The Day After Surgery

The day after surgery proved to be a memorable one for all the wrong reasons but primarily because instead of fixing my problem I had merely made a trade! That is not what I had in mind when I signed on for surgery and if there is anything redeeming one can take away from my experience it is to do your research on your surgical team as soon as you are contemplating elective surgery. As I previously shared with you dear reader, I knew well the neurosurgeon I had engaged. I did not know the orthopedic surgeon and was unaware that he was responsible for a certain critical part of my procedure. It is important for the consumer to take the time to troll the Internet or to engage a family member or friend to do this for you. One of the best places to look is your state's board of licensure for the health practitioner of your choosing. That might be the board of medicine or the board of chiropractic or even some other board. Regardless, these boards which are maintained by the state, are packed with critical information about your practitioner particularly their malpractice records and this information is free and available to the public.

Now, please don't get me wrong when I say this but keep in mind that we do have a litigious society and doctors are humans too. They did not spend their youth inside classrooms just to make mistakes. And yes, I know that we can be very arrogant at times. It sort of comes with territory you know? I mean really, should I go to work thinking "well, I'm pretty good at what I do." Hell no! You want a person who thinks they are the best and has spent their time making sure that they are, in fact, the best. That said, even the best of us do make mistakes and for that we are sued and these suits appear on our public records. As a practitioner I feel fortunate to have spent my time wisely with my craft and my patient's and I have a ZERO claims record. I confess it is something that I am quite proud of. But, do not disqualify a physician if he has had one or two suits over a decade or two of practice. What you do want to be on the lookout for is PATTERN and REPETITION. Those two together spell disaster and indicate that it is wise for you to move on and for your state board to police and discipline its ranks more thoroughly.

There are also pay sites, blogs, and opinion polls as well as public sites such as Yahoo, Google, and Kudzu where people will leave commentary on their experiences.  Be apprised that negative encounters get 10 times the press that positive encounters do.  That said, all good with zero bad should raise your hackles as if there might be some stuffing of the ballot box.  If, after a thorough search, you have come up empty handed then some of the pay sites such as healthgrades might be useful to you.  I have a tendency to stay away from those sites as I find that they typically offer you what you can get for free.  By all means, check your circle of friends, family and coworkers first.  Occasionally, there will be magazine articles in your area where "top doctors" will be rated.  This is usually a polling of physicians asking who they would go to if they had a specific problem with (fill in problem area).  This can be helpful as long as the quid pro quo is kept to a minimum.  A good search will probably require a day or two but in the absence of direct referral by your circle of known people it will be the next best thing.

In my case, I knew the capabilities and expertise of my neurosurgeon.  I did not know the same for the orthopedist.   I did feel that it was the orthopedic surgeon's responsibility to call in a substitute if he were too ill to continue with my case. I was unconscious at the time so I can not speak definitively about the circumstances at that moment and I did NOT legally pursue the orthopedist for this matter. Many have suggested that I should have and for the record, the pain I have endured surely made me wish I had. At the same time, I would not be the person I am today if not for the experiences I have just had. So there you have it.

My dilemma was just beginning and I questioned my neurosurgeon about the mirror image pain. He assured me that this was only because of the manipulation of the neural tissues at the site of incision and that all would be well within a two week time span. I impatiently waited and medicated. For me, percodan (now Percocet) and Darvon were my physicians first lines of analgesic defense. They proved less than adequate and quite frankly made me severely ill. Morphine was introduced IV for the next three days whilst in hospital confinement. This worked wonders and was by far superior to all other forms of medicaments to date. In the arms of Morpheus I rested comfortably.

Well, that was all well and good until it was found I was retaining urine! Uh-Oh! Out came the Foley Catheter. For those unfamiliar with this particularly odious and Draconian torture instrument, it is a hose about the diameter of a large Bic Pen (actually a bit larger) that is inserted up the penile urethra and into the bladder. This allows urine to pass freely and involuntarily into a collection bag strapped to the side of your hospital bed. The muscles of my bladder were in spasm and in sequence, a cadre of hospital personnel were called to my room to try their hand (and muscle) at ramming this thing up into me. After many unsuccessful attempts by all in attendance, the on-call urologist was awakened. He begged us to use the pediatric diameter pipe which was more akin to a knitting needle. Still, no luck but by this time my patience had worn thin and the urge to pee or go mad was to a raging head. I ordered all personnel out of my room in a very unkindly and rude manner and, against physician orders, I demanded that my wife assist me to the bedside in a standing posture. There upon with a mighty yell I let loose what felt like a stream of searingly hot  razor blades. The vision I have is out of body with me in a three point stance and my wife firmly planting my hips to her gut to keep me from collapsing. My head swam in pain and relief at the same time! MORE MORPHINE!!!!

The morphine, fed intravenously though a pain pump, swept up my veins like a white heat and continued up the back of my neck and to the top of my head in a rapid rush. It crescendoed in minutes to what I can only describe as a warm, full bodied, embrace. It felt like putting on your favorite sweatshirt as soon as it comes out of the dryer after you have shoveled snow during a blizzard and you are still cold and drenched to the skin. The relief brought tears of thanks to my eyes and a gentle rest to my body.

How was I going to bear more of this? What would I do if they  took away the pain pump? How long did I have to lie here like this? Not so fast dear reader. Let me catch my own breath from reliving that nightmarish day. The hospitalization will end soon enough. We will save the rest for the coming entry.

Until I speak to you again; keep the faith, stay strong, and never, never, never, give up!

Dr. Steven M. Green

Victory over Chronic Pain

If any of you out there in the blogosphere are suffering from chronic pain you have my sympathies but more importantly, you will have my encouragement and support. As a chronic pain patient myself I have endeavored to find solutions to my own issues and in so doing have been blessed with a body of knowledge and experience not otherwise available to non-sufferers or those new to the vagaries of chronic pain. Obviously, solutions will vary from patient to patient and the causes of chronic pain are innumerable so some of this will apply to you and other aspects will not. It is your job to pick and choose. Perhaps the best way to start is to begin with my own story.

I am a chiropractor by profession and thoroughly enjoyed the interaction with my patients on a daily basis for over a decade when I was suddenly struck with an injury that resulted in the herniation and fragmentation of a disc in my neck at the C5/6 level. The intensity of the pain and the complexity of the injury manifested itself quickly and within three weeks of the date of the injury I had lost the bulk of the muscles in my shoulder and arm and the bone was readily visible under the skin while my ability to use my left arm had been reduced to zero- also known as flaccid paralysis. Despite the best chiropractic services, this had progressed to a surgical emergency!

Using my contacts in the field I was able to secure the services of an imminently qualified neurosurgeon in whom I placed my full faith and confidence. As a matter of protocol, I was asked to seek a second opinion and was referred to a local orthopedist. He quickly seconded the motion of the neurosurgeon and surgery was scheduled post haste. The state of the art techniques of the day were utilized (1993) and things progressed slowly in the operatory. What was unknown to me at the time was that the local orthopedist who I had seen as a "second opinion" had actually become the "second chair" in the operation. I never would have knowingly approved this particular surgeon but things quickly went from bad to worse when it was revealed that this particular surgeon was suffering from his own chronic pain issue! My surgery was complex and it took three hours until the orthopedist was able to do his part. He was in agony by this time and he was in no condition to operate at that point. Instead of calling a surrogate or substitute, he did in fact operate and instead of using calipers and careful measurements to place a perfectly shaped graft into the neck he instead took a chisel, whacked off a reasonably sized chunk of bone and hammered it home! The results were quickly realized when I awoke from the anesthesia to mirror image pain! What was once left arm pain and dysfunction had now turned into right arm pain! And thus began a saga that was to last me a full 17 years!

During this time I have used traditional and non traditional avenues of health care. I have scoured the United States as well as Thailand, Singapore, India, and Malaysia. I have used supplements, vitamins, physical therapy, lasers, hypnotherapy, counseling, meditation, and yet more surgery. This has been a long and often frustrating process. By blogging I hope to bring to you dear reader some sense of hope and optimism. I hope that I can be a resource for you and a sounding board for your ruminations or frustrations on the subject. Ultimately, I hope to expedite your search for relief. As we go along, I will try and explore each avenue I took and the level of success that I achieved with that particular effort. In the end, I will share with you what keeps me going now and how I feel you can apply these same principles to allow you too to function more fully and enjoy life more completely. Stay tuned for periodic updates and feel free to chime in at any time with comments or questions.

Until we speak again, I remain sincerely yours in the hopes for a pain free existence...

Dr. Steven M. Green, DC