Well, the 5 years to wait for my follow up is over. Of course I dragged my feet scheduling the appointment, gotta go through the primary manager process for the referral. It was Dec of 16 or Jan of 17 when I actually got around to it. I had started my own business and I was having some other strange things going on. Pain in the right upper quadrant, comes and goes, ultrasound showed some minor things on the liver, so on to a CT scan to look at the gall bladder as well.
Did a HIDA scan, had to lay on the table for 2 hours without moving. I could see the liver and gall bladder working on a screen, that was kind of cool. Still no definitive answer for the pain. Went back to the GI NP and she said, well since you are getting the colonoscopy, let’s go ahead and add the other end to it.
So, of course that had to be approved by the PCM. I also mentioned the previous incident to the GI NP, she annotated it in my record, again and asked if I wanted a different surgery center, and I said nah, what are the odds………
Did prep and my appointment was later in the morning. Same old poor saps, starving, thirsting, waiting for the cattle call. My turn came, I let everyone know that I now have TMJ problems, had to explain that comment again and again. No mention of a history of TMJ problems on the pre-op form, I guess they did not listen t0 me previously. The GI doc did remember the incident. The new CRNA, not just to me, but new to the anesthesia world, assured me that she would do what she could to avoid it happening again. So, did the doc, so did the prep nurse and so did the tech in the procedure room. She was anxious about putting the bite block in, remember, the other end was first, so they needed easy access to the mouth and throat. She barely stuck it in my mouth, at arm’s length and asked if that was okay, I reached up and adjusted it a little. They proceeded with the anesthesia, again remembering not much after the push of the syringe…. They said I kept reaching up to my face during the procedure and when coming out of the anesthesia. I can’t imagine why I would do that? Well, I woke up, my wife was there and I tried to close my mouth, yes, it happened again…..they all looked at me, are you sure you can’t close, I moaned, I slobbered, I made the gesture to write something down……I gave the note to my wife “ is this a dream”, she looked like she wanted to cry, I knew the answer.
The head CRNA came out and said I know what to do……where was he five years ago, Ed was his name. He said we need to pop it back in, I motioned down in and then back up, that is what I remembered from being a dental tech. The jawbone has to be pushed down and then back to avoid breaking off the condyle. Ed looked kind of surprised that I knew that, smiled and said I got it! Knocked out again. When I realized my jaw was again locked open, I started freaking and trying to take the IV out, the nurse immediately took it out, anything to calm me down. Well, now they needed to start another IV, to administer the drugs, to knock me out again, is that healthy? I woke up, I could open my mouth but slowly, Ed was the man. I thanked him and his staff for knowing what to do this time.
By the way, it was the opposite side that popped out, no x-rays to show, which I guess is a good thing.
So, I have asked so many times, why, why, why. Why me? Why a second time, the first time was a fluke, but a second time. Could it be the dark cloud over my head or weak TMJ muscles, or getting too relaxed under anesthesia.
So, in my line of work, we always want to learn what we can out of every bad situation. We had several cases, from minor fall incidents to medication errors and all the way to malpractice cases. We had a good process of doing an investigation and analyzing what went wrong and how it could have been prevented.
Is there anyway to analyze why my jaw dislocates every time I go under anesthesia, should I have gone to a different surgery center? So many questions.
RJM Stuff N Such 