Surgery Tuesday… times TWO

Both Tom’s mother and my brother are having major surgery today.  Needless to say, we will be a bit distracted throughout the day until we hear that both are out of surgery and doing well.

Interestingly, both my brother Michael and Tom’s mother, Rose (“Nana”) are having full hip replacements.

Rose, who lives in Palm Desert, California had planned to have her hip replaced again (she’d had it done 12 years ago, but it needs a “renewal”) on April 2nd in Spokane, Washington, which is closer to both Tom’s sister’s family in Idaho and to our family in Seattle.  Plus, Dr. Benirschke, who performed miracle surgery on my ankle last year, had recommended a great surgeon in Spokane.  All was set. 

Until…

Last Thursday Rose fell in a parking lot and broke her femur.  It is a bad break, just below her current artificial hip and for reasons I don’t quite comprehend, that makes for a far more difficult surgery – or rather TWO surgeries done in one day, as they will now perform both a full hip replacement and repair her broken femur. 

When Rose was visiting at Christmas I told her that I was worried that she’d fall at home and couldn’t get help, as she lives alone.  She didn’t seem concerned (“I have a Rolodex on the kitchen counter”), but I remained very concerned and I must say that I’m just grateful that this happened in a public parking lot, almost right in front of a fire station!

The recovery is said to be at least a year – and given her age (85), it might even be longer.  :-(

Please think positive thoughts for Nana!

(Tom and his mother making Christmas rum balls, 2008)

My brother Michael, who is only 58 will also have a full hip replacement in San Francisco.  His surgery was scheduled for a few weeks ago, but his asthma was so bad he had to postpone his surgery.  He has always had bad bones, the result of Mom’s war-time and post-war malnutrition in Germany.

Please also think healing and positive thoughts for my dear brother Michael – a true “hippy,” so he should do just fine with this surgery!  :-)

(This is Michael, shooting a video in Africa.)

I’ll let you know how things go…

Anti-Cat Cage

I love having the cats with me on the bed, but the thought of them jumping onto (or even brushing by) my injured leg kept me from getting any real rest after I came back from the ER. Elisabeth suggested protecting my leg with an upside-down laundry basket, so Tom crafted this personalized, blog-colored (!), protective anti-cat cage:

Doesn't Bailey look positively thwarted?

Thanks so much to all of you for support and helpful suggestions. I really appreciate all the kind words and feedback. It sounds like my hope for a two-week recovery might have been a little off, eh? Dammit!

I'm still working as much as possible. The loopiness and nausea caused by the meds makes it hard (I've woken up finding myself typing -- or trying to type -- an e-mail!), but I'm doing what I can. Fortunately, my job can be done from home... assuming an ability to concentrate. Funny (not), the effect pain has on concentration!

Unfortunately, Tom is now being called on to do all the things I normally did, plus all the stupid little things like getting me water and bringing me toast in the morning. And making me cool inventions that make my situation more interesting and exciting -- like a laundry basket cat cage!

And now I'm off to project manage my recuperation... because project management is what I do! And this will take some good PMing because I'm hoping to have the surgery done by one of the nation's top ankle and foot surgeons, Dr. Benirschke, who practices out of Harborview Medical Center in downtown Seattle. Since we originally went to a different ER on the eastside, this means some real coordination and project management opportunities! (Trying to stay optimistic...) First step (pun intended) is to orchestrate the sending of my x-rays (do NOT believe them when they tell you they need to be picked up; this is the digital age, so they can be e-mailed!), to visit the surgeon early tomorrow morning, and to set up a time to go under the (gulp) knife.

Scary Moments at Harborview Medical Center

I live in a suburb on the Eastside, across the bridge from Seattle. Our local hospitals' clients are mostly upwardly mobile, successful professionals -- which often frustrated me when I taught childbirth classes because too-busy-for-real-life Microsoft couples would often ask me for a one-shot Saturday childbirth class to accommodate their busy schedules. If you were in for a stay at one of our Eastside hospitals like Evergreen (where I visited the ER last week), you'd probably run into people a lot like me -- professional, educated, very busy with work and family, and with no time for being waylayed.

I chose to have my surgery with the most amazing world-renowned surgeon, Dr. Stephen Benirschke -- which meant that my surgery and my subsequent hospital stay would be at Harborview Medical Center. I'd never been to Harborview before because it's considered the Pacific Northwest's trauma center and not a hospital for things like childbirth and routine well-care. As the county hospital, it's also the place where those without insurance are treated. So, it houses both the country's best surgeons and the county's indigents -- sort of an odd dichotomy.

I spent 90% of my time at Harborview in my patient room on the 6th floor of the Meleng Building so, other than some time at the Ankle and Foot Clinic (where I encountered some interesting characters, one of whom insisted she was injured "on stage, dancing with the Pacific Northwest Ballet, that she had 13 kids, and that she caught both Ted Bundy and the Green River Killer single-handedly), I really only met my two roomies.

Marilyn, my first roomate, was pretty normal. The poor girl had come into some tough times lately, both situational/personal and medical. She'd had spinal surgery and from all we could tell, her life would look up once she recuperated from the surgery. Her two dedicated sisters visited her daily and, although I overheard a few sisterly squabbles (which was only disconcerting because one of her sisters was named Carol), she was sweet and friendly, even through her pain, and we became buds during the two long, painful nights we shared there.

At 1:30 AM on my third night at Harborview, Beth was brought into my room. She too had undergone spinal surgery, though hers seemed to be a bit more extensive than Marilyn's. All was relatively quiet until early the next morning when the discharge nurses came in, informing Beth that she'd being going home that day, the same day I was leaving. They could barely wake her for a second and then she'd fall right back to sleep, snoring! And they were trying to inform her of her legal rights to not be discharged if she didn't feel that she was ready.

Helllloooo?! Even I could promise you that there's no way she was ready to be discharged! She was in a complete stupor and not at all conscious enough for a casual conversation, let alone understanding her legal rights!

I wasn't sure what was going on with Beth, but she was obviously agitated, completely out of it, and obviously not doing well. And the nurses came in occasionally to give her even more drugs, apparently not really concerned that they couldn't rouse her! Huh? How could she possibly go home in this state?!

At one point, I heard Beth get out of bed -- and I don't mean slowly and gingerly. She was moving quickly and angrily... with a spinal injury and recent surgery! I looked up and saw her fly by my bed! "Where's the *&^%$ bathroom?" she asked me. I pointed to the bathroom and she quickly turned around and positively flew, stumbling toward the door! I was sure she'd fall, but she didn't. Just as I was about to call the nurses, the bathroom door flew open and Beth practically ran back to her bed. Within seconds, she was snoring again.

I must admit that I was a bit freaked out at this point! When the nurse came in, I told her what had happened and that I was concerned for Beth's safety. She woke Beth enough to ask her if she'd been to the bathroom. "No," Beth insisted, she had never gotten out of bed.

OK, so I'm a liar. (Not.)

I called Tom and Kat at this point to find out where they were and when they'd arrive to come get me. For all I knew, Beth would get up again and not be so lucky this time -- and I didn't want to see her get really badly hurt.

Beth didn't get up again. When I left, she was sitting in bed, slouched over, and unresponsive. I don't know what happened to her, but I have a feeling she didn't go home when she'd planned to.

I have a screw loose!

Loosened and removed, in fact!

Today was my 6 month post-op appointment with Dr. Benirschke at Harborview Medical Center.

Based on prior experience, I’ve learned not to plan anything else for days when I have “quick” post-op appointments at Harborview – and lo and behold today turned out to be no exception. My appointment was at 10:15 this morning, it’s now almost 5 PM, and we just got home.

Why?

Oh just a little bit of minor surgery.

One of my questions for Dr. B today was why I continue to have limited range of motion in one particular area, and why that area continuously hurts and is perpetually swollen.

Turns out there’s a two-inch screw that Dr. B inserted to hold my tibia and fibula together to give that whole area more strength. Problem is, the dang screw has been causing me not only pain, but decreased range of motion and increased anxiety because it’d especially hurt when I moved my leg just so.

It turns out that there’s also a small risk of this particular screw breaking in the middle as I increase my range of motion, leaving half of it in each bone. That would most decidedly not be good!

“So when can the hardware be removed?” I asked Dr. B today. “Not for a year,” he replied. (Happy ankleversary!) “Except for this one… which I had a feeling might cause some problems. This one can be removed today.”

Gulp.

“What? Are you not emotionally ready?” he teased.

“No, I am. Or I will be. In a minute…”

An hour and a half later (because of his schedule, not my trepidation!), Tom, Elisabeth and I were in a mini-surgical suite, waiting for the surprise procedure.

I’m working on the “emotionally ready” part.

TK the nurse with the beautiful hair, prepared all the instruments and then Dr. B got to work.

First he had to find both the exact right spot and the exact right angle to locate the screw.

Good thing I trust the man blindly. Hey, any world-famous surgeon who answers his cell with “Joe’s Bar & Grill. Joe’s out” has my full trust!

After he marked my skin as if I was having some hoity-toity cosmetic surgery, he told me to just relax while he got things ready. Yeah, OK… but let me turn away first!

First things first. Sleepy stuff for my foot!

You don’t need to see all the shots at all the different angles, do you? Good – neither did I! I kept my eyes on my good ol’ focal point (because I’m a chicken):

First we need a sterile field…

… and then some slicing…

…and some poking…

and some “Marco! Polo!”

And then out came the hex screwdriver

And the vice grip on my leg…

…and some rockin’ and rolling…

And then… GOTCHA!

Dr B warned me about this next part. Because you can’t numb bone, he told me I’d feel it when he started twisting the screw backwards and withdrawing it from the bone. He said people described the feeling as “freaky.”

I can’t even describe what it felt like, except to say that I was very aware that it was deep inside my leg and it resonated in… well, yes, in a “freaky” way! Freaky and painful.

And then…

Well, hello there!

I was just relieved to hear that it was out. One can only take “heebie-jeebie” for so long!

I think Tom was relived too. Elisabeth, on the other hand, was loving the “blood and guts” (OK, no guts!) factor, and was snapping away.

Look! No more screw!

Immediately after it was all over, Dr. B suggested I get up and walk around, assuring me that since only the immediate area was anesthetized, I should be able to walk.

I took three steps and couldn’t believe it! The pain and the limited range of motion in that specific area was completely gone! I’d come into the hospital with a distinct limp and I left without one. (Or much of one…) Once again, Dr. B had performed his magic!

We celebrated with a quick lunch at Ivars on Lake Union.

Granted, this was one very minor hardware removal procedure. The more major one will occur in December, when Dr. B will remove both the 5” plate and the 2” plate, along with the 12 pins and various other hardware. For that procedure I’ll be in the OR and knocked completely out. (Which means sorry, no pictures!)

I’m still numb but it’s wearing off. I’ve been told that I’ll be quite sore for a day or two, but after that I should be moving around SO much better!

I can hardly wait!

How Being Broken has Mended Me

Tomorrow, almost two months after walking out my front door to take the dog for a walk and breaking my ankle instead, my cast will be removed. Immediately after my accident (in the ambulance, in fact), all I could think about was the need to call my boss and tell him that I most likely wouldn't be in the office in the morning. When I was told that the break was a bad one and would require surgery and six to eight weeks completely off my foot, I was at first in shock and then defiant.

"I don't have six to eight weeks," I insisted. "Not an option!" As a dedicated and consummate Senior Project Manager working on Microsoft projects, I am in charge of scheduling resources and following timelines to the tee for a very demanding client -- and breaking my ankle definitely was not in the scope of work!

No can do. Sorry. This injury doesn't fit into my schedule at this time. Thanks anyway.

The thing about project managers is that we seem to think that we can manage our own lives with the same control and finesse with which we manage other people's projects. That night, as I lay on the gurney in the emergency room, in agonizing pain with a foot that flopped awkwardly sideways, I began to realize that sometimes we can do neither.

The need for surgery allowed me to escape the pain -- both physical and emotional -- by focusing on a few project management tasks, such as finding the best surgeon in the Pacific Northwest, Dr Benirschke and scheduling surgery at Harborview Medical Center just four days after my accident.

I knew I was in good hands, but still, I had to insist to Dr. B, over and over, that "I really don't have time for this!" Clearly he'd heard it before and challenged me, sarcastically, yet lovingly, to get up and walk away if this didn't fit into my life's schedule.

Point well taken.

I spent four loopy days here...

....allowing me plenty of time to think. Even then, my thoughts were dictated by an I-don't-have-time-for-this attitude. And even in the hospital, I was in constant touch with my boss and co-workers, insisting that I'd heal faster than the average patient and that, fear not, I'd be back to work very soon.

I was obviously delusional, Percoset or no Percoset.

During the following week, I could neither think nor move without incessant, painful throbbing, and it was only then that I began to accept that I might not be as invincible as I'd made myself out to be, and that this injury might have a grip on me that I couldn't shake just by wishing it away. I was forced to accept that I had no choice but to slow down, stay quiet, let go -- and be grateful.

I'm normally an early riser, getting up and getting to work in my home office (or doing laundry or dishes) before getting in the car and driving to the office. But there simply was no getting up for the first three weeks after surgery. My toes would turn as purple as my cast within minutes and I was forced back to bed, elevating my foot and pacifying my pride. I had no choice but to slow down, to stay in bed, and to just simply rest.

And that's when being broken began to mend me.

I stopped fighting my injury and began to accept it. I learned to enjoy taking afternoon naps with Boo propped on the pillow, wrapped around my cast, or purring under the covers in the crook of my arm. I began to revel in not having to get dressed each morning and hurry out the front door, ready to fight traffic so I could get to work and fight project managers who -- oh, my god -- were in just too much of a hurry and who couldn't slow down long enough to ask themselves whether one extra day to finish a project would truly end the world.

I began to enjoy my mornings without an alarm clock jolting me from much-needed sleep. I began to enjoy watching TV in bed with Tom without my conscience insisting that there's work to do -- GO! And I began to let go of my need for control and revel in and appreciate Tom's devoted and capable caregiving.

I could feel myself letting go and, although I was more physically broken than I'd even been, I began to feel more emotionally quiet and steady than I'd been in a very long time. Suddenly work didn't seem so end-of-the-world critical, and what became life-saving critical instead was the commitment to walk for an hour every morning before work instead of work for an hour every morning before work (once this cast comes off).

I was changing and it was my injury that was bringing me this gift of perspective.

Soon I began to get up for longer and longer periods of time, starting with a few minutes in the living room...

... and eventually making my way down the steps...

out the back door (because I feared -- and still fear -- those outside, railing-less steps!).

As long as I have my cast, I still need help getting my scooter out of the house and into the car...

...but within five weeks of my accident, I was slowly beginning to return to real life, as I attended client meetings at Microsoft and even went out for dinner.

Even being out among the living felt different, though, as I became acutely aware of the availability of access for the disabled -- something I'd been only peripherally aware of before. I came to realize, through personal experience, that a long flight of stairs that pose no problem to 99.9% of the population can mean thousands of dollars of lost wages to one person whose family counts on her to put food on the table and a roof over their heads, and that a handicapped parking space means very little if there's no nearby accessible sidewalk.

Now that I'm preparing myself for the day that couldn't come soon enough eight weeks ago, I'm beginning to lament what I'll be giving up tomorrow when my cast comes off and I "walk" (with quotes, as I'm sure to hobble) the halls of Harborview Medical Center in my new Darth Vader walking boot.

Eight weeks ago I hit a brick wall (or flagstone step) that forced me to go from warp speed to mosey speed. But I'll be returning to full-time, in-office work next Monday and now I'm scared of something so vastly different than the fear that gripped me in the ambulance last January 4th: I'm scared that I'll forget the lessons of the past eight weeks and the peace that I found in the hidden blessing of a broken ankle.

I be stylin’! (Not. Oh, sooo NOT!)

So it seems that last month I was using my knee walker as a crutch (so to speak), which prompted my meanie doctor to force me to give it up so I’d put more weight on my foot. 

I was not happy to give up my knee walker because it made living with a broken ankle bearable.  I could get around incredibly quickly, use my hands, and carry stuff from place to place in the handy-dandy basket.

Once my knee-walker was gone, I was forced to use crutches to get around.  While I hated the crutches, I had no choice but to use them.  Fortunately my cool storm trooper boot provided my foot comfort and security and I was pretty mobile using both together. 

I dreaded the day when the powers that be would mandate that I give up the boot, but I assumed it was still a few weeks off.

Wrong.

I went back to Harborview’s Foot and Ankle Clinic today, expecting to be told that it was time to give up the crutches and walk using just the boot.  But nooooooo…  Instead, Dr. Benirschke the meanie, insisted that I lose the boot and keep the crutches! 

Nooooo!  Say it isn’t so!

But it is.  Over the next week or so, I need to phase from wearing the boot all the time, to wearing it less and less and wearing – gasp!! – SHOES more and more.

Shoes?  But not a single shoe in my closet fits my still-swollen left foot!  How on earth will I transition out of my sweet, secure boot?

After my medical appointment, Tom and I went to our favorite Mongolian Barbeque, where I got this fortune:

Uh – huh.  Wonders!  You want to see my new look? 

Well, there’s this corset-looking brace gizmo (very Little House on the Prairie, isn’t it?) that gets laced up and strapped around my foot and goes inside my shoes.

Are you wondering where all those straps go?  Yeah, me too!  They get pulled and wrapped and tightened around my foot, like this:

And then…

(Now don’t laugh. Really, it’s been a tough year and a tough week, so be nice.)

Over that lace-brace (which my insurance company will pay a hundred frikken dollars for!), I put on this:

You better believe I need that wide width!  Getting the shoe on my foot was excruciating, but I did it.

(That wide gap  between shoe hemispheres reminds me of my rectus abdominus muscle after my twin pregnancy!)

So yeah, this is my new look that, according to my fortune, will “do wonders”:

Thank goodness for wide sizes and long, stretchy laces! 

I’d like to tell you how I feel about all this, but I really don’t know how I feel about it yet.  Yes, I know that I need to progressively get back on my feet (so to speak) and that it won’t be comfortable to get there.  And yes, I know that the pain, even when it’s in my foot, is actually more in my head.  And yes, I know that fear and stress play a big role in how well -- or poorly -- one heals.  (Stress?  By the time I stopped work in the wee hours of the morning on Wednesday morning, I’d already put in 31 hours!)  I know all that.  But I still miss my trusty knee walker… and I will miss wearing my secure storm trooper boot.

I know what you’re thinking.  “Yeah, and in a few months you’ll say how much you miss your old lady sneaker.” 

No way!  That, I will NOT do!

Fun at Harborview Medical Center (and Adventures in the ER!)

If you have to break your ankle in a bunch of places, have "hardware store" surgery, a heeby-jeeby-inducing hospitalization, and a long recuperation, it helps to have this man as your doctor!

This is Dr. Benirschke -- and I mean THIS is Dr. B! He's one of the top foot and ankle surgeons in the world, but he interacts with his patients more like a long-time buddy than some high and mighty, egotistical doctor. He was on time to our appointment this morning but we were warned about "Dr. B Time" before we met him a few weeks ago It turns out that Dr. B. just loves connecting with his patients -- talking with them, laughing with them (how does he get so many people in pain to laugh?!), but more than anything teaching and educating them. He is filled to the brim with knowledge and he likes nothing better than sharing what he knows.

(Yes, I know I need to shave my leg, but my foot was covered in a splint for the past few weeks... and is again.)

So today the soft splint came off...

and the hard cast went on.

(Yes, I'll shave! Sheesh!)

Oddly enough, Dr. B asked me to turn onto my stomach when he put the cast on. You know why? Control issues!! No kidding! He might not have known me for long, but he does know me well! I'm a project manager; of course I have control issues! I was relieved to hear, actually, that he asks all his patients to turn on their bellies when he wraps the cast. Turns out people tend to want to "help" him (albeit subconsciously) by moving their foot this way or that, so not allowing patients to watch allows him to move the foot into the exact position he wants. And he definitely moved mine into a whole different position.

This is the most it's hurt since I was in the hospital! Tonight I'll break into the prescription pain meds for the first time since the day I got home from the hospital because this really HURTS!

Actually, the most painful part of the day was when Dr. B. removed the under-skin sutures where he clipped my tight calf muscle. Fortunately, I didn't expect such pain and it was over quickly... but oh. my. god!

Yes, I forgave him for causing me agony and I still adore him.

Selecting a cast color was quite the conundrum! These were my color choices:

Pink (which you can't see) was out because it looked too juvenile, I liked the green and the blue dots on the packages but the tech warned me that they were actually "pretty gross," and black couldn't be signed. It was purple or red. Or in our family, WSU Cougars' crimson, or UW Husky's purple. With apologies to Peter -- and a promise that should I ever break a bone again (oh god... the thought!), I'll get a red crimson cast -- I decided to go with purple, more because I like the color than as an "I love the UW Huskies" statement... although as a mother of a Husky, of course I love them. Exactly as much as I love the Cougars.

(This rivalry will probably be around for the rest of our lives!)

Amazingly enough, "Dr. B time" was working in our favor this morning, and by 11:00 we were cleared to go home!

Until I said those fateful words as I got off the bed: "I've had this annoying pain around my lung. It hurts when I cough or sniff. I'm sure it's probably just a muscle ache..."

Before I knew it, I was downstairs at the famous/infamous Harborview ER (right next to a shackled convict!), being checked out for a possible post-surgery embolism! I had it all -- EKG, x-rays, and of course a blood test (called a d-dimer). Amazingly enough, this time a nurse was able to find a vein on the first try! First I told her I loved her. Then I asked if we could take a picture of the first nurse that's been able to find my vein on the first try in a very, very long time! She thought we were crazy, but complied.

By 3:00 the test results were in and we were given assurance that my pain is skeleto-muscular, just as I suspected. I'm definitely moving in odd ways these days, reaching over my knee walker, twisting and picking up my laptop from the bedside table, and just being in bed too much. I am glad that we played it safe because really, an embolism would not be good at all. Not at all.

And now I think I'll take prescription narcotics for the first time in weeks and try to get some rest. (Those muscle spasms in my ankle as I fall asleep are torture!)