So I broke and dislocated my ankle on tuesday, finally got me to town on wed. When they went to reset it they gave me Ketamine. Anybody ever have that before?

Good lord, I didn't like it at all. Totally warped reality, no thanks. Took the learjet from Juneau and got into surgery this morning. Put a plate and some pins in there. Gave me a block they hasn't worn off yet so it doesn't hurt, but I am sure that it will soon.

Good times!

You have a Lear jet?

Good luck on the heal..

Do NOT blow the physical therapy.

You would not have liked it without ketamine.

Find yourself outside looking in?

Never heard of the ketamine, so cant help you there.

Hate to hear of your misfortune. Hope it heals quickly and you get back to doing whatever you want to.

Did they give you other drugs in combination with the ketamine?

Get to mending and do the PT.

I could still feel it. Had to reset it a total of 3 times.




Not exactly. My voice was all distorted and the world around me was shifting and not solid. Went to all kinds of strange colors........not an experience I want to repeat.

Ouch!! Sounds rough. I never decline pain meds. lol

Hope it mends up for you plenty quick

Damn straight.

I don't think so.

Hows your hoop?


https://www.novabucks.org/daterapedrugs_ketamine/

https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/ketamine.html

Horse tranquilizer. Used to be often mixed with rompum to tranquilize bears. Sister drug to PCP.

Called "special K" by the persons who use it at Raves (underground dance parties).

Ketamine is an old drug, but a good drug. Patients often complain it makes them feel nasty but it greatly relieves pain without having negative effects on blood pressure and heart rate, and does NOT cause respiratory depression. This can be critical when you're dealing with trauma. When you have a bad fracture-dislocation (such as an ankle F-D) you need to get it reduced asap to restore circulation and to prevent nerve damage. Ketamine gives docs the ability to do that. Most of the drugs we have historically used to reduce fractures/ dislocations in the ER produce one or all of these negative effects, but ketamine gives us a fast "out" when we need it. .

I've been given ketamine a couple of times- it can be disconcerting but it is better than morphine. I don't recall much when on ketamine but I did have some mild hallucinations as it wore off. What bothered me the most was the agitation I had as i knew I was letting minor things bother me far beyond the norm but I couldn't help it. Knowing I was being short tempered with people over things I typically did not notice was a real issue for me. It actually increased my agitation for a while.

Best wishes for a speedy recovery and, as mentioned, follow your PT regime precisely. Don't push it either as that can be as bad as not doing it, especially at first.

Thanks for the comments, Doctor. Ketamine is used extensively in veterinary medicine because of the reasons you elucidated. Most commonly used as part of a multi-drug combo with sedatives nowadays.

Early in my career used a lot of it by itself on feline patients. I think those kitties were trippin' during recovery!

You should not have been given Ketamine without first receiving a benzodiazepine, usually midazolam. The benzo is to cause enough “amnesia” so that you don’t remember the bad stuff about the ketamine and have “flashbacks”.

Ketamine is a great drug, but it is related to PCP and should never be given without a benzo pretreatment. Lots of guys in Vietnam got it and had really bad experiences and after-effects before people figured this out.

Lear jet AND ketamine?


Who wouldn't want that trip?......


Ace

Sorry to hear about the injury.

K Hole 30,000 feet!

Amen

Seen what it does to horses. Can't say I've had it given to me I know of.

We were cruising at 41K feet, made it from Juneau to Seattle in under 2 hours.

Wow.
Good luck, Hank.

Drugs to fly?

Drugs to reduce my ankle and stabilize it for transporting.

Speedy recovery hank!

Where ya at? Gotta take a inmate to Virginia mason in the am...

Harborview

It's a page out of Fear and Loathing in Las Vegas.

Copy . How ya like big city?

Well I'd rather be out at work honestly, puts a burden on those guys out there.

For sure, Seattle never sleeps...

Nasty nasty nasty...

I hate being out of control.

Pass me the bottle please.


Get well soon.

I had ketamine one time during a spinal steroid injection. I didn't like it at all. I had a psychedelic out of body type of experience and felt completely out of control. It scared me worse than almost anything ever has, I thought I had died. I had a few crazy scary dreams in the weeks and months after as well. They wanted to give it too me last year while removing a heel spur and reattaching my Achilles. I said no thanks and I think they used propofol and fentanyl instead.

That was ok, I just slept during the 2 hour surgery. Then they sent me home with 20 pain pills and said don't ask for any more. The first month plus was extremely miserable and it hurt bad for 6 months. I have to have the other leg done soon and I'm thinking about using a different surgeon. The guy who did my first one is fine but didn't take my pain serious at all. Did the surgery in his own surgical center which was just a room at his office. Then sent me home 30 min after I woke up. 2 days later I told him how bad it hurt and he said most people don't complain of pain and that I need to toughen up. 6 months later he told me the procedures he did on me were the most painful ones he does and they always hurt for at least 6 months.

The other surgeon said he would have done a nerve block and kept me 3 days in the hospital to make sure my pain was under control. He could believe I went through the last one with 20 pills. They cut my calf in 3 places and lengthened it. Spasms made you want to die. I would have taken ketamine over those. Having your Achilles cut off and screwed back on during a major psoriatic arthritis flare hurts.

Bb

The nerve block is something else. My entire lower leg is still 99% completely numb. I bet its saving me a lot of pain though. When that starts wearing off they are going to switch to oxycodone.

They gave me fentanyl on the jet, I told her just to give me enough to take the edge off. They were really good about it. I think I got about 100 total on the flight and then once I got here they lifted my leg and it slipped out of alignment again. They wacked me with 100 right then and there and put in some local anesthetic before they reduced it, again. They wanted to give me ketamine and I told them no way, so they gave me something else.

Hell with that.I'd be calling the other surgeon...

Damn Hank.

How long ya in town for?

No clue. Should find out more tomorrow.

That sucks. Got a good story to go with it?

Nope. Took a step off a porch that was less than a foot high and botched it.

Sorry to hear this ordeal. Take the oxys to stay ahead of the pain.

Your pain level is "always" 4 or higher when they ask.

I'm surprised the sx could not be done in Juneau.

What room number are ya held up in? Have any needs?

I’m in town on the ambulance tonight and can try to swing by supplies if you have any needs.

Will message you a contact number.

Man they should of shipped you to anchorage we all could of visited you and brought you some booze and hookers..

One of your dead hookers?

She was alive when I dropped her off at your place.. wth you do? Cincinnati chili killed her I see.

Dang! Nasty break and not even a fun story to go with it! I hope the surgery goes well and the recovery is fast. Summer is coming and I know you don't want to miss it!

Same here, prayers for your recovery!

Same here. I hope you heal-up okay..

I hope it heals well and quickly.

Sorry to hear of your escapades. Heal up, do the PT and get yourself back into the game as quick as you can. Take the time you need to heal and don't drag it on for years. The time actually needed is like pay it now or pay more later.

They tried sending me to ANC but I guess their ortho ward was full or something, so they sent me here instead.

Yep, it has some real advantages used even solo in certain situations, and some more when a couple additional drugs are added; however, what you describe is why it fell out of general use for quite a while in anesthesia practices with the exception of very young children who didn’t seem to get the dysphoric reactions. It’s come back a bit into favor again because research showed very small doses would affect the brain reducing the perception of some kinds of post-surgical pain.

And what D Roc mentioned above about good analgesia with cardiovascular support, something the narcotics don’t do is a huge advantage in many cases. It’s not a narco- but classified as dissociative drug.

My dogs seemed to enjoy it, take a trip and never leave the farm as the vet was fond of saying. Older rural folk generally didn't get the reference. IIRC special k was considered a boon in Vietnam but for the dissociative effects.

If you don't mind elaborating..What was so scary about being 'dead'...? ..

You don't like him enough to bring blow?

That sucks! Take care of yourself!

I know nothing about Ketamine but based on the above, don't blow the pt....or anyone else....

Seriously, sorry about the break/dislocation and I hope it heals quickly for you.

Here comes the pain..........

Dam Hang tough! and do what they tell you! Heal up Quick brother!

A guy that was working for me fell off a ladder a couple of weeks ago and broke his ankle - 3 breaks including a compound tibia fracture with frothy blood spurting out, dislocated shoulder, minor head injury. They gave him ketamine on the way to the trauma center and he, too, said that stuff sent him for a trip and he didn't want any more of it.
The surgeons were initially thinking that amputation may be his best bet, but decided to pin things up really good and hope for the best.

Keepin' on with the prayers, Hank!

I think the scariest part was feeling like I was floating above my own body looking down on it and then all the psychedelic stuff kicked in. I have three small kids and feeling like I was dying and leaving them behind scared me the most. Then it became this intense 70's like fun house that I couldn't get out of. My friend that did a lot of acid when he was younger said I had what he used to call a bad trip.

Fish good luck with recovery. I'd imagine the first week might be the toughest. Try to stay ahead of the pain by taking your medication before it gets too bad. Even though a long sleep feels pretty good it's almost worth having a clock wake you every 4 hrs to take your med. Waking up from a 10 hour sleep can be pretty miserable otherwise. That's assuming your Dr. Will give you something like he should for at least the first week or two.

Bb

That sucks. Hang in there.

And be sure to take plenty of stool softeners and eat all the greasy food you want, so as to keep the pipes a-flowing. Those pain meds can lead to some serious constipation.

Phenylcyclohexamines {Keta. and PCP) do not work on the CNS like opioids. Constipation usually not as bad, except IV.

If you can find a doc who is up on his meds, he can call a Rx into a compounder for something like Keta, and amyltriptamine, in a liposome base or DMSO. that can be applied topically avoiding first pass liver problems, and no central body problems. ie. works only on the pain area.


most drugs that cross the blood brain barrier will cause altered states

chemicaly not related to LSD, which is same basic structure as the serotonin released in your stomach.

Looks like I am getting discharged today. Going to hang out in seattle until tuesday, had to wait until I could get a first class seat the whole way back. Gotta have that extra leg room.

take those meds!! get well soon, sir

Sucks now, but you'll be ready for summer.

They tell me it will probably be 3 months before I can put any weight on my ankle. Hoping I don't lose my job.....

Jeez Hank, that would really suck on top of everything else. I sure hope it works out otherwise.

Do as some of the others have recommended and be sure and deal with the pain first before it hurts so much you don't want to do the rehab.

Are you getting one of those "wheelie kneelers" for that leg so you can go to the grocery store at least?

Driving going to be out of the question?

Hang tough and be a good patient..............to yourself first.

Geno

Going to be staying with family for a while.

Ouch. Worse break than my daughter had 2 years ago.

Heal fast!

There’s a perk if you’re looking for one. Hope things go well for you.

ETA: the first class cabin

Where you staying Hank?

Wo man, baby steps.. that would of been on day 2..

My daughter broke her ankle 7 yrs ago, they did surgery on it at elmendorf hospital. To this day she still has hardware in her ankle. Her whole summer was shot in the a$$ she was in cast for the duration of the summer, then physical therapy. To this day her ankle will start bothering her, we are pretty sure it's the screws they put in her ankle. I hope you have a speedy recovery!

Jesus Christ man, best of luck hank.

Thanks for all the well wishes guys, going to be a long road for sure. Puts some of my plans on hold but that's the way it goes sometimes. Just gotta deal with it.

Best wishes. I've never had ketamine, but swore off nerve blocks. They screw me up longer, and make me mean!
"The Warden" knows how to use her .38 - and I want to live a while longer!

Sometimes she goes, sometimes she doesn't...it didn't go. It's the ph uckin' way she goes.

Fackin way she goes.......she went.

My kid was bothered by the screws through the plate. Had that removed a year after.

Hank
Hard cast or Velcro walking cast?

Good luck and hope you heal quickly!!!

That must have been one heck of a fracture/dislocation to send you down to Seattle. I would have thought that Juneau would have had a pretty decent contingent of Ortho docs to deal with that there. Hope you had good insurance with your employer...

Do what you are told on your recovery and don't push the limits. You want that to heal correctly the first time! Revisions and repeat surgeries are a recipe for longer recoveries, more scarring, infection, and chronic pain issues. Hopefully you didn't have a lot of ligament damage with the dislocation/fracture. Physical therapy will be important as well... let them "push" you. Your "youth" is your friend!

Sorry you had to experience Ketamine. Great drug but it has it's issues. Pros and Cons have been highlighted by others. "Benzos" given prior to ketamine will usually help with the dysphoria/hallucinations. Some are just too lazy to give it. We used to use it a lot in the burn unit for dressing changes and debridements which were very painful for the patients. Ketamine provided a level of safety that narcotics could not as it supports spontaneous breathing vs respiratory depression/apnea. Back in the day, we didn't even lock up Ketamine or Pentothal in our OR (in contrast to narcotics and benzodiazepines)!!! Fast forward to today, the age of "experimenters" and "abusers" and everything is locked up behind one or two locked "barriers" including meds, syringes, needles, alcohol wipes, you name it!!! It has gotten so absurd that it makes it hard to respond to real emergencies in the OR! My 'cart" electronically locks automatically after 60 seconds... gets real old real quick, every day.

For all the pain, inconvenience, expense, and uncertainty, be glad it happened now and not 150 years ago. You'd likely be in the belly of a bear!

One day at a time.

They said they could remove them, all depending how the ankle healed. Her ankle healed up fine but My kid deferred that optional removing them, she did want to back in for any type of surgery.

i've had 3 screws in my left humerus, i slit it from the ball down, 32 yrs ago. it bothered me the first few yrs, but hasn't in the last 25 or so.

Had a bone graft in 1992. Ain't nothing like bone pain to grab your attention. Lol

Hard cast.

How's your day been Hank, for hurtin'?

FH, good to see you posting today. Hope the ankle's feeling better.

Not bad actually. Trying to keep moving as much as I can. A fellow 'fire member was kind enough to help me run some errands today, huge shout out to MallardAddict. Hell of a guy for sure. Pretty fun to cruise around in those motorized carts in stores. They don't go fast enough though.

Hey, watch that speed! Also, kudos to MA for the assist!

Not sure why but I am having some really weird dreams. Must be the meds,

Well, looks like they decided not to hold my position for me. Got my walking papers today. Gotta figure out what to do now.

I've got a Leer topper.

Injured on their job site?

Seems the ADA folks would have a talk with them...

Nope, not injured at work.

call them racists! well, that might not work for you... sorry they cut you, something good will come outta this, surely!

Aw that's a drag ,hang in there.It ' ll work out.

Wishing you the best hank.

That sure ain't right and hard to believe it's legal.

It's legal apparently, the company isn't big. It is what it is, nothing I can do about it.

What kind of work did you do?

Actually, the ADA says it is not legal...

Yep just read it as Art says it's not legal.. you might want to check into this.. we don't want you sleeping in the Chrysler New Yorker

That is wrong and illegal.

Depends on the size of the business. ADA and FMLA generally don't apply to small businesses.

Private non-profit hatchery.

ketamine was quite the drug back in college. Folks breaking in vet offices to get it. Syringe in the ass cheeks would keep them dancing a few hours.

Hank, have to comment on this one. First of all I hope that you are recovering well. Long story but I was knocked out of a tree by a broken branch in June. I drove my ankle up through the tibia and fibula and broke the fibula in several places as well as compression fractures on 2 vertebrae. This was on a Saturday evening and I had to wait until morning for surgery. They gave me Ketamine twice to try to relocate my ankle for circulation reasons. I agree on the outer body thing as I was flying over the USA with God talking to me. It was so crazy that when they had to give me the second dose I was really did not want to see what the next dream was like.
On a positive note I was 3 months non weight bearing but went through PT like a Wildman and now can walk with very slight limp after a long day on my feet. It will get better. I have several plates and screws still in there.
Biggest thing tie off on ascent and descent, I untied to come down and was swept out of the tree.

FMLA 50 or more employees ADA 15 or more employees and some states have even more tougher rules.. in the end he might want to look into this.

We had 10 full time employees and a handful of "seasonal" employees that never leave.

That is what I found also...

I know a very good ambulance chaser...

Over your PM limit

Did it seem like a dream or did it seem more real than reality?

Seems that just yesterday the FDA approved a nasal spray derived from Ketamine to treat depression.

At a way lower concentration.

Made room...

Is concentration depressed at high concentrations

Bristoe, not dream like at all . Very realistic. It seemed like I had dreams and craziness for way longer than I was put under for. It was very different from anesthesia.

So why not see the positive in the experience?,.....that your consciousness isn't a part of your body.

Just opened up this thread. Hopefully your recovery, is going well! memtb