Triggered

[Mik]

Crap. Hope it goes well. I've been going back to the piano lately, but doing mostly exercises for my weak area, timing.

[George K]

Mrs. George had the surgical release about a month ago.

It's really nothing more than a PITA.

[Aqua Letifer]

@george-k said in Triggered:

I'm not all that concerned. This is more of a PITA than anything serious.

D2 was worried whether I could still extend the middle finger independently. I assured her it's not a problem.

"Hold on."
"What?"
"I need to show you something, it's important. Let me just get my hand loosened up and there, there we go. Fuck you."

[George K]

@aqua-letifer said in Triggered:

"Hold on."
"What?"
"I need to show you something, it's important. Let me just get my hand loosened up and there, there we go. Fuck you."

I was going to post something along those lines, but you beat me to it, with a post that clearly surpasses ANYTHING I could have come up with.

ETA: By the way, I get along very well with this surgeon. And I pretty much did exactly that when he suggested surgery.

[Jolly]

Is he a social finger surgical specialist?

[George K]

[Axtremus]

Has your ability to flip the bird with that hand returned?

[George K]

@axtremus

[brenda]

Glad you have good and needed finger useage again, George. LOL

[taiwan_girl]

@george-k

[Mik]

@george-k said in Triggered:

@axtremus

V for victory!

Oh, wait……

[jon-nyc]

So success???

[George K]

@jon-nyc said in Triggered:

So success???

Surgeon put in long-acting local. 5 hours later, index & middle with no sensation. Should get another 4-6 hours out of it.

Of course no pain, lol.

Transition to bandaid tomorrow and will know more.

[George K]

Saturday was a painful day. Pain at rest which woke me at midnight Friday night after the block wore off. No incisional pain, however. It's a really small incision, about 1 cm long. Tendon is all banged up, and any kind of motion was painful as well. I did my best to do the exercises (flex and extend) the fingers, but it really hurt.

Yesterday, Sunday was remarkably better. No pain at rest, and by end of the day, motion was limited by stiffness and swelling rather than pain.

This AM, no pain at all again. Stiffness is better, and I'm able to type as though nothing had happened.

But, here's why I'm following up.

Years ago, we were approached by a drug salesman who was touting Ofirmev, a new formulation of acetaminophen, Tylenol. It was high-dose, a gram, and to be given intravenously for pain control, and as a supplement during anesthesia. Being the curious type, I was eager to try it, and I was amazed at how well it worked. I found myself giving much less narcotics during surgery, and patients seemed to require less in the recovery period as well. The dose was 1 gram, intravenously, every 6 hours.

The major drawbacks to it were twofold:

1. this formulation was expensive, and the hospital didn't want us using stuff that expensive (I think it was $25 a dose), when cheaper stuff (morphine) was available. Never mind that one of the advantages was less opiod use and fewer complications because of that.
2. It made your liver fall out. Well, if doses were too high, it caused hepatotoxicity, so you were limited to 4 doses per day.

And then something interesting happened. People started looking at the effectiveness of acetaminophen when given orally, but in large doses - again 1 gram every 6 hours. It works just about as well as the intravenous route, and is dirt cheap.

So, in preparation for my procedure, I loaded a gram about 3 hours beforehand, and then got on a 6,12,6,12 schedule. It worked like a charm. When it wore off at midnight Friday night, that's what woke me. I took a dose, and I was pain-free in an hour, and slept until 5:30, when I needed another dose. I continued it through Saturday and Sunday. Worked great.

Today, I have no need for it, so I'm done.

Amazing drug.

[Jolly]

Glad to hear that. Less pain or pain free is good.

[Jolly]

On a related note...What about the 650mg extended release acetaminophen pills? Better, same or worse?

[George K]

@jolly said in Triggered:

What about the 650mg extended release acetaminophen pills?

No idea. I didn't have any handy, so I just took a gram q6h.

Total dose not to exceed 4g in 24h.

I suppose one of those q4h would be about as effective, perhaps with no dip. But, it's q4, and that's a PITA.

[George K]

Day 10 post-op.

Negligible pain, unless I fall asleep with my fingers flexed. Then, it takes some effort to flex them more and then extend them.

I'm somewhat disturbed by the fact that I still have some pain on the dorsal (back) of the affected finger, but function seems good, although I can't extend it as far as the other three fingers.

Wound looks good. No drainage, no pus. Minimal swelling. I have no dressing applied, and the sutures come out Thursday morning.

[Mik]

I use the extended release Tylenol now and then. Pretty good, much better with some ibuprofen. Luckily it’s only once every few months. My arthritis is very well controlled by meds.

[George K]

@mik the high dose acetaminophen is amazing for acute pain. One gram every 6 hours. Mrs. George has had dental extractions and (!) a joint replacement using little more than that for analgesia.

Don't exceed the dose, supplement with opioids and anti-inflammatories (which acetaminophen is not!) as needed.

As I've said before, I was impressed with the intravenous route for this drug, and now, it seems that the oral is just as effective.

If you can take it prophylactically, all the better.