quote:

Originally posted by sleepla8er:
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Mars, in addition to locating an Orthopedic Hand Surgeon to perform the procedure, please have a consult with the Anesthesiologist.

Complications increase for older patients being placed under general anesthesia. To save costs, many hospitals are using Certified Registered Nurse Anesthetist.

RN Anesthetist perform a number of the same types of procedures as MD Anesthesiologists, but RN Anesthetist are not medical doctors even if they hold a doctoral PhD degree.

Please ask the person assigned to your wife if they are a MD or RN PhD. The conversation you need to have with them is about the possible side effects of the planned anesthesia on a patient who is your wife's age and if what they have planned is the best anesthesia practice for someone her age or just cost effective?

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You are obviously an anesthesiologist ( rather insecure, I suspect)... I am a nurse anesthetist. I have anesthetized patients who ranged in age from 2 weeks old ( pyloric stenosis) to 104 years old ( fractured hip). Have practiced since 1984 and have never been involved in a lawsuit. I work independently , without an anesthesiologist. Please don't try to sell yourself at the expense of the public's piece of mind . That's not fair to them. mike

IIRC, Gustofer is a CRNA also.

I will say that I am an anesthesiologist and see repairs all the time. That looks absolutely horrible. That dude needs to get a peer review and send to quality.

Bone doc is the resident orthopedic surgeon on here.

The lateral makes it look like there is a slab fragment on the palmar aspect of the bone. If so, that'd be a bit of an issue. On a dog, I mean...

These x-rays are a mess. From my limited knowledge as a paramedic and from the multiple orthopedic surgeries my wife and I have had I would suggest, at the, least a second opinion is called for.
As far as anesthesia, My last surgery was 2 months ago (rotator cuff, bicep tendon repair and AC joint decompression) and I had a nurse anesthetist. I have had difficulties with a general and because of that and my age (76) he suggested Propofol, Versed and Marinol (Dronabinol). I felt so much better after than when I had a Gerneral.
Best wishes for a successful outcome.

quote:

Originally posted by 1flynDO:
I will say that I am an anesthesiologist and see repairs all the time. That looks absolutely horrible. That dude needs to get a peer review and send to quality.

Bone doc is the resident orthopedic surgeon on here.

Could her asymmetrical tendon loading was an issue for him? He asked her before the radiographs if she had mulitiple broken fingers when she actually has the neurological issues with the arm. Her fingers can only stay pulled back or flex together and thumb stays extended.

quote:

Originally posted by mike28w:
You are obviously an anesthesiologist ( rather insecure, I suspect)... I am a nurse anesthetist. I have anesthetized patients who ranged in age from 2 weeks old ( pyloric stenosis) to 104 years old ( fractured hip). Have practiced since 1984 and have never been involved in a lawsuit. I work independently , without an anesthesiologist. Please don't try to sell yourself at the expense of the public's piece of mind . That's not fair to them. mike

Hi Mike, please go back and read my entire post again, at no point did I wrote anything disparaging about RN Anesthetists.

The advice I gave Mars was:
1) Ask the person assigned to your wife if they are a MD or RN PhD.
Why, because there is a difference in the training and knowledge required for these licenses and as the patient, they have a right to be informed and make the decision.

2) The conversation Mars needs to have with them is about the possible side effects of the planned anesthesia on a patient who is his wife's age and if what they have planned is the best anesthesia practice for someone her age or just cost effective?
Why, because they have the right to be informed and make the decision.

I am not an anesthesiologist, more importantly this thread and my post is NOT ABOUT ME OR YOU!

I have no doubt your training includes case studies of multiple medical screwups involving anesthesia.

I have no doubt that you are more aware of the dangers related to anesthesia than I am.

Instead of giving me shit because you think I said something negative about Nurse Anesthesiologists, I would like your next post to be helpful to Mars by suggesting what questions he should be asking the anesthesiologist ahead of time and what kinds of anesthesia you would use and avoid using for an older patient.

Now if you don't want to be helpful to Mars and just want to continue this, my email address is in my profile. Feel free to reach me there.

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They are going to do it local anesthesia.

He said he is going to free the tendon, remove the metal plate, screws and then re-break the bone then pin it back together again.

And she gets to look forward to 6 more weeks of pain and cast again.

Last time she got three days worth of pain meds because pillbillys.

None of this really bothers her, but the thought of getting a staph infection and needing a PIC line terrifies her.

quote:

Originally posted by Signets:

IIRC, Gustofer is a CRNA also.

I thought that he is an M.D.

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Hi Mars,
Glad to hear about the use of local anesthesia and how spirited she is going into this repair.

I've not had a PIC line and the two major injuries I've experienced have been broken neck and torn from the bone quadricep muscle/patella tendon.

Have you asked about working with a doctor who is a pain management specialist?

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My sister in law had to have a PIC line when she got a bad staph from having her ankle pinned from a break.

Tabitha lived with them for months to take care of her. Now SC's wife's RA is so bad Tabitha goes up every Wednesday to help her shop and take her for her treatments. With her hand broke, she can't drive to go help.

Any updates????

She goes next Tuesday for corrective surgery.

Wow.

No bill for the fix? Hell, you should send them a bill.

Everything is covered. Even PT.

Thanks for the update. Hoping for a good outcome.

I’ve got a buddy of mine that’s a hand surgeon. If you want his info let me know. He’s got a office off off Holcomb and another down at St Joseph’s.

I will say I absolutely %100 trust him. Known him for 10+ years.

Pre-op. Surgeon says he is merely going to free the tendon and see if the joint will straighten out with therapy.

I call bullshit. The surgeon is too afraid to fix it properly. It will require a rebreak.

He could talk big shit about fixing it, but now he just wants out.

Her finger looks terrible.