Wednesday, March 24, 2010

Post Sabbatical


It’s more than 10 months since I posted my last article on May 7th, 2009. While this blog was originally intended to introduce various experiences during my sabbatical trip over the world, the last two articles focused on my devastating shoulder injury.

This new article still puts a substantial focus on what’s going on my injured shoulder, but I’ll try to include some international experiences in medical care. There are not so many patients who got a surgery in two different countries rather than where they were born. My case is Switzerland and US.

First of all, here is a brief summary of my left shoulder/arm/hand/fingers improvements: I regained the motion of my fingers, wrist, and elbow by 5/7/09; I began to lift my shoulder a little bit by 6/14/09; then suddenly nerves came back to allow me to lift the shoulder up to 80 or 90 degrees in 6/21/09; and I regain my shoulder motion up to 140 degrees by 3/22/10. Even with this restricted motion, it was possible to enjoy skiing. I skied for 21 days during which I skied with Kent, my son for 12 days.

Toward a full range of my shoulder motion (so as to play tennis :-)), I took a surgery on 3/23/10 that removed the bone-supporting plate and thick scar tissue from my shoulder. Here is my story:

At 8:15am, I checked in at University of Washington Medical Center’s Surgery Pavilion. The waiting room seems like a hotel lobby: a bunch of sofas, chairs, and even stools as well as work desks with many electronic/Internet outlets, so that families and friends do not have to waste their time or just get relaxed. I just recalled that, when Kyoko was in labor at Evergreen Hospital, the lobby had nice chandeliers and a grand piano that of course gave live music. When my dad and I waited for my mom’s coronary surgery at a Japanese university hospital two years ago, I recalled that the waiting room had just many long seats and its floor was just titled (but not carpeted.) When I waited for my PT session at a Swiss university hospital, I used to sit at a long seat on a long hallway. Is this culture of having a gorgeous waiting room only in America?

At 9am, a nurse called me but advised my wife and kid to stay at the waiting room, because kids are not permitted to enter a pre-op room. However, they are supplied with my code name, (i.e. FU07MU) with which they can check a waiting room’s monitor to see how I am doing. I don't know about Swiss hospitals, because I was alone when I was hospitalized in Switzerland, but I’ve never heard of it in Japan.

Each pre-op room is a complete compartment. I dressed a surgery gown and laid myself on a bed. Nurses and anesthesiologists visited my compartment one after another as introducing their names and roles as well as checking my name, DoB, and procedures I will take. When I took a surgery in Switzerland, I didn’t even meet any anesthesiologist while I met an ER doctor, a surgery doctor, and a couple of nurses. Anyway, the first anesthesiologist explained about a planned procedure of anesthetizing me during this surgery: giving general anesthesia (i.e., putting me to sleep) and thereafter injecting anesthetic into nerves under the neck so as to make all from my shoulder to fingers numbing for the next 20 hours, which controls post-surgery pain. When he asked me “is this what you are interested in?”, I quickly responded to him, “yes, but I hurt brachial plexus, too when I broke my shoulder”. Then, he needed a consultation with his colleagues. Murphy’s law: nothing goes well smoothly to me. The 2nd anesthesiologist showed up 30 minutes later (probably after a meeting with the 1st guy), asked me about the details of my injury, checked my online medical record, and said to the 1st guy “Look. Dr. Winston mentioned about his brachial plexus injury.” They told me that they would need to change their plan, because they should avoid any risk to worsen my damaged nerves. According to them, I might take a local, static anesthesia onto only my shoulder, which may increase post-surgery pains. Again after waiting for 30 minutes, Dr. Warme Winston visited my pre-op room. “Hello! Dr. Fukuda”. It sounds strange to be called Dr. Fukuda by a doctor, though. Two more doctors, Erika and Rick also showed up. (I forgot their last names.) Dr. Erica pointed out a possibility of thick scar tissues limiting my shoulder motion. Dr. Rick checked my pre-op health condition a week ago. It seems like they are all ready. Dr. Winston marked my left shoulder with his initials, placed his hand on it, and prayed for a successful surgery and a full recovery of my shoulder motion. After waiting for 30 more minutes or so, another nurse showed up, gave me an anesthesia injection, and began to carry me to a surgery room as saying “I am a good driver but not so good at carrying a stretcher.” I lost my consciousness even on my way to a surgery room. I still recall that, at St. Moritz, I was carried on a stretcher to a surgery room, saw the surgery room’s entrance doors open, and looked up really bright lights.

My wife checked the waiting room’s monitor frequently. She knew that I was carried to a surgery room at 11:40am and was moved to a post-anesthesia care unit (PACU) at 2:50pm. So, it brought 3+ hours to my surgery. At the same time, Dr. Winston visited the waiting room to explain to Kyoko about my surgery with some pictures. She was advised to wait for 15 minutes to check if she can enter PACU but actually had to wait till 4:30pm. It seems like I woke up at 4:10am. I immediately realized that my left fingers were not numbing, which means that the anesthesiologists took plan B. Dr. Winston came to PACU to give me the plate and screws taken out from my shoulder, and mentioned that my shoulder got lifted 180 degree and my arm’s external rotation is about 60 degree. He has also explained to my wife that I will gain all full motions through physical therapy. Now, I have to take 3 PT sessions per week for the next 6 weeks. Thereafter, Kyoko and Kent came to PACU. She helped me with eating some yogurt. My wife told me that the doctor suggested that, if I suffer from pain (because of the local/static anesthesia), I could stay at hospital over a night. From my former experiences, (one at Evergreen in 2007 and the other at St. Moritz in 2009), I was sure that EKG cords would keep attached to my body, an ivy would keep inserted into my arm, and I would have to be checked by nurses frequently over a night. I asked Kyoko if she likes me to stay at hospital. I really wanted to go home as initially planed as an outpatient surgery. After receiving another injection to relieve from nausea, I walked around PACU and left the surgery pavilion at 5:30pm. Yes, even after having a 3+ hour surgery, a human being (of course including me who now came back from a cyborg :-)) is quite strong to walk soon! But again I’ve never heard of a 3+ hour outpatient surgery in Japan. At St. Moritz, I had to be hospitalized for 5 days! This is another experience only in America.

It was 6:30pm when we came back home after having driven through a traffic jam on the SR-520 bridge and stopped by Trader Joe’s to buy some ice cream. It was very delicious mango ice cream.

This finally closes my blog. Thank you.

Picture 1: White Scar Tissue between Upper Arm (left) and Shoulder (right)


Picture 2: Cleaned Joint between Upper Arm (left) and Shoulder (right)


Picture 3: Plate Taken Out from My Shoulder


Picture 4: 10 Screws