Tuesday, June 4, 2013

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


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... 

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