Wednesday, December 19, 2007

Under Better Circumstances - Dec 19

We had a wonderful visit with Blase last weekend! Blase and his climbing partner were the first ones who arrived on the scene of my accident after my cousin Jason called for help. Blase also wrote a moving message and account of the rescue (in this blog - "Blase's Message - Sep 2"). It was great to connect with Blase under better circumstances!

Melissa and I had a chance to hear about Blase's work studying Montana's glaciers, his play on rock and snow in the West and stories about important people in his life. Blase and I circumambulated the great Peter's Hill - a towering monolith standing at least 200 feet high and providing a commanding view of downtown Boston. We ate scrumptious thin crust pizza at the local eatery and gabbed into the late evening.

Besides getting to make Blase's acquaintance for the second time, it was instructive and healing to reflect on the accident and rescue and to create a composite picture of what took place. Hearing his perspective helped me to understand how others reacted to the accident. I felt moved to hear that a whole crew of Park Service firefighters had scrambled up - ready to help but possessed of no technical rescue know-how. I stood in others' shoes when Blase depicted the team of 17 rescuers, drenched in sweat and out of water, straining to carry me safely and quickly.

It didn't hurt to hear Blase's perspective on my leg, either. As he noted, it sure looks a lot better than the last time he saw it. Though the rescuers worked diligently, the prospects for my foot had seemed somewhat dim with an eight-hour carry. He was pleased to see that I kept the foot, let alone that I am able to get around smoothly with crutches. The skin on my heal has been out of the woods for a couple of months, and my range of motion and strength returns slowly but surely.

This last point brings me to the aftermath of getting unscrewed. Curiously, the screw removal has left me with an interesting bit of pain at the fracture site that occurs intermittently with weight bearing. With any luck, this pain means that the bones have a little more play which should stimulate bone growth. I also have more flexibility in my ankle - still very limited. This increase in flexibility means that I can try to work my muscles back to life. I am amazingly weak - my right thigh can hardly handle a single-leg squat of even 6 inches! However, through some weight lifting and the contortions concocted by my physical therapist, I hope that this will improve quickly. I am cleared to swim as well, since the stitches were removed today.

Here is the news on the bone front. The orthopedist didn't schedule another visit until April! He said that we wouldn't see much bone growth before that, but we ought to see signs four months out from taking the screws out. He also said that the more important sign is how I progress. If I am able to return to more normal activity and don't feel any pain with weight-bearing, twisting or higher impact movements, that would be a better sign of recovery than an inconclusive x-ray in April.

All this is to say that I am well within a "normal" timeframe and that full recovery is going to take a long time. I continue to be patient and to have a fantastic attitude (except when I don't). In order to stay on the bright side, my latest response to "how are you?" is that I'm doing great considering that my leg almost got hacked off last summer. For the moment, my mantra is "grateful for my life, grateful for this trial."

Saturday, December 8, 2007

Unscrewed! Dec 8

Yesterday, I had surgery to remove several screws in my leg. The three locking screws (the blue ones in the picture) were connecting my tibia to the rod. In theory, by removing them, it will "dynamize" the rod - meaning that there will be a little more play in the bone ends. Hopefully, this will stimulate bone growth. The other two screws were holding my tibia and fibula together. They actually had broken, so only the short heads of the screws came out. (We had been told that this might happen). Those screws had been put in place to stabilize my ankle. With them out, we are hoping that I will get more range of motion.

The orthopedist performed the surgery using general anesthesia. Back in August and early September, when I had a surgery nearly every other day, it seemed like no big deal to "go under." I was totally dependent on the medical teams, and it wasn't that hard to surrender my consciousness at times. This time felt harder. I am glad to be "unscrewed," but I wasn't keen on having general anesthesia. I found it unnerving to breathe deeply into the mask and inhale the artificial-smelling gas. Earlier, while sitting in the waiting room, I also thought about the range of caregivers that I had experienced during my stay in the hospital.

Some were excellent - in tune with what I needed. Others brought strange power struggles into the room. One nurse in Colorado helped out when Melissa was at her wit's end trying to negotiate with the company that rented wound vacuums. The nurse spent an hour on the phone convincing the company to deliver a portable version. Frank, the ICU nurse and Rob, the anesthesia PA came to visit me several times after I had left their unit in the CO hospital.

On the other hand, after my flap surgery, one nurse was terribly passive aggressive. My catheter was draining improperly, and I was swelling noticeably. However, she gave a variety of excuses that delayed its removal. The next nurse came on shift and removed it immediately. Another nurse delayed giving me the oral pain medication that I was taking (percocet) for almost an hour after I asked for it. When I complained that I was in significant pain, she entered with a loaded syringe saying, "I'm going to give you a shot of morphine." After I protested, she chided me that the oral medication wouldn't take effect for 20 minutes - exactly why I had requested it earlier!

One nurse finally encapsulated it for me. She said that more important than wound or pain management, her top priority was good patient advocacy. Hospitals are complex places, and patients need to be and to have good advocates. Yesterday, I asked to forego "Versed," a medication that commonly is used to diminish anxiety before surgery. However, a medical practitioner had told me that it is actually a diluted amnesia-inducer. The advice helped me self-advocate to skip that medication.

So now, with this surgery finished, I will spend the weekend in bed (not as glamorous as it sounds). Then, we begin to "mobilize" my ankle - starting at my PT appointment on Monday morning. I hope mightily that getting these screws out will accelerate my return to some sense of normal function and activity. I also hope that this surgery will do the trick - stimulating my bones to grow. There is nothing to do but be patient and diligent with optimism and physical therapy. As Melissa said, "I'm looking forward to this being your last surgery."