sun was shining… and Friday was the first such day.

The sofa was moved up two flights of stairs easily, (dislocated shoulder and all) and my wife and I arrived at the hospital at 1 pm.

At check-in, the polite and helpful person in Admission took us through the paperwork, including the question of what kind of room we wanted, only to find out that there actually were no rooms available. There would be one private room available when someone else checked out, but that was it. She encouraged us to go upstairs anyway. The upstairs nurse would find a place for me, she assured us, although when we overheard her asking the upstairs nurse “where yuh goin’ res’ dem den?” it did give us an opportunity to laugh out loud. She looked quite embarrassed when she woke up and realized that we were sitting right in front of her. A quick apology has us all laughing...

Upstairs, we sat in the waiting area, and promptly fell asleep, in spite of a little anxiety that I feel whenever I walk into a hospital, and recall some terrible happenings seen on some episode of ER – like the one where “the resident screwed up and the guy died,” which seems to happen every week with a different twist.

At around 3:30, just as we were getting antsy, she told us that the room was ready. I jokingly said to her “we should just go straight to the operation and forget about the room!” I was about to be very glad that she didn’t take me on.

As I walked into the room and sat on the bed, I wondered what a room in the US would look like. This one was clean, and had a television and an adjustable bed – which was what I would expect for J$5000 per day (about US$85.) The paint was a little “chippy-chippy” here and there. There was no remote for the television in sight. Toilet paper and towels were not to be found (probably appropriated by prior residents many years ago, never to be replaced.) On the other hand, there were no roaches, and not too many mosquitoes coming through the open doors and windows.

At this point, it was one of the nice, warm Jamaican afternoons that migrants from Jamaica in Toronto and New York dream about. There was a big tree outside with spreading branches, and a neighborhood sound system was just warming up for a night of “boom-boom” music as my grandmother used to say.

By now, I had had my temperature, blood pressure and weight taken. To my untrained eyes, the equipment seemed fairly modern, although I did notice them sharing the equipment between quite a few nurses.

I settled into my room, and awaited the arrival of my parents, who I began to guess were going to arrive before the surgery started – as it was now 4:30. They came just in time for my “gowning” ceremony. I knew to expect that they had some little hospital gown with my name on it, replete with wide open spaces in the back for the butt to stick out of.

Sure enough, the nurse arrived with a nice blue cap and a pink gown with flowers. “Pink?” I said in dismay. “That’s all we have left …” she said in sympathy.

My wife, mother and father had a good laugh when I came out of the bathroom, and took pictures. That was definitely the low point.

One came 5pm, 6pm, 7pm, 8pm … and the official story from the kind but uninformed nurses was that they didn’t know what time it would be, but it would definitely happen that night.

My parents left to have dinner and came back with something for my wife to eat. I, by now was raving with hunger, having had nothing from 9am that morning. I snuck a couple of peanuts into my mouth, savoring the nice roasted, salted taste. I even imagined that they helped a little.

By now, my Jamaican ingenuity had solved the problem of not having a remote for the TV. I remembered that on top of every cable box were buttons, and I was able to find these while standing on a chair and reaching to the box, above the TV and change the channels to something decent (carefully avoiding programs like ER.) Of course, there was nothing good on. And my anxiety was still ebbing and flowing at the thought of all the interesting things that had gone wrong in my television-based memory – “Oh, no … CODE BLUE…. Get the crash cart… CLEAR….. KA-THUMP…. huge body convulsion… beep….. beep…. beep.”

9pm. 10pm. 11pm. At that point I had had enough, and I yanked on my jeans and shoes and walked out in my pink “nightie” to find out what the deal was.

The nurses once again affirmed that it would definitely be tonight, and that the doctor had operated all last night until about 8am that same morning. Wow.

But not to worry, they said, let’s call and find out what time your surgery will be. One of the nurses called down to the operating room and got him on the phone. She asked him a few questions, and then asked him if he’d like to speak with me.

He did, and was quite apologetic at the long wait, but things had gotten moved around when some frozen, human tendons had come in from Miami and two people needed them put in their knees before they went bad.

By now, I was feeling a little bad that I was so impatient, when there were human tendons thawing out before they allowed some poor wretch to walk again after years of confinement to their beds. Who was I to stand in the way of their surgical miracle just because I could not wait through a few reruns and I couldn’t forget all those episodes when Dr. Carter, the erstwhile resident, was chastised for intubating when he should have been doing something else.…?

I slunk back into my room with a sheepish smile for my family and told them about the tendons. I should be going down at 12:00 midnight I said.

After I sent my parents home (they were asleep, drooling on the furniture) I settled into the single hospital bed with my wife. The nurse came in and gave us a suspicious look and asked us if we’d like another bed … like a cot in that room… a SINGLE cot for my wife. I guess the sight of me curled up half-naked beside her prompted that…

Another bed came in, my wife settled into it, and we fell asleep.

At 1:30 the phone rang, no-one was there and an orderly came in to wheel me to the operating room. I gave the wife a last longing look and lay down for the ride, half-asleep.

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We went down the hall past the nurse’s station, and into an elevator. The orderly said nothing. The nurse was watching me carefully (lest I bolt, I’m sure.)

I was rolled into the corridor outside the operating theater, so called because… I have no idea. I could feel my naked butt against the sheet. It’s a good thing I had the presence of mind to…

“Hello Mr. Wade” came a nice warm and female voice, I’m nurse (Smith was it?)” A black, plump middle-aged woman looking like everyone’s grandmother smiled at me and that sure did help the jitters. I couldn’t remember her from ER (thank God I didn’t get Abby, who is a ditz and had that bad affair with those several guys over several seasons.)

The nurse engaged me in some small talk, before another warm, but younger, female voice introduced a cute face behind glasses, surrounded by hospital scrubs. She introduced herself as my anesthesiologist. At this point I knew… it was better to be in a not so modern hospital in Jamaica among friendly, familiar voices and people, than to be on ER. Or in one of those cold American, hospital factories I’ve believed that US hospitals have become.

We did the Jamaican dance – what school did you go to, and do you know so and so. Of course, we had some friends in common, and we chatted on, until she started explaining about how in a minute “I wasn’t going to like her” when she gave me an injection in the neck to deaden my arm and shoulder.

She further went on to explain that they were probably only going to give me a local.

That sounded… interesting… as I knew they were going to drill a small hole in my clavicle. And they were going to use a piece of nylon to connect my shoulder bone to that clavicle. It sounded like a combination of watching a carpenter work, and being at the dentist.

Oh shit.

After getting one injection to get an IV in, I laid for an hour while an entire gallon of saline solution mixed with an antibiotic dripped slowly into my bloodstream. I’m not sure where it all went… I promised myself to drink more water from now on.

Then the cute-ish anesthesiologist injected my neck, directly into something sounding like the Brachial Nerve.

That hurt a bit, and then the tingling she had promised started with a huge twitch in my left arm, akin to a muscle spasm, but not quite. She stuck the needle in and while I couldn’t see what she was doing, I could feel different parts of my arm responding with some strange sensations. She asked me “where did you feel that” at each point and I told her. She said that she needed to make sure that my arm was totally dead before the doctor started the surgery, and that I would need to let her know if I could feel anything.

I promised her.

Remember the story about the guy who had his leg amputated while he was wide awake, and they thought he couldn’t feel anything, but he felt everything, but couldn’t respond because he couldn’t move his body? I think it was on ER… That was the thought I was having.

Anyways, she kept on playing this game, and a growing sensation started creeping down my arm, until my fingers stopped obeying my mental commands to move them. She remarked, in response to my request to make a fist, “Ah ketch him now!”

And then I was left for some time to my own thoughts, while they went around the back, probably to stage right of the theater, to sharpen the drill bits they were going to use, and to prepare the Ajax to clean up the big mess they were obviously about to create… and that nurse Smith would have to clean up just because you children are always making a mess around here, and you needed a good spanking, etc. etc.

I realized that this was all nonsense, of course, and decided to use some of my meditation techniques, honed from 15 or so years of on and off practice (OK, more off than on.) I tried several before realizing that these techniques, developed over thousands of years in the Far East, did not come close to being able to deal with “the time in ER when the guy came in and they operated on the wrong part of his anatomy.”

In the background, I could hear some sounds (which I, of course, strained to hear more clearly.) I could hear a doctor or nurse saying “Mrs. Brown, I need you to move your leg a little to the left.” In response I could hear a grunt… followed by a “Good… now move your other leg six inches to the right.”

For all I know, they could have been doing a manicure (at 4am in the morning.) Or childbirth… or like the time on ER when the insane guy who thought he was pregnant found out that….”Mr. Wade? It’s time for us to go in.”

My heart skipped a beat as we entered … the operating theater.

It looked like a clean, better-lit, ganja-less version of my mechanic’s garage.

I saw one of the doctors/nurses/mechanics swabbing the floor with what I swore was Ajax. Yuk. I looked around for the drill.

They swapped me over to the operating table. Me and my dead arm… that felt like a knapsack.

I looked up into what looked like a dental light.. except that there were twenty bulbs instead of two.

I lay there while they did some “critically important things” like change the music playing in the background and talk about this other guy who they had operated on the week before that I kinda looked like.

I felt like I was too close to one side of the very, very narrow table and I moved over just an inch to get better placed.

I looked around then over to my left… HEY… wasn’t that my arm dangling off the edge of the table? My dead arm?

It was eerie. I recognized the arm as mine, with the same hair and shape I recalled from quite a few baths and laps in the pool. But it was like looking at another person’s arm, not my own.

Well, not wanting to have my arm dangling untidily off the table (who knows what else it might decide to do on its own, especially with that cute-ish anesthesiologist walking around, and having responsibility for a needle in my neck.) I reached over with the good arm and picked up the dead one and laid it carefully down beside me on the table. That was close….

Finally, the doctor came in and started shaving my shoulder. At least, I think that’s what he was doing, as I could only hear some scraping sounds. I don’t think he used any shaving lotion, which probably violates some health code someplace. I thought to myself… I think that’s gonna hurt when I can move this arm of mine again.

Then came a cautionary voice. My anesthesiologist casually mentioned that she thought the blood pressure monitor was mis-calibrated, as the person before me also showed a spike in blood pressure.

Now, the little medicine I know tells me that one’s blood pressure goes up under stress.

I wonder now if my medical team was not starting to think that I was being a wuss.

My evidence of the truth of that thought was the announcement a few minutes later that were going to do the operation after putting me under a general anesthesia, or in technical terms “asleep.”

A few short words later and the next thing I knew I was waking up in my room asking my wife for something eat. I ate some soup. She claims that I ate my mother-made cheese sandwich. I still ask her what happened to it, thinking that she’ll confess to sneaking off with it.

I glimpsed my father at some point, in cycling clothes.

I slept, dozed and babbled from about 6:30 until about 12:00, and demanded to know the whereabouts of that cheese sandwich.

My arm gradually regained it’s feeling, thankfully, starting with the fingertips. I’ve never been so happy to have my arm attached to my body. I’ll never again utter the line “I’d give my left arm for that.” That is, unless it’s for something really cool.

So I was happy to see my hand’s feeling coming back and start to show my wife and mother that I could indeed move my hand again, quite proudly. That is, until the pain started in my shoulder. It was a dull, deep aching pain that would not go away, regardless of how I squirmed and shifted in the bed. I tried adjusting the bed using the electrical controls, lifting up the back and then lowering it, lifting up the feet, and then lowering them.

But nothing made a difference, so I asked my wife to run and get the nurse. She returned with yet another injection, and asked me where I would prefer to get the “jook,” in the thigh or in the butt. I asked her which one would work faster, and she said confirmed that, of course, that would be the butt.

I offered my butt for her immediate consideration – and I vigorously denied my wife’s assertion that it had anything to do with her age and/or physical beauty (I heard her muttering something about “dese young t’ings” and my alleged interest in being the centre of attention.)

Anyways, notwithstanding the trauma of the injection was well worth the pain relief and slightly euphoric effect that came quickly.

Lunch came, I changed from my surgical garb into street clothes and it was finally time to go.

24 hours later, the deed was done and my shoulder injury was corrected (I believe.)

I went home and sat down with my laptop for the next 10 hours or so, getting up only to use the bathroom.

And am I glad I have a left arm.