I started a blog in February. I was losing weight and I thought it would be fun to network with others doing the same thing. Then, one day, my blog stopped having new posts. This is the story of why…
She’s up, she’s down, she’s up, she’s down, she’s up…
Uh-oh. Holy mackerel, is she ever down.
And not just in weight.
I have indeed lost a few pounds. But there is more down to the story.
Four weeks ago, I was doing what we all do, especially us Type-A personalities. I was moving way too fast and I was not paying one bit of attention to what I was doing. My mind was racing ahead to the zillion other things I wanted to do that afternoon. So when I went to put out the dog, I did not notice as I stepped into a coil of lights dangling from the trellis, which acted like a noose around my ankle.
To my bewilderment, the cement I was about to crash onto came rushing up to my face. I slammed down like an anvil in a cartoon. My glasses cut my face; my knees, shins and hands were cut and scraped. I heard the crunch as the bone in my upper arm shattered. It almost felt like an electric shock.
I do have to admit, even I realize I have really wacky priorities. My first thought was “I hope nobody saw me”. Then I felt to make sure all my teeth were there. Check.
My next thought was for my little dog, who had flown out of my arms when I fell. Sadly, she is no Lassie. She did not sit alongside my broken body until help came. I think if she could speak, she would have shouted “woo-hooooo!” as she took off gleefully down the street. Actually, now that I think of it, I am certain she did shout “woo-hoooo!” in her little doggie voice.
When I tried to get up to get her, the pain was astonishing. I croaked her name and, naturally, received no reaction. She continued to frolic through the neighbor’s shrubs. I swear she turned and smiled at me. When I pictured her teeny, adorable little body being squished flat by a speeding car, adrenaline helped me drag myself up on the trellis. I finally caught up with her two houses down and scooped her up. My right arm was hanging uselessly at my side and throbbing steadily. Blood was dripping down my face and my hands and knees were keeping time with the agony in my arm.
I recognized this was very, very bad.
After retrieving Bella from her lark through the neighbor’s yard, I staggered into the house. The sweet college boys who were doing odd jobs for me were eating the pizza I had ordered for them just a half hour earlier. It felt like a lifetime. One of them looked at me and said “Did you know you were bleeding?” No one can accuse his parents of wasting their tuition money.
I advised him I indeed was aware that I was bleeding and, additionally, I thought I had broken my arm. They all clamored to drive me to the hospital right away. But my daughter had just run to the bank and, unreasonably, I wanted to wait for her. So, I assured them, I would be ok for the few minutes it would take her to get home. And I went to sit in the den. As usual, I was completely wrong. I was definitely NOT ok waiting.
I sat at my desk with everything in my body throbbing in concert with my heart, which was galloping. The minutes seemed to be weeks long. I was getting shocky and nauseous, there was no sign of Mary Kate, so I gave in and two of the boys drove me to the ER.
I must have looked ghastly, because one of them kept up a cheerful, nervous patter all the way there. Every bump in the road reverberated through me and I focused on not throwing up, which would have been the final ignominy.
At the hospital, I was seen right away, one of the perks of my daughter working there. The boys stayed until Mary Kate arrived. That is when the dam broke and I, someone who NEVER cries, began to weep in horrible, hiccupping sobs.
I was crying so hard I could barely answer the questions the doctor was asking me. When I went for x-rays, the tech was incredibly nice and gentle, but I involuntarily shrieked every time she moved my arm. This is just one sample:
Me: sob sob hiccup sob
Tech: Ok, Marie, I am just going to move your arm a little (gingerly moves the arm 1 centimeter).
Me: loud scream Oh! I’m sorry, sob, sorry, sob, I’m so so sorry.
Tech: That’s ok, I just need to move it a little more (even more gingerly moves the arm ½ centimeter).
Me: loud scream Oh sorry, sob, sob, I’m sorry, sorry, I’m so sorry.
Tech: Ok, just let me see how this one came out.
Me: sob Is it broken? sob
Tech (grimacing): It looks like it…
Me: BOOOOO HOOOO HOOOOO
Before this, back in the exam room, I had told the nurse the pain was nine out of ten. Hey, I didn’t want to be greedy. When I returned from x-ray I said, weeping all the while, “I have to change it. Can I change it? I need to change it. It’s a ten. It’s a ten. I was wrong about the nine, it’s a ten, not a nine. The nine was completely wrong, it’s a ten. Can I change it? Is it ok to change it? Because I have to change it to a ten…” And I kept going. I NEEDED PAIN MEDICINE.
The doctor eventually came in and mildly confirmed it was broken. So be sure to follow up with your orthopedist on Monday. Like I had a bunion or something. And I meekly said ok, they gave me a sling, a single Percocet and sent me on my way with my smashed arm and mangled body.
Much, much later I started to think more about this ER visit. The Percocet, predictably, did nothing to touch the pain. I was in agony. Every movement hurt. And, I thought, “my” orthopedist? Like I keep one on retainer? I couldn’t have even told you the name of an orthopedist in my county. But there was nothing I could do until Monday morning. They had sent me home and I had acquiesced. This was Saturday night. I suffered through another day, just waiting for Monday morning, and, I thought, some relief. Silly me. I had no idea I was about to embark on The Hilarious Adventures of Plucky Marie, Casualty Girl: Chapter Two, Marie Tries to Find Adequate Medical Care
So. Monday comes, after a torturous weekend. I called the first name on my insurance list, we’ll call him Dr. Smith. I told his clerk I had broken my arm on Saturday and had been advised by the ER I had to be seen right away Monday morning. In a bored voice, she told me they couldn’t see me until Thursday. Oh, I think, she didn’t hear the broken arm part. So patiently I repeated myself and said I needed to see someone today. Sorry, she said. I asked if there was anyone else in the practice. No, she said, sorry.
Starting to feel panicky, I was trying not to cry. I thanked her and called the next name on the list, we’ll call him Dr. Jones.
Dr. Jones’ clerk was very pleasant and told me they could see me that morning. I couldn’t drive, so my wonderful sister rearranged her whole day to take me. We get there and the door says ‘Dr. A. Smith & Dr. B. Jones’. Dr. Smith was in the same office as Dr. Jones. I felt like Alice in Wonderland. Their practices were separate but they shared the office and their appointment clerks sat next to each other. But that first woman, Dr. Smith’s clerk, with utter indifference, turned me away without an appointment. She never even asked the woman sitting next to her if Dr. Jones had anything available.
Dr. Jones was very sweet, very attentive and approximately 300 years old. I know, I’m being silly. He was actually more like 400 years old. He asked me how old I was so many times my sister started to giggle. Then he “lost” my x-rays, coming in and out of the examining room over and over, patting his pockets and muttering “They must be around here somewhere!”. I thought maybe it was a little comedy act he was putting on to help me relax. No such luck. He decided I needed another set to be taken by his technician.
The tech, we’ll call her Merciless Cow, told me to lie on the table, which was almost impossible for me due to the pain. I asked if I could have something under my shoulder to support it. The Merciless Cow acted as though she had never heard of such an outrageous request before. She finally roughly shoved a rolled up towel under my broken shoulder, took the x-rays while I tried to keep from passing out, then, without warning, she yanked the towel out from under my arm. I screamed so loudly my sister heard me in the waiting room and I actually briefly lost consciousness. The doctor ran and got me water and smelling salts.
He tells me that the head of the humerus bone in my arm is shattered into four fully separated pieces. That I will need shoulder replacement surgery. That I need a CT scan. That he doesn't do that kind of surgery, someone else will have to. But come back to see him, ummmm, hmmm, ummm, let’s see…Friday. After I have the CT scan that his office is arranging for Thursday.
My sister and I stumble back to the car in shock. I can hear his voice in my head saying ‘shoulder replacement, shoulder replacement’ over and over. REPLACEMENT!?!?!?! I am only 53 years old. Oh my God. I am in agony. My sister looks at me and says, "If you need surgery and a CT scan and your arm is broken in four places, why the fuck didn't he just admit you?!?!" So I start crying, because now I am in pain AND scared and I say I don't know. So all the way home she's yelling "I'm turning around and taking you to the ER" and I'm saying, "No, just let me go home and take some Percocet" and she's saying "You can't wait another WEEK to take care of four broken bones in your arm!!" Crying and yelling, crying and yelling, all the way home. Where I proceed to almost faint again.
Within a few hours, I give in. Mary Kate takes me back to the ER. Surely they will admit me. Surely they will help me. They give me IV dilaudid, which helped me sleep for about 2 consecutive hours, if nothing else. The doctor never even touches or looks at my arm. He does read the x-ray and tells me, you’re going to love this, “I’ve seen worse”. Come closer, doctor dear, so I can kick you in your testicles and then tell you I’ve seen worse.
At midnight, they send me home with oral dilaudid, promising it would help. I am too exhausted to dispute this. I wake up in pain at 2 am and it was too soon to take it again. Dozed. Wake up again at 3, still too soon. Dozed. Wake at 4, took one, dozed until 4:20, wake up in agony as if I took nothing.
So now I sat there doing Lamaze breathing with fiery knives of overwhelming pain slicing down my arm, which was three times its normal size and dark purple. Everything else, my cut and bruised legs and knees, my scraped hands and wrists, my cut face, are nothing in comparison. I am at my wit’s end.
At approximately 8 a.m. Tuesday, my son calls. His friend is engaged to the son of an orthopedic surgeon in my area, try that practice. I call there and that morning finally meet…Dr. Wonderful.
Dr. Wonderful is pleasant, handsome and take charge. He is also beautifully dressed. The whole package. (What can I say, I’m wounded but I still have eyeballs!) “First thing,” he says, “We have to get your pain under control.” Now I want to marry him. He then proceeds to list all the other things I will need: home care, a shower bench and, best of all, after the pain meds, a raised toilet seat. Heaven! It’s funny how your priorities change when you can’t sit down to pee without shrieking. Surgery is probably going to be needed, but not until the swelling and bruising go down over the next few days.
I float out of there on a cloud of optimism, with a fistful of prescriptions and a soft focus vision of Dr. Wonderful in silver armor on a white horse. Someone has listened to me. Someone is taking care of me. Someone cares!!!
I order my toilet seat and shower bench and they arrive so quickly it’s as though the guy had been standing behind a tree in my yard just waiting to be asked in someday. Because I cannot lie down, I settle, loaded with drugs, into an armchair in my sunroom. It is not too bad. I have the TV, a comfy chair, lots of light and as long as I DO NOT move, I am relatively comfortable.
I am blissfully unaware that I will be living in that chair for the next five weeks.
A sunroom during the day is a cheerful, cozy place, even if the weather is bad. Mine is full of cushy, overstuffed furniture to cuddle into whether reading or watching TV. A sunroom at night, when it is after midnight and all the lights are out and everyone else is in bed, is a spooky, gloomy place, full of the echoes of the things that happen during the day, a pair of the girl’s shoes under the bench, a book left by the reader that has slid to the floor. It is also unbelievably noisy. I live on a busy street, on a corner. There is nothing to muffle sound and many cars and trucks go by, even in the middle of the night. And I heard every one of them, even with all the windows closed and the blinds drawn. I would just start to doze off when some rattletrap would lumber by. It was hard enough to try to sleep sitting up, scootched into the left corner of the chair so my right arm was not touching anything but the pillows I had supporting it.
I went for a CT that Thursday. The doctor wanted to see if the pieces were displaced, or moved out of order. If they were all neatly tucked together, I might be able to get away with nothing more than a sling for a few weeks. I have to say, I was utterly certain this was going to be the case. I did not think, not for a single second, that I would have to have any surgery. That seemed preposterous to me. I was young and healthy. Well, young-ish and healthy-ish. My bones would never be so contrary as to be displaced! Honestly! The idea!
I was so out of it by Thursday, I barely remember going for the CT. I know I went to Dr. Wonderful on Friday too, but I hardly have any memory of that either. The medication, pain and lack of sleep were taking their toll. I know the doctor did tell me on Friday that he suspected the bones were displaced to the degree I would need surgery, but he wanted to check the CT results when he was at the hospital that afternoon. If they were, surgery would be early the following week. “Oh, like Wednesday?” I said. “No, like Monday.” he replied.
Hmmmmm. Well, that’s silly anyway. I’m not having surgery, I think to myself. As usual, as I have said before, I was completely wrong, wrong, wrong.
By that Friday afternoon I was scheduled for an open reduction/internal fixation of my four-part proximal humerus fracture, to be done as a same day surgery at a local surgery center. That comforts me a little. Just a surgery center. Well, it couldn’t be too bad then. My Multiple Sclerosis was not a complicating factor that would have it done in a hospital. So it would be simple. Sort of like having a tooth pulled or an ingrown toenail taken care of. My biggest concern was that I might have to have a urinary catheter. I am so shallow. Oh, and stupid. As a result of my ignorance, even as a nurse, I am completely and utterly unprepared for what I am in for.
The craziest part is when I called the center to find out what time I had to be there on Monday, the girl turned around from the phone and called to someone “What time is the Open Reduction on Monday?” Open Reduction. She said it. Right into my ear. And “open” means just what it sounds like. I know what an open reduction is. And it still never registered. I was primarily irritated that I had been demoted to a procedure, not a name.
My daughter Mary Kate brings me to the surgery center bright and early Monday morning, nine days after my fall. I am relaxed and cheerful. I am certain I will be sufficiently medicated to be comfortable and that this will fix my arm. Better in a few days, I’ll be. So I have no qualms. What a moron.
The staff is very nice. The nurse anesthetist shows me one part of the anesthesia they are going use, an interscalene block. A catheter will be put in my neck and medicine will go in there that will completely numb my shoulder and arm. With that I will only have sedation for the surgery, not general anesthesia. So I need neither intubation nor catheterization (yay, the panties stay!). An attached pump will go home with me, pumping medicine to the blocked area for four days, by which time the pain will be reduced. Well, that sounds great!, I think. I am still cheerful and relaxed. Especially since I still have my knickers on. They will give me a little something to relax me while they insert the catheter in my neck. And to be honest, except for a brief memory of being wheeled into the operating room, that is the last thing I remember until I am offered ginger ale in the recovery room. According to my parents, this is six hours later.
Dr. Wonderful appears in the Recovery Room with copies of my x-rays. He proudly shows off his work: a plate and about a billion screws that are holding my arm bone pieces together. I look at it as though it belongs to someone else. “Wow” I say while sipping ginger ale. I feel no connection to that hardware whatsoever. I had no idea there was going to BE any hardware, so it doesn’t sink in.
What I don’t realize has happened, and won’t until days later when I look it up on the internet, is this: I was placed on the operating table and put under conscious sedation, meaning I was heavily sedated but not completely unconscious. Because of the drugs used, I wouldn’t remember anything. The operating table was then raised into a seated position. Every bit of me, except for my right shoulder, the area to be operated on, was covered in surgical drapes, including my head and face (Can we talk about my claustrophobia? I practically need to be sedated just typing this.).
My right lower arm is swathed in sterile wrappings. With a scalpel, Dr. Wonderful makes a curved cut from the top of my shoulder six inches down my arm, which is then spread wide open and held in place like that with metal surgical retractors for the extent of the surgery. Muscles and blood vessels and nerves are pushed and/or cut out of the way to reveal the bone. The broken pieces of the head of the humerus were fitted together and fastened.
Dr. Wonderful then chose a plate and number of screws. Holes were drilled into my arm bone with an electric drill, the plate was fastened onto the bone and broken pieces with the screws until everything was nice and put together. Throughout the surgery the surgical site is continually flushed and suctioned to keep blood out of the way. Additionally, my arm was repeatedly manipulated and x-rayed during each step of the operation to make sure everything was fitting together as it should. At the end, I was sutured up and sent on my way.
Alrighty then. Not quite like having a tooth pulled. No wonder it freaking hurts.
I go home. My arm is numb and I have plenty of pain medicine. I sleep off and on over the next day and I feel…ok. Then a few things happen. First, my legs swell up like two giant slugs attached to my body. To the extent that anyone looking at them gasps. There is no delineation from my thighs to my ankles and my feet look like giant marshmallows with little dots where the toes are. Add the fact that my skin is as white as paper, this is not a pretty sight. I look like the Michelin man from the waist down.
I call the surgeon’s office. They tell me to call the surgery center. And to keep my feet up. Which is what I have been doing since I fell, but whatever. So I call the surgery center. They tell me to call the surgeon. And to keep my feet up. I call the surgeon back. They tell me to call my regular doctor. And to keep my feet up. I call my regular doctor. His office is closed for a few days. I am surprised the answering service does not tell me to keep my feet up. I call the surgeon back. They are not pleased that the hot potato has landed back with them. “Ok, well, keep your feet up and I’ll tell the doctor. We’ll call you back.”
And I also now realize that my arm isn’t really numb anymore. The pump was supposed to be effective for four days. This is the third day, but there should be another 24 hours plus to go. Then I notice the neck of my t-shirt is wet. Right where the catheter is. As a matter of fact, the catheter is leaking. The numbing medication that is supposed to be going into my arm is now dripping down my chest.
I call the surgery center about the catheter and they tell me to come in, the anesthesiologist will adjust the catheter for me, and he fastens it with surgical glue. He also gives me a nice bolus of analgesia, which numbs me for a blissful couple of hours. The nurse anesthetist says, “You know, I thought it looked a little out of place when you left the OR.” Oy vey. Maybe THEN would have been a good time to adjust it? But I keep my mouth shut, because otherwise everyone has been so nice to me. She points out my swollen legs to the anesthesiologist. “Hmmm.”, he says. “They weren’t like that on Monday.”, she says. “Hmmm.”, he says, “Keep your feet up.”
At home the surgeon’s office has called back about my legs. Get a pair of Jobst stockings. These are stockings that are about two inches by two inches and you have to get your whole leg into them and they perform miracles. However, the real miracle is getting them on. What no one has taken into consideration, including me before I plunk down $85 for the stockings, is that it is hard enough to get them on with TWO hands. With one, it is impossible.
Before I can even get too upset about the legs, like magic they go back to normal. The interscalene block catheter comes out. And then I settle into my routine of the next four weeks. Living from pain pill to pain pill, completely incapacitated, unable to drive, unable to dress without assistance, unable to lie down to sleep, sleeping in a chair. It will be seven weeks before I can sleep through the night. The pain and the stress have a terrible impact on my MS symptoms, ramping them up, causing major issues with walking, cognition, tremors and numbness. My daughter has to help me put my underwear on and does my hair. My mother and friends and church cook for me. I can’t even spread butter on toast!
The six inch long incision is breathtakingly ugly. Gradually it sinks in that I have had major surgery. That this is going to take a long, long time to recover from. And I become extremely depressed. I feel as though my body has let me down by breaking. I feel as though life has let me down by throwing me this incredible curve when I am already dealing with so many disasters, MS and being out of work. I feel like Dr. Wonderful let me down by not telling me what the surgery entailed. But, to be fair, I asked no questions either. Part of that may be because I was demented by pain, narcotics and lack of sleep, but…they could have given me a clue. The picture of my face in the waiting room that morning should be next to the definition of ‘clueless’ in the dictionary.
But here’s a scary fact: according to my daughter, who was with me, Dr. Wonderful did explain exactly what was entailed when we were in his office that Friday morning before the surgery. I just couldn’t hear it.
I have home physical therapy ordered. Janet, who comes to the house three times a week, is wonderful. She is cheerful and no-nonsense, patient and kind. She is tolerant when Bella the Maniac Shih-Tzu jumps all over her like, well, a maniac. She manipulates my arm gently to get back my range of motion. She is relentlessly encouraging and supportive. She tells me to rest and take care of myself and how to manage my arm and pain better. She worries about me and my blood pressure. She scolds me when I do too much. She is a major contributor to my healing process. I love her.
Gradually I start getting out a little, but a simple trip to the supermarket exhausts me. My sweet father drives me everywhere, doctor’s appointments, the stores, even a job interview. Yes, I went to a job interview two weeks post-op in a sling. (I didn’t get the job :(). We go to the supermarket and can’t find a parking spot, so we park in the designated “Parent with Child” spot, at 76 and 53 years of age, giggling like two kids. I do have to say it is a treat spending that time with my father, like I was little again.
After eight weeks, the incision is completely healed (although still hideous). And so are the bones in my arm. Dr. Wonderful gives me the good news: I can drive again! It has been two months since I fell. My life screeched to a halt that day and is very, very slowly creeping back to normal. I am not there yet. I now go to out-patient physical therapy three times a week (Mike is a great therapist, but I do miss Janet!). My arm is gradually, painfully getting strength and motion back. I can dress myself now and sort of do my hair.
On the plus side, I have been overwhelmed by love and concern from everyone I know. I have received flowers, cards, food, calls and visits that have humbled me as I see people go out of their way to make me feel better. I never could have imagined such an outpouring. It has been a true gift that has added its own kind of healing.
It is going to take me a long time to process this experience. There has been a lot of bad, a lot of craziness but much good as well. Many people came through for me, supporting and encouraging me, telling me they loved me and thought about me and were devastated for me. Dr. Wonderful was wonderful. He put me back together. I am trying to focus on all that instead of how hard it was to get appropriate care, how horrifyingly brutal the injury and surgery turned out to be, how this accident impacted my sense of safety and how long it is taking me to return to my interrupted life.
I am getting better every day. And that’s the story!
