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Howard C. Berkowitz hcb at gettcomm.com
Sat Apr 1 21:13:28 BST 2006

Another anecdotal recollection--well, anecdotal after I reviewed the 
chart; I don't remember much of the time in the SICU.

I had a CABG in 1994 at Georgetown, and the stepdown analgesic 
protocol in the SICU went from titrated opioids to Toradol.  Their 
practice, at the time, was to give an initial 3X loading dose, and 
then the conventional Toradol dose, with Percocet po, decreasing the 
Toradol until I could stay on Percocet. Has anyone else encountered 
the practice of a loading dose?  I asked my surgeon, who sent one of 
the cardiac anesthesiologists to visit, and asked about the practice 
-- he swore by it, but said that as far as he knew, it had not been 
reported in the literature.

The only significant complication was total destruction of my left 
auditory nerve, which already had about 20% loss from a childhood 
heatstroke. I'd still tend to think that was caused by a random 
embolus that didn't land some place more critical.

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