Thursday, March 17, 2011

The Emergency Room

This wasn't the kind of breaking up I had in mind. No, not at all.

You may be aware that I recently tumbled down the stairs of our quaint house in Tiny Town while attempting to do some laundry and broke my leg severely. In this post, I will set down some thoughts about the Emergency room and what happened there as a kind of cautionary tale. Because you know what? The minute you injure yourself severely, you realize that you are utterly uninformed about how to deal with such an emergency! So, I offer you my story.

After the fall and the excruciating separation of several pieces of bone in my right leg, I was extricated from our stairwell by a fabulous trio of EMT's who used their extreme savvy, calm voices and a fair amount of rippling muscle to hoist me into the air, onto a gurney and into the ambulance. I saw my darling husband FF out there in the driveway and yelled "don't leave me!" and then for a couple of minutes it seemed to me as if he had. But he had only jumped into the front seat of the ambulance. The big EMT hooked me up to a morphine drip. (Yay morphine.) The young skinny EMT just sat there and for some reason (perhaps it was the morphine?) and I became unduly preoccupied that he was too young to be around so much pain, and I felt sorry for him.
In the emergency ward, I was wheeled into a cold, white room with featureless walls that were pickled by the florescent light. FF, who was still in a state of shock and awe from the whole event, sat in a chair giving me brave smiles occasionally and at other moments just sat with his head in his hands. We were left there. For a long time. A very long time.

First Lesson: No one in the Emergency Ward will ever tell you what's going on or how long you are going to be there. It is apparently an unwritten law of emergency room staff to remain mum about why you are lying there unattended for so long, who is going to come if anyone, and how long you might be there. FF and I were in the emergency ward for nearly 10 hours, and by the time we wheeled out I was almost unconscious from exhaustion and he was ready to faint from hunger, thirst and general anxiety. No one ever offered him a snack.

Here kudos go to our neighbor, J., who picked us up in our car, drove us to get some drugs on the way home, handed me the throw-up bucket in the back seat, and who helped FF hoist me up to the bedroom when we got home. J's wife, L., was the only person I allowed to touch me when I was in white hot growling mode lying at the bottom of the stairs after the accident, so kudos to L. as well. The fact that she is very good with dogs probably has something to do with how she handled me when no one else could. But, back to the throw up bucket...

Second Lesson: Narcotics are very good, until they are very bad so hold off for as long as you can. Nausea is as bad as pain. Maybe worse. At least you can sort of grasp pain like a challenge, as if it were an enemy. But nausea just inhabits you, and makes you sit there with your head in a basin, sweating cold sweat, dreading the next wave and wishing you were dead.

The first morphine was a lifesaver. The next morphine was like a warm blanket. And the next dose of morphine hit my stomach like a bag of yesterday's shrimp. So there I am in the Emergency Room vomiting copiously, and a nurse comes in and shoots me full of some anti-nausea medicine. This did not work at all. So they tried more anti-nausea medicine. And more. By about 6 hours into our Emergency Room experience, I had had three drips of morphine and three doses of industrial anti-nausea medicine, and I had been continuously nauseated for at least four hours.

There is much to say about narcotics, including how grateful I have been to have had them, how much I learned to beware them, and the workmanlike way they slowly ate away at my sense of emotional well-being. Indeed, about 3 weeks into this experience, I finally decided to start backing off the Vicodin because I started to get frightened by my 24-hour fog and the surprise bouts of weeping. The drugs blessed me with some of the weirdest, coolest dreams of my life, but they eventually seemed to be sapping my will to do or care about anything.

So, in short, be careful of how much drug they give you, or you give yourself. Ration. Put up with a bit of pain. It is, however, a delicate dance : You have to learn how much pain to let yourself experience before you've gone too far. "Going too far" means that even if you take the drugs, they won't help you out as well as if you'd taken them a little earlier. So, stay awake to when you need to take a pill, but don't take it one minute before you have to.

Third Lesson: Water Will Not Kill You, No Matter What They Say. First, a disclaimer: Always do what the doctors and nurses tell you. That said, in the ER I was denied water for nearly 10 hours by nurse's orders. I had not had anything to eat or drink before I came, so I guess I was around 12 hours with no water, and vomiting regularly. In an unbroken person, this would be a bad thing, right? That would be dehydration, right? So just imagine the debilitating effects it had on me, an injured person! But still, requests for water to sip were denied. So FF would go secretly to the sink and wet a paper towel and let me suck on it when no one was watching. I can still taste the cardboard flavor of that water and will never forget the gratitude I felt for it.

Fourth Lesson: It Is Not Your Imagination: The Doctor is a Child and You Need to Pray. At one point, I awoke from my narcotic haze to discover that Dr. Doogie Howser himself was trying to set my ankle into a splint. What's worse, he was making bad jokes of the type that people make when they're nervous, jokes that were utterly inappropriate for a boy of 12 to be making. I am almost sure that when he tried to force my foot into a painful right angle by bracing it against his soft, child-like belly, he made some crack about "if this hurts, please don't kick me in the groin", at which point the nurse had to shush him. When this happens, you are too weak to protest and at that point you must accept that you are in the hands of God. Close your eyes. Learn to pray.

Fifth Lesson: No One Tells You How Bad It Will Be When You Get Home. I guess they figure it will be dispiriting. Or possibly none of the doctors or nurses really think outside the chill, sterile atmosphere in which they work. So let me tell you: The first two weeks will be Hell. And your house is absolutely not set up for someone with a broken leg. And your mate will become ragged from lack of sleep and taking care of you. And you will feel bad about it all in addition to just feeling like crap.

But those are stories for another day. Soon, I'll post something about how to prepare your home for a broken-legged person.

Until then, by all means, watch your step!

Tuesday, March 8, 2011

Breaking My Leg, Discovering My Growl

The Exile has been somewhat scarce to this blog lately. And though I can't blame it entirely on recent dramatic events in my life or in the world, I do have an excuse: I broke my right leg good and proper.

I have never broken a bone before, so it was necessary for an overachiever like myself to do a real number on her first break. I spiral fractured my right tibia, and I made mincemeat of my right ankle, slicing off the posterior meleolus and deranging and dicing some pretty important ligaments in the process.

Turns out the ankle is a complicated and delicately-made item. I had always suspected as much: Of the parts of my body that I've ever looked at with suspicion, that is, with the sideways thought that they might fail me one day, chief among them are the ankle, the wrist, and the knee, in that order. For some reason elbows, hips and spine (mine, anyway) seemed sturdier to me. But the ankle has always been an iffy proposition in my opinion: It takes too much weight, too much abuse and, in my case, is way to slender for the job it has to do. Fundamentally, an ankle is two long sticks (tibia and fibula) tucked into a kind of tripod formed by bones called meleoli which are, in turn, sort of rubber-banded together by a complex criss- crossing of ligament and muscle. The design has always served me well.

Until a sunny Saturday three weeks ago when I heard my husband come home from the gym. I skibbled down the stairs with an almost empty laundry basket of things to iron, when I simply missed one of the very irregular 220 year old pine steps of our house in Tiny Town and crashed. Half of me. The other half (the right one) remained hung up in the balustrade in a most unnatural position. That's how it happens: One moment you are thinking hoagie, the next you are screaming and your mind is awash with pain.

It's amazing to me how in one split second a person can turn from a happy, lunch buddy to an animal trying to free itself from a trap, growling at all who come near and wailing in an odd tone that even she herself does not recognize. It's a shock. But this is what happens, and do not be surprised if one day this happens to you. Do not feel ashamed about it. After the worst is over and you're lying in bed well-medicated you will look back and, if you have any sense, you will realize that the critter you met at the bottom of the stairs is an important part of you that you had simply never met before. For beneath all the clothes, manners, education and culture there is an animal body whose only aim is to protect itself by any means possible. This is when you hear your own growl for the first time. You hear the growl, your mind asks, "What the hell is that?", and you realize it is yourself. And then you growl. And growl. Growl.

In the next several posts, I will be offering some wisdom from my own all too raw experience about what to do you when you break your leg. I am discovering that there is little true information available about what really happens during this process, and that the saw-bones and hospitals in general do not fill you in on some really important things you'll want to know. I hope this will come in handy to someone, somewhere.

In the meantime, be careful on the stairs.