Tuesday, June 11, 2013

I have the best friends in the world

Part Three

Two months it has been since I broke my leg. And I keep wondering... what on earth would I have done if this had happened to me anywhere else? Not just talking about possibilities of this happening in another country while on an adventure, but what if I had been living in any other place than where I happen to live?

Here in Boston I was able to quickly get health insurance that will pay for this whole mess. I had the best doctor in the country taking care of me. And I've got an amazing community of friends who have been willing and able to step forward and be incredibly generous. I've had friends letting me stay on their couches and in spare rooms, giving me safe places to stay while I recuperate. Being unable to cook or take care of my own meals I've had friends bringing me meals, bringing me groceries that I don't need to prepare, or sending me credit to the restaurant delivery website FOODLER so I could order delivery. Once I started physical therapy I had friends drive me to my appointments twice a week.

I had friends witness my huge achievements (going up stairs for the first time, getting to put on my own shoes, going up stairs while on crutches, taking my first limited steps again!) and others simply cheering me on as I pushed forward. Keeping me positive even during times I felt pain and frustration at my limitations.

For the last two months I never once felt alone or abandoned by those in my life. They rallied around me, and I am more grateful than I can express. It is humbling, to bear witness to such visible proof of the love and kindness I have in my life. I joke that it is Karma catching up to me. But, you know, I do try to be the best friend I can be to the people in my life. This is proof that trying to be a good person does result in good things in return, when it counts.

Both Dr. Smith and Ned, my adorable physical therapist, tell me I am making huge amounts of progress. I look at what I have accomplished, and they are things I didn't think would be possible this soon two months ago. I have gone, in just two months' time, from being almost thoroughly bedridden, requiring a walker and shuffling slowly and painfully even the shortest of distances... To being on crutches and getting around (relatively easily) finally all on my own. I am partially weight bearing and the prognosis is that I'll be off the crutches altogether in just one more month. It's incredible.

My little brother told me that he knows the reason I did this. He said it was just so I'd have a scar I could compare to the ones our dad has (who does indeed have some doozies!). I have decided that the reason is so I could become part cyborg, so that when the robot army uprises I will be in position to take control and thus eventually gain domination over the entire world. *Smiles* I just know that no matter how or why it all began, I finally see an end to this mess. 

Going to India last year taught me how to persevere through some rather intense emotional shit. Succeeding showed me I could handle anything that comes at me. Making it through this has taught me I can persevere through intense physical shit, as well. Both things also taught me the same lesson... ask for help when I need it. I am not alone, and I have a lot of people who love me. That knowledge is powerful. And something I'll never forget or take for granted.



Wednesday, June 5, 2013

Saga of the Broken Leg - In the hospital

Part Two: Mass General Hospital

The nurses I had at Mass General were truly awesome. They thought I was a wonderful patient as well. Not demanding, patient, and friendly. They loved me. :) As Pasta would put it, it was a room. (He has this theory, it's a thing.)

I had friends come visit every day, which really helped keep my spirits up. Two came to visit every day. One day I had so many visitors that I began to get overwhelmed by the amount of people in my teeny little hospital room and suddenly ran out of cope. I had to tell the crowd, "too many people! Half of you leave." It was actually a really nice problem to have had.

My hospital room was as comfortable as we could make it. I had my iPad, my iPhone, my Kindle. Bouquets of flowers... though one friend sent me beautiful flowers and a cute little bear and then forgot to sign the card. I did find out who it was (Shazza!) and enjoy teasing her.  Pasta brought me a little bear from his apartment to keep me company. My friend Ron Newman brought me a really awesome teddy bear. Perfect in every way. I named it Paul Newman. (And no, it is not Paul. I refer to it always by its full name.)

So one evening when Bill shows up and gives me this great purple monkey, I look around my room at the three bears and immediately christen the monkey Goldilocks. To me it made perfect sense. And was totally hysterical. My friends didn't quite get it. One wanted to give the money a wig. That would have made it less funny! I'm still not sure if she agreed with me in the end because she finally did agree with me or if she just thought I was high. *Laughs* I did have great drugs. Even if they didn't make me goofy brained.



This was my first stay in a hospital. So there were things that sucked ass. First among them was being woken up every 2-3 hours at night to check vitals. (After a few days when I went off the IV drugs and onto the pill pain meds it was also to give me medication.) Also majorly sucktastic were the night orderlies you had to call to help with various things you can't do for yourself. They were usually loud, and sometimes lazy. I could definitely tell the ones who were annoyed that you'd pushed the call button.

Another thing that sucked was the afternoon I started having a major panic attack in my room. I frantically push the call button to ask the nurse for an Ativan. Ativan is the anti-anxiety medication that I take. Only the idiot who answered the call (not a nurse) just assumed I wanted my pain meds (despite the specification of me saying I needed an Ativan), and when she looked at my chart and saw it wasn't time for my pain meds yet she ignored my call. When my nurse did get to my room while making her rounds I was still in panic mode. Sobbing and agitated and very angry. She was furious with the person who had ignored my call. I wish I could have been there when she ripped that person a new one.

One thing that crossed my mind during my hospital stay was how glad it didn't happen while I was in another country. Another country where I don't speak the language. That incident above demonstrates that even when we're speaking the same language, misunderstandings happen. My imagination enjoyed forcing scenarios on my brain about what would have happened if this had happened last fall in India. Or the previous year, in Ecuador. Yes, there were medical professionals I dealt with in both countries who spoke perfect English. But only the doctors. Often, the nurses and staff only spoke the local language. And guess what? I only saw a doctor twice after my surgery. I dealt day in and day out with nurses and staff. I'm so fucking grateful this happened here. Even with the horrible situation of the American health insurance system and my lacking any.

At least until the hospital sent me someone from Patient Financial Services. 

Hospitals LIKE being paid. Astonishing, no? So they will actually help a person get health insurance if it is an option. Which, in Massachusetts, it is. In fact, it is technically required by law here. I was skating under that law the past two years because I have not made enough money to afford it, and because for much of that I was getting unemployment I didn't qualify for the State run programs. Turns out I qualify now. And the hospital person helped me with the forms and she sent it all in for me. I didn't know this, but apparently when you apply for Mass Health the insurance is retroactive ten days from the date you submit the application. I submitted on April 10. So as soon as my health insurance was approved, I gained coverage dating back to April 1. The entire broken leg was covered by insurance! Hallelujah! Enormous weight... suddenly off my shoulders.

Another thing the hospital provided was a physical therapist. It was her job to get me ready to leave the hospital safely. They provided me with a walker, and Evil Lena taught me how to use it. I refer to her as Evil Lena because this was just two days after major surgery and she was forcing my body to do things is really did not want to do! Like move. The slightest activity exhausted me. I think I went five feet once and was ready to collapse. I'd never felt so helpless in my entire life. I only had four sessions with Lena, but in those four sessions she taught me some exercises for my leg that would help with range of motion, and she taught me how to deal with stairs. I could handle down using crutches. But up was not possible. My upper body strength just couldn't do it. So I learned how to go up stairs bumping up sitting on my butt. And needing a chair or stool at the top of the stairs.

The final test before she signed off on my safety was (using the walker) to walk from my room at the end of the hall all the way to the nurses station and back. I only had to stop twice. :) I had the promise of two additional home PT visits for the following week when I finally got discharged. And by this point Friend 1 (ex-boyfriend Curt) had arrived to help by picking up my prescriptions from the pharmacy and packing up the stuff from my room. Then, when Friend 2 arrived (yay Persis!) with the car big enough for me to sit lengthwise across the back seat, I said goodbye to everyone and Curt wheeled me downstairs, myself and my wheelchair loaded down with a walker, a pair of crutches, bags of stuff, a grabber, and an extra brace for my leg. We forgot the flowers. :(

After manhandling me into the car, on the way to Pasta's place (where I'd would spend my first week of recuperation), I asked them if they wanted to see the spot of my accident. Curt took photos of the dastardly location for me. Then we went on to Pasta's place, where I promptly failed at stairs and lucked out that Curt is a guy who was able to hoist me up the steps so I didn't have to just camp out in the driveway.

That was April 13. 

To be continued...

Tuesday, June 4, 2013

Why I've been radio silent here for two months - Saga of the Broken Leg

PART ONE

On April 9th I was out for a walk. It was one of the first really perfect spring days of the year and I needed some air and a chance to clear my mind because I had been horribly depressed so my friend Pasta suggested I go for a walk. I was distracted, and walking at a brisker pace than normal and ended up tripping on a piece of sidewalk that had cracked up and I fell. As I fell, and particularly when I landed, I felt more pain than I have ever felt before in my life. I'm talking like a 15 on a scale of 10.

Since the pain was originating around my right knee I knew immediately that something was Very Wrong. I rolled instantly to my left side and just laid there on the sidewalk, dazed. Then panicked. I didn't have health insurance, and I had no idea what to do. I knew that if I called 911 I'd be taken to the hospital and likely end up in debt so far past my eyeballs I'd never get out of it. But oh gods the pain!

I was nearly right around the corner from where a friend lives. Yet I searched my phone and didn't have her phone number, so I couldn't call her for help. So I did the next best thing. I called my closest friend. And it went to voice mail. I don't remember if I left a message, because so much of this is just foggy in my memory. But he texted me back, saying he was In a Meeting. And asked what was up.

At this point help finally stopped to render assistance. A bicyclist at first, then a woman coming out of her home, then two drivers passing by. I was crying so hard from the pain it was hard to communicate. Plus I was trying to text Pasta and remain coherent there and splitting my focus was frustrating me. So was knowing that the woman from the house had called 911. Paramedics (and lifelong debt) was on its way. But I also knew I needed to go. The pain told me that much.

I managed to convey in text to Pasta that I thought I'd broken my knee, that I was waiting for the paramedics, and that I wanted him at the hospital. (Though I did have to tell him no, I didn't know what hospital yet as I was still waiting for the paramedics.)

The whole time this is going on, the woman is staying on the phone with 911 and the bicyclist is sitting on the sidewalk beside me, holding the hand not holding my cell phone, offering me comfort the best he could. I really do love people.

Fire truck arrived first. I had to very sternly tell them no to a neck brace. I had not hit my head, there was no pain or stiffness, all pain was in my leg, and I am extremely claustrophobic and no they would not be allowed to put me in a neck brace. The pain was still a 15 when the paramedics (a pair of women) finally arrived. So being rolled onto a back board, and then hoisted none too gently onto the stretcher, then bounced into the back of the ambulance, was horrible.

They asked what hospital I wanted to go to. I've lived here for six years now and I should know the good hospitals vs the bad hospitals. But at that moment I just wanted pain relief as fast as possible. So I gave them the name of the nearest hospital... NOT one of the good hospitals... and I think they hit every pot hole and bump between my accident site and the ER.

My first thought when wheeled into Imaging for my x-rays was that the last time I'd had x-rays taken was in Pushkar, India. And the differences were more than enormous. For one thing, that doctor's visit cost me $1.38. This would be significantly more. For another, I got real help this time. I wasn't manhandled. I was cared for. They took great pains to try to be gentle with my leg as they forced me into more and different painful positions in order to get the angles they needed.

When I got back to my room, Pasta showed up, and I cried. I was in just so much pain. They gave me morphine, but it wasn't strong enough. I don't remember if Lawrence Memorial or MGH bumped me up to Dilaudid, but praise them!

We finally get told that it was my tibia that broke, not my knee. That I would likely need surgery, and they were transferring me to Mass General Hospital. Currently ranked the best hospital not only in Boston but in the entire United States (according to the 2012-13 U.S. News & World Report “America’s Best Hospitals” list). I knew MGH was better than Lawrence, so I didn't argue this decision.

Pasta said he would meet me there, he wanted to run home first. Since I hadn't brought my beloved iPad on the walk with me, I asked him to pick that and a few random items up for me while he was home. Then I went with a new (and much more careful drivers) paramedics and was on my way to the next hospital of the day! I called my parents from the back of the ambulance. "Happy birthday, dad! I broke my leg!" *Laughs* Yes, it was my dad's birthday. It's why I'll never forget the date all this went down.

MGH wanted their own x-rays taken. Apparently Lawrence Memorial hadn't done too good a job. Argh! More painful positioning of my leg! But when back in my room, I handed my phone to Pasta and asked him to take photos for me. I wanted to see my leg. 


Yep! Not the knee! Also? Owwwwwww!!!

I was informed that yes, I would indeed be needing surgery. But since they still didn't know if it would be that night or the next morning I was still not allowed to eat or drink. It was past 4pm at this point. I hadn't eaten at all that day, and hasn't had anything to drink since that morning and was wicked dehydrated. They couldn't even give me an IV for fluids. It sucked, mightily.

I did get to meet my surgeon. Dr. R. Malcolm Smith. He is now one of my many imaginary future husbands. Chief of orthopedic trauma at Mass General. I got the top guy at the top hospital doing my surgery. I totally drew the lucky straw (as it was) that day! Anyway, I think I remember that my leg had been covered, and Dr. Smith said something about wishing he could have seen it. And I was all, "oh! I have pictures!" And showed him the photos Pasta had taken with my iPhone. *Grins* I win! 

Dr. Smith showed me the x-ray of my broken leg and explained things, but between pain and awesome drugs I didn't understand very well. But he did tell me that the amount and kind of damage I did was more in line with a high speed/high impact car accident, not a fall on the sidewalk. Everyone who has seen the x-rays and heard what happened has been astounded by how I managed to do it.

 

Ok, this is NOT a bad drawing of a face over an x-ray of a leg. It's my poor job of showing all the damage done. You can compare things to the second x-ray, taken after my surgery.

The horizontal and vertical lines near the corner there are the two fractures. I also twisted the tibia, knocking it out of place. The three circles are showing where the gap are between the tibia and the femur. Some of the gaps are almost nonexistent, and the gap in the middle is huge. What I didn't mark down is on the side by the fibula. The tibia and femur are supposed to line up. You can see in this x-ray that they clearly don't. The arrow pointing down above the fractures is to show how that whole section of bone impacted down when I fell.

I ended up with a plate, 8 pins, and 44 staples. The staples came out, but the rest of that hardware will be setting off metal detectors for the rest of my life! 

So anyway, back to my story. Nurses cut my pants off me (first time I'd worn them, too!) and got me into a gown. I'd pretty much end up wearing it for the next few days, so I'm glad it fit. :)  Two more friends ended up joining Pasta that evening, keeping me company and keeping my fear at bay in the ER while we waited for me to get a room in orthopedics and to hear when my surgery would be. Bill even brought me flowers. *Smiles*

I finally got to eat around 10, when we got word that surgery was scheduled for 7:30am. Then around midnight or so I got a room, said bye to my friends, and got settled into my home of the next five days. Bill had promised to come back in the morning so I wouldn't be alone prior to and after my surgery.

But when they woke me up extra early and I didn't know timing of anything I told Bill to not come after all. That was a mistake! Because holy fucking shit was I terrified. I'd only ever had my wisdom teeth out before, this was bigger. I didn't know what to expect, I was all alone, and I was powerless to do ANYTHING. When the nurse came in the have me take off all my jewelry, I balked at taking out my less than a month old earrings. No way was I going to let those close up! Especially since the nurse could give me no good reason for why I had to take them out. She finally just said we'd talk to the anesthesiologist. Who, btw, was insanely... majorly hot! Yes, I notice these things even through my panic.

He told me that the reason they wanted to take out my earrings was in case they got caught on something. No one wanted them to get yanked out. I was arguing the likelihood of that when Dr. Smith walked in. He immediately recognized I was trying to remain in control over something. Said to the nurse to just put tape over my ears and be done with it. Then went on to 100% make me not scared by being super calm and massively in charge and explained what was going to happen and joked with me and I fell in love with him.

They wheeled me into the operating room, which I wish I had a picture of because my last conscious thought was that it was like I'd just been wheeled onto the set of a science fiction movie. It was all gleaming and silver and white and unlike India, where the machines were likely older than me, these were obviously brand spanking new. 

It was so cool. 

Waking up, drugged and alone and in ungodly pain... Not so cool.

To be continued...