Propofol is where it’s at, ladies and gents. Throw in a side of Versed, and it’s the best day you’ll have all week.
As we have repeatedly established here, I hate general anesthesia. Hate it. I always get massive nausea, no matter what precautions are taken (e.g. Scopalamine patch applied the day before surgery) or the medicines that are thrown at it after surgery (e.g. Zofran, Phenergan, and Reglan). I also have a hard time waking up and significant memory loss. The first knee scope I had resulted in three days that I do not remember. During that time, I ended up in a town two hours away and had no memory of how I got there. I also agreed to and signed up for a triathlon after that one. So, those directions they give you about not signing legal papers for at least 24 hours after surgery? Yeah, it’s important to follow them.
Back to the point of this post. My surgeon knows that I can’t handle the idea of general anesthesia, so he agreed to work with me this time. Since we were planning a pretty simple (comparatively) hardware removal and arthroscopy, he decided to do a nerve block instead of anesthesia. To be specific, he decided on an adductor canal block. This one uses ultrasound guidance to inject anesthetic around the saphenous nerve about mid-thigh.
Turns out, surgeons can be trumped. Even though I’d talked with my doc about how we weren’t going to do anything other than a block, my anesthesiologist disagreed. He had already looked at my previous records (points to him for that) and knew that we weren’t doing general anesthesia, but he wanted to use Propofol and Versed. I said straight up no to the Versed because I hate the idea that it’s meant to induce memory loss. I argued until he (literally) threw his hands in the air and said in an exasperated tone, “It’s like you’re asking a carpenter to build a house with only a hammer!” I finally gave in just to get the show on the road. Also because the surgical nurse was standing outside the door, tapping her foot while waiting to take me to the OR.
I walked back to the OR and was helped onto the table. I was awake for more of the prep than I’ve ever been. I was awake for the block, and it was not a big deal. Didn’t really hurt, but I was also distracted by the nurses getting me ready. My arms were placed out to the sides and strapped down. A large something or other was place over my chest and arms, and it blew warm air to keep me from getting chilled from the cool OR temperature. A nasal cannula was placed for extra oxygen. My surgeon placed the tourniquet. Someone (I think his PA) put a soft block under my left foot. And then I was out. Actually, I suspect I wasn’t out, but the Versed kept me from remembering anything past that point.
I woke up in the recovery room, and I felt the best I’ve ever felt after surgery. The clock was right at the foot of my bed, so I could see that I woke up right at 7:30 (that’s pm; it was a long day). By 7:35, I was asking my nurse how long I had to stay there. Her response was “one hour.” By 7:45, I was asking if I HAD to stay for the WHOLE hour or if that was just a guideline. By 7:50, after I declared myself ready to go, the nurse gave an exaggerated sigh and said, “We’ll take your vitals at 8, and then we’ll see.”
My surgeon randomly walked through the recovery room and stopped to check in (I think he was the only one still doing surgeries that late). I told him I felt great and was ready to leave. He said that everything went well. He took out the screws, cleaned up some cartilage on the patella, looked at some of the other cracked cartilage and removed a large mound of fibrous scar tissue on the lateral side.
So far, with this surgery, I’ve felt much better than even after the last scope (and worlds better than the big surgery). The worst part was the 12 hours I spent with my head in a bowl after taking two doses of the narcotic pain reliever. I was told to take the pain medicine as soon as I got home so that I had it in my system before the block wore off. I shouldn’t have listened.
Below are the two screws that were placed to hold my tibial tubercle in its new position about 16 months ago and have now been (obviously) removed. I told the nurse I didn’t want to see them, but they ended up going home with me anyway because she said everyone wants to see their hardware. I guess it’s cool to see how big they are–look, they’re bigger than the cat in the background.
p.s. The title of this post is in reference to MJ. When told that I was going to get Propofol, I was informed that no one has had a bad reaction to it. “You know, it’s the stuff that Michael Jackson took.” To which I replied, “Um, is that not what you’d call a bad reaction?”