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Sunday, October 27, 2013


       I know, I has been three weeks!  Many of you know that I am a two-fingered typist.  Now, with my right arm in a sling, I am a one-fingered typist...and the left one at that.  Plus, you should try operating the mouse with your non-dominant hand sometime.
     Having finished with my excuses, I can tell you about the repair to my right rotator cuff.  It was done at Roper-St. Francis in downtown Charleston by Dr. Keith Merrill last Wednesday afternoon.  The surgery took a couple of hours.  As part of the procedure the anesthesiologist installed a drug distribution system to dispense 10 ml per hour of "super-lydocaine" for 50 hours.  There is a sphere the size of a large orange in an external pouch and a very thin length of tubing inserted under the skin to dispense the numbing agent right next to the nerves that need to be numbed after the general anesthesia has worn off.  It works like a champ!  For the distaff side of my readers I'm told it is similar to an epidural. There was NO post-op pain.  Don't worry; there's a "however" coming.
     Thursday afternoon I began to have some shortness of breath.  By lying flat and consciously trying to slow my breathing I could get my respiration rate down from a rapid and shallow 30 to normal rates.  BP, pulse and temp. were all normal.  I called Dr. Merrill and left a message.  When he called back to tell me to go to the ER, I answered the phone from a gurney in the ER to tell him that I was already there.  It was Durelle who said, "Let's not wait for the call-back."  When you say, "...difficulty breathing" in an ER, they move fast.  Within seconds, it seemed, I was on a gurney with my shirt and sling off, and I was plugged in to oxygen and an EKG.  The next procedure was dye-assisted CT scan to make sure that there were no wandering blot clots from the surgery lodged in the lungs.  Two phlebotomists in two arms were unsuccessful while leaving large (6-8 sq in) hemotomas behind.  In their defense, I was dehydrated.  We needed the IV for the dye so the doctor tilted the gurney to lower my head and used a vein in my neck!  On Halloween he'll probably go as Dracula.  At any rate, the lungs were clear.  He then did some tests to measure my lung capacity.  He put a mask on me and had me inhale a medicated mist for a while.  By then I was breathing normally.  He gave me an inhaler and sent me home with instructions  to go to the main ER downtown if it happened again.
     Guess what?  It happened again on Friday.  I just could not get enough air.  I could not speak more than four words without stopping to breathe before continuing.  Cindy, who was off work doing her own post-op recuperation, drove us into the city.  Again, the "can't breathe" gambit got their attention.  Again, out came the oxygen tubing and the EKG and other sensors.  Then in walked Dr. Louis, a personable and perceptive young man.  Within five minutes he had asked a few questions, listened to my lungs and decided that the "super-lydocaine" being dispensed by the "OnQ" device was leaking over to the phrenic nerve that has a major role in lung function.  He was helped by the fact that all the usual causes had been eliminated the afternoon before.  So he turned off the dispenser and left me, still on oxygen, for a couple of hours (I had my Kindle) so that the drug would get out of the system.  He then asked me how I felt, and I said,"Normal".  He sat me up, pressed a stethoscope to my back and exclaimed,"Oh, Wow!"  After living in a world of puzzling, gray area diagnoses, a nice black and white success has to be very satisfying.  For my part it sure was good to get my lungs back.  There was only a couple of hours left on the machine.  He told me that if the pain returned to the shoulder, I could turn the flow back on for a half hour shot.  That would be enough time to sedate the shoulder, but not the lungs.  He was right on.  Saturday, nurse Durelle pulled the tube out of my shoulder and removed some tough tape, and I was finally able to get dressed without the "medicine ball".
     With the sling and keeping the shoulder as still as possible I can now get by with no pain meds.  I even managed a bath today while keeping the dressing dry.  It will get removed tomorrow morning.  It was an exciting few days, but "All's well that ends well."  My hat is off to Dr. Hunter Louis.  Meanwhile my arthritic hip is patiently waiting for the shoulder to be well enough to manage a walker so that it can be replaced.

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