We all have those dates that are and will be burned into our memories forever—the happy ones like engagement and wedding dates, births of children, as well as the ones we’re less fond of, like deaths of loved ones and other tragedies. March 12 is one of the latter for me.
The day I juiced my right pinkie.
I was multi-tasking—making breakfast, homeschooling, and juicing some brown bananas. In the process, I failed to assemble the juicer—a Champion—correctly. Banana juice sprayed out the backside, and in an extremely foolish attempt to figure out what was going on, I placed my hand along the backside of the juicer and apparently up into the bottom of the juicer. Of course, I didn’t think I was doing that (putting my pinkie up into the bottom of the juicer) or I wouldn’t have done it. The net result was that the juicer grabbed my pinkie and, well, juiced it. Not my whole pinkie, just over ½” of it. Enough to hurt. A lot.
Blueberry Girl, fifteen years old at the time, completely freaked out, so she was pretty worthless. Ellie was just seven years, and I yelled at her to stay in her bedroom. QOTPE, ten years, remained super calm and got me the clean towel and bag of ice I demanded.
My husband worked a half hour away. There was no way I was waiting for him to come home and take me to the ER. (No matter how fast he came, I knew it wouldn't be fast enough.) And I really don’t like to trouble friends or neighbors for help if I can avoid it. So I drove myself to the nearest hospital, the one where I got gutted like a fish a few years earlier. My experience then was extremely poor and I didn’t want to go there, but I feared going into shock driving into the big city and getting lost as well—I didn’t have a cell phone to direct me.
Naturally, the person admitting me absconded with my bag of ice and let me stew for what seemed like forever. Why he felt compelled to take away my ice is beyond me. Maybe one of the doctors who reads here will chime in on that.
Per the usual (and this was 11 years ago), I didn’t get seen by an ER doc for what seemed like forever. It might not have seemed so long had some insensitive lout let me keep my ice. Anyway, they finally took me back and the doctor mercifully administered a nerve block in the form of bupivacaine.
Most of the time when dealing with average injuries to the fingers when anesthetic is required for cleaning out the wound and/or stitching, the drug of choice is lidocaine, which numbs the area for about two hours. In other parts of the body, epinephrine may be mixed with the lidocaine to increase the efficacy and duration of the anesthesia, but it should not be used on fingers, ears, the nose or the penis.
And when a person does an exemplary job of inflicting injury, a more powerful anesthetic may be warranted. Bupivacaine was the joy juice used on me that day, and it now holds a special place in my heart. It’s used in those times when more extensive coverage is needed and/or for a longer period of time. In my case, I received the initial injection in the ER and then, I believe, another one at the hand surgeon’s office later in the day to help hold me over until the surgery would be performed the next morning.
The references below address some of the differences between bupivacaine and lidocaine, advocating for using lidocaine most of the time because it wears off quicker. There are those few instances, however, where you want that anesthetic to last as long as possible. When people are having to work with knives, tools, and equipment more to provide for their families, there will be more opportunities for injury. Having medications and other supplies to manage trauma is part of being prepared.
And while learning how to perform a nerve block is a good idea (links below)—education is always good—that doesn’t necessarily mean we’ll be using these supplies ourselves. There’s a good chance we’ll be able to find a qualified doctor to help in an emergency. We just want to be sure to have the supplies s/he needs to care for our family members in the best way possible.
And tomorrow, I’ll share how you, too, can get your very own bupivacaine.
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