加里•琼斯 used to be the person everyone could count on to help out when they needed it. 他是女儿林莉认识的工作最努力的人之一, 通常超过20分钟,每天走5000步，很少坐下来休息. But that was all before a surgery that left him in excruciating pain 24 hours a day, 他生命中的每一天.
事情开始于五年前盖瑞做了颈部手术 持续的疼痛. 据外科医生说, the procedure was a success and should have eliminated—or at least significantly reduced—his pain. But in a post-operative follow-up appointment, he told the surgeon he still had pain in his forearm.
The surgeon checked for all the usual issues like blood clots but couldn’t find the source. 她送他去急诊室做额外的检查. 一小时内, Gary was on an operating table getting treatment for multiple severe abscesses in his lower arm. They were all infected with Methicillin-resistant Staphylococcus aureus (MRSA) bacteria. MRSA is dangerous because the bacteria is resistant to most antibiotics that doctors use to treat staph infections.
Gary’s infection was so bad they had to operate on his arm multiple times over the course of several days. 起初，感染还在蔓延, so Gary was sedated while doctors discussed the possibility of amputation with his family members. Fortunately, during the third surgery, doctors could see the infection stop spreading. 他们清理了伤口，给伤口上了真空吸尘器. Within a few days, Gary was discharged from the hospital and on the road to healing.
但还有另一个问题：在他的右臂做了那么多手术之后, 加里的右手失去了功能. 他不能握拳，也不能摆动手指. For a right-handed professional painter, the disability in his hand meant he couldn’t work. He also had to learn to perform daily tasks like eating and signing his name left-handed.
“It was a scary feeling after coming out of the sedation to learn that I almost lost my arm,加里说。. “但我很感激，也很庆幸感染没有蔓延.”
As Gary was healing, he started to feel severe and excruciating pain in his right forearm. 等到他去看外科医生，进行为期一年的术后预约时, 疼痛使他虚弱不堪，影响了他的日常生活.
The surgeon offered to perform a nerve conductive test to find out where the pain was originating. 但是加里的女儿林莉, 谁是护士？, 担心测试可能会增加他感染另一种MRSA的风险. 外科医生把他送到了疼痛诊所.
Pain specialists tried a few tests to find out what was causing the pain but could never pinpoint the source. The best they could do was prescribe opioid painkillers in ever-increasing doses as his body developed a tolerance over the years.
“当你服用那些止痛药时, 我不在乎你是谁, 它会改变你的性格,加里说。. “当我服用那些药物时，我的生活就像进了厕所.”
他的家人也注意到了这些变化. 他的妻子丹尼斯知道他开车不安全, 所以只要他想出门，就得有人开车送他. 他不能独自照看孙子，因为他可能会睡着, and he didn’t trust himself to hold his youngest grandchild for fear his arm might fail and he would drop them. 他最喜欢的爱好，比如远足和打猎，也不在讨论范围之内.
On top of all that, he was still experiencing the most intense pain imaginable. 加里形容这种感觉就像击中了你的搞笑骨, 但大多数人所经历的痛苦并不是那几秒钟，而是, 一直都是这样. “疼痛程度是9或10分, like someone had my arm in a vice and was repeatedly smacking it with a sledgehammer all day, 每一天,他说.
他知道他需要别人的意见. His brother happened to be visiting a friend in Utah County who recommended a surgeon at U of U Health that might be able to help. 他们叫 克里斯托弗前言，医学博士，公共卫生硕士, a 整形和重建外科医生 犹他健康大学的研究员, 外科学系的助理教授, 在整形外科预约了一次.
Dr. 古迪纳夫，外科学系的助理教授 斯宾塞·福克斯·埃克尔斯医学院 trained as a plastic surgeon with a focus on nerve and reconstructive microsurgery. 他擅长复杂的手部和上肢损伤. 他看到的大多数病人在汽车或摩托车事故后都有严重的创伤, 或者是工作中的工业事故.
在初次约见之后. 古德纳夫花了些时间研究加里的情况. 他点了一份 核磁共振成像 CT扫描以及其他一些测试. He consulted with the surgeon from Gary’s original procedure to confirm the details of the surgery and the postoperative course. He found where the nerve was misfiring and felt confident that surgery could help with Gary’s pain.
“他问我，‘你的最终目标是什么?’我告诉他我想停掉止痛药，”加里说. “If I could get function back in my hand, that would be a bonus, but if not, no big deal.”
Dr. Goodenough found significant scarring in the tissues where Gary had abscess surgery. 它包裹着向下进入手部的神经. 大发娱乐大多数人都知道它们是“搞笑骨”神经.
“手术的第一步是释放疤痕组织, 释放神经，给它更多的空间,” Dr. 前言说. 因为这条神经控制着前臂的肌肉, 这个陷阱很可能是加里手部功能受损的原因.
“When your body is trying to heal, everything sort of sticks together to heal the area,” Dr. 前言解释. “但在愈合完成后，该组织通常会收缩. 在这种情况下，收缩发生在加里的神经周围.”
There was still a risk that more scar tissue could form and the pain would come back. 所以博士. Goodenough还在神经周围植入了胶原蛋白. This provides a barrier where scar tissue can adhere, keeping it away from the nerve. 最终包装纸会分解，人体会吸收胶原蛋白组织.
手术前，Dr. 加里对这一系列的结果做好了充分的准备. 他可能需要不止一次手术. 他可能只能缓解部分疼痛. Other reconstructive surgery options might help Gary regain function in his hand later. 与任何手术一样，有出血和感染等额外风险. 根据加里的病史，感染的风险可能很大. 但加里愿意冒这个险.
Gary vividly remembers the feeling when he came out of anesthesia and the surgery pain medication started to wear off. 他说：“我立刻就能感觉到那种剧痛消失了。. He scheduled an appointment as soon as he could with the pain clinic to talk about getting off the opioids. They gave him two options since he had been taking such high doses for so long: go off completely and spend a few days in the hospital to “detox,或者通过逐渐降低剂量来让他的身体断奶. 他选择了后者.
那是在2023年3月, and he is still on track to be off the pain medication by the beginning of 2024. 加里动情地想，这和博士的工作有什么不同. 足够好，手术对他的生活产生了很大的影响.
“I didn’t think I would ever be able to use my hand again and not be in so much pain all the time,他说. “当我没有那么多痛苦时，我的生活好多了. 我不是一个脾气暴躁的老头. I feel like I’m being useful in the world now instead of just a blob on the Earth."
对他的家人来说，这是天壤之别. “我和我的兄弟们找回了爸爸，”林莉说. “以前，大发娱乐不觉得自己有爸爸. 他什么也做不了. 他会尽力帮忙或在场，但这是不一样的.”
加里还注意到认知和心理健康的改善. 他的脑雾消失了，他能更好地记住事情. He also doesn’t feel so bleak about a future where the only choice was to continue on high-dose pain medication. He can go out with family on hikes and look forward to spending time with his three children and six grandchildren.
Surgery had another unexpected benefit: His “mannequin hand” that had no function now has movement again. He can feel his pinky finger for the first time in years and wiggle his fingers. 当他的神经功能恢复时，他仍然会感到阵阵疼痛. Goodenough calls “little zingers”—but at least he knows that temporary jolt of pain won’t last.
为博士. 够了，加里正是他想要大发娱乐的那种病人. “We have seen a lot of developments in the last 10 to 15 years taking care of patients with 慢性疼痛 from damaged nerves,他说. “但除了一小群定期做这项工作的外科医生之外, 没有多少人知道大发娱乐可以解决他们的痛苦.”
这对加里这样的人来说是个好消息, 谁经常相信大剂量止痛药是他们唯一的选择. Even 10 or more years following initial nerve damage, some patients could still get relief. “手术可能不会消除所有的疼痛或完全恢复功能, 但它可以让生活变得更好,” Dr. 前言说.
“Dr. 古迪纳夫的个性很好，他能解释一切。”加里说. “在很多其他医生对疼痛无能为力之后, 听到他说我在正确的地方，他可以大发娱乐我，这对我来说意义重大.”