I just got a call from the cardiologist I saw last month. I had been having some problems with a rapid heart rate after surgery on November 25th (links can be found here, here and here). I wasn't expecting a call so late in the evening (it's 7pm) (or during the holidays at all), so I was quite surprised when my mum handed me the phone and told me who was on the other end. Great news! Everything is fine =) The cardiologist said he was just looking at the ultrasound results and everything looked good. There is nothing structurally wrong with my heart. In his words: "You can put any concerns you had about your heart on the back-burner". Hurray! We will probably never know exactly what caused the problems after surgery, although it was probably caused by some sort of combination of the surgery itself, the electrolyte imbalance issue after surgery, pain management problems and all the pain medication I was on. I am still really happy that the ER doctor I saw on December 2nd noted the high heart rate and sent me to the rapid assessment clinic, and that we got it checked out. Given everything else with the bone infection I had this year and now the external fixator, it is better to be safe than sorry. I still don't understand how the hospital doctors could justify discharging me after surgery without first trying to figure out what was causing the problem. A resting heart rate of 130 is just no okay to not be investigated. But at least it all ended well =)
Going to bed tonight a happy girl!
Monday, December 28, 2015
Sunday, December 27, 2015
Post-Christmas Vomiting and my Tinsel Fixator!
Christmas day was very pleasant. From playing games with the family (just the three of us: my mum, brother, and I), a lovely roast beef dinner, and opening presents, it was a wonderful quite day.
Unfortunately I woke up vomiting bright and early Saturday morning. Vomiting that soon turned from throwing up Christmas dinner to throwing up bile which than rapidly progressed to dry heaving. Definitely not my way to spend the day. I also had a fever and chills.
Fortunately, after sleeping (or at least lying in my bed) for a solid thirty hours, I now feel much better and am able to stomach some food without feeling like things will come rushing back up again. This is great news because the nursing student within me says that not drinking anything for thirty plus hours is not exactly the best thing for your body. So I am now indulging in a nice cup of lemon tea.
On top of that, it is kind of hard to keep track of time when you are sick definitely which makes it hard to remember to take medication and do "the turns" on my fixator. I did manage to get the turns done, but didn't take any medication yesterday. As a result my leg did hurt a bit more than usual, but nothing unmanageable.
Being sick when you have an external fixator definitely sucks. As if the fixator wasn't bad enough, then add the throwing up/dry heaving, muscle pain, fever and chills, inability to get comfortable... I was not happy.
On a much brighter note, here are the pictures I took when I decorated my fixator for Christmas. Although my house was (probably still is) covered in stray bits of tinsel, it was totally worth it!
Unfortunately I woke up vomiting bright and early Saturday morning. Vomiting that soon turned from throwing up Christmas dinner to throwing up bile which than rapidly progressed to dry heaving. Definitely not my way to spend the day. I also had a fever and chills.
Fortunately, after sleeping (or at least lying in my bed) for a solid thirty hours, I now feel much better and am able to stomach some food without feeling like things will come rushing back up again. This is great news because the nursing student within me says that not drinking anything for thirty plus hours is not exactly the best thing for your body. So I am now indulging in a nice cup of lemon tea.
On top of that, it is kind of hard to keep track of time when you are sick definitely which makes it hard to remember to take medication and do "the turns" on my fixator. I did manage to get the turns done, but didn't take any medication yesterday. As a result my leg did hurt a bit more than usual, but nothing unmanageable.
Being sick when you have an external fixator definitely sucks. As if the fixator wasn't bad enough, then add the throwing up/dry heaving, muscle pain, fever and chills, inability to get comfortable... I was not happy.
On a much brighter note, here are the pictures I took when I decorated my fixator for Christmas. Although my house was (probably still is) covered in stray bits of tinsel, it was totally worth it!
 |
| Don't mind the pile of stuff on the bed - I didn't finish wrapping gifts until Christmas day... |
Friday, December 25, 2015
Merry Christmas! A day of being
Today is a special kind of day. A big day. A cozy, surrounded by family, gift giving, and a kitchen full of tasty delicious smelling things to eat kind of day. We all know what I am talking about. Today is Christmas.
So I want to take a moment to wish everyone reading this a very Merry Christmas! May your stockings be stuffed, your pesky relatives pleasant and the turkey just right. Oh, and may your cookie tin never run empty!
Despite all the hecticness in life, today is a day when we can all pause, breathe, relax. I am not a particularly religious person. I don't ascribe to any one religion or piously go to church every week. Nor do I pray or read a Bible. But I do believe there is something about Christmas that is important. This evening my mum and I attended a candle lit service at a local church. Doing so is not a long standing tradition for me, but rather a new thing I started to do a year or so ago. Although I am not a Christian, I felt there was something missing as I sat at home, just me and my mum. Perhaps a service on Christmas Eve could help fill that something. The pastor who conducted today's service said something that I think is important. He said that while the craziness of the world continued outside of the church, for about an hour we were separate from it. We all came together for a purpose, as a community, without out cellphones, distractions, or things constantly demanding our attention. We were in the church and it was quite. At the end of the service, the lights were dimmed, we lit out candles and we sang Silent Night accompanied by the piano. Once we had finished, the pastor asked us to sing again, but this time only the first verse and without the piano playing. He wanted us to reflect on the stillness in the auditorium - our own stillness. So we sang, our voices echoed round the vaulted ceiling, and our candles flickered in the dark. The world had stopped; none of the crazy work schedules, chores to do, lists of present to buy for this or that person mattered; all we heard where our voices singing in unison. In contrast to the entire world outside those church doors, we were completely insignificant, but the quietness and our voices were profound. For lack of a better word (and I do not mean this sacrilegiously), it was magical. It was peaceful.
And I think that is what makes Christmas special. It's not about the presents or pleasing the in-laws or getting that ham cooked to perfection. It is about taking a pause, reveling in the stillness. It is a moment to reflect and be calm. To just be.
As an immigrant with very view relatives in this country, I spend a lot of time alone. The time spent alone has increased tremendously since pausing my education to deal with my health. I really do spend a lot of time alone. A lot of that alone time is spent in quit, reflecting on things, just enjoying the moment and being. But there is not a lot of just being going on amongst people. It is not something that often happens to many people at the same time, be it do to a chaotic home life, busy work schedules, constant access to the news, distractions, differences in hobbies or beliefs, or something else. But we do not often just be together. Someone always has a worry about the future or a big plan to carry out, a project to finish or an appointment to settle an urgent matter or a date with another friend. But on Christmas we pause, we take a break. The world is quiet. And if we want to, I think, we can just be all together. And doing that altogether with a group of strangers tonight is what makes Christmas special to me.
Today it doesn't matter that I am not about to enter what should be my final semester at school. My worries and fears about my leg and the external fixator are set aside. Everything will just be quiet. It will just be. And I will be just being with my family. And that means more to me than I can express.
On a completely different note, this is my 200th post on this blog! That, my friends, is a pretty big accomplishment if you ask me! I am proud of myself for sticking with the blog (even if I am sometimes a bit behind on posting updates) and am extremely pleased at how the blog is turning out. There is something quite satisfying in leaving this record of events for myself - a record of both the good and the bad that will hopefully be a reminder of how much I have grown over the years while dealing with the bone infection and its aftermath. Aside from documenting the medical aspect of my tibia-less mess, pecking away at my keyboard has been a good way to reduce stress and sort through my thoughts and feelings. Nothing like venting my frustration or fear to the void that is the internet in order to feel better. XD. Perhaps this blog has also provided others with a nugget or two of valuable advice. I hope my posts so far have been as enjoyable for you to read as they have been for me to write. And if you like what you read, I hope that you keep coming back as I blog myself into the New Year and beyond. Perhaps I will even get to a 300th post at some point. But for now, I think that two-hundred posts is quite an amazing feat, and I will therefore stick with a big Hurrah!!!
So I want to take a moment to wish everyone reading this a very Merry Christmas! May your stockings be stuffed, your pesky relatives pleasant and the turkey just right. Oh, and may your cookie tin never run empty!
Despite all the hecticness in life, today is a day when we can all pause, breathe, relax. I am not a particularly religious person. I don't ascribe to any one religion or piously go to church every week. Nor do I pray or read a Bible. But I do believe there is something about Christmas that is important. This evening my mum and I attended a candle lit service at a local church. Doing so is not a long standing tradition for me, but rather a new thing I started to do a year or so ago. Although I am not a Christian, I felt there was something missing as I sat at home, just me and my mum. Perhaps a service on Christmas Eve could help fill that something. The pastor who conducted today's service said something that I think is important. He said that while the craziness of the world continued outside of the church, for about an hour we were separate from it. We all came together for a purpose, as a community, without out cellphones, distractions, or things constantly demanding our attention. We were in the church and it was quite. At the end of the service, the lights were dimmed, we lit out candles and we sang Silent Night accompanied by the piano. Once we had finished, the pastor asked us to sing again, but this time only the first verse and without the piano playing. He wanted us to reflect on the stillness in the auditorium - our own stillness. So we sang, our voices echoed round the vaulted ceiling, and our candles flickered in the dark. The world had stopped; none of the crazy work schedules, chores to do, lists of present to buy for this or that person mattered; all we heard where our voices singing in unison. In contrast to the entire world outside those church doors, we were completely insignificant, but the quietness and our voices were profound. For lack of a better word (and I do not mean this sacrilegiously), it was magical. It was peaceful.
And I think that is what makes Christmas special. It's not about the presents or pleasing the in-laws or getting that ham cooked to perfection. It is about taking a pause, reveling in the stillness. It is a moment to reflect and be calm. To just be.
As an immigrant with very view relatives in this country, I spend a lot of time alone. The time spent alone has increased tremendously since pausing my education to deal with my health. I really do spend a lot of time alone. A lot of that alone time is spent in quit, reflecting on things, just enjoying the moment and being. But there is not a lot of just being going on amongst people. It is not something that often happens to many people at the same time, be it do to a chaotic home life, busy work schedules, constant access to the news, distractions, differences in hobbies or beliefs, or something else. But we do not often just be together. Someone always has a worry about the future or a big plan to carry out, a project to finish or an appointment to settle an urgent matter or a date with another friend. But on Christmas we pause, we take a break. The world is quiet. And if we want to, I think, we can just be all together. And doing that altogether with a group of strangers tonight is what makes Christmas special to me.
Today it doesn't matter that I am not about to enter what should be my final semester at school. My worries and fears about my leg and the external fixator are set aside. Everything will just be quiet. It will just be. And I will be just being with my family. And that means more to me than I can express.
On a completely different note, this is my 200th post on this blog! That, my friends, is a pretty big accomplishment if you ask me! I am proud of myself for sticking with the blog (even if I am sometimes a bit behind on posting updates) and am extremely pleased at how the blog is turning out. There is something quite satisfying in leaving this record of events for myself - a record of both the good and the bad that will hopefully be a reminder of how much I have grown over the years while dealing with the bone infection and its aftermath. Aside from documenting the medical aspect of my tibia-less mess, pecking away at my keyboard has been a good way to reduce stress and sort through my thoughts and feelings. Nothing like venting my frustration or fear to the void that is the internet in order to feel better. XD. Perhaps this blog has also provided others with a nugget or two of valuable advice. I hope my posts so far have been as enjoyable for you to read as they have been for me to write. And if you like what you read, I hope that you keep coming back as I blog myself into the New Year and beyond. Perhaps I will even get to a 300th post at some point. But for now, I think that two-hundred posts is quite an amazing feat, and I will therefore stick with a big Hurrah!!!
Thursday, December 24, 2015
A year ago today
A year ago today I had an MRI scan to see what was going on in my leg.
A year ago today, I sat nervous in a waiting room waiting for my name to be called and to be ushered through a set of giant doors.
I crammed my backpack and clothing into a ridiculously tiny locker and changed into a pair of pajama pants, a t shirt (sans bra) and sweater so I could be comfortable and metal free during the scan.
I lay down nervously on the cold hard adjustable table that would slowly slide me into the MRI machine.
I remember how uncomfortable my hips felt not far into the scan, how my toes slowly went numb.
I remember being told that I didn't need an IV like I had for MRIs in the past because my scan didn't require a dye injection. Half way through the scan a woman came in and said this needed to be done anyways. The staff outside the room had been comparing the current MRI to the one I had in fall 2012, and the scan in progress showed that there had only been minimal healing in the previous three years.
I remember lying there, all alone after the woman left and the scan resumed, thinking "I can't do this again. I can't fight the infection a second time". I felt so helpless, lost.
And here we are, a whole year later. Neither plus nor minus a day. So much has happened during that year. So much worry and fear. So many appointments, blood work, scans. One blissful weekend soaking up good news suggesting the bone infection hadn't returned which turned out not to be true. Night sweats, exhaustion, bone pain, sores on my shin. Multiple oral antibiotics, almost nine months' worth. Two PICC lines. Eight week of IV vancomycin. Surgery in August to cut out an entire chunk of bone. Finding out I needed an external fixator instead of a bone graft. Three months spent on crutches while we waited to see if the infection would come back. Major surgery in November. And now an external fixator.
When I think about it, life is absurd. That is what my mum always says. This year had been so far from normal, and yet it had become normal. How strange.
Without a doubt, the last year has been a busy year. A hectic year with many ups and downs.
I hope next year is better.
A year from now, I want to remember growing bone and learning to walk again.
This will all be worth it when I am on my own two feet, back in nursing school and doing normal things.
A year ago today, I sat nervous in a waiting room waiting for my name to be called and to be ushered through a set of giant doors.
I crammed my backpack and clothing into a ridiculously tiny locker and changed into a pair of pajama pants, a t shirt (sans bra) and sweater so I could be comfortable and metal free during the scan.
I lay down nervously on the cold hard adjustable table that would slowly slide me into the MRI machine.
I remember how uncomfortable my hips felt not far into the scan, how my toes slowly went numb.
I remember being told that I didn't need an IV like I had for MRIs in the past because my scan didn't require a dye injection. Half way through the scan a woman came in and said this needed to be done anyways. The staff outside the room had been comparing the current MRI to the one I had in fall 2012, and the scan in progress showed that there had only been minimal healing in the previous three years.
I remember lying there, all alone after the woman left and the scan resumed, thinking "I can't do this again. I can't fight the infection a second time". I felt so helpless, lost.
And here we are, a whole year later. Neither plus nor minus a day. So much has happened during that year. So much worry and fear. So many appointments, blood work, scans. One blissful weekend soaking up good news suggesting the bone infection hadn't returned which turned out not to be true. Night sweats, exhaustion, bone pain, sores on my shin. Multiple oral antibiotics, almost nine months' worth. Two PICC lines. Eight week of IV vancomycin. Surgery in August to cut out an entire chunk of bone. Finding out I needed an external fixator instead of a bone graft. Three months spent on crutches while we waited to see if the infection would come back. Major surgery in November. And now an external fixator.
When I think about it, life is absurd. That is what my mum always says. This year had been so far from normal, and yet it had become normal. How strange.
Without a doubt, the last year has been a busy year. A hectic year with many ups and downs.
I hope next year is better.
A year from now, I want to remember growing bone and learning to walk again.
This will all be worth it when I am on my own two feet, back in nursing school and doing normal things.
Echocardiogram
Yesterday afternoon I had the echocardiogram that the cardiologist wanted me to have just to make sure there is nothing structurally wrong with my heart. In case you haven't gone and read the slew of updates about various things that I just got caught up on, and I don't blame you if you didn't (not sure I would have either if I wasn't the one typing this) here is the gist of it: I had some issues with tachycardia, or a rapid heart rate, while I was in the hospital after my ex fix surgery. The doctor's in the hospital weren't to concerned and discharged me. I ended up in the ER a day later. The doctor there was quite concerned and said he was surprised that the hospital sent me home without first being seen by a cardiologist. As a result, he referred me to the rapid assessment clinic who said he wanted me to have an echo just to make sure everything was okay. If you want to read about the whole thing, the links are here and here.
I wasn't really sure what to expect with the echocardiogram but assumed that I would have copius amount of cold gloppy jelly all over my chest. That and that I would have to take my top off. Nothing like lying on a stretcher tits out in front of a complete stranger. *sigh* That's health care for you.
My assumption was half right, half wrong in the best way possible. Like the appointment I had with the cardiologist, I first checked in at the admission desk (although I was not being admitted). This time I got neither an ID bracelet or a bright yellow one proclaiming to the world how much of a fall risk I am. Score! I then went back to the cardiologists office where I sat for a while (our fault, we were early anticipating the line ate admission would have been longer. Apparently not the week of Christmas) with my mum and people watched a bit. Around 2:00 my name was called, I was led down a small hallway by a friendly echocardiogram technician, and then ushered into a small room with a sink, chair, stretcher, cart full of blankets towels, and hospital gowns, and the echo machine itself. Music was quietly playing in the background. I was instructed to take everything off from the waste up and put on a hospital gown and told the tehcnician would be back in a few minutes.
The technician was incredibly friendly and curious about my fixator. She was quite concerned that I might be uncomfortable on the stretcher because I had to lie on my side. This is kind of difficult and awkward, although not outright painful. The technician turned the lights off in order to be able to see more on the computer screen as she did the echo. She laid a towel over my chest and then carefully slid the gown off of my left shoulder. My boobs were not exposed! Score two! She was very friendly throughout the echo and curious about the fixator. As she got to work, I told her all about the broken legged, bone infected, tibia less ordeal. The towel stayed over me the entire time; the technician was able to freely move the transducer (looks like thing used one a pregnant woman's belly when she has an ultrasound) around as needed. At no point ever did I think "Omg, I'm alone in a room with another person and I don't have my top on". The entire thing was pretty relaxing. Not to say that I would want to have one again, but the staff definitely try to make it ask comfortable as possible. The only part that was a bit uncomfortable was when the technician (I think sonographer is the right term) had to press the transducer hard on my rib cage. I should also add, the technician did not have to use loads of cold gloppy stuff. Score three! She did have to use a bit, but it was more room temperature than anything and it was easily wiped off with a towel. Once the echo was done I was given a towel and left alone once more to get dressed. After that I could go home. Instead, mum and I took a nice drive through the countryside and got several small last minute gifts (just to tease him, all in good fun) for my brother for Christmas.
The cardiologist should call me with the results. I don't expect this for some time what with the Christmas this week and New Year's next. I am fine with this as we are not expecting anything negative to have shown up. It was more precautionary than anything. My heart rate was between 90-100 throughout the echo, so it is still not perfect, but it is much preferable to 120 or 130. I know it still fluctuates at home too, but all in all it is getting better.
And that's it! I am caught up on blogging. This is great because I have some fun advice style stuff I want to blog about, like how the bone transport process works and how to make tea on crutches. I felt bad blogging about this kind of stuff while I wasn't posting any update, and then I wasn't posting any update anyways so... you get my point. Now that I am caught up I feel free to blog about other stuff.
I wasn't really sure what to expect with the echocardiogram but assumed that I would have copius amount of cold gloppy jelly all over my chest. That and that I would have to take my top off. Nothing like lying on a stretcher tits out in front of a complete stranger. *sigh* That's health care for you.
My assumption was half right, half wrong in the best way possible. Like the appointment I had with the cardiologist, I first checked in at the admission desk (although I was not being admitted). This time I got neither an ID bracelet or a bright yellow one proclaiming to the world how much of a fall risk I am. Score! I then went back to the cardiologists office where I sat for a while (our fault, we were early anticipating the line ate admission would have been longer. Apparently not the week of Christmas) with my mum and people watched a bit. Around 2:00 my name was called, I was led down a small hallway by a friendly echocardiogram technician, and then ushered into a small room with a sink, chair, stretcher, cart full of blankets towels, and hospital gowns, and the echo machine itself. Music was quietly playing in the background. I was instructed to take everything off from the waste up and put on a hospital gown and told the tehcnician would be back in a few minutes.
The technician was incredibly friendly and curious about my fixator. She was quite concerned that I might be uncomfortable on the stretcher because I had to lie on my side. This is kind of difficult and awkward, although not outright painful. The technician turned the lights off in order to be able to see more on the computer screen as she did the echo. She laid a towel over my chest and then carefully slid the gown off of my left shoulder. My boobs were not exposed! Score two! She was very friendly throughout the echo and curious about the fixator. As she got to work, I told her all about the broken legged, bone infected, tibia less ordeal. The towel stayed over me the entire time; the technician was able to freely move the transducer (looks like thing used one a pregnant woman's belly when she has an ultrasound) around as needed. At no point ever did I think "Omg, I'm alone in a room with another person and I don't have my top on". The entire thing was pretty relaxing. Not to say that I would want to have one again, but the staff definitely try to make it ask comfortable as possible. The only part that was a bit uncomfortable was when the technician (I think sonographer is the right term) had to press the transducer hard on my rib cage. I should also add, the technician did not have to use loads of cold gloppy stuff. Score three! She did have to use a bit, but it was more room temperature than anything and it was easily wiped off with a towel. Once the echo was done I was given a towel and left alone once more to get dressed. After that I could go home. Instead, mum and I took a nice drive through the countryside and got several small last minute gifts (just to tease him, all in good fun) for my brother for Christmas.
The cardiologist should call me with the results. I don't expect this for some time what with the Christmas this week and New Year's next. I am fine with this as we are not expecting anything negative to have shown up. It was more precautionary than anything. My heart rate was between 90-100 throughout the echo, so it is still not perfect, but it is much preferable to 120 or 130. I know it still fluctuates at home too, but all in all it is getting better.
And that's it! I am caught up on blogging. This is great because I have some fun advice style stuff I want to blog about, like how the bone transport process works and how to make tea on crutches. I felt bad blogging about this kind of stuff while I wasn't posting any update, and then I wasn't posting any update anyways so... you get my point. Now that I am caught up I feel free to blog about other stuff.
Wednesday, December 23, 2015
OS appointment - December 18th
I had another appointment with my orthopedic surgeon last week Friday. This was the first appointment since I started doing "the turns". I was curious to see if the slack had actually been turned out of my frame yet. While I had been watching the tube part of my fixator lowly inch itself along, less than a millimeter a day, I hadn't actually started to notice anything different about my pin sites - no new scabs or scar tissue, no pain or discomfort aside from the same old, same old. In fact, I would argue that aside from the odd moment of stinging here and there and the pain I was having around my bottom pin, the pain overall was decreasing steadily.
The day of the appointment I got a call from the fracture clinic saying that I could come in anytime I wanted to. I won't blog about it now because I already did on Friday before heading out to my appointment.
Mum and I made it to the hospital in good time. There was hardly any traffic and the driving conditions were good. Many people have been complaining about the weather; no snow yet and it looks like it will be quite warm on Christmas. People want snow! This is Canada for Pete's sake. Truth be told though, as much as I like snow I hope we get as little as possible this year. What with the crutches and external fixator, I do not need the added risk of injury that slippery, wet, icy conditions bring, or the difficulty of crutching through a meter of snow...
The drive up to the hospital was pleasant and I caught a picture of a transport truck that I found quite funny.
I know that Fluke is the name of the company that owns the truck, but I didn't read it that way. When my eyes scanned over the phrase, my brain interpreted as "If we deliver your stuff on time, it's only by accident". After all, the word fluke is synonymous with chance or a stroke of luck.
Obviously I like word puns.
Mum and I were checked in at the reception desk at the fracture clinic around 1:15pm. We hope, since we had been told to come in whenever we wanted to, that we wouldn't have to sit in the waiting room for several hours before being seen as usual. This was not the case. So I had plenty of time to people watch. As usual, the people waiting looked miserable. Except this time it was worse than miserable. People just looked depressed. There I was, tinsel on my fixator, dressed in a skirt and nice shirt because heck, I was happy to get out of the house, and everyone else looked discouraged and downhearted. I know well enough that a broken bone can have a pretty sizable impact on a person's life. But come on... seeing everyone so miserable was a bit much. I know that I can't tell the extent of a person's injury just by looking at them. Nobody can. But given everything I have overheard over the last four years while I sat in the fracture clinic, I know that a lot of people also have injuries that heal pretty quickly or are, in fact, not that serious. As a nursing student as well, I know that health care professionals put up with a lot of stupid stuff, patients who are completely worked up about something ultimately insignificant. Anyways... I just don't understand why the people always look so unhappy at the fracture clinic. Perhaps my own history has changed how I see things. Of course I am going to see a broken wrist ad insignificant when it comes to my own situation, but to the person with the broken wrist it is still a pretty big deal.
One thing that stuck out to me while in the waiting room on Friday - there was another patient with an external fixator, the same as mine, just red (they are colour coded by size) and on his thigh. Mum suggested that I go over and talk with the guy, but I wasn't sure. I have never seen someone outside of a hospital bed so doped up on pain medication. In the end, I didn't speak with him, but it was nice, almost comforting, to see another person with an external fixator. I know that other people have one and see pictures of them all the time on the online support group I am part of, but it is different to see in person.
As usual, I had x rays before being called back to a "room" in the clinic itself. By room I mean three walled area with a curtain where the fourth wall should be in a row of several other "rooms" across from another row of them on the opposite wall. Basically you can hear everything that is said between a patient and the doctor with the illusion of privacy. I hope the people sitting there today where impressed with what they heard my surgeon and I talk about!
There is, as expected, a logical order in which my surgeon sees his patients. The people with earlier patients get seen first. That logic didn't apply to me. I saw my surgeon walking past my little cubby (for lack of a better word). He walked past, back tracked, stuck his head round the curtain, and then came to see me instead of where ever he was going. Having a fixator does pay off! I think my surgeon was just excited to get to see my x rays (and if things were going in the right direction, and that is why he got the receptionist to call me and tell me that I could come in whenever I wanted to).
He eagerly pulled up my x rays and explained what was going on. Here are the x rays.
They clearly show that the external fixator is working and moving the
"loose" (as in it's not actually connected to my or the rest of my bone
at the moment) piece of bone down my leg and the IM nail. This is good.
It means all the slack is gone and things are going as planned despite me
not feeling the pins track through my skin.
There is, however, even better news. Something is happening that, given my surgeon's reaction when he saw it, is not something that was expected to happen yet. As the pieces of bone are slowly moved apart a tiny bit twice a day, the bone is tempted to heal itself. Cells start to bridge the gap between the ends of bone. These cells do not automatically equal new bone. Instead, they form cartilage, the precursor to bone. The hope is, obviously, that this has been happening as I do "the turns". What was not expected, however, was for this to already be visible on my x rays.
On the image below, I have circled an incredibly tiny little white fuzzy cloud that showed up on the x ray in the gap at the top of my tibia. My surgeon wasn't expecting this cloudy spot to show up this soon. What it tells us is that the bone transport is actually working! Of course this is still only one very tiny spot. I still have months to go before I am finished doing "the turns" and the loose piece of tibia connects to the bottom part that is attached to my ankle. Many things can still go wrong and slow down or completely stop the bone growth. But this is by far the best news I have received health wise since we suspected the bone infection had returned in October 2014, well over a year ago. I couldn't have asked for a better Christmas present and hope that 2016 will be a year full of healing and nice new health bone.
According to my surgeon, it will take six to nine month for the cloudy spot to look anything like the solid healthy bone in these x rays. So there is still a long road ahead, but we have started out on a good note.
We also talked about pain. My surgeon said that his patients are usually pretty stoned throughout the time they are making adjustments to their fixators. He was surprised when I told him I was hardly in any pain at all (I only take a long acting pain medication to help me get comfortable and sleep at night). He said maybe I will get lucky and be pain free. There was one explanation he gave that could perhaps explain the lack of pain. Usually bone transports got the other way, from the top up. As a result, the moving portion of bone moves against the muscles, stretching them and ultimately causing pain. Given where the infected section of my tibia was, the normal way of doing things wasn't possible for me, so we are doing a reverse bone transport. This means that the bone is moving downwards, the way muscles are set up. Fingers crossed this means I will only experience minimal pain.
On a side note, he asked me about the ringing in my ears. This is a side effect of the IV Vancomycin I was on for eight weeks during the summer. He asked because spoke with another doctor who wanted to prescribe it to a patient willy-nilly. When he heard that, he thought of me and ringing it caused in my ears (a health are professional's unique experiences with patients become part of his/her working knowledge, so they easily recall things depending on a situation. This is the kind of thing that only experience and not a medical textbook can teach). Given that, he thinks twice about prescribing it unless absolutely necessary. I am glad that what I have been through might help someone else who might be prescribed this medication. As for myself, the ringing comes and goes. It is worse at night when it can be pretty maddening. I miss things being quite, although it is not bad when there is background noise on. My surgeon said it could take up to a year for it to go away.
After all was said and done, I gave my doctor a box of Merci chocolates to share among the staff. He did amazing work on my leg (with more tome come), and his staff have been fantastic, so with Christmas coming I thought it would be a nice way to say thank you. As a nursing student I was taught that patient's cannot give gifts to individual staff members (and said staff member can't accept a personal gift), but patients can give a gift to the entire staff of a floor or clinic. He said he was going to start nibbling on them right away. That is what I love about him, he is not snobbish or stuck up like other surgeon's I have seen. Yes, he is a doctor and probably makes a lot of money, but he is really down to earth and genuinely a nice person.
Before leaving, as mum took pictures of my x rays and I made to get of the stretcher, one of the ortho technicians came over, wished me a merry Christmas, and gave me a big hug! How nice is that? As I have said before, the staff are fantastic and they truly make appointments, which are usually quite stressful, enjoyable and more relaxing.
On the way out we made an appointment for January 8th, three weeks away. My surgeon said that he had set up an impromptu clinic day on Wednesday December 30th. His clinic days are usually on Fridays, but I think he has too many patients to miss a week (Friday is New Year's day so the clinic will be closed). He told me that I could show up without an appointment if I had any concerns.
And that was the appointment. Best news ever! Well, not ever... that will be when I can walk normally again and get back to nursing school. But definitely the best news I have had in a very long time. After falling in the 1% where things go wrong for so many years, it was about time I fell in the 99% where things go right. Not that having an external fixator is common, in fact is it pretty rare, but things with the fixator are going well. I was smiling for the rest of the day.
And just because, here is my leg the day of the appointment. Despite a few small hiccups when part of the incision opened up a bit (treated with steri-strips), things are healing well!
And me... looking good! Still smiling on Sunday =)
The day of the appointment I got a call from the fracture clinic saying that I could come in anytime I wanted to. I won't blog about it now because I already did on Friday before heading out to my appointment.
Mum and I made it to the hospital in good time. There was hardly any traffic and the driving conditions were good. Many people have been complaining about the weather; no snow yet and it looks like it will be quite warm on Christmas. People want snow! This is Canada for Pete's sake. Truth be told though, as much as I like snow I hope we get as little as possible this year. What with the crutches and external fixator, I do not need the added risk of injury that slippery, wet, icy conditions bring, or the difficulty of crutching through a meter of snow...
The drive up to the hospital was pleasant and I caught a picture of a transport truck that I found quite funny.
Obviously I like word puns.
Mum and I were checked in at the reception desk at the fracture clinic around 1:15pm. We hope, since we had been told to come in whenever we wanted to, that we wouldn't have to sit in the waiting room for several hours before being seen as usual. This was not the case. So I had plenty of time to people watch. As usual, the people waiting looked miserable. Except this time it was worse than miserable. People just looked depressed. There I was, tinsel on my fixator, dressed in a skirt and nice shirt because heck, I was happy to get out of the house, and everyone else looked discouraged and downhearted. I know well enough that a broken bone can have a pretty sizable impact on a person's life. But come on... seeing everyone so miserable was a bit much. I know that I can't tell the extent of a person's injury just by looking at them. Nobody can. But given everything I have overheard over the last four years while I sat in the fracture clinic, I know that a lot of people also have injuries that heal pretty quickly or are, in fact, not that serious. As a nursing student as well, I know that health care professionals put up with a lot of stupid stuff, patients who are completely worked up about something ultimately insignificant. Anyways... I just don't understand why the people always look so unhappy at the fracture clinic. Perhaps my own history has changed how I see things. Of course I am going to see a broken wrist ad insignificant when it comes to my own situation, but to the person with the broken wrist it is still a pretty big deal.
One thing that stuck out to me while in the waiting room on Friday - there was another patient with an external fixator, the same as mine, just red (they are colour coded by size) and on his thigh. Mum suggested that I go over and talk with the guy, but I wasn't sure. I have never seen someone outside of a hospital bed so doped up on pain medication. In the end, I didn't speak with him, but it was nice, almost comforting, to see another person with an external fixator. I know that other people have one and see pictures of them all the time on the online support group I am part of, but it is different to see in person.
As usual, I had x rays before being called back to a "room" in the clinic itself. By room I mean three walled area with a curtain where the fourth wall should be in a row of several other "rooms" across from another row of them on the opposite wall. Basically you can hear everything that is said between a patient and the doctor with the illusion of privacy. I hope the people sitting there today where impressed with what they heard my surgeon and I talk about!
There is, as expected, a logical order in which my surgeon sees his patients. The people with earlier patients get seen first. That logic didn't apply to me. I saw my surgeon walking past my little cubby (for lack of a better word). He walked past, back tracked, stuck his head round the curtain, and then came to see me instead of where ever he was going. Having a fixator does pay off! I think my surgeon was just excited to get to see my x rays (and if things were going in the right direction, and that is why he got the receptionist to call me and tell me that I could come in whenever I wanted to).
He eagerly pulled up my x rays and explained what was going on. Here are the x rays.
 |
| Side view |
 |
| Front view |
There is, however, even better news. Something is happening that, given my surgeon's reaction when he saw it, is not something that was expected to happen yet. As the pieces of bone are slowly moved apart a tiny bit twice a day, the bone is tempted to heal itself. Cells start to bridge the gap between the ends of bone. These cells do not automatically equal new bone. Instead, they form cartilage, the precursor to bone. The hope is, obviously, that this has been happening as I do "the turns". What was not expected, however, was for this to already be visible on my x rays.
On the image below, I have circled an incredibly tiny little white fuzzy cloud that showed up on the x ray in the gap at the top of my tibia. My surgeon wasn't expecting this cloudy spot to show up this soon. What it tells us is that the bone transport is actually working! Of course this is still only one very tiny spot. I still have months to go before I am finished doing "the turns" and the loose piece of tibia connects to the bottom part that is attached to my ankle. Many things can still go wrong and slow down or completely stop the bone growth. But this is by far the best news I have received health wise since we suspected the bone infection had returned in October 2014, well over a year ago. I couldn't have asked for a better Christmas present and hope that 2016 will be a year full of healing and nice new health bone.
We also talked about pain. My surgeon said that his patients are usually pretty stoned throughout the time they are making adjustments to their fixators. He was surprised when I told him I was hardly in any pain at all (I only take a long acting pain medication to help me get comfortable and sleep at night). He said maybe I will get lucky and be pain free. There was one explanation he gave that could perhaps explain the lack of pain. Usually bone transports got the other way, from the top up. As a result, the moving portion of bone moves against the muscles, stretching them and ultimately causing pain. Given where the infected section of my tibia was, the normal way of doing things wasn't possible for me, so we are doing a reverse bone transport. This means that the bone is moving downwards, the way muscles are set up. Fingers crossed this means I will only experience minimal pain.
On a side note, he asked me about the ringing in my ears. This is a side effect of the IV Vancomycin I was on for eight weeks during the summer. He asked because spoke with another doctor who wanted to prescribe it to a patient willy-nilly. When he heard that, he thought of me and ringing it caused in my ears (a health are professional's unique experiences with patients become part of his/her working knowledge, so they easily recall things depending on a situation. This is the kind of thing that only experience and not a medical textbook can teach). Given that, he thinks twice about prescribing it unless absolutely necessary. I am glad that what I have been through might help someone else who might be prescribed this medication. As for myself, the ringing comes and goes. It is worse at night when it can be pretty maddening. I miss things being quite, although it is not bad when there is background noise on. My surgeon said it could take up to a year for it to go away.
After all was said and done, I gave my doctor a box of Merci chocolates to share among the staff. He did amazing work on my leg (with more tome come), and his staff have been fantastic, so with Christmas coming I thought it would be a nice way to say thank you. As a nursing student I was taught that patient's cannot give gifts to individual staff members (and said staff member can't accept a personal gift), but patients can give a gift to the entire staff of a floor or clinic. He said he was going to start nibbling on them right away. That is what I love about him, he is not snobbish or stuck up like other surgeon's I have seen. Yes, he is a doctor and probably makes a lot of money, but he is really down to earth and genuinely a nice person.
Before leaving, as mum took pictures of my x rays and I made to get of the stretcher, one of the ortho technicians came over, wished me a merry Christmas, and gave me a big hug! How nice is that? As I have said before, the staff are fantastic and they truly make appointments, which are usually quite stressful, enjoyable and more relaxing.
On the way out we made an appointment for January 8th, three weeks away. My surgeon said that he had set up an impromptu clinic day on Wednesday December 30th. His clinic days are usually on Fridays, but I think he has too many patients to miss a week (Friday is New Year's day so the clinic will be closed). He told me that I could show up without an appointment if I had any concerns.
And that was the appointment. Best news ever! Well, not ever... that will be when I can walk normally again and get back to nursing school. But definitely the best news I have had in a very long time. After falling in the 1% where things go wrong for so many years, it was about time I fell in the 99% where things go right. Not that having an external fixator is common, in fact is it pretty rare, but things with the fixator are going well. I was smiling for the rest of the day.
And just because, here is my leg the day of the appointment. Despite a few small hiccups when part of the incision opened up a bit (treated with steri-strips), things are healing well!
Cardiologist Appointment - December 10th
On December 10th I had an appointment with a cardiologist at the rapid assessment clinic regarding the issues with tachycardia/high heart rate.
Fortunately, this appointment was at the local hospital so I did not need to make the hour drive up to the hospital in Hamilton. This saved a lot of time and discomfort.
Upon arrival, I had to register at the admission desk (even though I was not being admitted to the hospital). Aside from an ID bracelet, I also got a bright yellow bracelet; I am officially a fall risk now. Thanks a lot fixator. It became obvious, both in talking to the lady at admission and crutching to the cardiologists office, how completely abnormal having and external fixator is. I got so many stares... The lady at admission was very curious about it, and the cardiologist himself had quite a few questions about it.
Before seeing the cardiologist I had an electrocardiogram (ECG) to check the rhythm and rate of my heart. I had already had several of those during the latest hospital admission, so I knew what to expect. At least this time I had my bra on...
After that my mum came back into the room (I had kicked her out of the room during the ECG, just to be clear. Having a doctor see my boobs in the hospital two weeks earlier was bad enough without my own mother seeing my boobs) and we waited for a bit until the cardiologist came in. The cardiologist was really friendly and professional. He also wore worn out doc martins that looked slightly out of place with his dress shirt and pants and stethoscope. He asked a lot of questions - family history, personal health history, medications, how I was feeling, etc., etc., Then he took some time to thoroughly listen to my heart with his stethoscope. After that he looked at my ECG and stated what we had already heard during my hospital admission: my heart rhythm is normal but fast. He believes that it is likely related to the major surgery I had, the physical trauma of having an external fixator, being slightly anemic, and the pain medication I am on. This is in contrast to what the doctors said while I was in the hospital. Not once did they mention the trauma of the fixator or the surgery itself. They also told us that the tachycardia couldn't have been caused by my pain medication, which would have caused bradycardia, or slow heart rate, instead. But the cardiologist was confident that all the things I just mentioned could have been a contributing factor, plus that I had been immobile for four three months and that I had been chronically ill for so long (even though the infection should have been gone since surgery number four in August), which means it takes more effort to be mobile because everything is deconditioned. Given all this, he didn't think that the appointment with him was unnecessary. Like the ER doctor I had seen the previous week, he said that it is important to get a high heart rate checked out and was surprised that I had been discharged after surgery without having seen a cardiologist in the hospital. He also suggested we do an echocardiogram of my heart just in case there was something going on structurally. All in all, though, he said that he didn't think there was anything major that we needed to be concerned about. So that is great news, and a relief to know that everything is going well with my ticker.
Since then, I have still had some issues with tachycardia, but all in all my heart rate seems to be slowing down. At the most it is around 100, instead of the 120-30 it was at for a whole, but it gets as low as the 70s! Fingers crossed that it continues to decrease as I recover from surgery =)
Fortunately, this appointment was at the local hospital so I did not need to make the hour drive up to the hospital in Hamilton. This saved a lot of time and discomfort.
Upon arrival, I had to register at the admission desk (even though I was not being admitted to the hospital). Aside from an ID bracelet, I also got a bright yellow bracelet; I am officially a fall risk now. Thanks a lot fixator. It became obvious, both in talking to the lady at admission and crutching to the cardiologists office, how completely abnormal having and external fixator is. I got so many stares... The lady at admission was very curious about it, and the cardiologist himself had quite a few questions about it.
Before seeing the cardiologist I had an electrocardiogram (ECG) to check the rhythm and rate of my heart. I had already had several of those during the latest hospital admission, so I knew what to expect. At least this time I had my bra on...
After that my mum came back into the room (I had kicked her out of the room during the ECG, just to be clear. Having a doctor see my boobs in the hospital two weeks earlier was bad enough without my own mother seeing my boobs) and we waited for a bit until the cardiologist came in. The cardiologist was really friendly and professional. He also wore worn out doc martins that looked slightly out of place with his dress shirt and pants and stethoscope. He asked a lot of questions - family history, personal health history, medications, how I was feeling, etc., etc., Then he took some time to thoroughly listen to my heart with his stethoscope. After that he looked at my ECG and stated what we had already heard during my hospital admission: my heart rhythm is normal but fast. He believes that it is likely related to the major surgery I had, the physical trauma of having an external fixator, being slightly anemic, and the pain medication I am on. This is in contrast to what the doctors said while I was in the hospital. Not once did they mention the trauma of the fixator or the surgery itself. They also told us that the tachycardia couldn't have been caused by my pain medication, which would have caused bradycardia, or slow heart rate, instead. But the cardiologist was confident that all the things I just mentioned could have been a contributing factor, plus that I had been immobile for four three months and that I had been chronically ill for so long (even though the infection should have been gone since surgery number four in August), which means it takes more effort to be mobile because everything is deconditioned. Given all this, he didn't think that the appointment with him was unnecessary. Like the ER doctor I had seen the previous week, he said that it is important to get a high heart rate checked out and was surprised that I had been discharged after surgery without having seen a cardiologist in the hospital. He also suggested we do an echocardiogram of my heart just in case there was something going on structurally. All in all, though, he said that he didn't think there was anything major that we needed to be concerned about. So that is great news, and a relief to know that everything is going well with my ticker.
Since then, I have still had some issues with tachycardia, but all in all my heart rate seems to be slowing down. At the most it is around 100, instead of the 120-30 it was at for a whole, but it gets as low as the 70s! Fingers crossed that it continues to decrease as I recover from surgery =)
Post-op Appointment - December 3rd
I had my post-op appointment for surgery number five on Thursday December 3rd.
After rushing home from the ER in the city I live to grab something to eat at home, change into some clean clothes, and brush our teeth, my mum and I set out to the hospital in Hamilton were I had the ex fix surgery done. Fortunately we made it in good time and were even able to nab a wheelchair at entrance to the hospital (they usually disappear pretty early in the day and then you have to use one of those weird hospital transport chairs, the one's with the metal mess for a seat that leave a weird imprint on your butt... link can be found here).
I am always amazed how grumpy people look in the fracture clinic waiting room. I was sitting there in a rusty old hospital wheelchair happy to be out in public and still have my leg firmly attached to my body and everyone else just looked miserable. I honestly don't understand it. If I am able to be happy and smile despite everything I have been through health wise (and am still going through with the external fixator), how can so many people with much less serious injuries look so miserable?
Anyways, that is just something I have noticed on quite an occasions while I sit in that waiting room.
Before seeing my surgeon, I was called back to get x-rays. Let me tell you, getting x-rays when you have an external fixator is no easy task. There is a lot of awkward twisting and turning as you try to get into the required position for the x-rays while trying not to bang the fixator off of anything. Plus all the stiffness in my knee; that makes it even trickier.
Once the x rays where taken I was sent back to the waiting room full of miserable looking people, sporting a variety of casts or braces, some on crutches, others in wheelchairs, some completely mobile on their own two feet. Not long after I was called back to the clinic.
Before seeing the surgeon, one of the ortho technicians took off all the dressings on my leg. This is how it looked a week after surgery:
The staff at the fracture clinic are incredibly kind and it is obvious that they strive to do an excellent job. Between my surgeon himself, his OR staff (many of whom have been in the OR with me during my last three surgeries), and his clinic staff, I am extremely fortunate. Not only do the clinic staff do a fantastic job, they are so friendly; I always have a good laugh or nice conversation with at least one person there. I have been going to this fracture clinic since the start or 2012, so there is some history there. I am sure that has an impact on the interactions I have with the staff. I am a familiar face!
Once the bandages were off, my surgeon came in and it was x-ray time!
These are my x rays:
After rushing home from the ER in the city I live to grab something to eat at home, change into some clean clothes, and brush our teeth, my mum and I set out to the hospital in Hamilton were I had the ex fix surgery done. Fortunately we made it in good time and were even able to nab a wheelchair at entrance to the hospital (they usually disappear pretty early in the day and then you have to use one of those weird hospital transport chairs, the one's with the metal mess for a seat that leave a weird imprint on your butt... link can be found here).
I am always amazed how grumpy people look in the fracture clinic waiting room. I was sitting there in a rusty old hospital wheelchair happy to be out in public and still have my leg firmly attached to my body and everyone else just looked miserable. I honestly don't understand it. If I am able to be happy and smile despite everything I have been through health wise (and am still going through with the external fixator), how can so many people with much less serious injuries look so miserable?
Anyways, that is just something I have noticed on quite an occasions while I sit in that waiting room.
Before seeing my surgeon, I was called back to get x-rays. Let me tell you, getting x-rays when you have an external fixator is no easy task. There is a lot of awkward twisting and turning as you try to get into the required position for the x-rays while trying not to bang the fixator off of anything. Plus all the stiffness in my knee; that makes it even trickier.
Once the x rays where taken I was sent back to the waiting room full of miserable looking people, sporting a variety of casts or braces, some on crutches, others in wheelchairs, some completely mobile on their own two feet. Not long after I was called back to the clinic.
Before seeing the surgeon, one of the ortho technicians took off all the dressings on my leg. This is how it looked a week after surgery:
Once the bandages were off, my surgeon came in and it was x-ray time!
These are my x rays:
 |
| Side view |
 |
| Front view |
We learned that the section of missing bone is slightly
larger than we thought before surgery - 6.5 cm instead of 6 cm. My surgeon had
done the math beforehand and calculated that I will be doing "the
turns", or adjusting my frame, for 95 days. This includes tightening the
slack out of the system and regrowing 0.75 mm of bone per day. When a frame like this is put on, there is not as much tension on the pins as is needed to actually get the bone transport moving, so it takes some time to work this slack out, if that makes sense. The 95 days is broken down into about 8
days of turning out the slack and 87 days of actually transporting the chunk of
bone attached to the top to pins down my leg. After that, the frame will be on
for several additional weeks to make sure that the new bone is hardening and the
bottom of the loose piece of bone is connecting (or "docking" if you want to get technical) properly to the bottom part of
my tibia.
After explaining this, my surgeon fished around the pockets of his scrubs and pulled out my new best friends, a small shiny wrench. He said, word for word, "If you lose it, go to the hardware store and buy a new one. It is a 7 mm wrench." I find that there is something laughable, almost absurd, in the fact that I am using a tool, a tool widely outside of the medical field, to regrow my tibia. XD
My wrench:
I keep thinking wench, like a pirate. But no. It is wrench. No r. I do not have a wooden leg (although it sometimes feels as stiff as one). I am not a pirate... there is no association with wenches and pirate ships and big black flags with a skull and cross bones on them. But I'm getting side tracked...
I adjust my frame three times a day. In the morning, I do half a turn, which moves the loose chunk of bone down 0.5mm, and a quarter turn in the evening (twelve hours later), which equals 0.25mm of movements.
The surgeon said that he would send orders to the home nurse to take the staples out on fourteen days post op (the following Wednesday) and instructed me to keep cleaning the pin sites with hydrogen peroxide. He also said that I could put smaller dressings around the pins. And that was that. Mum made an appointment to come back in two weeks (Dec. 18th) while one of the lovely ortho technicians put a new dressing on my leg and then we took the scenic along the Niagara Escarpment home.
It did take several days for the home nurses to receive new orders for the pin site dressings and so that they could take out my staples, but we got there in the end. I had tried calling, without success, my surgeon's office on Monday but got no response. So I called the fracture clinic itself. They said they couldn't help me, so they put me through to the office of the ortho doctor on call at the time. No one answered, so I left a detailed message about what was going on. And then in the afternoon, my mum had the brilliant idea that I could call my infectious disease specialist's office. I am not sure who got what message when and who actually spoke to my surgeon, but the orders arrived on Tuesday and I got my staples out on Wednesday the ninth. All 57 of them. Yay! It has taken some time for the incision to heal. It's a good 20 some odd cm long, so that is understandable. We went through several packs of steri-strips, but it is almost completely closed now.
ER visit - December 2nd
As previously mentioned, I was discharged from the hospital on December 1st even though I hadn't had a bowel movement in eight days... the doctor told me that things would likely work themselves out on their own but to go to the ER if, in his words "it felt like I was giving birth". Wow, such inspirational words! And I say that with as much sarcasm as I can humanly muster.
Everything went well when I was discharged. At least, things went well at first. I slept in my own bed, got my medication sorted, and enjoyed some real food (because there is no way that hospital food is real). On Tuesday 2nd I took several things to help get things moving along. At this point I was starting to get a bit uncomfortable, which, given not have a bowel movement in over a week, is kind of expected. I took a stool softener, lactulose (twice, and I hate that stuff so I was getting pretty desperate if I was willing to take it twice in one day), and bisacodyl. Still nothing. And then evening rolls around, sitting at the kitchen table having dinner with my family and I did not feel okay anymore. It wasn't so much pain in my gut than incredible discomfort. I hoped it would pass and decided to lay down on my bed for a bit. It soon became evident that things were not going to feel better.
Around 8pm mum and I decided to go the the ER, knowing full well that I had a post op appointment In Hamilton the next morning at 9:30. Good bye sleep! At the triage office they took my vitals. The nurse was pretty concerned with my heart rate, a lovely 140 beats a minute while sitting down! Remember I had been having problems over the course of the previous week and that pompous internal medicine resident said not to worry about it? Well, the triage nurse was worried about it and said he would see if we could be seen pretty quickly. Unfortunately for us, this didn't happen and we still sat in the waiting area for several hours before being called back.
Once we were called to be seen by a doctors or experience was great. The doctor I had was fantastic. He was actually quite concerned about the high heart rate and didn't understand why the hospital discharged me without trying to find the route cause. His main concern was that I could have a blood clot in one of my lungs because I had major surgery and was immobile a good 95% of the time. Plus the fixator. All those factors put people at a greater risk for blood clots. He was surprised that no one from the thrombosis team came to see me while in the hospital. Fast forward several hours later and I was getting a CT scan of my chest and an x ray of my abdomen. Thank fully there was no blood clot! Hurrah!
At some point, the other issues worked itself out. Be it due to all the stuff I had taken earlier in the day, or the sudden burst of physical activity it took to get around the hospital (movement is known to help with this sort of thing, and I had been laying in a bed most of the previous eight days), we will never know. But at least things got moving.
The ER doctor was happy that there was no blood clot but concerned that something else could be causing the high heart rate. He agreed that it could just be a combination of the major surgery and trauma caused by the external fixator or one of my medications, but said it was still important to get it checked out and to try to find the route cause. He said he just was not comfortable with a patient who had a resting heart rate of 140. He prescirbed me a bunch of stuff in case the issue I originally came in for caused more problems and referred me to the rapid assessment clinic to see a cardiologist to make sure everything was a okay with my ticker.
So with a prescription for some lovely things like citro-mag and the promise that the rapid assessment clinic would contact me within two days, I was discharged around quarter past seven. Just enough time for us to race home, brush our teeth, comb our hair and don clean clothing so we would look presentable at my post op appointment and scarf down some breakfast. All on zero hours of sleep. But, at least we would actually be able to make it to the appointment!
Everything I was wearing clashed! And I don't think my abdomen has ever been so distended before. Just goes to show what no... well, you know what... for eight days can do to you. Prescription pain medication has many perks, but it definitely has it's down falls too.
Everything went well when I was discharged. At least, things went well at first. I slept in my own bed, got my medication sorted, and enjoyed some real food (because there is no way that hospital food is real). On Tuesday 2nd I took several things to help get things moving along. At this point I was starting to get a bit uncomfortable, which, given not have a bowel movement in over a week, is kind of expected. I took a stool softener, lactulose (twice, and I hate that stuff so I was getting pretty desperate if I was willing to take it twice in one day), and bisacodyl. Still nothing. And then evening rolls around, sitting at the kitchen table having dinner with my family and I did not feel okay anymore. It wasn't so much pain in my gut than incredible discomfort. I hoped it would pass and decided to lay down on my bed for a bit. It soon became evident that things were not going to feel better.
Around 8pm mum and I decided to go the the ER, knowing full well that I had a post op appointment In Hamilton the next morning at 9:30. Good bye sleep! At the triage office they took my vitals. The nurse was pretty concerned with my heart rate, a lovely 140 beats a minute while sitting down! Remember I had been having problems over the course of the previous week and that pompous internal medicine resident said not to worry about it? Well, the triage nurse was worried about it and said he would see if we could be seen pretty quickly. Unfortunately for us, this didn't happen and we still sat in the waiting area for several hours before being called back.
Once we were called to be seen by a doctors or experience was great. The doctor I had was fantastic. He was actually quite concerned about the high heart rate and didn't understand why the hospital discharged me without trying to find the route cause. His main concern was that I could have a blood clot in one of my lungs because I had major surgery and was immobile a good 95% of the time. Plus the fixator. All those factors put people at a greater risk for blood clots. He was surprised that no one from the thrombosis team came to see me while in the hospital. Fast forward several hours later and I was getting a CT scan of my chest and an x ray of my abdomen. Thank fully there was no blood clot! Hurrah!
At some point, the other issues worked itself out. Be it due to all the stuff I had taken earlier in the day, or the sudden burst of physical activity it took to get around the hospital (movement is known to help with this sort of thing, and I had been laying in a bed most of the previous eight days), we will never know. But at least things got moving.
The ER doctor was happy that there was no blood clot but concerned that something else could be causing the high heart rate. He agreed that it could just be a combination of the major surgery and trauma caused by the external fixator or one of my medications, but said it was still important to get it checked out and to try to find the route cause. He said he just was not comfortable with a patient who had a resting heart rate of 140. He prescirbed me a bunch of stuff in case the issue I originally came in for caused more problems and referred me to the rapid assessment clinic to see a cardiologist to make sure everything was a okay with my ticker.
So with a prescription for some lovely things like citro-mag and the promise that the rapid assessment clinic would contact me within two days, I was discharged around quarter past seven. Just enough time for us to race home, brush our teeth, comb our hair and don clean clothing so we would look presentable at my post op appointment and scarf down some breakfast. All on zero hours of sleep. But, at least we would actually be able to make it to the appointment!
Surgery Itself - November 25
Surgery itself went really well and was uneventful. Before I headed back into the OR, my mum and I were told that surgery could take anywhere between two and four hours. I didn't see my surgeon until my post op appointment on Dec.3rd, but he did speak with my mum right after I was wheeled into recovery. He said that everything had gone really well and that the surgery only took two hours and ten minutes. This meant that there were no complications at all. He was very happy with how the remaining parts of my tibia looked and said that the surrounding tissue and muscle looked great, no signs of infection! This, of course, is fantastic news!!!
There really isn't more to say about the surgery itself. I am so thankful that is was uneventful. This type of thing is quite traumatizing to the body as is without things going wrong. Given how rough my hospital stay was afterwards, I am even more thankful that the surgery went well. My surgeon did an amazing job!
There really isn't more to say about the surgery itself. I am so thankful that is was uneventful. This type of thing is quite traumatizing to the body as is without things going wrong. Given how rough my hospital stay was afterwards, I am even more thankful that the surgery went well. My surgeon did an amazing job!
Surgery Number Five: Nov. 25 - Dec. 1
I am finally getting to my list of things to update about. I was hoping to do a marathon of updates all in one day, but the thought of it alone completely put me off. I sleep an insane amount at the moment, and even when I am awake I am still pretty knackered (or uncomfortable due to the fixator) so sitting down and typing (and thinking about what I will type!) for several hours straight is not a great idea. I will focus on one post at a time instead.
To be completely honest, I have put off blogging about surgery, at least in part, because doing so meant having first to sort through a tone of pictures. After almost a decade, I pretty much take pictures of everything health related. As a result, I not only have pictures of the good stuff, but also of the bad stuff. And when I say bad, I mean much more than bad. This latest surgery and hospital stay where really really rough and, quite frankly, looking at the pictures of how I looked hurts. Nobody wants to go through major surgery and the recovery period that follows. No one wants to be completely wiped out or experience uncontrollable pain. There are pictures of me from after this surgery in which I look absolutely horrible. Just looking at them is painful and a reminder of what I have been through. So it was hard to sort through everything and, as a result, I kind of put posting about it off for a while.
In addition, I have decided not to post many of the pictures that were taken of me. I believe that I have always been open (perhaps more so than I should have been) with the images I have shared on my blog. When I started this blog, my intent was both to create a record of events for myself and to provide information/advice about chronic osteomyelitis to other people affected by it. This is still my intent, albeit the focus has shifted from osteomyelitis to external fixators and regrowing bone. Given my latest surgery, however, I no longer believe that everything has to be shared. I can maintain a record for myself and continue to have this blog be a source of information for others without posting everything. Some things are too personal. Therefore, many images are omitted.
Now to get to surgery number five and the week long hospital stay that followed.
On November 25, I got up around quarter past five. Mum and I had to leave around six to get to the hospital by seven. There was not much for me to do as I had packed my hospital bag the night before and didn't need to worry about all that nonsense that is breakfast. Fortunately I am not a hobbit - missing a meal or two wasn't the death of me XD. I got dressed, made my bed (which takes a pretty long time when you have to hop around the bed on one leg) and then posted a little blurb on this blog. By then it was time to head out. The drive to the hospital in Hamilton was pretty uneventful. We did run into a bit of traffic, something which we haven't had with previous surgeries which were scheduled for eight instead of nine am. Regardless of this, we made it to the hospital in good time. Mum dropped me off at the front entrance so I could head to the admission desk while she parked. We picked a good time to arrive - right after I got there and took a number to wait in line it got really busy. I only had two people ahead of me.
After registration, where I got to rattle off my ever growing list of allergies, mum and I headed to same day surgery. All patients are sent there to be prepped for their surgery regardless of if they are same day patients or will be admitted to hospital after their surgery. This was my fifth surgery and I have to say, of all the other surgeries I have had, the time spent in the pre-op area this time was the worst I have ever experienced. When I arrived my nurse didn't even introduce herself to me. She handed me a gown and told me to change, came back a little bit later to take my vitals, which she wrote down on a piece of paper towel and left behind when she went to attend to another patient, and then see never came back. I'm not kidding, she never came back.
I was sitting on a stretcher in a hospital gown that fit surprisingly well given how small I am and my own robe by 7:15. By 8:00 nobody had come back for us at all. There were patients who arrived after me who had everything done - changing into a gown, vitals, IV started, giant check list of questions... not me.
While we waited I did some soduku puzzles and took a picture of my leg for old times sake. I mean, it will never look the way it did again, right? One long thin pink scar; the only permanent mark the broken leg/bone infection ever left, and that was about to change. Note my one sock! I had a slipper to wear on the other foot for when I needed to head up to the OR waiting room.
Mum and I kept hearing nurses talk about how over worked and understaffed they were. By 8:00 we were getting a bit worried. Surgery was scheduled for nine and usually you are sent upstairs a good half hour before surgery starts. This is because you still need to speak with a whole bunch of OR nurses and the anesthesiologist before surgery begins. Mum went to ask a nurse if we would be seen soon and the nurse said they were aware that we were there. 8:30 rolls around, still nothing. Again my mum went to speak with one of the nurses and mentioned that my surgery was supposed to be in half an hour. The nurse said she would be right there. Nope. Didn't happen. In the meantime, we hear another nurse proclaim that they were not going to start any more IVs because they were too over worked and the OR staff could deal with it. Not long after this, we heard a nurse mention my last name over the phone. Apparently the OR staff had called down wondering where I was. This was about 8:45. Still, nothing happened. Finally, just before 9:00, a nurse (not the one assigned to me) started hurriedly asking me lots of questions because my surgeon told them he was coming to see what was going on. He showed up about half way through the questions. He did not seem impressed and took over from there.
We walked (well, I crutched) to the OR waiting area together. He asked me how I was feeling, to which I replied "nervous". He said that was good, there would be something wrong if I excited. So I replied that I was excited to start regrowing my tibia, but really nervous about the surgery itself and getting my external fixator. Then he said that all the staff had been ready and waiting since 8:30. Well then! The same day surgery nurses done messed up. My surgeon went off to go talk to some of the people who would be assisting in surgery while I sat down for a few minutes to talk with the other OR staff e.g., anesthesiology, scrub nurses. The one nurse needed the information I provided when the nurse downstairs asked me all the questions. Apparently it was all for show for my surgeon because none of that that info was put into the computer or attached to my chart. The OR staff were not impressed. I did find out that I couldn't get a never block; it had something to do with the nerve block not covering the entire area of my leg that would be operated on. I was promised lots of lovely pain meds after surgery and that they would put lots of freezing stuff in my leg during surgery. From there two of the nurses escorted me to the OR, where we met up with my surgeon and the rest of the staff. My surgeon said I was a pro on the crutches. I have had too much time to practice over the years. We got into the OR and the usual routine happened. While getting prepped, I looked over to see my surgeon admiring my Angry Birds crutches. I am glad they are a hit! At this point an IV was started, all the prep work done on me, and I was out.
Next thing I know I was waking up in recovery. As soon as I opened my eyes (and noticed it was around 11:15) I started asking how many pins my fixator had. It took a while to get an answer, but I finally found out it was four. At this point my leg was covered by blankets so I couldn't actually see the fixator. Pain was managed pretty well at first, but over time it started to creep up on me. I kept asking for more pain medication, but was told I had reached my limit. By 1:00 it had gotten really bad and by 2:00 I was constantly telling the nurse that things were getting worse. This was 10/10 pain, the worst I have ever had. I remember telling the nurse that I couldn't take it anymore. Finally the nurse said she would call the anesthesiologist, but he didn't come down until 3:00. At this point I was shivering uncontrollably and my teeth where chattering. I suspected that a major mistake had been made in the order for pain medication, which the nurse confirmed when she said something about a wrong box being checked or something along those lines. A day or so later the anesthesiologist actually came by to apologize for what happened and to make sure I was okay. Once new orders where given, I received a lot of pain medication. For a while, a nurse sat on a chair solely with the purpose of watching me and making sure I was all right (and this usually only happens for the first little bit after you are wheeled into the recovery room). The anesthesiologist talked with my recovery room nurse a lot, but every time they talked they moved farther away from me, glancing at my with furtive looks, as if they didn't want me to hear what they were saying. It was at this point I realized that they were actually really concerned about me. They kept pumping me full of pain medication for another hour (I think), until things settled down. During this time, my mum was allowed to see me for a few minutes. Then I was left alone for a bit again.
Sometime in the late afternoon I was wheeled up to the orthopedic ward. Unlike the last two surgeries, this time I was in a semi-private room instead of a ward.
Me, not long after being moved out of recovery to the orthopedic ward. Say hello to my lovely fixator! Also, after everything I have been through I am a professional patient - nothing like your own blanket in the hospital!
When I was moved to the orthopedic ward, I was finally given a pain pump, or patient controlled analgesic. The black cord hanging over my stuffed animal in the picture above was attached to a button that only I was allowed to touch (the nurse really emphasized that). Whenever I pushed it, I would get extra pain medication for break through pain. At first I was pushing the button to the max, so my long acting stuff was upped so I needed to use the pain pump less.
I am not sure when it happened for the first time after being moved from recovery, but I started having periods of uncontrollable shivering and teeth chattering. I think the first time was very early Thursday morning. I do remember that it was night time and that the rapid response team was called. Between Thursday and Saturday afternoon, it happened three times. Along with the shivering, I would feel freezing cold, the staff would cover me in heated blankets, and then my temperature would spike. My heart rate would also go really high, into the 150s. As a result, a resident from internal medicine was called (I think this was Thursday afternoon). I did not like him. He was a pompous ass. I don't usually say that about people, especially health care professionals, but he was the perfect example of one. He walked in, introduced himself, looked at me, and proceeded to say that I looked a lot better than he expected me to look and that I should be much sicker given my lab work. Apparently my potassium level plummeted pretty severely after surgery. He said he believed that I was suffering from refreeding syndrome, which means he thought I had an eating disorder. I have never had an eating disorder. I take pride in eating healthy (although I like to indulge sometimes too) and try to eat a healthy balanced diet. Instead of approaching the situation from a neutral perspective, he made an assumption about me without ever meeting me based on a single lab value and the fact that I was shivering and my heart was racing. Forget that I had just had major surgery, had been on antibiotics the majority of the year, had been chronically ill for years, and had major issues with pain management after surgery, all of which can cause the symptoms I was having. He just assumed I had an eating disorder and seemed genuinely disappointed when that turned out not to be the case. Sadly, this was not the last we saw of him. All my nurse where great, as well as my doctors, the physiotherapists, all the lovely staff on the rapid response team (who even came to check on me later on because they wanted to make sure I was okay and commented on how much better I was looking). Everyone was fantastic expect the internal medicine resident.
Anyways...
On Thursday, physio came to see me and get me moving a bit. He asked if I wanted to get out of bed and sit in a wheelchair. I was not obligated to do this a day after ex fix surgery, but as always, I put my best foot forward (literally!) and got into a wheelchair. It took some time and perseverance to get it done and to get the IV pole and all the cords to cooperate, but I did it. Physio said I was a rock star XD I was hunched over a basin fighting back nausea the entire time, half asleep with my eyes closed and head leaning on my hand, but I sat in that chair! On Friday I managed to get to the washroom with a walker.
Because my potassium level had tanked, I was pumped full of lots of IV potassium. As a result, my IV pole grew.
Thursday night I ate my first real meal since the evening before surgery. Mmmm! Pudding!
I look sad, tired, worn down, and loopy. You can tell how horrible I felt because having pudding is never a sad occasion, yet I looked pretty unimpressed by the chocolaty goodness in front of me.
I do not remember very much of that Friday, but I know that I got out into the hallway with my walker several times on Saturday.
On Sunday I used my walker to get to the sun room with my mum where we could watch a gorgeous sunset over the city. Just before midnight I had more problems with a high heart rate. My nurse did an electrocardiogram, which showed that my heart has a normal rhythm but that I had tachycardia.
Monday morning I was washing my hands in the washroom, which I was allowed to go to by myself by that point when I shivered a couple of times. It stopped by itself so I finished up and made my way to bed. And then out of nowhere, full blown uncontrollable teeth chattering and shivering and high heart rate (as high as the 150s) again. Fun times! Not... Physio gave me a break that day so I could rest up a bit. I also discovered that my tongue had turned white and it felt like the top layer had been scrapped off. I told my nurses and doctors several times, but never got anything for it. On Monday night, the resident who was in the operating room with my surgeon took off all the bandages on my leg for the first time. Although I was coming to terms with the fixator, seeing those pins jutting out of my skin was a shock. I sat there very quietly as he worked away. He asked me if I was okay. "Yes, trying to take it all in," I said. He replied that it was normal to feel like that and that it would take some time to get used to the fixator and pin sites.
On Tuesday word had it that I was going home. From an orthopedic perspective, I no longer needed to be in the hospital. I was mobile, my pain was well managed, and my incision was looking good. My nurse very kindly washed my hair for me in the morning and then physio came to practice the stairs with me. Once more, I kept asking for something for my mouth, which my doctor on floor (the ortho resident) had confirmed was oral thrush, probably due to the antibiotics I was on, but didn't get anything.
Later in the morning, two nurses redid the dressing on my leg and showed me how to do it myself.
My leg! 57 staples an all!
At another point in the morning, a very friendly woman from internal medicine came to talk to me. She actually wanted to keep me in the hospital for a few more days to run a some more tests to try to figure out what was going on with my heart. Just after she arrived, however, the pompous internal medicine resident from several days prior showed up, and put a stop to that. Although my heart rate reached a whopping 170 several hours earlier when I came back from walking in the hallway, he was completely unconcerned. he said that was alright because I was young; my heart could withstand a heart rate that high and that it wasn't above 200 so it was not an issue. He then added that his heart rate regularly gets that high when he works out. Yes, because that is completely comparable to me. A petite twenty-three year old that has been chronically ill for years, who has been on crutches for the last three months. Over those three months, minus the odd trip to Ikea or the one time at the zoo, the most exercise I got was a brief trip into Wal-Mart or crutching down a long hospital corridor to get to the fracture clinic once every few weeks. A person who had just had major surgery! According to this guy, just like a grown man exercising, it is perfectly healthy for my heart rate to sit at 130 and regularly spike to 155 when I get up to pee. It was clear, however, that the matter was settled. His word carried more weight than that of the other internal medicine person.
After this, the only problem preventing me from going home was I hadn't had a bowel movement since before surgery... so eight days earlier. Have you ever not pooper for eight days? Think how uncomfortable you would feel. Normally it is policy that patients have a bowel movement before they are discharged because it is important to make sure that every system in the body is working properly after surgery. Apparently, however, Wednesday is the big surgery day for the floor, so they need lots of available beds. This means that they try to discharge as many people as possible on Tuesdays. So it didn't matter that I hadn't met all the requirements to go home, because I was being discharged anyways. I was told that thing's would probably work themselves out but to go to the ER if it felt like I was giving birth.
I was discharged in the early afternoon with a long list of prescription medications, ranging from long and short acting pain medications of various doses, something to treat my oral thrush, a medication specifically for nerve pain, and a slew of things to get my bowels up and running again. For convenience sake, mum and I decided to go to the hospital pharmacy and enjoy some hospital cake in the cafe on the main floor (I love hospital cake, as weird as that sounds) while we waited. An hour or so later we were on our way home. By then it was rush hour, so we keow we would get stuck on the highway. I would be in pain no matter which route we took home, so we opted for the scenic route which normally takes longer than the highway, but not when there is a traffic jam. And after a week in hospital it was nice to see the world again!
Here are all of my medications once we got home. Some are taken every day, others are as required. When mum and I got home we had to write out a schedule for what to take and when. It took quite a while to figure out. I was taking seven different things, plus extra stuff from constipation (thanks narcotics, thanks a lot). Some stuff was twice a day, other three times, some stuff even four times. I am glad my mum was there to help, because it was quite confusing in my drug induced fog.
The hospital made me these cool dossettes with my long acting pain medication, which was tapered down over several weeks, organized in them. This was a life saver and made organizing all the medication much easier for us!
Inside of dossette #2, which had way less pink pills (6mg of hydromorph contin) than dossette #3. The green ones are the lowest available dose, 3 mg.
When I got home, I slept, and I slept for a long long time. Some parts of the hospital stay were amazing, like the nursing care I received, but there were also part that really sucked, like the error regarding pain medication after surgery, the uncontrollable shivering, the pompous internal medicine resident, and being sent home without pooping... I was glad to be home in my own bed surrounded my the gazillion pillows and blankets I had prepared to try to make life with my external fixator comfortable. I had to be back at the hospital less then 48 hours later for my post op appointment, but that didn't matter because I was in my own bed!
To be completely honest, I have put off blogging about surgery, at least in part, because doing so meant having first to sort through a tone of pictures. After almost a decade, I pretty much take pictures of everything health related. As a result, I not only have pictures of the good stuff, but also of the bad stuff. And when I say bad, I mean much more than bad. This latest surgery and hospital stay where really really rough and, quite frankly, looking at the pictures of how I looked hurts. Nobody wants to go through major surgery and the recovery period that follows. No one wants to be completely wiped out or experience uncontrollable pain. There are pictures of me from after this surgery in which I look absolutely horrible. Just looking at them is painful and a reminder of what I have been through. So it was hard to sort through everything and, as a result, I kind of put posting about it off for a while.
In addition, I have decided not to post many of the pictures that were taken of me. I believe that I have always been open (perhaps more so than I should have been) with the images I have shared on my blog. When I started this blog, my intent was both to create a record of events for myself and to provide information/advice about chronic osteomyelitis to other people affected by it. This is still my intent, albeit the focus has shifted from osteomyelitis to external fixators and regrowing bone. Given my latest surgery, however, I no longer believe that everything has to be shared. I can maintain a record for myself and continue to have this blog be a source of information for others without posting everything. Some things are too personal. Therefore, many images are omitted.
Now to get to surgery number five and the week long hospital stay that followed.
On November 25, I got up around quarter past five. Mum and I had to leave around six to get to the hospital by seven. There was not much for me to do as I had packed my hospital bag the night before and didn't need to worry about all that nonsense that is breakfast. Fortunately I am not a hobbit - missing a meal or two wasn't the death of me XD. I got dressed, made my bed (which takes a pretty long time when you have to hop around the bed on one leg) and then posted a little blurb on this blog. By then it was time to head out. The drive to the hospital in Hamilton was pretty uneventful. We did run into a bit of traffic, something which we haven't had with previous surgeries which were scheduled for eight instead of nine am. Regardless of this, we made it to the hospital in good time. Mum dropped me off at the front entrance so I could head to the admission desk while she parked. We picked a good time to arrive - right after I got there and took a number to wait in line it got really busy. I only had two people ahead of me.
After registration, where I got to rattle off my ever growing list of allergies, mum and I headed to same day surgery. All patients are sent there to be prepped for their surgery regardless of if they are same day patients or will be admitted to hospital after their surgery. This was my fifth surgery and I have to say, of all the other surgeries I have had, the time spent in the pre-op area this time was the worst I have ever experienced. When I arrived my nurse didn't even introduce herself to me. She handed me a gown and told me to change, came back a little bit later to take my vitals, which she wrote down on a piece of paper towel and left behind when she went to attend to another patient, and then see never came back. I'm not kidding, she never came back.
While we waited I did some soduku puzzles and took a picture of my leg for old times sake. I mean, it will never look the way it did again, right? One long thin pink scar; the only permanent mark the broken leg/bone infection ever left, and that was about to change. Note my one sock! I had a slipper to wear on the other foot for when I needed to head up to the OR waiting room.
We walked (well, I crutched) to the OR waiting area together. He asked me how I was feeling, to which I replied "nervous". He said that was good, there would be something wrong if I excited. So I replied that I was excited to start regrowing my tibia, but really nervous about the surgery itself and getting my external fixator. Then he said that all the staff had been ready and waiting since 8:30. Well then! The same day surgery nurses done messed up. My surgeon went off to go talk to some of the people who would be assisting in surgery while I sat down for a few minutes to talk with the other OR staff e.g., anesthesiology, scrub nurses. The one nurse needed the information I provided when the nurse downstairs asked me all the questions. Apparently it was all for show for my surgeon because none of that that info was put into the computer or attached to my chart. The OR staff were not impressed. I did find out that I couldn't get a never block; it had something to do with the nerve block not covering the entire area of my leg that would be operated on. I was promised lots of lovely pain meds after surgery and that they would put lots of freezing stuff in my leg during surgery. From there two of the nurses escorted me to the OR, where we met up with my surgeon and the rest of the staff. My surgeon said I was a pro on the crutches. I have had too much time to practice over the years. We got into the OR and the usual routine happened. While getting prepped, I looked over to see my surgeon admiring my Angry Birds crutches. I am glad they are a hit! At this point an IV was started, all the prep work done on me, and I was out.
Next thing I know I was waking up in recovery. As soon as I opened my eyes (and noticed it was around 11:15) I started asking how many pins my fixator had. It took a while to get an answer, but I finally found out it was four. At this point my leg was covered by blankets so I couldn't actually see the fixator. Pain was managed pretty well at first, but over time it started to creep up on me. I kept asking for more pain medication, but was told I had reached my limit. By 1:00 it had gotten really bad and by 2:00 I was constantly telling the nurse that things were getting worse. This was 10/10 pain, the worst I have ever had. I remember telling the nurse that I couldn't take it anymore. Finally the nurse said she would call the anesthesiologist, but he didn't come down until 3:00. At this point I was shivering uncontrollably and my teeth where chattering. I suspected that a major mistake had been made in the order for pain medication, which the nurse confirmed when she said something about a wrong box being checked or something along those lines. A day or so later the anesthesiologist actually came by to apologize for what happened and to make sure I was okay. Once new orders where given, I received a lot of pain medication. For a while, a nurse sat on a chair solely with the purpose of watching me and making sure I was all right (and this usually only happens for the first little bit after you are wheeled into the recovery room). The anesthesiologist talked with my recovery room nurse a lot, but every time they talked they moved farther away from me, glancing at my with furtive looks, as if they didn't want me to hear what they were saying. It was at this point I realized that they were actually really concerned about me. They kept pumping me full of pain medication for another hour (I think), until things settled down. During this time, my mum was allowed to see me for a few minutes. Then I was left alone for a bit again.
Sometime in the late afternoon I was wheeled up to the orthopedic ward. Unlike the last two surgeries, this time I was in a semi-private room instead of a ward.
Me, not long after being moved out of recovery to the orthopedic ward. Say hello to my lovely fixator! Also, after everything I have been through I am a professional patient - nothing like your own blanket in the hospital!
I am not sure when it happened for the first time after being moved from recovery, but I started having periods of uncontrollable shivering and teeth chattering. I think the first time was very early Thursday morning. I do remember that it was night time and that the rapid response team was called. Between Thursday and Saturday afternoon, it happened three times. Along with the shivering, I would feel freezing cold, the staff would cover me in heated blankets, and then my temperature would spike. My heart rate would also go really high, into the 150s. As a result, a resident from internal medicine was called (I think this was Thursday afternoon). I did not like him. He was a pompous ass. I don't usually say that about people, especially health care professionals, but he was the perfect example of one. He walked in, introduced himself, looked at me, and proceeded to say that I looked a lot better than he expected me to look and that I should be much sicker given my lab work. Apparently my potassium level plummeted pretty severely after surgery. He said he believed that I was suffering from refreeding syndrome, which means he thought I had an eating disorder. I have never had an eating disorder. I take pride in eating healthy (although I like to indulge sometimes too) and try to eat a healthy balanced diet. Instead of approaching the situation from a neutral perspective, he made an assumption about me without ever meeting me based on a single lab value and the fact that I was shivering and my heart was racing. Forget that I had just had major surgery, had been on antibiotics the majority of the year, had been chronically ill for years, and had major issues with pain management after surgery, all of which can cause the symptoms I was having. He just assumed I had an eating disorder and seemed genuinely disappointed when that turned out not to be the case. Sadly, this was not the last we saw of him. All my nurse where great, as well as my doctors, the physiotherapists, all the lovely staff on the rapid response team (who even came to check on me later on because they wanted to make sure I was okay and commented on how much better I was looking). Everyone was fantastic expect the internal medicine resident.
Anyways...
On Thursday, physio came to see me and get me moving a bit. He asked if I wanted to get out of bed and sit in a wheelchair. I was not obligated to do this a day after ex fix surgery, but as always, I put my best foot forward (literally!) and got into a wheelchair. It took some time and perseverance to get it done and to get the IV pole and all the cords to cooperate, but I did it. Physio said I was a rock star XD I was hunched over a basin fighting back nausea the entire time, half asleep with my eyes closed and head leaning on my hand, but I sat in that chair! On Friday I managed to get to the washroom with a walker.
Because my potassium level had tanked, I was pumped full of lots of IV potassium. As a result, my IV pole grew.
I do not remember very much of that Friday, but I know that I got out into the hallway with my walker several times on Saturday.
On Sunday I used my walker to get to the sun room with my mum where we could watch a gorgeous sunset over the city. Just before midnight I had more problems with a high heart rate. My nurse did an electrocardiogram, which showed that my heart has a normal rhythm but that I had tachycardia.
Monday morning I was washing my hands in the washroom, which I was allowed to go to by myself by that point when I shivered a couple of times. It stopped by itself so I finished up and made my way to bed. And then out of nowhere, full blown uncontrollable teeth chattering and shivering and high heart rate (as high as the 150s) again. Fun times! Not... Physio gave me a break that day so I could rest up a bit. I also discovered that my tongue had turned white and it felt like the top layer had been scrapped off. I told my nurses and doctors several times, but never got anything for it. On Monday night, the resident who was in the operating room with my surgeon took off all the bandages on my leg for the first time. Although I was coming to terms with the fixator, seeing those pins jutting out of my skin was a shock. I sat there very quietly as he worked away. He asked me if I was okay. "Yes, trying to take it all in," I said. He replied that it was normal to feel like that and that it would take some time to get used to the fixator and pin sites.
On Tuesday word had it that I was going home. From an orthopedic perspective, I no longer needed to be in the hospital. I was mobile, my pain was well managed, and my incision was looking good. My nurse very kindly washed my hair for me in the morning and then physio came to practice the stairs with me. Once more, I kept asking for something for my mouth, which my doctor on floor (the ortho resident) had confirmed was oral thrush, probably due to the antibiotics I was on, but didn't get anything.
Later in the morning, two nurses redid the dressing on my leg and showed me how to do it myself.
My leg! 57 staples an all!
After this, the only problem preventing me from going home was I hadn't had a bowel movement since before surgery... so eight days earlier. Have you ever not pooper for eight days? Think how uncomfortable you would feel. Normally it is policy that patients have a bowel movement before they are discharged because it is important to make sure that every system in the body is working properly after surgery. Apparently, however, Wednesday is the big surgery day for the floor, so they need lots of available beds. This means that they try to discharge as many people as possible on Tuesdays. So it didn't matter that I hadn't met all the requirements to go home, because I was being discharged anyways. I was told that thing's would probably work themselves out but to go to the ER if it felt like I was giving birth.
I was discharged in the early afternoon with a long list of prescription medications, ranging from long and short acting pain medications of various doses, something to treat my oral thrush, a medication specifically for nerve pain, and a slew of things to get my bowels up and running again. For convenience sake, mum and I decided to go to the hospital pharmacy and enjoy some hospital cake in the cafe on the main floor (I love hospital cake, as weird as that sounds) while we waited. An hour or so later we were on our way home. By then it was rush hour, so we keow we would get stuck on the highway. I would be in pain no matter which route we took home, so we opted for the scenic route which normally takes longer than the highway, but not when there is a traffic jam. And after a week in hospital it was nice to see the world again!
Here are all of my medications once we got home. Some are taken every day, others are as required. When mum and I got home we had to write out a schedule for what to take and when. It took quite a while to figure out. I was taking seven different things, plus extra stuff from constipation (thanks narcotics, thanks a lot). Some stuff was twice a day, other three times, some stuff even four times. I am glad my mum was there to help, because it was quite confusing in my drug induced fog.
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