Only You Know Your Body

As I recover from yet another surgery (my 14th, unless I'm forgetting one), I had another reinforcing lesson that I felt was important to share with all of you.  Doctors are fantastic, amazing people.  My father is one, and I have an incredible amount of respect for and trust in him and his peers. That said, they aren't perfect, and they don't know everything. The human body is incredibly complex, and each one of us is truly unique, so things may work differently or impact us differently. The moral of this story - you need to be an active part of your care and the choices made around your care. When you feel something is heading in the wrong direction, you need to voice your concern. When you raise a concern and feel you aren't being heard, don't hesitate to walk away.

I'm now past the 24 hour mark after my second knee-surgery (another arthroscopy, but this was just a cleanup vs a repair done 5 years ago on a different ligament). So far, the post-op experience is truly night and day from last time in a good way. Last time started with me being incredibly nauseous in recovery, and then more so on the ride home thanks to the nurses insisting that I needed to pop a Percocet.

That knee surgery was the first in a series of surgeries, and the beginning of me being more active in my pain management choices thanks to the learning I was doing about my body with all the experience I was getting as a patient. That first knee surgery was followed two years later by back surgery (minor - a microdiscectomy at L5/S1 to resolve major sciatica in my left leg that left me numb from the calf down, and feeling like my leg was being cut open from the calf up). The surgery went fine, but I was very nauseous afterward, both in recovery and at home. While I was smart enough to refuse the Percocet or Vicodin they offered me in recovery, they gave me an anti-nausea drug (anti-emetics, as the class is called). This was in addition to the one they typically give during general anesthesia. Not fun puking when your back was just operated on.

Two years after that (this past summer), I had my double hernia surgery. It was a different experience. This was by far the biggest surgery I have had. My others were done via microsurgery with scopes and small incisions and tools. This was a full, open procedure, and lasted 3 hours.  My abs were being cut, and a prosthetic mesh was being sewn in to reinforce my muscles once the tears were stitched up. Granted, going in, I was in the best shape I've ever been in, but the real benefit came from my knowledge of what I do well with - and what I don't. I was lucky to have a very good bedside-mannered anesthesiologist who really listened to me. I told her I get nauseous from anti-emetics and from many pain meds. While people around her were skeptical ("No, you don't understand, they keep you from feeling sick," was the chorus around me), she believed me.  I told her specifically about my recovery-room experience after my back surgery where the only variable was the anti-emetic the nurse put in my IV.  Within about 15 minutes, I was throwing up.  So, she believed me.  She removed them from her plan.  I woke up from the surgery with a clear head (ok, after about 10-15 minutes of grogginess), and was smiling and lucid quickly, and ready to go home faster than expected.  My recovery, while painful due to my abs being cut, was really far easier than expected.  At my two week post-op check up, my doctor felt I was about four weeks ahead of schedule for my recovery. I credit starting on the right foot as much as I do with my level of fitness going in.

Unfortunately, my left knee became a problem almost as soon as I got back into running.  By September, it was clear I'd need my knee scoped again, so the running stopped.  I tried to avoid surgery by taking it easy for a while, but the inevitable happened on December 21st (yes, I know, I scheduled it for the end of the world). While being prepped, I was visited by the anesthesiologist. He was nice at first, but his ego came out really fast. I told him that I did not want any anti-emetics as they made me sick. He sort of blew me off, and said, "Well, you need to be more specific. I use X, and it works really well, so we'll do that." I repeated myself, and said I've had a lot of surgery and know well what to do for the best outcome. I don't want any. He pushed back again, but only after rolling his eyes and looking annoyed.

I'd much rather he have a moment of being annoyed than me feel sick for a day while also dealing with surgical pain. That's what this is about - the ego bruising you may be afraid to do to a doctor is nothing compared to what you might go through if they don't listen to you. Do you owe them anything? Does your puking somehow boost their self-worth? No, of course not. Egotism and pompousness aren't good qualities, so they don't deserve to be repaid with your suffering. If you know better, do better (as Oprah says).

So I really pushed the anesthesiologist about what not to give me. Despite all his eye rolling, laughing at my comments and push back, I prevailed. He cut me off, threw his arms in the air, and said, "Fine! Fine!  I'll just X it all out, ok?" To him, it was about his expertise being challenged. To me, it was about quality of life. Which do you think is the nobler cause?

Let me put a little disclaimer on this post. This doctor was actually very good, and did a great job once we were on the same page. He didn't let my push back get in the way of his professionalism in the OR or the quality of care he gave. This post is not an attack on him at all, but the interchange we had serves as a great foundation for this blog post - one I've been thinking about for a while.

The funny thing is, as scientists, doctors should be curious and observe reactions to learn. Instead, some of them are too engrained in their knowledge and feel too high and mighty to hear the views of a common idiot like myself. Heaven forbid he learn something that makes him an even better doctor. Funny, it's the same issue we saw with the world being flat and when it was thought to be the center of the universe. Only idiots thought otherwise. Eventually, common belief was disproven, and only idiots thought otherwise. That's the thing with knowledge - it's always evolving and growing. Wouldn't it be better to evolve and grow with it?  Of course! Some people just care to be more engrained and stubborn in their egotism.

So, who was right? Well, I woke up feeling great. I went home within an hour of waking up. I've felt great since. Clear mind, very manageable pain. Heck, I'm not even using crutches. Now, I'm not saying I would be doing poorly if I was throwing up yesterday, but it certainly wouldn't have helped. It wouldn't have kept my mind clear and positive, and that is directly related to how well I recover. You need to start on the right foot if you want to get to the best outcome, and that only comes with the right choices along the way. I made sure the right choices were made for me.

Only you know your body. Don't let someone else's ego force you into a place you know you shouldn't be.  Doctors are amazing, but amazing isn't the same as omniscient or infallible.

No one else can enlighten.your.body.