Wednesday, 10 June 2015

Post Op 2.5

heyyyyy-o, more hospital-o.

We last left off with a small infection, which was mildly terrifying, but now seems to be doing quite fine in the end.

Dr. Z thus postponed my next check-up from the following Monday (3 days after he saw me) to June 8 instead.  Thus I had my second "official" post op appointment on June 8, though it was really my third since Dr. Z saw me for the infection... but whatever.

This is not Dr. Z. That is also not me.

After dealing with hospital red tape for about an hour - which involved standing for about an hour, something I don't recommend when your foot still needs 24/7 elevation - I got in to have my X-ray and was ushered into a clinic room.  My boot, wraps, ortho socks and gauze were removed quite efficiently (and mildly painfully) by the ortho tech (seriously, people, these are BROKEN BONES you are handling) and Dr. Z peeped his head around the curtain rather furtively, saw it was me and came in and said hello.

A bit dark. Perhaps appropriate for my current mood.

He spent some quality time poking at the wound site with gauze and cleaning solution, and decided things were looking far better. So that's a relief.  I still need to keep cleaning it daily with Betadine and covering it, but that's not so bad.  He had the Chief of Surgery take a look at it as well, and they both agreed things were healing nicely.

Dr. Z then brought up the X-ray from the day of admission, whereupon the usual happened - someone stumbled by, went "whoa" and thus a small crowd of medical people stood around gazing at it, and in turn, me.  There were murmurs that basically involved "it's impressive you managed to get out of using external fixation for this one" which continues to make me very happy.

Also not Dr. Z. Also not an X-ray of an ankle. Look, I do what I can, okay?

Clearly becoming more comfortable with us, Dr. Z went on to chat a bit about the day that I came in. "I could not believe you were not screaming, and how comfortable you seemed to be," he said. "You just laying on that bed making jokes and making sure I'm a good surgeon." He smirked at that one. I guess he DID hear me talking to the nurse after all.  He also - something I didn't know before - told me the ankle was open on BOTH sides, not just the one side like I thought, and also meandered a bit in illustrating exactly why it was such a very bad ankle break.  All fascinating; I think I could listen to this stuff for years and not get bored.

He had me rotate my ankle a bit and said that was looking pretty good, and the fact that I wasn't screaming upon rotation was a good sign.  He took a look at the new X-ray, hemmed and hawed a bit and then called in the Chief of Surgery, who also hemmed and hawed and then they both decided that it would be a good idea for me to have a bone growth stimulator.  To make a long story short, that's showing up tomorrow morning, complete with therapist to teach me how to use it.  Basically, my fibula (the little bone on the outside of the leg) was shattered into quite a few pieces, and because some of them were so small they couldn't actually put them back together. So, the bone itself has to basically totally re-grow.  From the sounds of things, we may be looking at bone grafts, floating chip removal, and of course, screw removal whenever that time comes.

Still not Dr. Z, but indicative of my life path

We also talked about pain, and probably for the first time ever I didn't get a lecture on pain meds. Maybe because the original X-ray was still so fresh in Dr. Z's mind, ha ha. Pain is still a real issue; it goes from being okay some days to being absolutely horrible others.  Sometimes it aches, sometimes it throbs, sometimes it burns, sometimes it stabs, sometimes it squeezes, sometimes it feels like a million bug bites.  It likes to move around. Whatever the kind of pain, it sucks. And it's kind of itchy, too.

Friday, 29 May 2015

Almost a setback

It's hard to believe it's been almost two weeks since I posted! The time has crawled by sometimes and flown at others.  Usually, it flies when I'm sleeping 23 hours a day. One day in there, I actually stayed awake for 12 hours with just a one-hour nap in there and I felt like I had been awake for several years.  I know that probably sounds like a dream life to many of you, and I'll be real here - that's one of the better parts of this thing, being able to sleep WHENEVER I WANT TO and having absolutely no real schedule to adhere to.

Anyway, at some point on Wednesday I started to feel kind of crummy and came up with a low fever. Fevers aren't something I come down with very often; even when very, very ill I will often not have one.  I had noticed some time ago that there was one very small part of my surgical incision which seemed to staunchly refuse to heal - a very, very small part of it - and was also cheerfully leaking goo. Not much, but just enough.

I decided to just keep an eye on my fever and piled about a full tube of Polysporin on top of the yuck spot, went to bed, and woke up the next day feeling much worse.  I spent almost the whole day in bed, napping on and off and generally feeling unwell.  

By Thursday later afternoon, my fever seemed to have parked itself and made house, so I decided to get in contact with my surgeon... just in case.  They are really very adamant about ringing immediately if you have fever, bad pain etc etc. so I decided to put aside my tension and worry about being considered a hypochondriac and talked to Dr. Z.  

He was very helpful and gave me some instructions to do at home. He looked at a picture of the abscess, then decided he would like to see me promptly the next morning. I was getting a bit more worried about this the more I thought about it, so naturally I agreed.

The ensuing evening and night were not at all enjoyable.  While my fever gently floated in and out of feverishness, I lay awake consumed by waves of nausea which expressed itself using the "both ends" method. All night. It was absolutely terrible.  By the morning, having had ample time to cry and scour the internet for information, I had worked myself into a frenzy, convinced that I obviously had a terrible surgical infection and would need to be admitted to the hospital. I packed a bag and all in between hurling up stomach acid. 

Magically, my fever curtailed itself (as these things do) around 6am, just in time to head to the hospital.  It's like when you have a problem with your car - you always have problems, but never when someone who can actually FIX it is around.

Dr. Z was basically waiting for us on arrival, and quickly ushered me back into an ER bay.  The ankle was examined and after some prodding and poking he proclaimed himself quite relieved and that this was not nearly as bad as he had expected.  Perhaps needless to say I, too, was relieved, but also annoyed at myself because I felt like I had wasted both our time and if there's something I hate, it's feeling like a hypochondriac.

However, it did turn out the thing has an infection, and now I'm on an impressive antibiotic regime which requires waking up in order to take it every six hours for the next week. Oh joy.

But. That said... and those of you whom I spoke to during this what I'm sure was horrifically annoying to listen to me whine about experience... (you know who you are, and thank you) at least I didn't have to stay in the hospital.  I didn't realize exactly how intensely anxious I was about that until I lay in the ER with sweat literally running down my face. By the time we got back into the car I had sweated through my shirt. Disgusting. And then I had one of those cry-a-thon giant-gulping-sob episodes on the way home because I was feeling very sorry for myself indeed but also relieved and so glad I didn't have to be in the hospital.

I'M FINE. at least I think I'm fine. okay, I'm not fine at all.

I find hospitals very interesting places... but I don't enjoy being a patient very much, apparently.

Due to Dr. Z being out of country for the next week, we all decided we would like him to keep an eye on it rather than anyone else, so my next X-rays are postponed for one week. Hopefully I'll get good news! Still on massive painkillers, anti-nausea meds and blood thinners, and now antibiotics... but as Dr. Z said, I am really quite lucky to have gotten out of this (so far) with something that is only a small stumbling stone.  Given that I had an open fracture while literally laying in the dirt at a horse farm, I think that speaks well for both the job well done by Dr. Z and his team as well as my body's apparent decision not to have the worst immune system on the planet at exactly the right time.

In closing, though Dr. Z will likely never read this, and I hope he got the gist of the probably garbled message from sweaty anxious sobbing me, I am really thankful to have this man as a doctor. He's been so accessible, skilled, kind, empathetic, and magically actually seems to care.  I can't even remember the last time I had a doctor like that.  So Dr. Z, even if you never see this, or randomly stumble across it in 35 years or something, THANK YOU. As a patient, I can't stress enough how wonderful it is - an act or not - to have a doctor who actually cares and takes time out.  I truly am grateful to have landed where I did in terms of surgical and post-op care.

(That is not a reflection on the hospital as a whole, BTW. I stand by my bitching about the nurses.)

Now I'm going to hopefully have a nap, since my stomach has quietened itself after about a double dose of anti-nausea meds. Let's hope it stays that way....

Friday, 15 May 2015

Post-Op Appointment #2

Today I had my second post-op appointment, at exactly two weeks after the break and surgery.

We arrived about a half-hour early, since they do first-come first-serve when they give you an appointment block.  Basically, the orthopedic surgeons do their clinic with no proper appointments, so you just show up at the appointed time and if you check in after 10 people that means you're 11th in. If you check in first, you're first in. We learned this last time, so we showed up super early and it paid off when I was called in 15 minutes prior to my appointment.  Not waiting for three hours to see the doctor? Pretty worth it.

I hung out for a little while before the Orthopedic Technician, a guy named Edouard who was amazed that I didn't break my arm or hand instead of my leg, showed up and unwrapped my leg.

that view though.

The ankle was more swollen than it had been previously, and I'm not really sure why. I've been icing the crap out of it and elevating it like crazy.  Oh well. 

Note for the easily-squicked-out: mildly icky pictures ahead. You've been warned. :)

Dr. Z II, the Chief of Surgery at the hospital, showed up first and reviewed my history and the leg, noting that it was healing very well and that the stitches and staples (I have both, for some reason that nobody can tell me) could come out.  Edouard quickly went to work removing staples.  They really do come out pretty easily. It didn't hurt really, and kind of felt like tiny bug bites.  There was one section where it was slightly more painful, but all in all not bad. I hadn't heard good things about stitch/staple removal, so I was glad it didn't hurt very much.


No staples! #frankenfoot

They did the sutures next and that didn't hurt at all. I didn't even feel it. Small preference toward stitches, I guess.

Suture side of life... also the swollen side of life.

After this, Edouard re-dressed it, then put on this amazing super-long fuzzy sock.  He put this on my leg for me which was not exactly a lot of fun and ended up manipulating the ankle enough to cause some involuntary tearing up.  My surgeon, Dr. Z wandered in around this time and gave me one of his searching gazes (he is rather good at those) and asked why the red eyes, to which I explained about the sock.  He asked about the pain, and I told him it was still about the same - and it is.  I also asked why it wouldn't improve, and he just sort of shrugged and went, "well, mangled ankle, everything out of place, and a lot of hardware in there... pain is expected." So I guess even this amount of pain two weeks down the road is still normal. Who knew.

Dr. Z decided to take off the sock and look at the ankle himself, which led to yet more painful rolling around of the ankle.  Ugh. Edouard re-appeared around then with one of the moon boots, which I have now been ordered to wear for the next forever of my life.  I was originally very pleased with the idea of the moon boot since it beats a plaster cast, but after wearing it for about 10 minutes I became very displeased. I wasn't sure how much was residual pain from the doctors pretending my ankle was a football or how much was from the boot, so I took a nap at home and then wore it around for awhile.  It's definitely the boot.  I'm going to keep trying it for a few more days, maybe, and if it continues like this will definitely see the doctor about it again.  It hurts so, so much, and every time I tap it accidentally on anything it feels like my bone gets broken all over again. I think the air part is pushing against one of the screws that's holding the ankle together, down by my ankle bone.  Not sure but that's my educated guess based on my X-rays.

Hello, boot from HELL.

In all though, decent progress. Dr Z. said at least six more weeks non weight bearing, then another surgery at some point in here and physio and then basically learning how to walk again. It's funny how much you miss walking when you suddenly can't...

The only good part about the moon boot is that I can take it off and take a proper shower with a naked leg (!) in a few days, once the incisions heal up a bit more and the suture/staple sites are closed. Infection is still a little bit of a question; fingers crossed it continues to hold off!

Tuesday, 12 May 2015

Post-Op Appointment #1

Let it be known that the Canadian healthcare system has its excellent points, but it has its pitfalls as well.  One of those pitfalls is, simply, a shortage of doctors.  This leads to doing interesting things like scheduling a block of time when the doctors are available for appointments, and giving everyone who needs to see the doctor a mass appointment time. In this case, 2:45 PM.

Luckily, we arrived fairly early, and lined up and had my details taken around 2:30. This led to about an hour's wait time until I was taken back into the fracture clinic, had an X-ray taken, and then was immediately ushered back to see Dr. Z.

giant hospital splint

Dr. Z was pleased with the X-ray - viewable on the "before and after" post below - and at the rate of healing of the wound and surgical incision but opted to wait until Friday for stitch removal.  He took off my gigantic hospital splint and put on a much smaller one with Tensor bandages, then sent me on my way.  All in all, three hours to hear "looks good" and to get more pain medication.  Worth it, though, I suppose.

This is Nemo, he is my napping buddy and will give you a dose of cute before a dose of gross.

Plus I got cool pictures!

Cool Frankenfoot

Suture side (inside of foot)

Before & After: X-Rays

Before, hopefully this is obvious.

After, also hopefully obvious, about 10 days post-op.
Who can spot the floating bone fragment?!


View from The World's Most Comfortable Bed

I was checked out on Wednesday, May 6 and immediately drove home and went to sleep for about seven hours.  Then I got to take a REAL SHOWER (in the hospital, they gave you a washcloth and pointed you to the showerless bathroom and you washed up as best you could - not exactly ideal...) and finally washed the sand out of my hair.  I was not looking or smelling fancy when I was finally released, I will tell you that much.

Home involved sleeping for about 23 hours a day and then having terrible nightmares about the accident and/or everything else on earth most nights.  Thankfully, Matt is a good guy and will hold my hand overnight... which helps.  Even now, as I write this two weeks later, I'm still having nightmares and it sucks.

As time interminably floated on, I got this super fancy ice pack:


...and have spent a lot of time playing with digital horses on the Internet and watching TV and writhing around in pain from time to time.  Experimenting with pain meds (and by that, I mean not taking them after a major surgery) is not recommended, FYI.

But mostly I sleep.  Two weeks later, most of my day and night are still devoted to sleeping.  I guess my body is just totally traumatized... but whatever it is, it seems to be working, since my post-op appointments are showing good healing.

One interminable nightmare-and-pain-ridden night
Can't sleep? Take pictures of your ankle! :D

My Post-Surgery Hospital Stay

After the party it's the after party

I woke up eventually, laying in a hospital bed and feeling terrible.  I had a morphine drip, was on about a billion pain meds, and mostly slept and woke up for five-minute increments for the first 18 or 20 hours.  Eventually, the next day, the pain woke me up for real - something that the Dilaudid, Toradol, Gabapentin, and Morphine were just not touching.  

It's here where I get really angry.  The hospital where I stayed did a really good job getting me in, operated on, and efficiently taken care of.  I think the surgeons and surgical staff did beautifully and my complaint is definitely not with them, but the nursing staff? Ugh.  SERIOUS upgrade necessary. In all honesty, some of them were really good. But the majority were awful, and worse, incompetent.

I basically started to go into high levels of pain and pressed the nurse call button.  Hitting the nurse call button isn't something I would do unless it were really necessary, though of course they don't know that.  I proceeded to wait... and wait. And wait. My roommate started pressing the nurse call button. My third roommate started pressing the nurse call button.  Still no nurse. By this time I was in levels of pain that were literally sobbing and shouting for help, and still no one came.  I texted Matt when the whole thing started, and he, at home, got in the car and drove to the hospital - which at the time of day took him a full hour and a half - and got to me before a nurse ever did.  I am really upset about that, because it was serious pain.  I was in a hospital, not at a freaking hotel.  Plus, my room was close enough to the nurses' desk that I'm sure SOMEONE heard me and my roommates literally shouting for help.

Poor Matt had to drag a nurse into the room, where they gave me oral (???) pain meds (I was on an IV and oxygen my entire stay...) and kind of sat around watching me for awhile.  Nothing really took the edge off at that point, and after getting a thorough dressing down, the nurses finally paged an on-call doctor, who paged an anesthesiologist. All of this took a couple of hours. The anesthesiologist finally showed up, having also dubbed himself the Candy Man, and promptly knocked me out with yet another Ketamine experience. Evidently there was morphine, ketamine and three or four other painkillers involved, and whatever it was, it worked.

At some point prior to OMG PAIN my surgeon stopped in and checked things out, and asked me to wiggle my toes up and down.  Turned out, I couldn't do this. There was much concern all around, but it eventually ended with everyone deciding to wait another day to see if it was the nerve block that was causing the problem.  

Thankfully, it turned out that this was the case.  My surgeon checked in for a few moments every day, nothing huge, but hung out for a moment and would tell a bad joke or two and poke at my foot.  For some reason this was reassuring.

I honestly don't remember a lot from the next few days.  There was very little eating, a lot of sleeping, a lot of dozing off in the middle of composing sentences, a lot of what basically amounted to drunk texting (pro tip: don't morphine and text message. You will live to regret it.) and plenty of staring at the curtained walls and listening to my roommates complain.  I had three other roommates - thanks Canadian health system! - all in various states of health.  One had a broken ankle but had become infected, and the infection somehow reached her shoulders, and was in a lot of pain. One had a simple abdominal surgery and was checked out within 24 hours. (Lucky girl!) And one was a much older woman who had a lot of family visiting at all times and appeared to be on her death bed.  I felt bad for her... she was kind and sweet and didn't complain, but was obviously in a lot of pain.

This was my room, minus the tables, and all curtained off, and with a much more disgusting floor. I did not enjoy it at all.

By Monday morning, I felt like I was dying all over again.  I had basically become colorless, was nauseous all the time, and was sleeping about 23.7 hours per day.  Things seemed to be going backward.  I had to ring for a nurse every time I wanted to use the bathroom and it was a disaster trying to move at all.  Unfortunately, physiotherapy showed up Monday afternoon when I was busy trying not to throw up into a garbage can.  They completely ignored the fact that I was literally vomiting and insisted on fitting me for crutches and making me sit up in a chair for awhile. Remarkably, after this, things started to turn around a bit.  

The entire hospital stay was not one that I would ever like to repeat.  I'm a total proponent of socialized medicine, and think the US' system is horribly broken, but I will say this for most US hospitals: at least they don't leave their patients, just out of surgery, alone for hours on end, ignore their pleas for help, and don't shower/bathe them at all.  I also thought it was interesting that they expected me, totally spaced out on morphine, to somehow figure out what time it was, when mealtimes were meant to occur and how to get food.  That took some doing as well. I also hated being more or less ignored by doctors and nurses once I was out of surgery, more or less.  Ugh.

Definitely not a great experience and by Tuesday I was growing very restless indeed.  Thankfully, they released me Wednesday afternoon and I got to go home!

sort of.