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Day of Deception

September 24, 2020

The friend who helped me move out of storage was kind enough to drive me to the follow-up appointment for the surgery I had on Friday. Normally a very careful driver, he ran a couple of stop signs and hit a parked car while making a turn, which was quite unnerving, but the only damage done was to the passenger side mirror of his own car, but I was able to fix it as soon as we came to a stop.

The surgery was a bit of a surprise. This past winter I noticed a tingling in my left pinky that never went away that eventually spread to the lower side of my ring finger. Eventually, I inquired about it at osteopathic manipulative therapy and was sent to two neurologists and a hand surgeon for testing. They found mild carpal tunnel and severe compression of my left ulnar nerve. The hand surgeon, Dr. Christopher Koontz, said that I could lose the use of my left hand without the surgery, so I consented once he said the test results suggested it was too severe for physical therapy to improve it and that I was lucky that constant tingling was the only symptom. He recommended that since my left arm was going to be cut open anyway, that I get the surgery for carpal tunnel syndrome done because it was now done with a tiny endoscopic camera with a minimal incision and a three-day recovery time. The ulnar nerve surgery is less frequently performed and has a less predictable recovery time.

I wasn’t expecting the surgery to happen until October, but I was called to come in last Wednesday, September 16 for blood and COVID-19 testing. I was then told that I would need the surgery within five days or I would need another COVID-19 test, which thankfully wasn’t nearly as miserable as the one I got at the shelter. It’s very uncomfortable, but the one at the shelter, up my left nostril reddened and teared up my eye, and the pain didn’t go away for several hours. This one, at St. Barnabas, was uncomfortable, but the pain was gone within 5-10 minutes and was much milder than the pain I experienced the last time.

They then repeatedly called my brother as my emergency contact as I was at a socially distanced commemoration of the Occupy Wall Street anniversary and called me at 3:20 PM, leaving me a voicemail about my appointment “tomorrow” and telling me to call back. We kept playing phone tag, and they wouldn’t tell me the time of the appointment on the voice mail, always telling me to call back for the time and instructions. The ones I remembered were not to eat anything the day of the surgery from midnight until being released and that glasses and contact lenses are not to be worn in the operating room, so I made sure to bring my contact lens case and solution. I arrived later than they had wanted me (10:15 vs. 9:30), but talked to them by phone from the bus when I was almost there. At that point they told me that I needed someone who could drive me home. When I got there, they said I just needed an escort, even if I took mass transit. Not only did I find a friend who could do it, but her ex, with whom she was planning to have dinner that night anyway, had driven his parents’ car back to New York after visiting them on account of COVID-19. He knows me and did not mind driving me back, at least after she promised to buy him dinner.

Amusingly, one of the nurses could tell that I still had my underwear on under the hospital gowns (one font, one back). The orderly said that for what I was having, it wasn’t an issue. I couldn’t see the TV as I waited, and the corded remote stopped working after I turned it on. Until they moved me to an area with a recliner to make me more comfortable, I was stuck hearing about Major League Fishing.

The operating table had something massaging my legs, presumably to help my blood keep circulating. I was a bit amused by one of the ties on my arm being a bright Crayola green like a ribbon as they set me up. They made me repeat back to them what I was getting several times, which almost felt like they thought I was dumb, but I think it was for confirmation. Some admins had thought the surgery was for my right arm, so they needed to know that I knew what I was going in for. They also explained to me that the anesthesia would be going in my right arm rather than through my nose or mouth and had me explain back my understanding. When I had an endoscopy a few years ago, it felt like a cut in a film–that no time had passed whatsoever. Although I didn’t dream, it did feel like time had passed this time.

I had no idea how bad I’d be after surgery the way Dr. Koontz had made it sound so simple–certainly no walking to the Chinese restaurant for lunch. It was evening, much later than my friend had expected. My arm was dead weight. A tingling sensation was my only real indication it was still alive. My throat was very sore. I was told that this was from the anesthesia. I asked about what they had said about the anesthesia going in my arm, but the nurse said that they may have had to use an alternative method . The nurse gave me an Air-Eze Incentive Deep Breathing exerciser that pulls up a piston as I inhale, saying it was to prevent pneumonia. I had pneumonia as a teenager (which is when I learned of my allergy to amoxicillin), and my father died of pneumonia after a hospitalization when he was only 21 years older than I am now, so I definitely don’t want that to happen to me. She was shocked that it went straight to the top hard on the first try, but I still continued to use it until my breathing returned to completely normal without pain. The nurse helped me dress, although annoyingly took the hospital tread socks off me and didn’t put my own socks on until everything else was on and was ready to put on my shoes. She didn’t adjust my orthotic before she put my shoe on, so I had to do it in the bathroom, because that was really painful. She offered to help me go to the bathroom, but I was confident that I could do it myself. She left my shoes untied, and there was no way for me to get my contact lenses in one-handed, so it was fortunate that I was going in a car. My friend tried to tie them for me, but they were way too loose to be comfortable walking to bus, to train, transferring, etc. The nurse never got my sling on right, and my arm dropped as dead weight as soon as I left the building. My friends talked like a cute married couple in the car, so it’s good that they’ve stayed friends. I offered to buy her dinner, too, but she knows my budget.

I started to regain the ability to move my fingers the next day and was soon able to hold my arm up. If I didn’t, my fingers felt tighter and more tingly. Though my unpacking came to a dead halt, and I had to switch to wearing glasses full-time, I did manage, with difficulty, to cook for myself and load the dishwasher. With a lot of effort, I was able to arrange to be driven back to St. Barnabas for removal of the enormous dressing and follow-up care. The time wasn’t specified beyond “A.M.” but as a post-surgery patient, it proved to be a non-issue.

Dr. Koontz saw me pretty quickly and asked how I felt. I said that my whole hand tingled, but after getting the massive dressing off, which included peach and white striped bandages, cotton, plaster, and talc, he tested my fingers, and all have sensation and can move at least somewhat, so he knew it was a success. He explained that I have a muscle that he has never seen before that was compressing the nerve, so now the sensation of banging the humerus would be a bit to the side of where it used to happen because the nerve had been moved. I was also shocked to see stitching a quarter of the way up my palm. I had seen other people with carpal tunnel stitching like this before and knew what it was, but it wasn’t what we had discussed. He said it was because he was unable to cut through one of my ligaments, so he had to do it the conventional way, something to which I never would have consented based on the lack of symptoms–they had explicitly stated that the test results had shown that my right hand was much worse in terms of carpal tunnel than my left, and I can’t imagine getting surgery like that for anything in my right hand. It was only the dire prognosis that made me consent to the surgery in my elbow, something that the wrist surgery did not have.

I started to feel extremely nauseated and told the doctor so. I suspect it was the sight of the stitches in my own hand because I have no other explanation. He had me lie down on the exam table and brought me water and a banana. Someone else brought me iced tea. I didn’t care for the combination of flavorings in the tea, which seemed to be a mix of mint and fruits, but I drank it anyway and was quite grateful. I went to the bathroom before going upstairs to be fitted for a removable splint, but couldn’t get anything out either end despite the extreme and sudden attack.

Tony Cheng, the hand therapist, had a lot of questions for me that made the surgery sound disturbingly rash to me (not to be confused with the physical rash I showed on Instagram), but he said that the carpal tunnel surgery I had is the better kind–people who have it tend to report more favorable results despite the cosmetic improvements of the camera surgery. The fact that it was done at all is the disturbing part because the symptoms that led me to ask a doctor about it were all attributable to the ulnar nerve compression and not to carpal tunnel, something he thinks everyone over 40 probably has according to neurological tests. I started going into a reverie about the artwork that presents immortality as boring seems to be a sort of coping mechanism for the deterioration of the body with age because i still feel like I never have enough time to do what I want–to finish my own creative endeavours and experience as many of those of others as possible as well as the abortions in my life that are romance/family and career (apart from the dramas and novels I’ve written that may never see the light of day) especially since most people seem to think I look younger than I am. Of course, what’s done can’t be undone, and a successful carpal tunnel surgery can’t exactly be considered medical malpractice even if it wasn’t performed the way that had my consent. I still signed the paper, and it did not say that I consented only if it were done a certain way. Cheng talked about how all people’s bodies are different, from my unusual muscle to comparing marathon runners to sprinters, which made me think briefly about mutants and X-Men, and the mark of Sentinels that failed because they recognized that every human has some level of genetic mutation..

When Dr, Koontz said that I’d be getting a plastic splint with velcro, I though that they were ready-made and wondered why I would have to wait behind two people until 11:30, but soon realized that, unlike with the splints I got from podiatry or even when I slashed my left middle finger in grade 6 (a scar that remains sensitive to this day and fuels my fear of other scars), the splint did not exist yet, and I was fascinated by this process, although as it came together I was sure I had seen other people in such splints. He took a piece of flat light blue plastic with holes evenly spaced, compared it to my arm, and dipped it in a vat that said it was 160 degrees, which seems pretty low for softening plastic. I have burned and deformed plastic kitchen utensils (not badly enough that I don’t continue to use them), but they were generally boiling temperature. I can’t imagine it was centigrade, though, or it wouldn’t have been safe to put it on my arm at that temperature. He and an assistant wrapped it around my arm in a long sock of gauze and sprayed it with cans of rapid coolant. I am to come back Friday for further physical therapy, which begins with reestablishing my ability to grip, weakened by five days of not doing so. He said that as the only animals who use our hands to hold things, it’s one of the first abilities we lose, so I have to press it into that position with my other hand. It’s not that I can’t bend my left fingers into a grip, just that my ability to do so has diminished. I’m to come back earlier if it gives my elbow any additional pain, but the only real pain it’s given me is at the thumb hole, so I just sent him an e-mail to see if that counts. This is removable, so I can finally shower so long as I remember to keep my arm elevated. It was imperative that I not get that enormous dressing wet, and since I was staying home and resting anyway, I just put up with it.

I never did try Oriental House’s buffet when they had one–it was very small. That part of the building is curtained off and for rent thanks to COVID-19. This time I ordered shrimp with mushroom, which to mu surprise was basically shrimp with lobster sauce with mushrooms. I also got cheese wontons, which is what they tend to call crab rangoons here–a bit misleading because “cheese wontons” sounds vegetarian. Sometimes I love the sweet red sauce, but this one tasted basically like pineapple, so I stopped using it.

I walked to the Dollar Tree to look for AAA batteries for my razor, but tey had only “super heavy duty” crap that lasts two days–alkaline lasts about a week, and when the shelters wouldn’t allow us to have plug-in electric razors, I used to be so worried I’d run out of money entirely so that I couldn’t shave anymore, which thankfully never happened. I did find some DVDs that looked interesting, including a trilogy of Tsui Hark films. As with Wednesday, when I walked to the Belmont Library to return Frozen II, my back went out very quickly, and I had to rest, last time in the plaza where I flipped off the Columbus statue on Instagram, this time in the plaza near the post office.

I was weighed prior to the surgery at 294 pounds. I haven’t weighed that much since I peaked there decades ago, but since I’m not walking to and from the train each day, often several times, because of COVID-19, my weight has been going up despite a major increase of vegetables and fiber in my diet. Still, I wanted to get to Eneslow Pedorthics before they closed at 4 because I believe the wear to my shoes is having a serious impact, and i want to replace them before they become irreparable. If I don’t damage them too badly, I can repair the soles for about $100 and get at least another year out of them. They started closing at 5 this Monday, so I need not have rushed. They did not have any WWW shoes in stock, so I had to special order them and pay shipping. The shoes are $187 before tax. It’s really not right that I had to pay shipping on them, which added $10 to the cost, when I take the trouble to show up in person, but what can you do when few shoes are made on a last that matches the shape of your foot, causing most shoes that are supposedly your size to be extremely painful and your blister bores a hole through the top? It’s kind of like the complaint about women having to pay more for haircuts and personal care just because of their anatomy. My feet are quite nearly rectangular and do not taper off the way nearly all shoes do. It seems like a lot of people would find shoes like this more comfortable. It’s time here to take another pot shot at Charmaine Jones, who thinks that orthopedic “clown shoes” as one friend calls them are expensive to be fashionable.

Across from Eneslow is a TD Bank location, where I was finally able to get in early enough (4:00 closure) to resolve the PayPal issue and allow me to write checks again, such as to pay my portion of the rent. Unfortunately, once an account is closed, it’s closed, and only my savings account with TD still stands. This means that because of PayPal and its gobbeldygook about payment hierarchies, I have to buy all new checks. PaylPal refuses to take responsibility for the $81.55 they caused my account to be in the negative, and they refuse to reimburse me for the cost of the checks. If it were really my fault, they would not have used payment hierarchies as an excuse to weasel out of responsibility for what they did. I seriously don’t know why anyone likes PayPal.

Craig Hughes has ridden to the rescue again, applying me for a grant to pay the first three months of my rent. This will certainly make things easier until I have a usable checkbook again.

Still, to top things off, the MTA vending machine charged me, failed to write to my card, and said it was out of receipt paper. I think it will at least be restored to my account in a few days.

4 Comments
  1. Mr. Cheng replied to my e-mail to take off the splint for widening of the thumb hole but that it’s not a serious problem. I have to go back to the bank today, so I’ll probably wear it for that., I did put my contact lenses in this morning. The supermarket was almost unnavigable with my glasses fogging up every two seconds.

  2. I’m quite sure Dr. Koontz never said anything about doing the carpal tunnel procedure any other way. I think that would be a tort issue rather than one of medical malpractice. It would be my word against his, and he usually had a PA, nurse, or other doctor in the room with him when he saw me, so even though I’m very upset, I still don’t think I have enough evidence to have legal recourse.

  3. I reattempted with some other attorneys when I found the paperwork, and it does indeed specify that the carpal tunnel surgery was to be done with an endoscopic camera. It’s the same piece of paper that is why i knew not to eat, but also told me it was necessary to have an escort. It’s lucky that I could find it at all because I can’t find most things for the moment with my apartment full of boxes and my bookcases not yet in a usable state. I was also very alarmed to hear from Rehab Tech Alenger Cabrera that it wouldn’t be hospital policy to inform a patient of such a possibility. This makes me think that the fault is more on St. Barnabas Hospital than it is on Dr. Koontz, and very alarming the lengths that for-profit hospitals will go to make a buck.

  4. Although she isn’t the one primarily doing my physical therapy, today (10/21/20) Alenger Cabrera asked me to tell her again for what I was receiving physical therapy because she had not looked at my file. When I told her that I felt that Dr. Koontz was persuading me to have the carpal tunnel surgery based on the minimal invasiveness of the procedure because the test result said that it was mild, as opposed to the ulnar nerve, which the test said was under severe compression, she seemed disturbed, and she did not repeat the thing she said earlier about the hospital not warning people about complications, so perhaps she misunderstood me before.

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