The Femur Report - Part III

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

Introduction

This post finishes up the dark story of my broken femur.  (Of course it’s still broken, and it’ll be a long road back, but this will be the last time I’ll write about it.)  If you’ve stumbled on this post without reading my last two, click here and here to check out my first and second installments.

As I said of 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.

Surprises

During my third day at the hospital (November 29), my pain only got worse.  A nurse arrived unbidden at my bed and announced it was time for some pain killers.  At first I was pleasantly surprised—this was the first time I hadn’t had to ask for them—but then I saw him popping two rather large white tablets out of a foil pack.  “What are those?” I asked.  He replied, “This is Tylenol.”  I managed not only to keep from snorting but from saying something snide like, “Do you have any placebos I could use instead?”  I kept quiet because I sensed I had little goodwill to spare with these nurses, but really the Tylenol was a joke.

The stretches between the real medication grew longer.  I was now getting half the dose I had originally been given, and instead of every four hours it was every six.  I overhead a nurse talking about a shortage.  The pain had strange characteristics unlike anything I’d experienced before.  Instead of the leg just aching and throbbing and giving stabs of sharp pain—though I did have all of these—I also had the sensation that my thigh was as big around as a barrel, and that the bandages running along my three incisions were a quarter-inch thick and made of plywood.  My left wrist—uninjured in the crash—was also causing me a lot of pain; a nurse unwrapped the bandage from it to reveal that the whole wrist was a deep purple, with a stripe running along it of an even more saturated hue.  Nobody could explain what that was about; perhaps it was a botched arterial line.

I was on the phone with a friend when a nurse came around to inspect me.  She didn’t seem to need any input from me so I continued my conversation.  Suddenly there was an intense, sharp pain in my male unit and I shrieked (into the phone, of course).  All at once, the nurse had yanked out my urinary catheter!  The pain was accompanied by a sensation of frightening wetness which I took at first to be blood, but which was actually just some leftover urine.  My friend on the phone must have feared the worst and asked what happened.  “A nurse just ripped my catheter out!” I told him.  She looked at me sheepishly.  “Sorry, I figured if I did it all at once it wouldn’t bother you so much,” she said.  Sort of the ripping-off-the-Band-Aid strategy, I guess.

Later, another nurse expressed surprise that I’d filled my bedside urine receptacle.  “A lot of patients find they’re unable to urinate the normal way after they’ve been catheterized,” she explained.  I hadn’t known this and now I was greatly relieved.  From this moment forward, successfully peeing into that thing felt like a triumph.  In fact, whenever I did it I got Homer Simpson’s voice in my head yelling, “Yes!  Yes!  Ohhh, Yes!”

Presently the physical therapist arrived for my second session of the day.  Again, this consisted of taking a short march, with my walker, from my curtained-off cubicle down the row of other cubicles and back.  It was oddly exhausting but I guess I did well enough, for she announced that I’d have one more session the next morning, and if I could manage a short flight of stairs, she would sign me off as complete—meaning I could go home.

This great news was followed by another challenge:  after two and a half days, I had to defecate.  I steeled my resolve and figured that based on the success of my expeditions with the walker, I could handle the restroom.  I’d need help, of course.  I asked a nurse, and she responded as if I’d asked her to help me rob a bank.  “I’m not allowed to assist you with that,” she said.  “You have to get a physical therapist.”  Of course I had no way to summon the physical therapist, so I asked for a bedpan.  The nurse looked at me with disbelief, as if she’d thought bedpans were a best-kept-secret of the hospital.  “A what?” she asked.  Nice try.  “A bedpan,” I persisted.  She stalled for time.  “What size?” she finally asked.  What answer was she expecting?  “Small”?  “Never mind”?  I told her Large, and a bit later she came back with what I suppose was the large size bedpan, though it didn’t seem very large to me.  Not that I was an expert:  it had been sixteen years since I’d last seen one, when my brother Geoff was in the hospital.  And of course I’d never seen him actually use it, so I had no idea what to do.  Not that I was about to ask for a tutorial at this point.  I had to wing it. 

When I’d done my damage—serious damage, I might add—I found I couldn’t get the nurse to come over.  With great effort I held myself suspended over that foul, fouled bedpan for what seemed like a very long time.  Finally the nurse came over and I asked for help getting rid of it.  She said she’d have to come back.  They always say that.  I asked her to please hurry.

She didn’t.  To make matters worse, a couple of friends had arrived to visit.  I could hear them being denied access, based on me being “detained,” and I think I heard them chuckling.  And yet the nurse still wouldn’t come back.  Finally she showed up, her face awash in reluctance, and she gave an Oscar-worthy performance of having never in her entire career seen a patient actually use a bedpan.  Where I was desperate, she was hesitant.  The two of us grappled haplessly there, trying hard to keep the sheet from getting soiled during the disposal process.  It was like Tweedledum and Tweedledee trying to clean up after a grisly murder.  Thus was my last shred of dignity finally expunged.

Visit

As the patient across the curtain from me asked for some air freshener, my friends were finally admitted to my cubicle.  They’d come straight from work, which reminded me that there was still a world out there in which people worked in office buildings.  Not long after, four more friends arrived—all of these bike people—bearing Zachary’s pizza and (for themselves) wine.  Needless to say my spirits were buoyed; actually, I think salvaged would be the better word.  At first I didn’t think I’d be able to eat any pizza, as my appetite had been absolutely nonexistent since the previous morning.  I had one slice, and then, to my own astonishment (but nobody else’s), had another.  Looking back, those two slices and a third one the following morning were almost all I ate while at that hospital.

 Of course we all had much to discuss, such as the events I related to you in Part I of this tale.  Before long we had a full-fledged, rollicking dinner party going.  All this was of course good distraction from my physical pain; when I think of the visit I don’t remember suffering during it.  As a bonus, for the first time in two days I couldn’t hear that infernal TV across the curtain in the cubicle next to mine—we were drowning it out.  By the end of the visit I was pretty exhausted but was sorry to see my friends go.

My worst night

The evening dragged on and on.  There was a violent action movie playing on the TV, four feet from my head.  My leg was killing me.  My head felt vacuumed out, my mouth completely dry.  My mind wasn’t calm enough to allow reading.  I was tired of listening to music and didn’t want to ruin any more of my favorite tunes though future association with this bleak time.

Then there was a shrill alarm from a nearby cubicle.  I knew what it was, from my brother’s hospital days:  an I.V. drip had gone dry, or was on the verge of it.  It’s an important alarm, because if an I.V. goes completely dry, the vein collapses and can no longer be used.  But what else did this alarm suggest to me, with its absolute ear-splitting, incessant shriek?  It took awhile but I figured it out:  it was just as piercing and intolerable as a newborn baby crying.  That well might have been the design intent of this alarm, just to make completely sure it would be impossible to ignore.  And yet, astonishingly, the nurses—all four of them—were actually managing to ignore it.  Where were these people?  I pressed my call button.  Eventually a nurse arrived, looking put-upon.  “What is it?” she asked.  “Well, are you ever going to do something about that alarm?” I asked.  She looked startled, as if she simply hadn’t heard it until now.  Unbelievable.  (Why hadn’t the patient in that cubicle summoned her?  I have no idea.  Maybe he was dead, or maybe that cubicle was empty and it was just a malfunction.)

With the shrieking finally silenced all I had to contend with was the sound of people being shot, run over, and tortured to death.  The TV movie didn’t bother with music or dialog or anything:  just nonstop killing.  My wife hadn’t called, and I was getting worried that the hour would come when I couldn’t take phone calls, or that my calls weren’t making it through.  I had to tell my wife about the prospect of being released the next day, so she could find somebody to watch our kids while she picked me up.  When a nurse happened by I asked her if I could please borrow her phone, just for a couple of minutes, to call my wife.  (My own cell phone was with the police, along with my bike and other stuff gathered at the accident scene.)  The nurse looked down at the cell phone clipped to her waist, as if it had betrayed her with its visibility.  “Well, maybe a little later, when I come back,” she said.  Translation:   “No, and just to be sure, I’m never showing my face back here again.”  (Obviously if she’d been willing to loan her phone to me, she’d have just said yes.)

Suddenly, an object came sailing at me from behind the curtain across the aisle.  Amazingly, I managed to catch it.  It was a cell phone.  “Call your wife,” came a voice from behind the curtain.  “Talk as long as you want.”  I was filled with a sense of camaraderie with this unseen fellow inmate.  I called Erin, made some quick arrangements for my Great Escape, and then asked the nurse very sweetly if she could possibly return the cell phone to its owner.

As I tried to fall asleep I start to feel really, really bad.  My pain escalated and my heart was racing.  I could hear my pulse pounding in my ears.  Meanwhile, the wind was picking up outside and howling right through the leaky windows on my right, chilling me to the bone.  I even started to feel delirious:  I was having increasing difficulty convincing myself that the screams from the TV weren’t coming from actual people in the next cubicle, and that the wind through the window wasn’t going to spin me off into the night.

Somebody came by to take my vital signs.  Every one of them was bad.  I had a fever of 102; my blood pressure was crazy high; my pulse was 90 (compared to mid-40s normally).  The person taking these readings looked a bit concerned and commented on my fever, but then left.  She wasn’t one of the regular nurses.  Another hour crept endlessly by, my pain continuing to increase.  I was starting to feel frantic.  I pressed my call button.  A nurse came over.  I explained that my pain was through the ceiling and all my vital signs were bad, and that I didn’t feel right.  She said, “Well what do you want me to do?!”  I said I wanted a doctor.  She left.

I started to worry that I was actually going to die.  Looking back, this wasn’t exactly rational, but then I was half out of my mind.  I had a vision of a sensor moving through the room, beaming a red line that picked up everything and recorded it, and how quickly it would pass over me, how insignificant my form would be.  It would register even less then the bed I was in.  Moreover, my small existence was confined to the immediate present:  the fact that I’ve walked the earth for forty-two years was immaterial, a flash in the pan, and the future was completely up for grabs.  If I died right now, I thought, I would be erased so thoroughly I might as well have never existed.  It was the closest I’ve ever come to believing in my own mortality.

I pushed my button again.  A different nurse came.  I repeated my complaints and again asked for a doctor.  Instead I got the head nurse, but at least he was sympathetic.  He also seemed as disgusted with the other nurses as I was.  The first thing he did was give me more pain meds.  “You’re allowed to ask for these,” he said.  “The nurses have guidelines but they’re only guidelines.  They act like they’re rules but they can always consult with the doctor and they know it.”  Then he stripped off my bedding.  It was all tangled and knotted up, doing me no good.  Then he started pulling up and discarding the absorbent pads from beneath me.  These pads are basically the same thing as what you get with store-bought chicken, that sit between the chicken and the Styrofoam tray, to absorb drippings.  “Don’t let the nurses use these,” he said.  “They’re disgusting and uncomfortable.”  I couldn’t have agreed more.  The guy put my bedding back in shape and gave me an extra blanket.

After that I felt much better—just to have been paid attention to was greatly comforting—but the pain was still awful.  So I tucked my blankets in all around myself, thinking of how I used to swaddle my daughters when they were babies.  In my delirium my cubicle had seemed to grow and grow, to where it was the size of a handball court, then ever larger, like I was Alice in some Wonderland scenario.  I decided to try using these illusory sensations to my own benefit, and imagined I was a little Asian doll, wrapped tightly in a paper dress that was like origami.  I held absolutely still in my bed and soon began to feel I was rising up out of my paper-doll body, looking down at it, tiny but perfect in its symmetry.  I rode this perception as long as I could and the next thing I knew, it was hours later and I’d actually managed to sleep.  My head and body had that vacuumed-out, dried-out sensation and the pain was awful, but morning was that much closer, and it was finally time for more pain meds.  I even managed a couple more hours of sleep before dawn, and by morning the TV channel had switched to something merely asinine, rather than ultraviolent.

Final Push

Late the next morning (November 30), the physical therapist returned for my “final exam.”  She reiterated the plan:  I would use the walker to leave the hospital room, go down a hallway, and stop at the stairs.  Then I’d switch to crutches, go up a short flight and come back down, and then switch back to the walker and return to my bed.  If I could do all this, I’d be a free man.

It took a great while, perhaps ten minutes, to make it to the stairs.  Finally I got to the landing, but suddenly started to feel incredibly dizzy.  I told this to the PT, who had me turn so my back faced the wall, and said to lean back a little bit to rest against the wall.  She supported me at the waist.  I felt dizzier and dizzier.

Suddenly I awoke.  Holy shit, where was I?  How long had I been out?  Amazingly, I was still standing.  My vision returned and I saw the PT looking up at me, her face a picture of great concern.  There was also a nurse looking at me worriedly.  The nurse had brought a chair.  “Are you okay?” asked the PT.  “Did you pass out?”  Imagining another night in this hospital, I lied.  “No, I didn’t pass out, I’m okay, just a bit dizzy,” I said.  They sat me down in the chair and the nurse slapped a blood pressure cuff on my arm.  “You are really pale,” she said.  My blood pressure was extremely low.  I was taken back to my bed in a wheelchair.  Needless to say I’d totally flunked my final exam.  But to my surprise and relief, the PT said she’d give me another chance later in the day.

Not long after she left, I got a phone call from an MD friend of mine.  Hearing what had happened, he asked how long before my physical therapy I’d had pain meds.  I said not long before.  He advised that the pain meds can lower your blood pressure and lead to dizziness.  Remarkably, another MD friend of mine called not long after, and gave the same advice.  So I stopped asking for pain meds, and when the PT returned, a few hours later, I felt more confident.  Hedging her own bet, she’d brought a wheelchair.  “This time, I’m wheeling you to and from the stairs,” she announced.  At the stairs, I got up on the crutches, and heeded the PT’s advice:  “Up with the good, down with the bad.”  That is, I planted my good foot on the higher step and brought the crutches and bad leg up to meet it, and then at the top turned around and came back down leading with my bad foot.  It worked, and I passed.

From there, many hours passed in bureaucratic hassles.  The nurse wasn’t allowed to give me pain meds within an hour of departure, and since my departure time got dragged out two hours, I was in great pain when it was finally time to leave.  (I know:  waah, waah, waah.)  I was wheeled through the halls, into an elevator, down into the crowded lobby, and Erin went to get the car.  She pulled up and I was wheeled out there.  Getting into the car was really, really hard.  I had to lower the parking brake handle and grab the steering wheel and slide myself almost into the driver’s seat to get my right leg—which wouldn’t bend—into the car.  Erin got me all settled in and then, reflexively, gave me a little pat on the leg.  I yelped in pain.  Some homeless dude standing on the curb called out, “Man, you can pretend you’re embarrassed now, but when you get home you’re gonna want her to be pettin’ you!”  This was amusing, but then the guy repeated his quip continuously while Erin loaded my walker and crutches in the car and we slowly rolled away.  He wasn’t quite right, that guy.

Three friends had arranged to meet us at our house, mainly just for a visit but also to help moving me in from the car.  It was tricky extricating myself, Erin carefully moving my leg like a piece of rotting lumber.  It was like a contortionist’s act in reverse.  It’s a good thing my friends were there, because I’d forgotten our street is on a slope that ran perpendicular to my trajectory with the walker.  The walker is a spindly thing and surely would have buckled and collapsed like a crappy tin cheese grater had my friend not bolstered it from the side.

I made the ten or twelve feet to the porch steps in possibly less than two minutes.  I switched to the crutches, and here I had intended to rest for a minute.  But suddenly I felt really dizzy, just like during my ill-fated PT exercise, and I feared I would faint.  So I pressed on, getting past the stairs and continuing, on my crutches, in a sort of slow-motion sprint to the door.  Erin had it open already, and somehow I made the couch.  I was so relieved.  I had made it.  I was actually home.

Now

It’s been a month since the crash.  I can get around the house pretty adroitly with the walker and on crutches now; I generally use the crutches because I feel they present a slightly less pathetic sight for my family.  Sleeping is really difficult—I’ve never been good at sleeping on my back, and my leg still hurts—but it’s so nice and quiet here.  The only sounds are conversation, my daughters playing, the clatter of dishes, and my daughters practicing their instruments.  Fortunately my job allows me to work from home, so I’ve been back at that.  My right leg can bend almost ninety degrees if I dangle it from the edge of the bed and push on it with my other foot.  I have lost fifteen pounds and get chilled easily.  I have a long recovery ahead of me but I’m on my way.

dana albert blog

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.

dana albert blog

The Femur Report - Part I

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


Introduction

I had a bad bike wreck on Nov 27. Writing about its aftermath isn’t the most cheerful way I could spend my time, and I wouldn’t expect reading about it to be uplifting. Still, it’s been an extraordinary experience and it would seem a shame not to record it.

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 plain and simple as possible in the telling.

I’m not going to get into how the wreck happened. That’s a whole other story that makes me angry to think about. So I’ll start with when I hit the ground.

The ground

I’m on the ground. A second earlier I was upright, on my bike, enjoying a mellow, unrushed descent at the end of my ride. I’m astonished at how quickly I was dropped to the ground, like a duck shot right out of the sky. I’ve been cycling competitively for thirty years and this is not how a crash usually unfolds. I’ve written at length at how in a crash situation time seems to slow down and I can easily perceive what is happening and what action to take. Not so today. BAM—like that, I was down. I heard my helmet sliding on the ground but only for a second. I didn’t slide much, but rather ground to a stop.

Every experienced cyclist knows that after you crash the first order of business is getting out of the road. This isn’t a sports field where you have a moment for self pity or mustering your resolve—it’s a road and you could get run over. So you scramble to get up as fast as you can. In the past I’ve started this scramble even before I stopped sliding along the road. But today I cannot begin to get up. Mainly this is because I cannot stop screaming, and the screaming is taking all my energy, all my will. I am screaming louder than I thought possible.

I’m screaming in pain, which is remarkable. Crashing on a bicycle doesn’t usually involve that much pain, at least not up front. Initially our bodies give us a surge of adrenaline and endorphins and the pain is masked almost completely. We can snatch up our bikes, run off the side of the road, check things over, and (if it’s a race) can often straighten out our handlebars, climb back on, and start chasing back to the group. The pain doesn’t arrive until later, when you’re cleaning out your road rash. But today? This was at least twice as much pain as I’d ever felt before in my life.

I can see my bike in the road. The impact has knocked the chain off the front chainwheels, which vexes me inordinately. The water bottle has been knocked out of its cage. Closer to me, I see blood dripping on the ground but I’m not sure what part of me it’s coming from. And the ground, this road—it’s a medieval surface of smooth pebbles imbedded in asphalt. I can start to see why such a relatively low-speed crash has hurt so badly—it’s an incredibly hard surface (pebbles being far harder than asphalt) and doesn’t allow you to slide. Whoever chose this surface material should be tried for a war crime.

Help

With astonishing quickness several people swarm around me. They’re local residents who have heard my screams. “I’ve got to get out of the road,” I tell one. He is crouching next to me. “Don’t worry, we’re stopping traffic,” he said. For a moment I think of asking him to get the Advil out of my toolkit but of course I see the absurdity. “I’m in so much pain,” I tell him, and scream some more. I’ve found what for some reason seems the least painful position: my right leg is straight forward—its hip is the center of the pain—and my left leg is bent double so I’m in a half-squat, leaning forward, supporting as much weight as possible on my left hand. My left arm shakes with the effort. “Who has a signal?” someone asks. “I do, I’m calling,” someone answers. I tell them, “I don’t think I need an ambulance,” but immediately I realize this is wishful thinking. “Actually I do.”

A guy on my left says, “I’m a doctor. You’ve got a broken femur. We called an ambulance.” There’s a cyclist on the scene and he has taken my bike out of the road and leaned it up against something. I can see he’s put the chain back on and I take strange comfort from this. Someone asks me for my home phone number and in a moment I’m talking to my wife. This is the worst call to have to make. I give her the news—my head is fine, but something is broken—and hope that I sound merely miserable, not scared.

A fire truck arrives from a station that is very close by. I beg for pain meds. They work quickly but it could never be quick enough. I get 5 mg of morphine intravenously but it doesn’t do anything. They’re cutting off my clothing. The EMT gets to my right shoe and I ask him to let me undo the rotary buckles and take it off, sparing its life.

Here a massive wave of gratitude washes over me. This is the moment when I go from being in charge of my situation—which is to say, being helpless—to when I turn my situation over to those with special training who know exactly what to do. Imagine if I were on a battlefield, or a remote road alone, or on a mountain where my survival meant crawling for miles through my pain and injury. Then I’d really be screwed. I am relieved to be passively placed in good hands, where all I have to do is answer questions.

They get my helmet off. Now the medics are preparing a long scary-looking metal apparatus next to my right leg. The man who earlier identified himself as a doctor tells me, “They’re going to have to put you in traction. This will pull your right leg straight. You’ll have to lie back. It’s going to hurt like hell.” It does. I can’t stop screaming. It seems like nothing they could possibly do to my leg could hurt more than this. The traction device is basically an iron maiden for the leg. I get 5 mg more morphine and that’s all they’re allowed to give me. It’s still not enough, not even close. An ambulance has arrived somewhere along the line and I’m scooped onto a stretcher and into the back of it (more screaming). I’m begging for more pain relief.

(I’m going to pause my story for a moment now to make an observation: I can now speak from experience about the stupidity of torture. To be freed from this pain, I’d have told anybody anything. The fact that I have no secrets simply means that I’d contrive something, anything I thought would satisfy a questioner. If the medics had asked, “Are you part of The Institute?” I’d have said yes. If they’d asked if I knew who masterminded Operation X, I’d have said yes. I’d have begged for a list of suspected operatives and randomly circled names, if it meant being freed from this pain. That is how desperate pain can make you.)

At some point I am given some other drug, perhaps to treat anxiety, and I start to suffer less. But every bump in the road—and there seem to be endless bumps—makes me cry out. The ambulance’s suspension seems to be shot.

Hospital

We arrive at the hospital. I am whisked from place to place, hallways and curtains, and end up in the X-ray department. It’s all huge and industrial and Orwellian and when somebody says, “We have to move you onto the X-ray table” there’s an unmistakable note of apology in his voice. Four of them lift up the whole sheet and move me. It is impossible to set somebody down lightly when he has a broken femur and the table is hard as glass. More bloodcurdling screams. I have a flashback to 1984, when I was fifteen, in a hospital in Wyoming after a car wreck with my mom and two of my brothers, and I suddenly heard my brother screaming his head off from all the way down the hall. The shock of recognition—that’s my brother screaming!—was not so different from the shock I feel now: that’s me screaming!

The X-ray table is my worst enemy for what seems an endless period of one X-ray after another, many with my body arranged in torturous positions. They know my femur is broken but are trying to figure out if my pelvis is broken. Finally another excruciating transition to the gurney, and I’m taken back to a curtained-off row.

They get some more pain meds in me and I’m starting to get some real relief. Presently my wife arrives. Of course I’m glad to see her but also full of remorse at putting her through this. If she were some fiery hot-blooded type who slapped me across the face first thing, I’d probably have felt better. Of course it’s preferable that she’s stable, calm, and strong. She knows she doesn’t have the luxury of getting upset and making this her problem—it’s mine and she’s my support. A team of doctors arrive. “We’re going to drill a hole through your tibia and insert a long screw, so we can get a good purchase on your leg for traction,” one of them explains. I love the idea—if it means getting this barbaric clamp off my leg. “You’ll take the old traction thing off as soon as that’s done, right?” I ask. They assure me they will—soothingly, as if we’re in agreement that the old traction device is the center of all my pain.

The drill

My wife asks why this operation wouldn’t be done in an operating room. “Oh, we don’t need a room for it,” they assure her. “It’s not like a big surgery or anything, it’s just a procedure. And we have to do it right now.” And they’re not joking, there’s no leaving and coming back, no apparent bureaucracy, they’re already preparing. They put on these Plexiglas face shields like a SWAT team would wear. Now, maybe it’s just the pain meds, but suddenly I’m struck by how improbably good-looking they all are. It looks like the cast of an TV show, an eye-candy hospital drama that isn’t even trying to be realistic.

They describe the local anesthesia they’ll be using: Novocain and something else. I warn them that I historically metabolize Novocain very quickly, so it usually starts to wear off by the time the doctor thinks it should be kicking in. The doctors offer a blandly reassuring response. They’re putting the bit into the drill. I swear the bit must be a foot long. I crane to see what kind of drill it is. I’m hoping for Mikita or Skil. If it’s Black and Decker, I’m out of here. It turns out to be Craftsman, which is just barely satisfactory. I relate to them a story from my dad about a fleck of chrome from a Craftsman tool that befouled a photocell in a satellite and sent it way off-course. (At that time I may have thought I was only thinking about this anecdote, but Erin assures me I actually told it.) Now they’re ready to start.

“Erin, you may want to make yourself scarce for this,” I tell my wife, but she’s sticking around. I suppose she feels a duty to stand by me, but it also wouldn’t surprise me if she had feelings similar to my own: as horrible as this is, it’s fascinating. How often do you get a chance to watch something like this?

A resident will be doing the drilling. She lines up the drill. Her eye and her hands are as steady as a pool shark’s as he lines up a shot. She looks to be about twenty years old. The others are giving her advice and encouragement. The bit goes in. My head flops back on the gurney and I scream. Of course the pain is bloody murder but with it comes a strange feeling of vindication. Sure, this hurts like hell, but of course it hurts like hell—it should hurt like hell, I’m having a drill go through my leg! The pain in the bone is only part of it, though—the vibration along my whole leg is just as bad. As for the local anesthetic, it’s not quite up to snuff: I can feel the drill well enough to recognize when its direction changes and it’s being drawn back out of my leg. I get a huge sense of relief from this, knowing the procedure is almost over.

Then the drill is out and the resident is getting a pat on the back. I ask her, “Is this the first time you’ve done this?” She replies, “No, it’s my second. The first one was a disaster. Halfway in the drill died, and everybody had to run around looking for another drill before we could get the bit out!” Now I’m even more impressed with the calm she had beforehand. You know the saying: “Learn one, do one, teach one.”

Relief

To the screw in my tibia they attach, on either side, cables that run through little pulleys on an apparatus attached to the foot of the gurney. From these cables they hang water-filled plastic weights. With the cables pulling the tibia screw forward and thus pulling my leg straight, they no longer need the original traction device, and finally remove it. What a relief. Somebody notices that one of the weights is leaking and sends for a replacement.

Now they set about giving me a nerve block. This is kind of like the epidural that pregnant women get. I don’t know the exact science but it involves injection of drugs right into or near to nerves. To pinpoint where to administer this, they use ultrasound. One watches the monitor while the other administers the drug. “Okay, you’re right in position, drop some right there. Good. Go a little deeper here. Drop some more.” The guy has the depths of my leg mapped like some high-tech mining operation. “Okay, a little deeper, little more, okay—right there—drop the rest.” The sense of competence of this team thrills me, and then when the nerve block takes effect, the pain in my leg quiets down some more.

(Note: having read this, Erin wonders about the sequence of tibia screw vs. nerve block. She doesn’t remember which came first, but thinks it more logical that they’d have started with the nerve block. I distinctly remember the screw being first based on the pain, and based on my understanding that the screw was essential whereas the nerve block was just a nice-to-have. But as I said earlier, memory can be distorted.)

They move me to a hospital room and say “No food until after surgery tomorrow.” Not a problem. For once in my life I have no appetite.

To be continued...

That’s about all I care to write for now. If you feel like this was something worth reading, stay tuned because of course there’s more to tell.

dana albert blog

From the Archives - Old School

Introduction

This little essay captures what may have been my attempt to sound like a magazine writer. Looking back, what I find most striking in this essay is that its conclusion is completely untrue. I highly doubt I believed it even then.

Old-school - January 13, 1989

He’s in my French class. One of the traditional, seventies‑style cyclists. Incredibly long hair, capped by the black Campagnolo cap, bill turned up, worn high on the head, towards the back. Red jersey, blank save for some racy stripes‑‑ wool. He also sports the first‑generation lycra cycling shorts. They’re dull, lackluster, somewhat threadbare, and openly display the bulge of his reproductive equipment. His bare feet are shockingly white beneath his barely tan, shaven legs; his black Detto Pierto cleats, which had hung over his shoulders by their laces on the trip up to the classroom, are now on display on the floor where books normally go. Of course, he waited until he got to class to remove the old knit cycling gloves. During class he will frequently nurse off of his La Vie Claire water bottle, to wash down the banana and bran muffin. He brought the bike into class with him ‑‑ a daring feat since we’re on the second floor, and the stairs are a zoo between classes.

The guy’s got guts. The last fella I saw who showed that kind of effrontery was my brother Max, back when those wretched cleats with the toes curling (actually, curdling) up in front, and that red wool jersey that came down to his knees ‑‑ they didn’t make jerseys for kids back then ‑‑ made up his entire wardrobe. I used to sport a cap of the Campagnolo or Cinelli persuasion, bill up, myself, but that was the extent of my indoor cycling regalia ‑‑ just enough to get some recognition without risking the brutal gibe of my peers.

The bike is as old as his uniform. No stickers ‑‑ an obvious sign of weak heritage. I suppose I could ask him about the make, but I can guess his response: “She was built by an Italian framebuilder. I can’t tell you more than that, except to say that she’s very fast.” In other words, a Univega. Perhaps the affordable Viva Sport, as Max had. (He, too, expounded on its rich Italian origin with little provocation.) All the same, only a heartless fink would leave his mighty steed outside, to brave the fierce elements or the jeopardy of theft. I dare anybody to challenge this hardcore cyclophile about bringing the bike to class.

I almost feel irresponsible in this era of sleek, trendy apparel which has no respect for tradition. My shoes fasten with velcro, of all things, and are made in Korea, not Italy. There’s not a fiber of wool left in my cycling wardrobe, and my shorts and jerseys alike are billboards for sponsorship, forsaking the simplicity of blank jerseys that said no more than “I am a cyclist.” No longer is the bike a constant companion; in today’s cycling world, it’s a mere fitness tool, with no more personality than a Nautilus machine. Most importantly, even the best riders of today refuse to tie up their identity in the sport. They not only look like everybody else, but they are everybody else. They just happen to ride a bike, that’s all.

I have an urge to turn to this old world cyclist and say, “Power, brother!” But I would be out of place. I’m not one of him, and never again could be. I belong to the new generation of racers, who attend clinics and belong to clubs. It’s become trendy to be a noveau‑cyclist, to ride a quick, sporty bike with a “cream teal” paint job, and to wear sleek, fashionable pastel clothing and a lavendar helmet with a name like “Brava.” We attempt to keep training diaries, recording pulse rate, diet, and our performance during today’s “training session.” We throw around terms like “paceline”, “repetitions”, and “technique” and combine our riding with circuit training to maximize our “fitness potential.” Gone are the days of aimless, carefree riding for riding’s sake. The technology has raged out of control, too; many new‑ generation riders never knew life before step‑in pedals or shifters that clicked, or brakes with a “light, snappy” feel.

Most of all, the perpetrators of this stylish new breed of cycling aren’t rebels. Their conduct is met with complete acceptance, even admiration, from the layman. They need not explain their shaven legs. They have never known the scorn and mockery that cyclists received, and even accepted. To them, cycling is just another way to fill in the time.

Only the guy in my French class deserves to call himself a cyclist. The rest of us gave up that right when we left our cleats at home and started dressing like everybody else.

dana albert blog