Altitude Sickness
June 29, 2017

Surgical cocktails and other endangerments

By Brady Crain

I have spent the last 11 days recovering from a L3-4 Fforaminotomy, which is an operation involving the grinding away of bone in the nerve opening (foramina) that has been causing my sciatica for 30 years or so.

The day of the operation I got up at 3 a.m. and skied my 231st day. I was there for sunrise, which was beautiful, and the skiing was fine. Then I went to Alice Peck Day Hospital in Lebanon, N.H., which I never knew even existed. I arrived at 6:15 a.m., and was in the pre/post-op area by 6:40 a.m.

The nurses, P.A.’s, and associated personnel were excellent.  The phrenology nurse listened to my advice about IV placement (while exceptionally vascular, I have a lot of valves, which can be uncomfortable with an IV). And the anesthesiologist was easily the best I have encountered in terms of bed side manner, and since my last experience with anesthesia was respiratory arrest while I was awake, I would say that since I remember nothing I was at least spared the memory of overdosing if it happened.

The surgery was quick; the pre/post-op had coffee, and my mother had chocolate, and so I was up and about immediately upon waking up. I had a very complex medical conversation with my surgeon, and we discussed future strategies for spine management into my golden years.  Incredibly, I was nearly totally pain free. But this is, of course, was because I was as high as a kite. Before you go crazy, I had all of the conversations with the doctors, P.A.’s, nurses, and anesthesiologist about my status as a recovered prescription narcotics addict, and so we made the rather gutsy choice to only prescribe ibuprofen and acetaminophen in staggered 6-hour doses for pain management.

But, as it turns out, the surgical cocktail of Propofol and Verced turns out to be incredibly potent and long-acting. When my mother dropped me off at home at 12:30 p.m., I felt fine. I even went for a four-mile walk in the 90 degree heat. It felt great. I was still high.

When I finally came down, I realized that I was not a super-guy who could walk for miles with a stab wound in his back. For those of you who follow these articles, you will remember that I had not ingested an opiate or Valium derivative in 23 years. When I came down, I cried like a baby.

The only way to describe the feeling of those drugs leaving my system is the following scenario: Imagine you met the love of your life. You spent a bunch of time with that person, planning to spend the rest of your life with them, and then imagine that they die. They don’t need to have died horribly, but this person died in a way that was final, and that you were certain they were dead, and for 23 years you moved on and lived your life, slowly filling the hole they left. Then imagine that 23 years later, that treasured person came back, wrapped you in their embrace for a few hours, and then disappeared again.

That is what it was like coming down from a surgery high. Nothing in my life has ever felt lonelier than that afternoon. And I have had some lonely times in my life … like, North Dakota lonely.

So, I did what I was trained to do in countless meetings. I picked up the phone. Not one of my contacts was home, so I called the AA hotline, trying to find a ride to a meeting in Rutland. No dice. So I took my recently cut and ground spine, and got on a bumpy bus downtown and made a meeting. Some amazing things happened at that meeting, but as they say, what I saw there, what I said there, will stay there. I have been going to a lot of meetings since. It took about a week to stop feeling endangered.

As for the pain, for the first two days there literally was none. Zero. I took no anti-inflammatories, I walked four to five miles a day (walking is the recommended PT for this surgery). I thought I was getting away scot-free. But, again, no dice.

Day Three I woke up feeling as though I had been kicked by a mule, and started does of acetaminophen and ibuprofen immediately. My walking continued but by Day Four, the tissue pain was excruciating. Day Five, wasn’t so bad for tissue pain, but I started getting wandering nerve pain in my hip, lower back, and leg, and wandering numbness throughout the left leg and groin.

I called the surgeons office, they maintained that this was normal interaction between swelling tissue and recently awakened nerves. It is speculated that I might have had portions of my leg and groin that were numb for decades.

By day 10, my mileage had dropped from a high of 10-11 (in two stints) to between six and seven miles with an increasing return of previous left hip nerve pain symptoms, and so I started a course of prednisone to try to knock down internal inflammation surrounding the nerve.  As I write this, I am on day two of that course, and feeling pretty good… until I sat in a hard chair for an hour to write this article.

Even with the nerve pain increase from immediately post surgery, I am in much better shape than I was. Before surgery, I was getting symptoms inside the first mile. Now I don’t get them until at least mile three and I am still healing. It is time for my walk.

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