A pharmacist's perspective on health and metabolic disease
It’s been a busy few weeks/months? for me. For a number of years I have had issues with waking up with paraesthesias (pins and needles) in one or both hands, mostly in the ring and pinky fingers (ulnar nerve distribution). It was never properly diagnosed, but after physiotherapy and learning I am B12 deficient and going onto supplements, the issues mostly resolved, until I really stirred things up while bench-pressing in November.
Did you know it was possible to dislocate your ulnar nerve at the funny bone? I didn’t , until after I had done it and I can assure you it is very painful – especially to touch over the elbow region. After x-rays, ultrasound (very painful), physiotherapy and an MRI, the decision was made to operate.
Nearly two weeks ago* my surgeon moved my left ulnar nerve to under the muscles of my inner arm and it has been interesting being a heath-care consumer, rather than the professional.
Here are some observations
1) All of us make assumptions about people’s level of health knowledge, and we are probably only right about half the time. Assumptions were made about my level of knowledge about all sorts of things. Usually, they assumed I knew nothing, then after telling them I was a pharmacist, they (and I) assumed I knew everything about the topic…..except, often I didn’t have their specific knowledge.
It was appreciated when a health care professional gave me extra information about a process, because they thought “you might be interested”.
2) Low level pain makes everything even more difficult because the mental processes are elsewhere. There is a lot to be said for regular paracetamol (acetominophen)…..and someone else remind you to take it.
3) You don’t realise how much you need both hands, until one is taken away (I can’t lift anything for at least another two weeks and cleared by the surgeon/hand therapist)
4) Losing your independence is very difficult. Having to ask someone to tie your shoelaces, help you get dressed, cut your meat at dinner, or take you places can be very hard.
1) Ask what people understand…..don’t assume knowledge, or lack of. When healthcare professionals need care, we have some knowledge, but not the right knowledge, and sometimes we really have the wrong end of the stick!
2) Don’t judge someone when they are in pain, and sometimes the patient is the last to know that they are in pain.
3) Be objective when offering help, sometimes it can be can be hard to tell when someone needs help and when they are proud of maintaining their independence. Having said that, offer early, I only tend to ask for help, when verging on desperate…. But, please maintain the objectiveness when giving help. It can be awkward and uncomfortable to have to tie someones shoelaces or cut their dinner meat, but trust me, the person who needs help feels damned awkward asking! Making silly jokes might defuse the situation for some, but it makes others feel worse.
4) While regular paracetamol may be extremely effective for managing pain with the fewest adverse effects, trying to remember to take it four times daily is next to impossible for me! I’ll have more empathy for my patients in future.
From a low-carb perspective, managing this in the hospital was challenging. Asking for “dextrose-free” IV fluids caused many a conversation. I got through that one, then had to negotiate foods offered post-op. It seems that eating is a really important part of the post-operative procedure. Refusing food because you are not hungry is a sign of nausea (it doesn’t matter that you are metabolically flexible and fasting for 24 hour hours is not a big deal). I forget how many I was offered (and refused) icecream or sodas while waking up from the anaethesia. Eventually I agreed to have something “savory”. What I got was white bread sandwiches, probably spread with margarine, with slivers of ham, cucumber, or tomato. Oh well, I ate enough to make my nurse happy so I could go home. Then with instructions to ensure I had a “light” dinner, I went home and some time that evening, enjoyed small portions of bone broth, steak and salad!
The good news is that I am recovery well and am back at work thanks to a supportive workplace and team members and significant help from The Engineer and my father who came to visit for two weeks.
*This surgery was very carefully timed to not interfere with LowCarb Breckenridge…but lots of people have asked me if I got hurt skiing!