Monday, December 19, 2011

The Femur Report - Part II


NOTE: This post is rated R for mild strong language and disturbing images.

Introduction

This post continues the sad, alarming tale of my broken femur. If you’ve stumbled on this post without reading my last one, click here and catch up.

As I said in my last post, please note that though I’ve reported this episode as faithfully as I can, I cannot vouch for the accuracy of every detail. Especially where vast pain is involved, memory gets distorted. But I haven’t deliberately fictionalized anything and in fact have tried to be as straightforward as possible in the telling.

Waiting

On Sunday, the day of my crash, I had an overnight in the hospital waiting for the surgery. I don’t know if there was a reason not to operate right away, or if it simply took that long for the surgeons to be available.

My hospital room was the typical multiplex, with curtains separating the patients, so my world was constricted to a curtained cubicle with nothing in it but the adjustable bed and the rolling table alongside with its industrial accessories (e.g., drinking cup, kleenex caddy) the color of silly putty. The nurses were deathly afraid of me, donning rubber gloves for every interaction, even just filling my water. I was shown me the button to press to summon them, and in so many words told not to press it unless I really, really need something. (Kind of like “Go away, kid, ya bother me” except I couldn’t go anywhere.) My eyes were dry. I took out my contact lenses and ditched them on the side table where they writhed and dried up.

I slept okay at first because of the nerve block in my leg, but by the wee hours of Monday morning I was wide awake and suffering. The guy one curtain over was up too, watching some awful TV show. The TV, just beyond my curtain, was closer to me than to him. I could see a clock from my cubicle but couldn’t quite read the hands. I made it through dawn to a weakly lit early morning that seemed to take a whole day to get through. I had a phone in there but couldn’t dial out. My brother Bryan called, and managed to conference in our mom. She took the news pretty well, considering she’s a mom. Bryan and I joked that she should be the one to call our dad and tell him. (Those two haven’t spoken since 1984.)

Surgery

My wife arrived (taking care of our two daughters meant a certain amount of juggling) and in the late afternoon we got a reservation with the surgery department, and headed over there. It was a long trip because my gurney, with the traction apparatus sticking off the end, was too long for all but one of the elevators. Eventually we made it to a much larger curtained cubicle on another floor to await the operation.

It was quieter in there and for some reason—perhaps a more generous serving of pain meds—I felt a strange sense of calm. Maybe it was a forced calm, to protect myself from the unpleasantness of contemplating general anesthesia, or complications in the surgery. Prior to this accident, I’d never been checked into a hospital; had never had surgery (other than the screw in my tibia the previous day); had only broken one bone (tibia, age nine); and basically hadn’t put the medical industry through its paces. I was definitely having some dread; I drank in the sight of my wife, probably flat staring at her, as if saving up my memory of her for—for what? The afterlife? I babbled to her about this and that and everything else. On and on I babbled and she was kind enough not to ask me to shut up.

The surgery got pushed back and back until I was pretty much last on the docket. And then suddenly we were in motion again, down some hallways. We rolled past the nursing station and a convex mirror in which I glimpsed a horrific hollowed-out and jaundiced face, like a rock-video image expertly contrived to be as uncanny and creepy as possible. “Now there’s a sorry-looking bastard,” I thought to myself, just as the realization hit me—or had I known all along?—that the reflection was of me.

Probably you’ve heard about general anesthesia and how they put the mask over your face and have you count backward from 10 to 1, and before you get to 1 you’re out. Well, it’s not really like that. If the patient is a child, they may put the mask over her teddy bear’s face first. Lacking a bear, I chatted with the doctors, all of them very casual and upbeat, and a mask was produced. It wasn’t put on my face right away—it was more like when somebody is handing around beers. Then they had it on my face but nobody was asking me to count anything.

Suddenly I found myself in the midst of something violent. I seemed to be tumbling, head over heels, like I’d been pushed over the edge of a terribly steep ravine. I was being smashed from every side. Here and there I caught a flash of orange—the color of my cycling clothes. I struggled to understand what was happening and ultimately came to realize that I was in a fight—not a fair one, either, I was badly outnumbered—and was getting the shit beaten out of me. It was futile to fight back—all I could do was try to cover my head. And then suddenly I was on my back, in a hospital bed, squinting in the light.

Recovery

There was a dude in there, in the recovery room, sitting on a stool staring blankly at me. He really didn’t look very friendly. I asked, “Where am I?” He stared at me with a look that said, “Don’t make me laugh.” I grasped that the surgery was over. But what was that violence all about? I was really shaken up. “Is the surgery over? Am I okay? Did it go okay?” The guy was still silent. “You’ll have to talk to the surgeon about that,” he said finally. I wondered if the anesthesia had worn off prematurely during the operation. Could I have put up a fight with these guys, I wondered? Had this guy been in the room? Had I perhaps taken a swing at him? Is he wary of me lashing out again?

Still nothing from the guy. If he had just put his hand on my shoulder and said, “You’re in the recovery room, the surgery is over, and everything is going to be fine,” I would have felt so much better. They could hire an actor to do that. What was this guy’s skill set? To cover his ass? To note in my file, “Disoriented,” and move on? Without another word he had me wheeled away to my hospital room.

I got to my room and my curtained cubicle. I was in pain and—my earlier instructions be damned—pressed my button for the nurse. A nurse I didn’t recognize—he looked to be about eighteen—showed up, and I asked for pain meds. He disappeared. Ten minutes later I pressed the button again. He came back, looking sheepish. He explained that I wasn’t in their system—there was no record for me, no file—so they couldn’t give me anything. Sorry. Had I been thinking straight I’d have shown him my wrist band, but of course I wasn’t thinking straight. Just then my phone rang. It was my wife, Erin. She asked how I was and I told her about the file and the problem getting meds. I didn’t have much else to tell her.

I lay back. My original I.V. site, the inside of my left elbow, had been abandoned. It’s just as well—it had become blood-crusty and gross, the needle slack and flopping around, before the surgery. And now I had a big bandage on my left wrist, which was peculiar because it seemed like one of the few places I hadn’t been injured from my crash. (I’m exaggerating, of course; my whole left side was unscathed except for road rash on my fingers.) My right thigh was swollen to the size of a belly, my leg all wrapped up in miles of Ace bandage. There was a tube coming out of my leg attached to a weird double-disk contraption, floating free in the bed. I had a new I.V. going into the back of my right hand. The TV blared next to me. I zombied out for a spell, but couldn’t sleep due to pain.

Eventually—I have no idea how long I waited—another nurse showed up and apologized for the mix-up with my file. I’d been brought back to my room just as the shift was changing for the nurses, hence the confusion. (Such great timing. I made a mental note to take the recovery room guy off my Christmas list.) Finally I got some pain meds. Maybe ten minutes later a third nurse came over, telling me my wife was on the phone but they couldn’t put the call through because it was after 10 p.m. (The TV can be on loud all night, but humans must be shushed.) The nurse said that my wife wanted to know if I’d finally gotten some pain meds.

Suddenly I realized how ungrateful I had been: when I’d talked to Erin about the pain med problem, I thought I was just griping. I didn’t realize that by telling her of my problem, I had launched her into action, that from that moment forward she’d be doing everything in her power to resolve the issue. She’d probably been all over that nursing station like a rash to get things cleared up. Of course she would: “sucks to be you” is not in her vocabulary. I told the nurse—who herself hadn’t been filled in on anything—to tell my wife things had been ironed out and I’d gotten my medicine.

With my pain relieved, I was able to sleep for spells at a time. There was a device like a blood pressure cuff on my left calf that periodically inflated, then gradually deflated. Its purpose was to increase circulation, so as to prevent blood clots. The way it rumbled on my leg was like a cat purring, and a dozen times that night I awoke from a light sleep with the pleasant awareness of my cat Misha purring and stretching against my leg. Then I would remember where I was and the actual source of the vibration. At one point a nurse was attending to me, helping get me comfortable, soothing me with words, and checking on the device, and she had the patience to listen to me talk about my cat. “Mmm-hmm,” she said, sincerely, and said something nice about cats. She was a really sweet and caring nurse—as good as they come.

Purgatory

I needed to log thirty-six hours of hospital time, enough for a course of I.V. antibiotics to get into my system, before I could go home. I managed to sleep through the night until early, early the next morning (Tuesday). The TV behind the curtain could not be stopped. Information was coming in, drip by drip, of a big shooting in Oakland. The newscaster repeated every few minutes that one of the victims was a year-old baby. He wanted to be very sure nobody missed this point. He brought it up again and again, like a bully on the schoolyard rubbing it in. Across the hours of this coverage—one tiny new fact every half hour or so—there were the ads, depressing ones. A vocational college to try to re-employ you. A reverse-mortgage to get you “the money you deserve” (translation: “here, let us finish you off and completely destroy your financial picture once and for all, you stupid wretched bastard”).

My unit had been equipped with a urinary catheter. I have to tell you, these devices are overrated. When I had discovered the thing the night before, I was of two minds about it. First, I felt it was totally unnecessary, as I’d told the surgeons right before the operation that I’d just finished completely emptying my bladder. I guess that wasn’t good enough for them. At the same time, I looked on the bright side and thought, “Well, for once in my life I won’t have to get up in the night and pee. That’ll be nice.” But catheters aren’t like that. They never actually drain your bladder. In fact, the pee just sloshes back and forth between your bladder and whatever is at the other end of that tube. It’s really unpleasant because you always feel like you have to pee. Now I lay in bed and wondered who had thought this thing up. I pictured two surgeons who had just had their operating table soiled by their patient, and one surgeon says to the other, “Why couldn’t we just shove a tube right up the patient’s dick to drain off his piss? Make things a lot easier.”

Because my surgery had been pushed out so late, I had worried about getting dinner afterward, so Erin had gone out to the grocery store and outfitted my room with enough food for an army, or a bike club. I’d been too out of it to eat after the surgery, but now I managed to eat half a sub sandwich. I hadn’t eaten since Saturday evening (this was Tuesday morning) but after that half-sub I couldn’t eat another bite. My breakfast arrived and I couldn’t look at it, other than the milk. My neighbor was complaining—“Why do you keep bringing me this? I can’t eat this!”—and later I heard him barfing. No prima donna he; whatever they were serving him was literally making him ill. He would alternate between heaving and cussing.

On the plus side, my phone started to ring. My wife had gotten word out to my bike club about the crash; there had been much speculation because a cyclist from another club saw me being loaded into the ambulance and thought he’d recognized me. So calls began to trickle in from friends. I was so grateful for those calls. They reminded me that there was a world outside my curtained cubicle, and a world outside the gangland shootings and daytime TV, a world that I still belonged to, whose inhabitants still remembered me and wished me well. And then Erin arrived, bringing all kinds of goodies: an MP3 player, a book of existentialist philosophy, and my glasses (so I could finally read that clock).

During Erin’s visit, the physical therapist came around to get me on my feet and using a walker. This seemed absurd, of course, but she assured me it was possible. She had more info than I did about the surgery: because of the titanium rod, my leg was technically capable of supporting my full weight. She carefully lowered my leg to the floor. Somehow I got upright. I supported myself on the handles of the walker the way lazy people do the Stairmaster at the gym. My right (bad) leg was basically dangling, and that alone hurt. I pushed the walker forward six inches. I didn’t dare put weight on my right leg, and thus didn’t dare raise my left foot from the floor. So I used a squirming motion to slowly advance my left foot six inches. My right food would do nothing. It was about as responsive as a phantom limb; it could have been a counterweight strapped to my hip. I reached down with my right hand and pushed my foot forward. Amazingly, it complied, sliding forward six inches until it was level with its strapping, heroic, uninjured mate. I repeated this process and made a grand tour of about six feet out and six feet back, which took about five minutes. The physical therapist promised to return for another session later that day.


After my wife’s visit—she had to compromise between attending to me and giving our kids as normal an experience as possible—I put in headphones and listened to some music to drown on the TV. I chose the lightest, easiest tunes possible (e.g., Sade, Beck) and focused my entire brain on it. The music had never seemed so complex and multilayered, and for days afterward every track I’d heard would come back and invade my head. I almost always have some tune in my head, using about 2% of my brain power, but these came back strong, taking like half my brain. The tracks I listened to in there are ruined for me forever, so strong is the negative association with those hospital days.

I was in serious pain. The hospital ran out of the drip version of the pain medication and they started giving it to me orally. That didn’t work nearly so well. The pain began to take over, especially in the long dull sections of the day when I wasn’t on the phone. Soon it was all I could do to try to find a position where the pain was manageable. No other thought was possible; the idea of, say, reading seemed absurd. Using my hands I would adjust the position of the leg, causing it to shoot out rays of pain in every direction, and then hold very still and wait to see how far that pain would recede. If it went right back to the baseline (i.e., unacceptable) pain level, I’d try again. And on and on.

To be continued…

It’s late and time to think about something else for awhile so I can sleep. So I guess this is about as good a place as any to cut my tale off for now. I reckon there will be one more installment of my unpleasant story. There’s still a bit more to tell.

Other chapters

2014 update: it occurred to me to add links to all the chapters of this tale now that they're available. Here you go:

The Femur Report - Part I (posted Dec 11, 2011)
The Femur Report - Part III (posted Dec 28, 2011)
Physical Therapy (posted March 11, 2012)
Bike vs. Car - How I Broke My Femur (posted Nov 27, 2013)

4 comments:

  1. Dana - Man, I don't wish this on anyone. I'm sorry to hear this happened to you. The pain you described reminds me of Joseba Beloki's crash in the 2003 Tour. I hope you're feeling better these days. Hopefully you'll let your readers know how the crash happened and what your prognosis will be going forward.

    Hope you and your family have a Merry Chrsitmas. And hopefully a much better new year!

    Jeff
    Louisville

    ReplyDelete
  2. Dana, what a tale. I'm guessing that it really hurt, and that it still hurts. After reading your first installment, I started in on a comment to make fun of your pain, maybe even call you a sissy or something, but having never really experienced pain myself (my back hurt last year, but if I held perfectly still in just the right position and stopped breathing, it wouldn't even hurt), I thought better of it. I guess I'd figured that I'd probably experienced some level of your suffering when trying to keep up with you on the bike, but no, it's probably nothing like it. Our experiences with pain are usually second-hand, either through T.V. or movies, and in the movies when the guy gets his arm blown off or whatever, he just winces like a man for a moment then keeps doing his heroic deed. Here it sounds like you've become a pain-med junkie, like you’d do anything for “the meds.” Maybe we're being too hard on those Rush Limbaugh types who get hooked on pain killers.

    Anyway, I'm glad that you're recovered enough that you can still blog. Looking forward to the next installment.

    Bryan

    PS I'm sure you'll be crushing me on the bike in no time. Hang in there!

    ReplyDelete
  3. Fellows, thanks for reading, and for commenting. I have to admit, I've thought of Beloki's terrible crash of '03 a great many times since my crash, because he sustained the same injury I did. I watched a YouTube video of that crash yesterday, and Beloki sure looks to be suffering. Doesn't look like he's screaming, though ... doubtless he's a far tougher dude than I.

    Bryan, you talk about different types of pain. I really think our ability to tolerate pain has a lot to do with control. We can suffer on the bike because we're able to modulate the pain. Pain is trickier when it's mixed with fear. A lot of my suffering right after the crash was a) fear of nobody finding me, b) fear basod on knowing something was seriously wrong with me but not knowing what, and c) fear of not getting any relief and being trapped by the pain.

    Once the worst of the pain was over--which in my case was about a week--I was able to wean myself off the pain meds pretty quickly. This was not easy, but I made a decision to suffer a fairly predictable and manageable amount of pain rather than risk getting hooked on the meds. So, I have to disagree with you, Bryan, about us maybe "being too hard on those Rush Limbaugh types." Once somebody is illegally/illictly obtaining prescription drugs, because he wants more of the drug than a doctor would ever prescribe, that person is no longer treating pain--he's getting high. I have ZERO tolerance for that kind of weak behavior.

    ReplyDelete
  4. Obat Aborsi,,
    Nice bag you can earn money from that
    Thanks for your posting
    Visit me @, Jual Obat Aborsi,,

    ReplyDelete