![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
jesse_the_k) wrote2016-07-21 02:56 pm
Story Time: How Jesse Broke Her Ankle
The Fall
Sleeping in on a cold winter day is always cozy, but 9:45am on 23 December 2004 was past time to rise and glimmer. I put the tea water on and began my morning rituals in the littlest room. I felt light-headed as I rose from the porcelain throne. I grabbed two handsful of cold sink but my reflection faded into a noisy sea of gray. My last thoughts were “I seem to be passing out now.”
The chilly tile floor was not enough to bring me around, but the pain in my right foot did the trick. When I turned my leg to better inspect the foot, the leg rolled but the foot didn’t. That scared me so much I passed out again. At some point I hollered, and MyGuy, off from work, came to investigate. He helped me to sit up against his solid warm legs, but I promptly passed out again.
The Extraction
MyGuy also saw my foot and firmly distracted my gaze as he attempted to extract me from the bathroom. He brought in my manual chair, and managed to get me into it, but there simply wasn’t room for him to maneuver me out. I sure wasn’t walking out. Back on those old-fashioned tiles I had to recognize that even my number one superhero had limits. I called 911. Less than five minutes later, three friendly, competent and buff paramedics crowded the bathroom’s door frame, assessing the situation. They maneuvered that gurney (the cot on wheels) close and muscled me gently into 24 blissful hours of horizontality.
It was a sunny 3°F in the world beyond my front door. The paramedics supplemented my cozy bathrobe with every fabric item from their vehicle—including a towel for my head—I never travel hatless. One noted “quite convenient, that ramp of yours,” as they wheeled me out to their ambulance below.
Thence a lights, no-sirens trip to my insurance-approved hospital. In addition to their medical competencies, these EMTs had mastered “keep ’em laughing & calm” gurney-side manners. I deferred morphine since opiates tend to make me hallucinate, vomit, and lose touch with reality. Unfortunately, my firmly-connected reality hurt like hell.
The Journey Begins
I was rolled in to an ER cubicle (with actual walls and a sliding glass door). Paramedics and hospital staff cooperated in that elegant tablecloth wave so familiar to TV viewers: I was now on the hospital’s remarkable comfy gurney. In the next two hours at least a dozen people entered, introduced themselves, announced and executed their intentions, and departed. All present hoped that my blue and swollen foot had only suffered a serious sprain, and so deferred some procedures until the x-rays were available, around 60 minutes in. Alas, the radiographs clearly showed breaks at the ends of both tibia and fibula, requiring surgery to set the break and insert pins to ensure the right and correct ankle-angles. At this point they attempted insertion of a surgical-size IV. The third time was a charm.
Later I learned about the wonder of “butterfly needles,” routinely used for drawing blood or starting lines with younger patients. I demand them every time now, and it’s one & done.
Perhaps due to my fair city’s deserved reputation for extramural athletics, this ORAF—open reduction and ankle fixation—surgery was treated as totally routine by the medical folks, which helped me keep calm. Most crucial was my superhero MyGuy, who kept me safe by holding my hand.
Given my history with the medical establishment, I was surprised by the respect offered someone who is in acute pain of self-evident origin. As always, a new pain managed to educate me about its uniqueness. Staff acknowledged and worked around my sensitivity to latex, gluten, and asthma/migraine triggers. They weren’t so flexible when it came to pain relief.
Someone would pop in and ask for my pain number (where zero is heavenly and ten is the fires of hell). Since I had a freakin’ broken ankle, it hurt a LOT, like 6 no 7. They only offered morphine. After whining for an hour, they injected me with a super-duper NSAID called Toradol (Ketorolac) which soothed my ankle to a bearable 4, and completely obliterated all my chronic background pain. I experienced no bad effects from that drug.
By noon I’d been settled into a room, with surgery scheduled for 4 pm. MyGuy popped out to soothe our (mystified and worried) Lucy the Heeler. At 2:30 pm, they took me to surgery, where I was able to convince them to use a spinal block instead of general anesthesia.
[It takes me weeks to recover from general anesthesia; I can move as well as usual by day 7, but I can’t think clearly until day 18.]
Thankfully the “relaxing” medication came on like Joe Louis, so when I came to afterwards all I had to deal with was an amusing post-dental numbness from my belly button down. My cognition was as clear as it ever is a mere two hours past surgery. I asked what had been ordered for post-surgical pain, and was told “morphine.”
While each of the emergency staff, operating staff, and floor staff did an excellent job inquiring of my needs, there seemed to be no communication among or between them. I told them I could tolerate propoxyphene (the narcotic I’d relied on for many years before finally weaning myself free in 2004) but that Toradol had worked wonders earlier that day.
By 6 pm I was settled in my room, and they even supplied me with my first nourishment of the day, free of gluten and dairy. My missed breakfast made me a perfect surgical candidate. (Hospital food would garner a better reputation if it was always served after surgery.) MyGuy had supplied comforting home touches round my bedside, and held my hand reassuringly. I inquired again about post-op meds: the floor orders said “morphine.” In other words, no pain relief after surgery.
Perhaps the small statue of a writhing naked man hanging above each hospital bed should have clued me in. I & MyGuy spoke firmly to the night nurse, who at first didn’t want to “bother” the on-call resident. After she spoke four times to that recalcitrant, off-site personage, I finally got some meds. “Gee, Toradol’s an awfully strong drug for an ankle fracture. Oh, she has fibromyalgia too.” Around 7:45 pm I got one propoxyphene; at 8:30 pm a second, and around 10 pm she succeeded in getting the resident to approve orders for another Toradol injection. I was able to sleep fairly peacefully after that.
The day before Xmas began with a PT who was easily impressed at my walker and transfer skills. More gluten-free, gulpable meals followed and by 3:30 pm we were home again. Not surprisingly, we have almost all the tools needed to manage the next two weeks of one-legged life. The doc says “toe touch only” for my injured right ankle. He also said I may return to the pool as soon as the surgical wound heals - two weeks! [Yeah right, it was seven weeks.]
My ankle is wrapped in an Ace bandage, surrounded by a neoprene-like sleeve, and then immobilized in a hard plastic brace wrapped with yards of Velcro reaching up to my knee. For the next while elevation is the key, so I’ll be learning a new body size & position with my right leg sticking straight out. [Conveniently, I had elevating leg rest for my right leg, so I could still use my chair.]
The moral
Twelve years later, my ankles are definitely different. The worst sequela relates to the plates and screws. They don’t give like bone and tendon, so the right foot & ankle always hurts first (especially in very cold weather). Athletes generally have another surgery to remove any hardware; at the time, I couldn’t see the point. If I had to do it again I would go for the second surgery.
Learn the names of effective pain relief and write it on your “important things for an emergency” card. Just when I thought I understood living with a disability, something changes and there’s more to know.
Words can’t convey how wonderful MyGuy is.
no subject
I do fine with morphine in general. During the pancreatitis thing I was burning through oramorph too quickly for the prescribing to keep up, but I was fine on IV instead. They did keep raising PCA as an option so I could control the dosage when the pain burned through, and then not following through, which was irritating. Clearly it simplifies life if you can just go wth the default options. WRT in-ambulance IV stuff, I found the IV paracetamol (acetaminophen) surprisingly effective.
no subject
no subject
no subject
And then whoosh I'm down the rabbit hole and back with the info that there is no "standard" drink size, and no table where I can compare "a six-pack" to "three martinis."
Life Is Hard. have some soup.
no subject
no subject
I think I may need to explain that the injury in question was a broken tailbone before you realise the pun that I am attempting, however...
no subject
Does one splint a broken tailbone? That sounds like it would be antithetical to sitting.
no subject
no subject
no subject
no subject