My doctor's moving fast - should I be worried?

Life Health & Fitness
#1

Last Friday, the doctor (who is working on my broken thumb) told me:

  • 4 more weeks and we can start taking out the pins
  • 1 pin at a time, 1~2 weeks between
  • OK, we will put you to sleep for the procedure {I hate being awake for operations}
  • You don’t have to stay overnight, but OK, you may {Staying overnight lets us get insurance}

Last night (Wed, only 5 days later) he told me:

  • We can take out 2 pins this Saturday … {8 days instead of 28? WTF}
  • 10 or so days later, we can take out the other two {I thought it was supposed to be 1-by-1?}
  • No sleeping… it only takes 5 minutes and is painless {somehow I think taking metal pins outta your hand WILL hurt}
  • You can not stay overnight {Grrr… I want my insurance}

… now, I’ve heard of, and can understand, doctors EXTENDING recovery time… but shortening it… and so dramatically? He has gotten me to go to his clinic instead of the hospital, which is fine by me - none of those long waiting lines… He’s done physiotherapy stuff totally unrelated to my thumb {stretching my neck?, electro-shock on my spine?, electro-shock on my forearm?}

on the otherhand, his stitching job on the cut seems brilliant and looks like it won’t be very visible…

… so… should I be worried? should I consider changing doctors? or do I “think too much”?

#2

I imagine he’s going to give you a local anesthetic. I wouldn’t worry too much. It is in his favor to make the process longer…more visits, more money.

When in doubt, ask. It’s always fun to watch Dr.s squirm. :slight_smile:

Good luck and sorry to hear about your thumb!

#3

that’s what worries me… local just wears off real fast for me… hence asking to be put to sleep…

#4

that’s what worries me… local just wears off real fast for me… hence asking to be put to sleep…[/quote]

maybe miltownkid can join you and choke you out right before the pliers come out. :smiling_imp:

#5

that’s what worries me… local just wears off real fast for me… hence asking to be put to sleep…[/quote]

I’m no expert, but I would never voluntarily take on the risk of a general anesthetic unnecessarily, especially in a private clinic of a doctor who may not have an expert anesthesiologist around, and especially when the doctor is not recommending it in the first place.

#6

that’s what worries me… local just wears off real fast for me… hence asking to be put to sleep…[/quote]

I’m no expert, but I would never voluntarily take on the risk of a general anesthetic unnecessarily, especially in a private clinic of a doctor who may not have an expert anesthesiologist around, and especially when the doctor is not recommending it in the first place.[/quote]
Wise advice. General anaesthesia is NOT considered by medicos to be a simple procedure and there can be a very real risk of complications.
If you’re that worried (and I’d be the same, believe me), just ask him to give you some extra shots and maybe put up a sheet between you and your hand so you can’t see what’s going on.

#7

When the Dr’s freak me out here… or I’m not sure about their plan… I give my Dr. at home a quick call or an email… that might make you feel better if you’re worried.

#8

hey x08, try to avoid any general anaesthetic as much as possible, especially in a non-hospital situation like a clinic. it is not at all unheard of for generals to kill people, which locals almost never do. the pain relief thing should not be an issue with either anaesthetic: a general will not stop the pain that you feel after it wears off, just like a local anaesthetic.

suggest a pain medication like tramadol, or valium and a low strength opiate like propoxyphene as a minimum. do not settle for paracetamol (tylenol) alone, but doctors in hospital are reluctant to let patients away from the place while still under pain mediction any stronger than that, so you may have to insist on it. doctors used to be afraid to routinely prescribe opiate medication for pain on the grounds that you’d become addicted, but that’s now regarded as quite unwarranted, and the deal now is to relieve pain as much as possible, as the absence of pain can make the healing process faster. don’t take aspirin, ibuprofen, or similar drugs while you still have stitches in place, or healing surgical wounds.

did the doc examine your hand in between making these reassessments, or does he just want you to fit inot his schedule better? i mean, 1 week for the first pins to come out is not unusual for some kinds of pn position, and can allow better regrowth and strength in the bone later, but i can’t really comment as i have not looked at your break myself. they don’t have to come out one at a time, either. all at once is quite common too.

that’s my two cents worth of semi-professional advice. hope you find it useful…

#9

I believe the policy for reimbursing hospitals for stays has changed recently, maybe that’s the reason for his change of thinking.

#10

They can give you a local anesthetic and also some drugs that don’t konk you out but put you in a dissasociative state (where you don’t feel or care much about the gory details) for a short duration. They did that to me when I had surgery on my leg and I had an interesting time discussing the procedure with the doctor. And I AM squeamish about things involving SURGERY and BLOOD and stuff like that.

#11

I don’t have a doctor back home~

he has the same nurse who put me under when I was in the hospital…

jd> u mean miltown will pop-lock me into submission before a blow to the back of the head with a Wii controller? :stuck_out_tongue:

#12

[quote=“x08”]I don’t have a doctor back home~

he has the same nurse who put me under when I was in the hospital…

jd> u mean miltown will pop-lock me into submission before a blow to the back of the head with a Wii controller? :P[/quote]
This sets off alarm bells for me. A “nurse?” Or a proper anaesthesiologist? You should ABSOLUTELY NOT be allowing a mere “nurse” to be giving you general. Anaesthesiology is a highly skilled specialist occupation. There is NO FUCKING WAY a nurse should be doing this!

#13

for some more background information, now that we’re getting all technical, see

http://expertpages.com/news/mortality_anesthesia.htm

[quote]
Relative Risk of Anesthesia Compared to Air Travel

Clearly, we cannot point to a record of no anesthesia related death in the last decade. Even a death rate of 1 in 1 million anesthetics would be far better than we can boast. The death risk is sometimes calculated as the deaths attributable to accidents in 100 million hours of exposure. Assuming a death risk of 1 in 10 million for commercial aviation and assuming an average of 2 hours per domestic flight, the death risk would be about 5 per 100 million hours of exposure. If we assume a preventable anesthetic mortality of 1 in 100,000 and assuming the average anesthetic to last about 2 hours, the anesthesia death risk would be 500 per 100 million hours of exposure. Feel free to play with the data. If you think the average anesthetic lasts longer or shorter, or if you believe anesthetic mortality to be higher or lower than these data used here just plug them into the formula. You won’t be able to get away from the fact that anesthesia is far less safe than flying as a passenger with one of the big commercial airline companies.[/quote]
from http://www.apsf.org/resource_center/newsletter/1995/fall/gravenstein.html

while there are nurses who do post grad qualifications for anaestheisa, and there is even an ‘american association of nurse anesthesiologists’, i would still be reluctant to allow one to perform same for me if there was a better option, such as not having a general. specialist anaesthetists (anesthesiologists in the states) have a better mortality record: there are about 7 excess deaths per 1000 cases with complications among US nurse anaesthetists.
see ‘Mortality Rates Are Lower after Surgery when an Anesthesiologist Directs Anesthesia Care’
http://www.sciencedaily.com/releases/2000/06/000626115320.htm

all said, though, the death rate from general anaesthetics has plummeted from about 1 per 10,000 to less than 1 per 100,000 or better, depending on where you are, since the 1980s saw the introduction of better monitors and rescue drugs like dantrolene sodium. australia still tops the world in anaesthesia success, with about 1 death per 200,000 atttributale to the anaesthesia process alone.

see AANA J. 2002 Jun;70(3):193-202.
A synthesis of the Australian Patient Safety Foundation Anesthesia Incident Monitoring Study, the American Society of Anesthesiologists Closed Claims Project, and the American Association of Nurse Anesthetists Closed Claims Study.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12078467&dopt=Abstract

#14

Well I dunno what she is… I just call her a nurse because she assisted the doctor by knocking me out~

As for my break… it’s the thumb’s metacarpal (sp? closest to the hand), right at the end where it meets the other hand bones… it broke into 4 pieces…

#15

Anyway, this is all besides the point. Your a biker, for fuck’s sake. What’s wrong with a couple of good big swallows of rum and pulling the pins out with your teeth?

#16

They do have drugs that just knock you silly for a bit without being all-out anesthesia. They administer them for stuff like endoscopies that may cause a bit of discomfort.