Wednesday, October 24, 2012

A long painful night in the ER

Now that I have made it out of the woods and the paramedics arrived the wheels were set in motion to get me fixed.

Before I was transferred to the ambulance stretcher everyone (paramedics, fire fighters, homeowner, etc..) were in awe as to how well of a splint we made to keep my leg stable. Bruce and I thought nothing of it. We figured it was ‘all in a day’s work’. I was thankful for this splint for once or twice out on the trail I could feel my foot shaking independent of my leg even with the splint tight and aligned properly . That is not a feeling you want to have.

I was eventually transferred onto the stretcher and placed into the back of the ambulance. Bruce orchestrated with the firefighters where to take my bike (down the road to Bob’s house) and I bid him farewell.

In the ambulance the first order of business was cranking the heat to warm me up and then they could get my vitals. Both paramedics were apprehensive in cutting my cycling shoes off so they very carefully took my right shoe off together. They did a great job for there was little movement of my ankle/foot in the process.  Once the shoes were off my socks were cut off. The next order of business was a splint.
Do you have a SAM splint?

I know what you are talking about. We used them in the Military. Sadly, We do not have any.

Really? They are super easy to use and will brace my leg much better than our tree branches and bicycle tubes.

CT does not require us to carry them and our employer refused to purchase them for the ambulances.
He then began to fold some cardboard apparatus thinking that will splint my leg. I laughed and told him I’d rather keep the tree branches on my leg. The cardboard was abandoned and he then began to fumble through just about every compartment inside that ambulance. Just as I was about to tell him to stop and just take me to the hospital he found two splints a few feet long wrapped in plastic. They then tied those splints to my leg and we were off to the hospital.

The ambulance was now warming up and I was no longer shivering. The paramedic put an IV in my arm.
Should we do that before we start moving?

Nah. I do my best work when the ambulance is in transit.

With an IV then came some Morphine to ease the pain. By the time we reached Hartford Hospital I had two or three doses of Morphine. Didn’t really notice a tremendous difference in pain level though.

Alert and talkative the entire 15-20min trip, the paramedic and I swapped stories as he took my vitals and make sure I was alert. The driver did an amazing job navigating the bumpy roads to the hospital. None of the bumps made me cringe in pain from my leg. Or was it the Morphine?
That foot is not supposed to be twisted like that...

Once at the hospital, I was wheeled into the ER and was eventually transferred into an ER room and bed. Moments after entering the ER, Ginger arrived. The paramedics bid me farewell and told Ginger to take care of me. Various nurses and doctors and such came and went as they tried to establish my situation and what to do from there. At some point I got out of my cycling clothing. Nurses were apprehensive in cutting my bib shorts so Ginger helped me get out of them. Somehow we managed that without knocking my right ankle and foot.

Laying in the hospital bed with my foot slightly elevated was much nicer than sitting on my bike in the dark woods. The elevation helped the pain slightly. I still didn’t really notice much relief from the Morphine but just dealt with the pain. On the 1-9 scale I was sitting around a 5-6. The first time we went through that the nurse gave me a look and all I could do was

Guess I have a high threshold for pain?

First order of business were X-rays to determine the extent of the damage.
Once we knew what we were up against, an Orthopedic doctor took me into another room to try and re-align my ankle and foot. I understood this to be the first attempt before any decision is made for surgery. If this is successful then surgery may not be needed. Ginger and her sister were left to fend for themselves in my ER room.

The re-alignment consisted of a lot of physical movement. At one point my foot was hanging from string tied to my toes and the doctor was pushing down on my shin and twisting my ankle. In-between movements she would take an X-ray of my ankle to see how things were adjusting. The X-ray machine was really neat. It consisted of two small plates suspended by arms coming off the machine. She could position these plates anywhere she wanted. As soon as the X-ray was taken the image instantaneously appeared on her computer screen which she then used to gauge progress. Real-Time X-Ray. Pretty neat.
Throughout the re-alignment process all I could do was lay there and focus on breathing. The breathing helped me cope with the pain. I thing I was given a local shot beforehand to numb my ankle some but there was still quite a bit of pain.

The re-aligning process was going well for a while and then it was determined that as she got one bone aligned well (lets say Tibia) the other bone (Fibula) was not aligning properly.  I was left alone for a while. The doctor was probably consulting with other doctors during this time.
 Tibia is lined up well now, Fibula is still off..

Laying in a bed with my foot hanging from some string tied to my toes got unpleasant rather quickly. It did give me time to scan the room and also chat with the various nurses that would come into the room, grab something off the shelf and leave. It was through these observations where I dubbed the room the ER Closet. With me in there this room also doubled as an X-Ray room for fracture re-alignments. Quite humorous when you think about it.

After a few hours and several consultations with the Orthopedic Surgeon on call that evening it was determined that I will need surgery to properly align my foot ankle and leg. Surgery consisted of placing addition objects to align the bones and keep them together. This is called fixation. Fixation consists fo internal and external. The former being all pieces (plates, screws, etc) staying entirely internal to my body. External being some pieces protrude out into the cast. Internal is desired as external fixation can, possibly, present infection down the road where the fixation device protrudes outside the body. The method used would not be determined until they had me open and were seeing the broken bones first hand.

My stay in the ER Closet was over and I was wheeled back to my ER room for the remainder of the night. During this time Ginger made her way back to the hospital. She left sometime before midnight to pick up a few things at home and go get my Jeep which I left at Bob’s house. While at Bob’s, in the middle of the night, she caught him up to speed with what was happening in the hospital with me. Bob also told her what happened out in the woods (another story I have to tell you).
Notice how the toes on my right foot are rotated to the right relative to my kneecap. Not good.

Time seemed to move quickly in the ER. By the time I got out of the ER Closet and back into my room within the ER it was around 2AM. I was hungry but was not allowed to eat for I was scheduled for surgery later that morning. Lovely. I purposely did not eat a large lunch knowing Ginger and I would have a great home-cooked dinner that evening. Seeing as I was in the ER, dinner never happened. I did everything I could to fight off the hunger. After dealing with the pressure and pain of my broken leg the hunger was an easy fight. The exhaustion overpowered the pain my leg and I eventually fell asleep for a few hours.

5AM arrives and doctors began coming in and out of my room talking to me about surgery for later in the morning. Groggy eye’d I did my best to answer their questions and figure out what was going on. I was first on the docket for surgery that morning, sometime around 9 or 10AM.

Around 7 or 8 I was greeted with a pleasant smile: Ginger arrived. It was difficult for her to see me in this condition and difficult for me to face reality that I was laying in a hospital with a broken leg just three weeks and change before our wedding. We both wanted to ask the Whys and the What-Ifs but independently knew it was not worth the effort. We could do nothing about it and had to focus on the current situation and how we would continue moving forward. These kinds of thoughts take massive willpower.

As 9AM came and went I was getting antsy to get out of the ER and into the OR for surgery. Surgery was the next milestone and my sights were set on that. Unfortunately, as the suggested hour came and went, my mental game was falling apart. I did my best to try and ignore this and focus on something else but it was difficult. Eventually I was moved upstairs to the OR. This was good news.

Surgery was supposed to last a few short hours but ultimately lasted a lot longer than anticipated. Before I went into the OR I met all the doctors and everyone had me confirm from my own two lips which foot/leg they will be operating on. It was during this time where I met Dr. Kevin Burton whom was the attending surgeon and was running the show in the effort to fix me. I also had to fill out the paperwork a second time for the paperwork I filled out in the ER got lost and never made it upstairs to the OR. Dr. Burton got Ginger’s phone number and told her how things would pan out and that he’d call her when they were done. She then wished me the best and went off to work. I was subsequently wheeled into the OR. Once in the OR I was transferred onto the operating table and the Anesthesiologist placed my arms out in a T on supports. I moved around a little bit to get comfortable and do not remember anything after that.

Many hours later (2 or 3 PM?) I awoke in the post OP area. Lots of people coming up to me once they saw me moving around. I do not remember much of anything as I was still drugged up from surgery. I do remember something about asking if I wanted a shot into the knee area to numb my leg if the pain was too much. I told them the pain was fine and the concept was dropped.

An hour or so later I ‘officially’ woke up and was alert and could see straight. The nurse was very nice and made sure I was comfortable. A while later they wheeled me out of the Post OP and across the hospital to my own room. The orderlies thought it was a race and were running my bed across the hospital. Watching ceiling tiles flash before my eyes and the bed moving side-to-side made me very nauseous thanks to the anesthesia still in me.

The nurses then popped in to say hello and check up on me. I think it was now around 5 or 6PM.  Dr Burton also came in. He said they found a few additional fractures not noted on the X-rays so that took them a little longer to get everything aligned than anticipated. He was pleased to tell me everything worked with internal fixation. Two permanent stainless steel plates and a total of thirteen screws to put this Humpty Dumpty back together again. I also had a giant cast on my foot that came up to just below my knee. This meant I could bend my knee which was an added bonus.
Ginger stayed for a little but and then went home. I was left trying to shake the anesthesia out of me and try to go to the bathroom.
Bright and early the next day I was greeted by Dr. Burton. Everything felt okay. I had some pain in my leg from all the work they did but a steady IV drip of some pain killers kept things comfortable. The pain at one point tipped 6 or 7 on the scale, higher than when my leg was broken. Guess it was the price to pay to be fixed.

My Friday morning in the hospital consisted of learning how to use crutches (I was very apprehensive of getting out of bed but forced myself up and moving around) and eating some hospital powdered egg breakfast. I spent the afternoon watching Vanilla Ice flip homes on HGTV with a break for more learning with crutches. By late in the afternoon I met all my objectives for dismissal and was able to leave the hospital. A few friends stopped by and helped Ginger get me home.

Friday night was early to bed. My bed, finally...


Blogger Hill Junkie said...

Your posting is bringing back a lot of memories. In May 2010, I suffered a similar double-fracture while riding familiar terrain, although probably not quite as serious but still necessitating pins and screws. At the time I wondered how I'll ever bounce back, but I did. The PT will be very important when you start in a few weeks. Follow all the way through with it.

I do a little running now. My recovery has reached the point where can't notice any deficiencies in my left ankle/leg anymore, and running is the most abusive thing you can do.

I went 6 weeks zero weight bearing, 9 weeks in boot cast, and many weeks after that in PT. Hang in there. This will pass. In a couple years you'll barely think about it any more. Thanks for sharing.

10/25/2012 6:12 AM  
Blogger aumiller said...

Checked back in to read the rest...

Recovering this fall, I've done my best to avoid the 'what ifs' and not replay my own accident in my mind. I made up some team kit earlier this summer, and I put a quote from Point Break on the thighs facing up: 'it's not tragic to die doing what you love.' Boddhi...of course. I have no regrets. Shit happens. And I still love riding my bike. When I'm exploring the woods, i don't want anything else...nor do i want to be anywhere esle. This mantra has gotten me through the autumn and recovery.

Good luck with your wedding! We're thinking fondly of you in MA.

10/26/2012 6:50 PM  

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