Friday, October 14, 2011

Preparing for the Cut

I’ve been biding my time, waiting for my trip to the orthopedic surgeon where my fate for the next two months would be decided. Of course biding my time was my only option. I like to pretend that I had other options, but really biding was about it. Hopefully I was able to bide patiently. My husband may have another opinion about it.

I had been very clear and up front about not having any insurance, but unexpectedly everyone at the hospital and the doctor’s office had been extraordinarily nice and helpful. I had known that the ER had to treat me even thought I didn’t have insurance. However I had I had expected to be put at the end of a long line, or had to have my follow up appointment wait for a cancellation. However, my appointment with the surgeon was set up for just a couple days after my ER visit.

I discovered that a couple of short days rest in bed was not enough for my left ankle to recover. Crutching around was still quite out of the question. Standing was just barely possible. My husband tried to make the trip as easy as possible by taking the wheelchair as close to the car as he could, but he ran into one serious problem – stairs. Being taken down stairs in a wheelchair is rather like a trust fall, only I am severely lacking in trust. We did make it to the car without any serious incident. I was just pleased at getting in the car without crawling.

The surgeon’s office was easy to find and fortunately they had their own wheelchairs so I didn’t have to try and crutch my way through the office building. Unfortunately in order to prevent their wheelchairs from rolling off the property they resembled something that looked like it had been modified from a shopping cart. There was no place to put your feet, a wonderfully comfy seat of criss crossing grids, and unless the person pushing held the break while it was moving, the chair stopped abruptly with threats of me spilling out onto the walkway. Yep, this was definitely a beautiful piece of engineering that I wanted to abscond with and take out on the open road. But it did get me up to the surgeon’s office where I found all of the other people who had visited the ER recently, mostly for foot and leg injuries.

After a $50 copay and a short hour of waiting, I made it inside to a room where I finally got to see my right foot for the first time since the ER room. On first glance, I determined that I am part werewolf, and that part doesn’t include the rapid healing. My right leg and foot was still easily twice as large as my left, and now turning all sorts of lovely colors. Apparently, my bruises are from the fall color line. It was quickly determined that I would need surgery and that I would have a splint afterwards. I asked the surgeon about my non-surgical options, which he quickly dismissed. He stated that without surgery my ankle joint would probably not heal correctly, it would most definitely develop arthritis, and it would take a longer time to heal. I thankfully would not need what the techs referred to as a “tomato planter,” a series of metal rings around the leg, attached to your leg bone by pins. While easier to shower with, I found those things infinitely creepier, and a huge step closer to becoming a cyberman.

My leg was expertly rewrapped. My surgery date was set up just a few days away and I was set away with basically the same orders as the ER. They’re rather easy to follow, as I tend to naturally avoid intense jabbing pain.

Now if I could just figure out how to stop my butt from getting numb.

Wednesday, October 12, 2011

Memories, What Memories?

The doctors have actually been very understanding in that having bones floating around somewhat freely in my ankle might be pretty painful. So I have pain pills. And these aren’t, “oh here let’s sit around in a therapy circle and talk about your pain.” These are stealth ninja pain pills that sneak up on your pain from behind, silently take it out and cause you to fall asleep while in the middle of a sentence. My friends have had to put up with me randomly sleeping during parts of our conversation.

These pills also tend to wipe out my short term memory. So I repeat myself a lot. I repeat myself a lot. Thankfully my friends are wonderful people and can put up with me acting like a horribly random children’s toy with an electrical short. And the traditional friend response to that is bring food, lots and lots of food. So far I haven’t fallen asleep while eating yet. I’ve come close, but not yet.

The most frustrating thing so far is trying to finish a thought. I’ve been working on this short bit of writing for about two days now. I just get lost in the middle. It’s like going out into a snowstorm, only you don’t know why you went out there in the first place. Hopefully along with lowering the dosage of pain medication I can stop looking and feeling like a monkey who just got hit in the face with a fry pan.

Sunday, October 9, 2011

Home Life

I ended up firmly ensconced in the guest bedroom. And, as much as my mind and heart wanted to be downstairs, my broken, sprained left ankle simply refused to cooperate. My weight while not as substantial as it used to be was still larger than two, OK, six or seven super models put together. Putting that weight on my “less damaged” ankle and the act of crutching around was showing itself to be less and less of an option. Luckily my mother-in-law who actually does have one of everything, presented me with a wheelchair. I could now wheel around banging into woodwork and practice for my role in Whatever Happened to Baby Jane.

On my arrival, my pets were super happy to see me. And in the manner of loved ones everywhere they immediately jumped on my ankles, repeatedly. Thank goodness for ice and pain pills, oh and elevation. However elevation required pillows. I started, by proxy, collecting pillows from every room in the house. I eventually ended up looking like I was being eaten alive by a extra fluffy muppet. But I was relatively comfortable. Well, except when my dogs tried to play King of the Mountain on the pile of pillows that I was putting my feet on. Dogs have no respect for splints and ace bandages, well except for as implements in a game of tug of war. By the way, never leave a loose end when re-wrapping ace bandages around your foot.

Now came the challenge of describing exactly where my stuff was that I wanted. It was rather like reverse charades. Of course I had to also take into account that my husband has a negative spot check for anything that he isn’t actually holding.
“My book and pen are downstairs on the coffee table.”
“I looked, they aren’t.”
“Please look again, I’m sure I left them on the coffee table.”
“I looked again, they’re not there.”
“Try. Again.”
“Oh, I found your book and pen.”
“Really? Great, where were they?”
“On the coffee table under a piece of paper.”
Sometimes graciousness means smiling hard enough that your teeth are cracking while you're saying, "Thank you."

Now picture this conversation repeated for just about everything, underwear, sweatshirts, deodorant, and yarn, especially yarn. And before you even begin to ask, yes yarn is an essential in my life. There was just some stuff that neither my husband or mother-in-law could find no matter how well I described its location. So, after several attempts I knew what I had to do. I waited until both my mother-in-law and husband had left the main floor and then slid my crutches down the stairs and butt bumped my way on down to the basement. I grabbed a bag that I could hang around my neck and started crutching and crawling my way around the basement grabbing the missing essentials, which included the precious yarn right where I had described it.

Pulling myself back upstairs with my arms proved to be a bit more difficult, but ultimately doable and by the time I was back in bed I was exhausted, but satisfied. Unfortunately my little foray was not unnoticed.
“Where the HELL did that yarn come from?!”
“The basement pantry.”
“You know what I mean, you better not have gone downstairs to get it.”
“Well, no one else was successful in getting it.”
“If you ever even try to go downstairs again I’m hiding your crutches AND your wheelchair so that you’re stuck in this bed and have to let people help you.”
“ok”
“And mom, since you didn't notice her sneaking downstairs, you’re fired.”

Saturday, October 8, 2011

A Fistful of Paperwork

So I left the ER with a handful of paperwork, two wrapped up ankles, an orthopedic shoe, and crutches. So woo, great hospital swag acquired! Medically I’m not supposed put any weight on my right foot and to put as little stress as possible on my left foot as it’s already weakened and could easily roll and sustain further damage. That was a wonderful pep talk from the staff. At least I wasn’t planning on running the Portland Marathon.

Now I have to prove to the hospital that I’m not making any money. I found this concept interesting because it’s pretty difficult to prove a negative. Well, the balance in one of my bank accounts was actually going to make that pretty easy. So I need to provide a copy of my taxes, 3 months of bank account statements, and 3 months of pay stubs. The pay stubs are by far the easiest since they don’t exist at all. I also have to send in a letter describing my financial situation. This letter is, I’m assuming, so that the hospital financial office has something to laugh at during their lunch hour.

The drive home was quick, but my legs informed me that there are enough pot holes on that short route to provide jobs for a large number of people. And then the argument started. My husband and I live in the basement. Me being a hurt sick animal I wanted to crawl, literally, down into my hole and hide. After the eventful morning, my husband was a worn out, tired man and he wanted to tuck me into the guest bedroom on the main floor.
“Please”
“No.”
“Please, I can totally scoot down the stairs on my butt.”
“No.”
“Please, all my stuff is down there.”
“No, we can bring your stuff to you.”
“Please, if I’m already downstairs no one has to bring anything to me.”
“Except food. If you’re downstairs we have to bring you food. And how are you going to get to your stuff, you’re not supposed to walk on your right foot and you’re supposed to stay off of your left as much as possible.”
“I’ll crawl.”
“You will not. I know you, and the minute that I’m not looking you’ll get up because it’s easier.”

So I lost. While I sat in the parked car while my husband prepped the house I got my friends on board with the downstairs idea. I had formed up my troops and was ready make a new assault. However between crawling up the steps and the ten minutes it took me to maneuver the bathroom my will to bump down a full flight of stairs evaporated. Unfortunately my friends were still on board with the badly injured friend downstairs program. I collapsed, defeated on the guest bed and convinced everyone that moving might be possible after the pain pill arrived from the pharmacy. But other than that I was going to remain sedentary until my legs fell off or the sun swallowed the earth, whichever came first.

Friday, October 7, 2011

Diving into the Medical Bureaucracy

I have to say that over the years I’ve had too many experiences with ERs, and not all of them have been good. One of the most memorable was being left alone in a curtained room for over twelve hours while I repeatedly threw up from a migraine that I really thought might make my eyeballs explode. However, in their defense, ERs are much better at dealing with, “hi my bones might be broken,” than “hi, I’m in horrible pain that is difficult to test for and can indeed be faked by someone coming in off the street just looking for drugs.” In my defense the hours and hours of vomiting points to some serious method acting that I’m just not that committed to pulling off.

Anyway, I’m used to entering an ER waiting room full of a variety of interesting patients. Usually you’ll run into people with everything from a cold to those who got a little too close to their lawn tools. And then there are the truly special who injured themselves seriously a week or more ago, convinced themselves it was nothing and now their damaged appendage is about to fall off. So, the waiting room is nothing if not entertaining because you get to play guess the injury. This time around I was completely surprised when I rolled into a completely empty waiting room. It felt like I had made a wrong turn and ended up in a twilight zone version of an ER waiting room. I have never seen an empty waiting room. I felt a bit like the rest of the patients were hiding around the corner somewhere like those tricky lines at Disneyland where you think you’re through the line and then you turn the corner only to discover hundreds of people yet in front of you. So it appeared as if I was on the ER fast track. Or for those old enough to remember, I had an E ticket at Disneyland.

I wasn’t even waiting long enough to determine what 1980’s rerun was showing on the waiting rooms wavy TVs before I was rolled into triage. It was quickly determined that I was indeed broken, I was given a wrist ID and rolled back into the waiting area and before I could even wriggle out of my coat, I had a nurse navigating me back through the maze behind the passcoded doors of the ER. Even if they magically healed me up so that I could walk, there was no way I was getting out without a map as every hallway looked identical. Well, there was the hallway with the patient screaming profanities. That one stood out a bit.

I was wheeled into the ironically named Ambulatory Care unit. But I was hopeful. Perhaps I might actually be ambulatory again. My best hope was that I just messed up the tendons & ligaments in my ankles and we could just wrap them up tightly. It could be an excuse to get some brand new lace up boots. However first they pulled the old bait and switch. They’re now doing registration in the rooms. Instead of a doctor or a nurse I got a very nice office guy who wanted to fill in all of the insurance information that I didn’t have. And he tried everything,
“Did this happen in a car accident?”
“Nope.”
“Did this happen at work?”
“No, as I said, I’m unemployed so that would be very difficult.”
“Is there anyone you could sue?”
“No.”
Oh yes, sue. I should sue the person who is graciously letting me live with them while I get back on my feet. What’s that called? Shooting yourself in the foot. I think that would also require surgery and then I would have no place to live.

But after signing paper after paper that agreed that I was 100% responsible for what happened to me and all of the financial implications, the nice registration man left and the horde of nurses rolled in like the cavalry. It was quickly decided that I needed x-rays on both ankles.

I have to say that radiologists are some of the nicest people I’ve ever dealt with in a hospital. Who else can convince you to contort painfully broken bits of your body into artful poses for pictures? Either that or they’re really subtle sadists. But they’re also fairly quick about it and my x-rays were in the hands of the doctor by the time I made it back to my room. But the results weren’t quite as positive as I had hoped for. They stated that I had broken a metatarsal in my left foot, and that was the good news. That wouldn’t need a cast, it would just be uncomfortable. My right foot was much more problematic. I had broken the bottom part of the fibula, or the ankle bone, into three pieces. Not only could I not walk or place any weight on it at all, it would require surgery. I think the part of my brain that deals with money just overloaded at that point. It was then that I started wishing that Dr. Nick Riviera didn’t die during The Simpson’s Movie. “Any operation, just $129.95!”

The rest of my visit went just as quick and as efficient as the first half. They wrapped up my left foot, and splinted my right. I got a prescription for pain pills and an appointment with an orthopedist who apparently was going to pin a plate in my ankle. I’m not sure what I was looking forward to more, a lifetime of setting off metal detectors at the airport, or trying to talk the doctor into just manipulating the puzzle pieces of my ankle back into place manually. But I know I was looking forward to those pills numbing my ankle into oblivion.

Thursday, October 6, 2011

If This Was An Actual Emergency You Would Know What To Do

So, I had made it to the couch and was trying to convince myself that with ice and never moving again that everything would be OK. The rest of the household was behaving normally and contributing to this delusion. My husband had thoughtfully picked up all of the breakfast I had scattered over the carpet, however one of our dogs was doing a very good impression of a Roomba and trying mightily to find any scrap he had left behind. Our other dog was still trying to find a place to lie down on me to “comfort me. Since I wasn’t struggling, he finally settled on my lower back.

Now a rapidly swelling ankle that I couldn't bear weight on that hurts like a balloon full of razor blades would usually send me right to the ER. However my life decisions, as well as my decisions regarding my day to day activities, have to be tempered by my lack of funds and insurance. So first we rang up Zoom Care a pay as you go facility. The pluses for Zoom Care are that you can make an appointment online or over the phone. The minuses are that for a possible bone break is that they have to send you out to a facility for x-rays, and then they send you home while they wait for someone to read them. Zoom Care then rings you up and lets you know if you have a broken bone and what you should do about it.
“I’m sorry, we can see the bone sticking out of your leg from your supposed compound fracture, but we’re going to have to send you home while we wait for that diagnosis to be confirmed.”
So Zoom Care seemed like less than an ideal solution to my issue as wandering around from place to place on possibly broken bones for an extended period of time was appearing less attractive with every passing swelling, bruising moment. We then tried calling Urgent Care units. There used to be Urgent Care units attached to hospitals so that more critical patients could be quickly shunted over to the ER and the Urgent Care could make use of the hospital could make use of the hospital facilities. Unfortunately for whatever reason, the Urgent Cares attached to hospitals have closed. Perhaps they weren’t making enough money as I’m sure they were a top choice for people like me without insurance. So that left my husband and me with about two hours wasted and after a dare to place my entire weight on my right ankle (I lost,) we were headed off to the nearest ER. As we were going out into public I did get it together enough to change out of my breakfast soaked pj’s into some slightly more socially acceptable sweatpants. I only needed a sports jersey or a bedazzled tank top to complete my camouflage for the ER waiting room.

As my mother-in-law actually does have one of everything stored away in her house a set of crutches was quickly found so I could hobble to the car. OK, I crawled, I crawled to the car. No dignity was involved whatsoever. Having already been covered in breakfast I thought that I couldn’t sink any lower. I was wrong. Random whiny baby noises kept coming out of my mouth despite my resolve not to say anything. These noises were interspersed with horrible nonsensical profanities. I'm actually surprised that a random nun from my childhood didn't show up and slap me in the face for some of the things that I said.

The first obstacle after finally getting in the car was simply finding the emergency room. Even though the ER was attached to a hospital its immune system was no defense against the plague of construction that had already infected the streets around it. We found ourselves following detour signs just to find an entrance. Well, my husband was following the signs; I was making pathetic little whining noises every time we went over a bump or a pothole. But the signs eventually led us to an entrance where they had a large covered ramp of a detour, but wondrously they also had wheelchairs and valet parking. I got settled in a wheelchair and my husband started wheeling me towards what was undoubtedly going to be a very large expense.

Wednesday, October 5, 2011

Downfall

Like a lot of people I've been unemployed for quite some time. I'm now counting my unemployment in years now somewhat like a bad relationship. And hand in hand with extended unemployment goes feelings of shame and self loathing, as well as the more common symptom of not being able to buy coffee and one of the most important but often overlooked - no health insurance. For many people this means they just skip the yearly checkup that they don't want to go to anyway. In my life this has much more dire consequences.

I do live in a state which has a health care plan for the poor and unemployed, but unless you're a child, (I'm not,) there are so many applicants that all new applicants are put into a lottery system and chosen like letters at BINGO. However, I do know someone that this actually happened to. So unlike the lottery the state health care plan seems to have better chances than being hit by lightening twice, but then if you do get hit by lightening you can get treated. So there are resources available to me, but only by odd strokes of luck. So I need to psychically make my name come up or pick the winning lotto numbers. So currently I'm not taking advantage of these wonderful resources.

I figured that right now my main job was just not getting hurt. Unfortunately, I am very, very, VERY bad at my job. I am one of those people that can injure myself just standing around. And walking, wow...the perils of walking for me cannot be underestimated. I once fell off a curb and broke my ankle, while walking, not extreme fast walking, or even jogging - just walking. And I never get a good story out of it either. I meet people with casts and bandages and it's always, "I was snowboarding down a mountain and an rabid albino elk was heading right towards a preschool. So I ran it down, but it broke my leg while I was wrestling it humanely to the ground. You?"
"Oh, I tripped over a curb while I was trying to walk and talk at the same time."

So by now you can tell that the story of how I actually injured myself is going to be fairly uninteresting, you can stop reading now, but the next post is going to be about the ER and will contain several references to the actual injury, (just warning ya.) Now you would think that after living in a relative's basement for over a year that your mind would internalize how many steps there are in a staircase. At least for my brain, this is not the case. Have you ever walked up or down a staircase and thought that there was one fewer or one more step than there actually was? Usually this causes you to take a giant step or knock up against that last step. Nothing bad usually comes of it. USUALLY. Well, my brain miscounted THREE steps. Yep three, triplets, one more than two, and way too many to recover from. I actually went over the side of the staircase. My right foot hyper extended underneath me and made a sound like a giant Rice Crispy. I have no idea what my left foot did simply because my right hurt so much. It was like my own foot filled with broken glass came up and kicked me directly in the brain. I was carrying my breakfast which ended up half on me and half on the floor.

So falling is bad. A fall that you can't get up from is worse, and a fall that you just end up writhing on the floor crying while covered in breakfast is even worse. To his credit my husband didn't even giggle at my Jackass type stunt gone horribly wrong and was right there trying to assess the damage. My dogs quickly showed their mettle. Our troublemaker of a girl was quickly trying to snarf up as much breakfast as she could off of the floor and me. She's not picky as long as food is involved. Our concerned boy circled for a bit and then tried to lie down on my legs. Good intentions, poor execution. I seem to vaguely remember repeating "It hurts," over and over again. Apparently I become a master of communication while in the midst of a painful injury, and almost throwing up. That I know was communicated with hand signals and grunting. Yes, I know that grunting is not permitted in charades, but neither is bodily fluids so we're going to allow it.

Once I crawled over to the couch I spent a little time in denial trying to convince myself that I hadn't really injured myself badly at all. Unfortunately rapid swelling, bruising and the feeling of things moving inside of my ankle that shouldn't be moving were rapidly convincing me otherwise.