Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Thursday, June 05, 2014

What would you do?

This is a 2nd post in a few hours so be sure to scroll down.

Here's my dilemma:

My surgeon uses nerve blocks to decrease pain and allow more rapid discharge from the hospital after surgery.  Usually he uses one with a steroid and epinephrine which decrease inflammation and bleeding.  I am refusing those because of the strong chance it would cause agitation during a period that I am to be laying still for 2 weeks.  Anesthesia agreed with this.  They did tell me that this means I will have more pain, which I knew.  And they offered me another kind of nerve block that is just an anesthesia and so is much safer for me.

The problem is that I looked it up and it has a 1-5% chance of agitation being a side effect.  That's tiny, except that I'm very sensitive to agitation.  I've already had akathesia twice from meds that don't often cause it and because of having it twice I'm more at risk from now on.  I also am just more likely to be agitated from anything than most people.  But 1-5% is so small.  And it probably means the difference between overnight and several days in the hospital.  On the other hand I've heard people say nerve blocks can be very uncomfortable while wearing off and not that effective overall.

I am supposed to talk to the anesthesiologist on the day of surgery and decide.  But I need to have made my mind up fairly well on the agitation component beforehand.  I'm leaning toward not risking it and dealing with the pain.  Which terrifies me as I think it will be pretty substantial.  So I'm asking everyone I know, what would you do?

4 comments:

Rachael said...

I think the agitation would be really disruptive - if you can't be still you risk damaging the ankle. However, it may be more possible to be still with pain. You might look into some breathing techniques and self hypnosis or biofeedback that would help you deal with pain. So my vote is to risk pain over agitation.Here are a few sites you might look into:
http://www.howtocopewithpain.org/resources/breathing-exercises-2.html

http://www.prevention.com/health/health-concerns/how-deep-breathing-and-meditation-alleviate-pain

http://www.webmd.com/pain-management/guide/stress-relief-for-pain

Your Dr. Mind may have some insights, as well.

Good luck with your decision!

Jean Grey said...

I don't know. I don't know if a nerve block without epinephrine will last long enough to be worth the risk- and how much it would buy you. But I also wonder with those reported rates of agitation so low, if they are even above the level of a placebo. Most people who need nerve blocks are experiencing enough pain and trauma that could itself be causing the agitation. It is a hard call to make, and your body does have unusual reactions to meds.

Annehueser said...

I too have unpredictable reactions to drugs and I would opt for pain rather than agitation.

Michal McAllister said...

Another vote against the risk of agitation!

You have some great readers. I like Rachael's suggestions.

Keeping you in thought and prayer,

M