Most people wake up from general anesthesia with blearily opened eyes, the irresistible urge to rub their nose, and that's about it. Many will flail their arms a bit, but without strength, and the moment quickly passes. Occasionally someone will rouse combative, which is why staff stay nearby as they emerge, to keep them safe, and on the bed.
Much more rarely, they wake up fighting and uncontrollable, and strong. So that the nurse and tech, sometimes the resident, are using their body weight to keep them from running all the way to the floor. I've seen a few bad wake-ups, the worst* still has to be the Tongan woman just coming out of heart surgery, swatting away orderlies. I got her to focus on me, sat her up, and slowly she came around to post-anesthesia version of oriented.
This week, the second worst wake-up. Strong guy, went down oddly, taking a lot of drugs to get any effect during induction, more to get him out. This is often a sign of recreational drug use (or chronic pain narcotic tolerance), and long term smoking. It also meant that he metabolized the hell out of the propofol at the end of surgery, and woke up before the dressing and knee immobilizer were on, swinging and kicking. Nothing could calm him down, although the worst passed off after a few minutes. When we turned him up to get the roller under him, he snatched at me. This is dangerous, a grab so strong and he could wind up on the floor. I held my place, but rolling him over scared me. I took the time to get him to grip tight to his own elbows, made him promise to hold, and we rolled FAST. It worked, to my deep relief.
I've found I've lost my taste for the adrenaline high. I've had a headache, intermittently, ever since. This is why I like boring, nothing going wrong.
That this is the weather does not help me, although it's exactly what to expect this time of year, here.
18 Jul 3:53 pm 101(f) 41(dew point) (winds) 13 N 10G20 FEW080 SCT120
D's brother, who lives about 40 minutes away from them, agreed to help C and Moira move tomorrow. C seems to think they may not need him. He's not moved as many times as D and I have, but you never know, sometimes cockeyed optimism is right. I've never seen it happen relative to a move, but one never knows.
*Not counting post anesthetic psychosis, I've seen that twice. Can't find anything online to describe it, it's pretty rare. I'll see if I can get some data from our Director of Anesthesia for next week.
Labels: friends, surgery, work