Medical students make the *best* patients

So I am finally returned from the UK!  (Grammar Nazis beware, the English language does my bidding – here there be monsters of syntax.)

I’ll update y’all on that once I get my nearly 1800 pictures under control.  For now, I’ve got a new story straight from the very belly of the patient experience – my first surgery.

Now wisdom teeth extraction isn’t generally considered a big deal.  I had a hard time getting any good numbers in Canada, but I’m guessing your average, busy oral surgeon sees thousands of cases every year, most uncomplicated and with unremarkable recoveries.  There are some serious possible consequences, of course, such as nicking the inferior alveolar nerve (causing numbness over the lower lip and possibly part of the tongue) or awful reactions to the prescribed drugs or anaesthesia.  All of which I read up on, of course.  But the general understanding is that these are uncommon to rare.

Didn’t make me less nervous, funny enough.

(NOTE:  I don’t like naming doctors I see, whether my feelings towards them are positive or negative, so I’ll just call my surgeon Dr. X and my anesthesiologist Dr. Y.)

The morning of surgery was a bit miserable.  Not only was I stressed out and anxious, I was thirsty and starving since I couldn’t eat after midnight before my noontime surgery.  Plus we were up earlier than I would’ve liked so we could drive up to Calgary.  Just not a happy camper.

I don’t know what I expected (whitewashed walls?  blood on the floor and screaming in the air?), but the office was quite nice.  And the staff even nicer.  Right from the get-go, they walked you through what would happen over the next few hours.  No surprises.  No scrambling.  Everything nice and orderly.  Just the way the neurotic, obsessive-compulsive personality-type med student likes it.

First up was a bit of paperwork and a consult with the surgeon.  And you know, Dr. X has absolutely mastered the art of that first contact with a patient.  Soft voice without being pandering, firm handshake, reassuring smile, and calling me the “guest of honour.”  You can’t help but smile.  Not only that, but he clearly knew enough about me to know that I’d driven all the way from the Hat and hadn’t eaten or drank anything in over 12 hours.  He assured us he’d send us off with ice packs, lots of gauze, and some drugs for the road home, plus they’d rehydrate me during surgery to make up for the lost fluids.  It sounds weird, but it felt astoundingly good to be understood.  Especially without having to ask to be so.  I didn’t need to explain or justify anything – he knew.

We ran through the risks of the procedure; since my roots aren’t even close to fully formed, he quoted about a 1/200 chance of damaging the inferior alveolar nerve, and even then you usually only stay numb a few weeks.  Good to hear the numbers, though 1/200 doesn’t sound too rare to a med student!  Still, my parents have spent a hell of a lot on getting my teeth straight and I’d like to prevent future abscesses, so benefits >>> risks for sure.

Then sorting out the accounting with Bank of Mom.  Always open, tee hee.  (P.S. – If anybody’s ever made a claim through the U of A health coverage, can you walk me through how you did it?  Seems awfully complicated.)

The final wait seemed longer than it probably was – watching mom play Scrabble only keeps your mind off things for so long.  You can’t help but think of the friends who’d had bad reactions to whatever, of the things that could go wrong listed on the consent form you signed minutes before… I’ve noticed that my reaction to that kind of nagging, oppressive stress is to simply ignore.  Ignore those thoughts. Ignore the fear.  Just live one moment to the next, knowing that you’re in excellent hands.  Knowing that everything’s going to be fine.

Or hoping, at least.

Then the nurse came for me.  Also a nice touch, not having to call you up like a witness to the stand, but already knowing your face and where to find you.  She did a marvellous job of keeping me talking and laughing all the way to the prep room.  And – THANK GOD – no gown!  Seriously, there’s nothing less dignified than those stupid things, especially since the surgery was only going to take 20-30 minutes.  I wasn’t terribly pleased about the gurney, though.  Makes you feel like a sick person just being on it.  Next I ditched my shoes, glasses, and wool sweater.  Getting a bit more nervous again.  Dr. Y, the anesthesiologist, ran through the allergy/reaction/procedure spiel again (yay for double and triple checks!), but without the warm fuzzies I got from Dr. X.  This gentleman was there to do his job, not to mollycoddle anyone.  Fair enough.  But the anaesthesia was what I was most worried about, so it would’ve been nice to get some reassurance, or even a hand on my shoulder.

Since the operations usually cater to needle-phobic teenagers, the usual practice is to put you out with nitrous oxide, then maintain general anaesthesia via IV for the rest.  They gave me the option of watching the IV getting set up and inserted, but I was properly spooked by the whole idea of anaesthesia, so I opted for the N2O.  Ease me into my first surgery rather than getting dumped into it.

They coach you on how to breathe in the gas, then put the slightly alarming rubber mask over your nose and mouth.  Big breath in… hold it… then when you’re ready, blow out.  Didn’t feel anything.  I was still hyper alert and waiting for a reaction.  Plus the gas tastes funny.  So again.  Big breath in… hold it… hold it…

Then I felt it.  The background noise became louder than the voices around me.  A strange mechanical buzzing fills my ears.

And that’s it.

My next memory is of the nurses voices in recovery.  I knew who they were and where I was within a few seconds.  Their words became understandable a few seconds after that.  I was fully alert, but wasn’t quite in control of my body.  When I cracked my eyelids open, the room was swimming a bit, so enough of that nonsense.  Just listen to the ladies talk.

Important note to remember:  Even if that patient you put out has their eyes closed, NEVER assume they can’t hear or understand you.  I could.  Perfectly.

As I slowly got better control of my limbs, the nurse popped by to ask whether I’d like to sit up a bit.  I decided that’d be silly.  I was perfectly comfortable and warm under my nice blanket.  Nope.  No moving.

Dr. X came around and told me the surgery went well – all teeth gone, no issues.  I tried to say thank you, but with all the gauze and freezing, it came out more like, “Fang oooh.”  He got the idea.

Much to my chagrin, that lovely nurse came back and told me she was going to raise me up a bit.  No democracy this time.  But I didn’t feel as nasty as I’d thought I might.  So I watched the nurses come and go for a bit, resting my eyes when I didn’t.  Not sure how much time passed, all I knew was that I didn’t feel pain or like throwing up.  Success!

I started to really look around.  There were about half a dozen beds in recovery, not a lot of machines around, just your standard monitors like the one attached to my finger.  Only then did I even notice I had an IV in my left hand.  Didn’t hurt at all!  (Note to self: IVs don’t have to hurt.)

When I finally sat all the way up, I was feeling totally with-it, if a bit full of gauze.  The nurse replaced it and took out the IV with no fuss.  With all my personal effects back on my person, I took a few hesitant seconds to stand.  No vomiting, yeehaw!  In fact, I felt pretty damn good.  I was a bit off-balance, but otherwise totally fine.  This was even better than I’d thought.  The only thing still annoying me was my lower lip and tongue.  Absolutely no feeling.  None.  Worried me a bit, but didn’t surprise me.  It was just humiliating trying to talk.  My brain was constructing perfectly logical, understandable sentences, but my mouth simply refused to cooperate.  “Ah vee fahhh,” I said to my mom.  Thank God we have some sort of telepathic link and she knew I meant “I feel fine.”  She just smiled and stifled a giggle.

I popped a hardcore ibuprofen before hitting the road, which seemed to help.  The 3 icepacks didn’t for long, though.  They each stayed properly cold for maybe 20 minutes.  Not too helpful for a 3-hour trip.  Lucky Brooks is close enough!  Frozen peas are just the best invention.  Just… best.

To sum up the rest of the evening, there was ice cream, jello, applesauce, and lots of calorie catch-up.

So since then, I’ve been taking it easy, taking my drugs at all hours, rinsing with a slightly unpleasant chlorhexidine concoction, and trying not to smile or laugh.  The swelling’s actually been quite minimal, though the pain tends to come in aching waves.

And now I write to you with one hand, the other holding the glorious frozen peas to my face.  Took me a few hours, but it’s finally finished!  The rambling can end.  But thanks for reading if you got this far, and hopefully I’ll have Facebook pictures, a video, and a blog post on the UK by next week!

 – Atalanta

Photo courtesy of: Naito8 | FreeDigitalPhotos.net

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4 Comments

Filed under Medicine, Personal & Blogs

4 responses to “Medical students make the *best* patients

  1. Angela Goudman

    With today’s IV cathlons, it is certainly not necessary for IV’s to hurt. I don’t know if you knew this or not, but the current ones we use don’t have a needle that actually stays in you (unless you use one of the older butterflies). There’s a stylet that punctures the skin, but it comes out of the cathlon and gets covered with a shield. The only thing that stays inside you is a blunt plastic cathlon.

    Just to note, you might have some anesthesia at the operative site for weeks afterward. When I had my gallbladder removed, I had no sensation around the highest incision for several weeks, if not months, afterward. Eventually, though, the nerves do start working again. The important thing for now is to take it easy – remember, you will get a stress response, the same as with any stress/trauma to the body!

  2. Thanks for the advice, as always. 🙂 And I certainly wouldn’t mind having little-to-no feeling at the op site, but I don’t think I’ll be that lucky, lol. The swelling has really bloomed nicely since I wrote this!

  3. That nursing student you know

    I suppose that nurse was okay. I usually ask first (especially with things like sitting up!) and heavily hint that eventually it’s not going to be a question, then just get it done later, if it was no at first. The nurse could’ve explained why you needed to sit up, though, really… That’s kinda rude.

    • To be honest, I didn’t really mind. I was slightly out-of-it and I know they want you up and moving as soon as you can. Trying to explain that to a half-unconscious patient might not have worked out so well, lol.

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