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Drug-induced escape

The anesthetist parted the curtain and came into the enclosure.

“It’s time for us to get you to the operating room and into surgery,” she said. “Are you all right?”

A couple of nurses in masks stood next to him. Everything seemed to be in motion.

“Do you think you could leave me here for another five minutes?” I said. “Actually, you could leave me here for the rest of my life.”

The anesthetist chuckled and the nurses along with her. They understood. I suspect they had heard it all before.

I was lying in the hospital bed, in gown, and completely absent the world around me. The nurse had tapped a vein and started a saline drip. Shortly after, she hung a bag of antibiotic. During this process, emotions had come to the surface and I cried.

“Is everything all right?” the nurse has asked.

“It’s just so infrequent in this life that you give everything over to the control of other people,” I said. “That’s a load of vulnerability I’m having issues with right now.”

“Let me ask the doctor if we can give you something for that,”

I took heart in that. Having been sober for over three decades, I’ve only ever given myself over to drug effects at surgeries—one on the knee in 1992, one for a foot issue in 2009, and two for carpel-tunnel in 2010. Frankly, I liked those moments when the drugs took over, however brief. When the nurse said she’s ask the doctor for a shot of something, my heart didn’t leap, but a smile spread over my face.

The anesthetist came in a gave me a shot of Versed, a benzodiazepine used to reduce anxiety before surgeries and for conscious sedation in instances when full-under anesthesia is not needed. This produced a deep sense of ease and confidence. I was floating.

Then, she took out another syringe and injected fentanyl into the IV port. That produced the best, finest, greatest feeling I think I’ve ever had in my life.

Thus, when I told them they could leave me on that gurney for the rest of my life in that state, I meant it. Of course, they laughed. They understood.

I don’t remember much of the rest of Friday and not much of Saturday or Sunday either. I made the mistake of taking a Tylenol 3 Friday after the surgery and before bed. I like codeine a lot and I liked that Tylenol 3 as much as I’ve like anything. But it made sleep restless and itchy and put me in fog for most of the day on Saturday.

So, here we are on Wednesday, five days since the surgery. I haven’t taken another codeine/acetaminophen pill since that one on Friday. I haven’t needed much of anything since the surgery. Call it a high tolerance for pain. Of, better, call it bad judgement of one’s own tolerance for pain.

My shoulder is swollen and bruised. It would be hard not to be so. The doctor poked around with arthroscopic tools and needles and thread in there for almost three hours. What he thought would be a routine rotator-cuff repair was far more complicated than what the MRI had revealed. He reported to me that the tears were long and drastic. Fortunately, he was able to stitch everything up. But due to the nature of the tears in the tendons, he has lengthened the whole process of physical therapy and recovery by two weeks.

“Do nothing,” he told me when he made a follow-up call with me on Saturday. “Follow the procedures we’ve established, and I’ll see you on Monday.”

Good enough. My “procedures” have me sitting in a chair that automatically lifts my affected arm (right) to a pre-set angle, starting at 60 degrees and increasing by five degrees a day. Today, I’m up to 80 degrees. It doesn’t hurt except to put my arm in the device and to take it out again. I have to gingerly lift my right arm with my left. Then comes the ordeal with putting my arm back into an immobilizer, a complicated sling.

The next in the procedures includes using a refrigerated cuff over the shoulder for several hours. My son loads the cooler with water and frozen bottles of water and turns it on. I let it run all day, pumping noiselessly the cooled water from the chest through tubes to the cuff. Both the chair and the cooler/chest were prescribed by the doctor a week or so before the surgery and delivered to my house.

That was an interesting moment when the man showed up to deliver the devices and show me how to use them. I had bumbled along the last two months, confined to casing (sorting) mail in the office, hoping for the day this injury would be repaired and I could start the healing and recovery process. Surgery was an abstract concept, a something that would occur at some indistinct moment in the future. But when the man wheeled in the chair and unloaded the cooler from its box, suddenly, the surgery was a real event—one of which I knew nothing and for which I had nothing to expect.

The only thing I knew was that I was going to get those drugs. It’s almost like I looked forward to the surgery not for the rotator-cuff repair but for those few moments before the Propofol kicked in to put me under completely. The few moments of Versed- and fentanyl-produced well-being. It’s not a feeling I get in real life often, well-being. But leading up to the surgery, I sure wanted it and knew I was going to get it.

Was it worth the three days of fog and fatigue? Did the advantages of that feeling of well-being outweigh the disadvantages of drug hangover and associated disorientation and sickness?

No. It didn’t. I’m glad I got it. I’m glad all this is being taken care of as a work-related injury. But I can’t say I look forward to another surgery. The costs for that moment of freedom—months of pain leading up to the surgery, months of pain to come—were just too great.

The whole thing also makes me glad that sobriety is more important, with all its discomforts and puzzles and problems, than any moment of drug-induced escape.

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