Posted by Bill Sandweg on 07 October 2019.
A sad story appeared recently in the national press. A young cricket player in Australia broke her thumb in a game. She went to a nationally recognized hospital in her area for treatment. She was correctly told that this could be easily fixed with a surgical procedure followed by placement of a cast over the thumb. She consented, the procedure was done and she was sent home in a cast.
Six days later, she returned in excruciating pain. When the cast was removed, the doctors and nurses were shocked to see that her thumb was cold, dark and almost completely dead. The cause was immediately obvious, someone had forgotten to remove the tourniquet at the base of the thumb which had been placed to control bleeding during the surgery. The tourniquet had continued to keep blood from flowing to the thumb after the surgery and the thumb was dying.
When doctors reviewed the medical records to see how this could have happened, they found that someone had checked the box to indicate that the tourniquet had been removed at the conclusion of surgery. It was unclear who had checked the box when it was obvious that the tourniquet had not in fact been removed.
After attempts to save the thumb were unsuccessful, doctors had to amputate it. They tried to replace it with one of the patient’s big toes but the result was less than completely successful. The young woman will never play cricket again. She has a thumb that is unattractive and not very functional. In addition, she has problems with the foot from which the toe was taken.
The moral of this sad story, to the extent there is one, is don’t just assume that severe pain you are having after a surgery is normal. Don’t just assume the doctors and nurses have done everything right. Pain is the body’s way of telling us something is wrong. Severe pain is the body’s way of telling us something is seriously wrong. While there will almost always be pain after a surgery, it should not be excruciating and should get better over the next couple of days. If it does not, or if it gets worse, start making noise and insisting that someone examine you.
I have seen a number of cases in my practice in which there has been a surgical error and the patient has extreme pain after the procedure. Often, the patient assumes that the pain is normal and does not call to complain. They don’t want to be a bother or be seen as a whiner. When the patient does call to complain, it is often the case that a low level person in the doctor’s office assures the patient that the pain is normal and nothing to worry about. Don’t let these people put you off. Be polite but persistent that you want to be seen by someone. If there is something wrong, the sooner it is recognized and addressed, the better the chance that you won’t suffer a permanent injury like our poor Australian cricketeer.