One afternoon, while packaging beads for sale in your gallery, your left thumb starts to hurt, especially when you’re opening the tiny zippered bags that hang on the pegboard. Like everything else, you ignore it until it becomes so painful that you are unable to do the things you need to do. During your reluctant visit to the rheumatologist, he examines your thumb, palpates the joint, which makes a sort of crunching sound, and looks up at you in disbelief. “It’s bone on bone! How did you not feel that?” So you have a high pain threshold. Honestly, until recently, you never felt any pain, so how would you know?
There are several treatments for gimpy, arthritic thumbs. You’re already past the least invasive possibility of effective physical therapy, but he can inject it with cortisone, splint it and see if that helps. If it doesn’t, then you will probably need to consider thumb joint arthroplasty. You didn’t even know a thumb joint could be replaced! You opt for the injection and thumb spica (splint), which you wear 24/7 and for a short while, the pain subsides. Four months later, you’re back for another injection and then another four months after that. Your only options now are to learn to live with the pain and loss of function, or have the joint replaced. You already know there’s no living with it, so he refers you to a hand surgeon in the same clinic.
When you first meet your surgeon, he seems a bit arrogant, but after working with doctors daily for so many years, you almost expect that. He really is an excellent surgeon, and anyway, bedside manner is overrated. You know some really nice warm, fuzzy kind of docs who are delightful people, but only average doctors. You’ve had enough experience with bad surgery to know that skill is critical, personality is just icing on the cake. He sends you for x-rays and when you come back, he points out what you already know. Your thumb joint is shot. He explains thumb joint arthroplasty and what to expect from surgery.
In a nutshell, he will harvest tissue from the tendon on the under side of your left forearm, about two and a half inches up from your wrist, to make a pad that he inserts into the space where your cartilage has worn away. You’ll wear a plaster splint for a week, then you’ll come back for a full fiberglass cast from knuckles to just below elbow. After three weeks in the cast, you’ll return to have the cast removed and be fitted for a brace that you must wear for another month or two after you return to work.
The surgeon performs your surgery in the clinic’s outpatient ambulatory center. On the big day, your older son accompanies you and plans to stay until you go home afterward. He hates anything connected with illness or hospitals, but you’re his mom and he knows you are counting on him. Your 90-minute surgery is uneventful. In your private recovery room, you are fully alert in just a short time, since you’ve had only a nerve block in the left arm and light anesthesia, no heavy-duty drugs. To keep any pain at bay, a nurse brings you a pain pill, Darvocet. You’ve never taken it before, but you’ve already researched it and you’re not worried about it, because it’s a completely different drug with a completely different chemical structure from the opiates that killed you 15 years ago. As instructed by the surgeon, you’ve already filled your post-surgery prescription.
During recovery, you and your son are chatting when you begin to experience a familiar sensation. Very quickly, your heartbeat slows and you feel no need to breathe. Drifting off to cool, peaceful repose as everything becomes dark around the edges, you hear him call to you, “Mom. Mom. Wake up!” Too late for that; you’re already on your way out. The last time you looked at the monitor, your heart rate was in the low 30s. He goes to find a nurse. You can hear him in the hallway telling her that you are “overly dramatic sometimes” (talk about projecting), but maybe something is wrong. The nurse comes in. “Honey, you need to go out in the hall and wait.” She hurries from the room, her white shoes squeaking on the tile. You hear the eery beeeeeeeeeeep as the monitor’s peaks and troughs resolve into a flat line. The crash cart arrives soon after.
The next thing you remember, you come to as some guy in turquoise scrubs beats on your chest, a knot of doctors, nurses and techs looking on. They barrage you with questions. “No, I have never taken Darvocet before. Yes, this has happened to me once before when I took codeine after my hysterectomy 15 years ago. Yes, I feel fine now.” Your vitals seem stable and everyone finally leaves. Your son, scared sh*tless, watches you like a hawk. His anxiety level is through the roof. You chat with him as though nothing has happened, but soon, you feel drowsy again, the monitor beeps more slowly and you are on your way out once more. He yells at you to wake up. Before the slow beep…beep…beep of the monitor becomes one long beeeeep, he has gone for the nurse. Another rush of activity brings the crash cart and a roomful of panicky people. You come to with the same guy in turquoise beating on your chest. Later, when you think to look, your chest is one huge, purple bruise.
You feel fine now, although your chest hurts. This time, leaving nothing to chance, the surgeon calls for an ambulance to take you to the hospital, where you spend the night in the cardiac unit, wide awake and just wanting to go home. The nerve block has long since worn off, but the pain is relieved with a couple of Tylenol tablets. In the morning, your surgeon stops to check on you, shaking his head in disbelief over the whole episode. Yours is the first emergency of any kind at their surgery center; you are an anomaly. He confers briefly with the hospital cardiologist, who will discharge you as soon as you fill out the papers agreeing to pay for your visit. Of course.
Finally home, you send your son off to work, make coffee with your good hand and get comfy in your favorite overstuffed chair with your feet up. Sitting with your hand pointing up, as though to ask a question, keeps the swelling down and you feel no pain. Dozing in and out, it occurs to you that had you not taken that pill at the surgery center, you’d probably be dead for real. You’d have come home, insisted that you were fine on your own, as you did today, and sent your son to work. You’d have taken a pain pill, and because the reaction happens so quickly, there would have been no time to dial 911….
You do lead a charmed life.
(to be continued)