Thursday, December 16, 2004
Ouch
I have not written in a while due to a pretty serious ankle injury. Two weeks ago while playing my regular Wednesday night full court basketball game with a group of guys that have been playing together for about 5 years I went down hard. I jumped up for a rebound and came down on my left foot which landed on someone's shoe. My ankle immediately rolled over and hit the floor. I knew instantly that the injury was very serious so I let out a loud yell, partly from the pain and partly to send a signal to everyone on the court to get away from me while I writhed on the floor in agony. Before even glancing down at my disfigurement someone waiting to get into the game shouted from the opposite end of the gym, "Oh god, its completely out, I can see it from here! It's completely out!" Then he ran out of the door to the gym so as not to look at my twisted foot.
I glanced down and saw that my foot, which I was trying to elevate by grabbing the back of my left knee while lying on my back, was twisted at a 90 degree angle from normal and was swelling fast. I could not see, nor did I want to see my ankle bone. Although a few players were unable to come within 50 feet of me many did come to my aid. I asked one guy to please hold my leg up while a couple of buddies dragged a bench on to the court to support my elevated leg. After this was done a discussion ensued about how to get me to the hospital. There were arguments for and against an ambulance when one friend said, "Oh no, Tom's out of work so he doesn't have insurance, we'll have to bring him to the hospital." I quickly informed everyone that I had decent insurance through my wife so that was not a concern. They briefly discussed trying to hoist me on to the bench and carry the bench out to someone's car to take me to the hospital. In the end I told them that the pain was just too intense to think about having these guys try to move me so I told them to call for an ambulance. Good decision.
When the paramedics arrived (preceded of course by a fire truck) they immobilized my lower leg with an inflatable bag and then cut my sock off and began to remove my shoe while one EMT started an anti-biotic IV and prepared to give me Morphine. Up to this time quite a few guys were making frequent comments about how stoic I was being. They were saying things like, "Tom, you're handling this great, man that looks bad, it's gotta hurt." When the shoe was removed these comments changed to, "Oh man, you are handling this unbelievably well, oh god!" I figured that this meant the bone went through the skin, which it had. The paramedics did a good job getting me stabilized in the exact position that I seemed to want to hold my mangled foot. Then after a small dose of morphine through an IV, which did absolutely nothing to dull the pain, got me into the ambulance without too much jostling and I was on my way to the hospital.
On the ride over I had lots of questions for Lori, the paramedic who rode in the back of the ambulance with me. She asked me repeatedly about my pain level. "On a scale of 1 to 10, 10 being the worst pain you have ever experienced, where are you right now?" "9-1/2, I had second degree burns when I was 9 years old that were worse." "Ok, I need to check your blood pressure between every 10 miligrams of morphine I give you." I was told that the ankle was dislocated and tendons were probably torn, and that I had a puncture wound which she could not be sure about but was a concern since bleeding and infection could cause problems. I asked if having the ankle remain dislocated for a prolonged time was a problem. She said that tendons have a "memory" and so it was always good to get things back into place quickly because that would tend to help them heal faster. The problem was that I had eaten three hours before and they liked to wait 6 hours after eating to give patients the powerful conscious sedation that they would give me prior to popping the ankle back into joint. She told me that not only was it important that I not see, or feel the ankle being popped back into the mortise joint it belonged in but it was important that I not remember it either. Conscious sedation lasts only long enough to accomplish the task but during it the body shuts down to the point where any food or liquids in my system could cause major problems. I could drown in my own puke.
When I got to the hospital I received immediate attention, which was terrific, and started getting the same questions over and over, "rate your pain on a scale of 1 to 10." "Nine." "When did you last eat?" "3 hours ago, but it was a small amount." I started getting pretty impatient and the pain was getting no better. A lot of hospital staff seemed to be interested in walking past my emergency room gurney to look at the curiously bent foot. After repeating over and over my answer about when I last ate a doctor leaned over my bed and explained for the fifth time that the conscious sedation could not be given within six hours of eating. I said, "Well you are not seriously suggesting that we leave the ankle alone for another 3 hours right." She said, "No because we really need to see what is going on with the puncture wound." So I said, "So what are we waiting for, pump my stomach and lets get this over with, how bad could it be, I am sure that anything is better than how it feels right now." When I said this a nurse standing over my right shoulder looked at me and her expression told me that she was about to get sick. I could tell that she knew something I didn't know and she wished her shift was already over. I told her, "Don't worry, I'm sure it's uncomfortable but the ankle feels worse." "You don't know what you're talking about you poor dumb bastard," her face told me.
The nurse measured out a length of plastic tubing from my nose to navel and then extended it slightly and got ready to fish it up my nose, down my throat and into my stomach. I asked her to use my right nostril since I had a little cut that had been bothering me in the left nostril. "I want to go home now," her face said. She had me hold a glass of water and told me to wait until the plastic tubing, which was slightly thicker than a number two pencil, reached the back of my throat. Then I should take a swallow of water to help pull the tube down my throat. A strong numbing spray was used to numb the throat. I do not have a problem with gag reflex and I have a pretty strong stomach so I thought, "no problem."
Then she hurt me real bad. For the first time since getting hurt I cursed and cried as she tried to ram this tube into my nose. "Ugh, f__k, damn," I said as my hand shook trying not to spill the cup of water. "I'm sorry, I'm sorry, I have to try the other side!" "Aaah, damnit,damnit," I whimpered as she tried to force the tube into my more narrow left nostril and I felt blood running from my nose and tears streaming down my face (my eyes were closed during this delightful interlude). Now she switched again to the right nostril and rammed it through my nasal cavities with all her strength, when I felt it in the back of my throat I swallowed some water as my hands shook so much I was sure that I'd spill the whole cup in my lap. "I'm sorry" she said again. "No problem, even though you did make me cry." I told her. As soon as the tube made it to my throat I felt much better because I knew that my ankle, which by now felt like it had swollen to 4 times its normal size, would soon be back into its joint. The stomach pumping part was not a problem but the removal of the tube did hurt. As the tube was being pulled out the doctor told me that they were going to quickly sedate me, so relax ...........
The next thing I knew, I was groggy, could not really feel my ankle and was told that the ankle was in place and I was going to surgery. I was wheeled to a spot on a hallway where an anesthesiologist told me that she was going to knock my ass out cold so a surgeon could cut open my ankle and looked around for mangled tendons and bone fragments. She warned that all anesthesia use contained risk, blah, blah, blah ..... This was the informed consent speech, as if anyone would insist on having the surgery with no sedation!
"Goodnight".
In no time I was in my room in a plaster cast and the doctor told me that he repaired two severed tendons, removed a small fingernail like piece of cartilage that had broken off my talus bone (part of ankle) and had found no actual broken bones. The surgeon told me that he made a second incision in my ankle in order to drill a small hole in the talus bone to promote bleeding which could help form new cartilage. The fact that no bone was actually broken was a very positive sign and I should make a full recovery. The bone protrusion through the skin was not a broken bone but probably part of the intact talus bone or the lower part of my fibula bone. I was told that I needed to wear the plaster splint for two weeks followed by a hard cast for 4 weeks and a soft cast for 4 weeks after that. Within six months if all goes well I should be as good as new.
I spent three nights in the hospital where the pain was worse than I expected (never broke anything before) and yesterday I finally got the heavy splint off, the nylon sutures removed, and a hard, lighter weight, fiberglas cast put on. I have been given Rush Limbaugh's drug of choice "Oxycontin" for pain management which I am using conservatively - mainly only at bedtime so I can sleep. I have found it very difficult up to now to spend anytime reading, on the computer or hopping around on crutches due to the pain and an energy level of near zero. It is finally getting better but I am frustrated about being dependent on family members for such mundane things as carrying my dinner plate to the sink.
Will write more soon. Happy Holidays.
I have not written in a while due to a pretty serious ankle injury. Two weeks ago while playing my regular Wednesday night full court basketball game with a group of guys that have been playing together for about 5 years I went down hard. I jumped up for a rebound and came down on my left foot which landed on someone's shoe. My ankle immediately rolled over and hit the floor. I knew instantly that the injury was very serious so I let out a loud yell, partly from the pain and partly to send a signal to everyone on the court to get away from me while I writhed on the floor in agony. Before even glancing down at my disfigurement someone waiting to get into the game shouted from the opposite end of the gym, "Oh god, its completely out, I can see it from here! It's completely out!" Then he ran out of the door to the gym so as not to look at my twisted foot.
I glanced down and saw that my foot, which I was trying to elevate by grabbing the back of my left knee while lying on my back, was twisted at a 90 degree angle from normal and was swelling fast. I could not see, nor did I want to see my ankle bone. Although a few players were unable to come within 50 feet of me many did come to my aid. I asked one guy to please hold my leg up while a couple of buddies dragged a bench on to the court to support my elevated leg. After this was done a discussion ensued about how to get me to the hospital. There were arguments for and against an ambulance when one friend said, "Oh no, Tom's out of work so he doesn't have insurance, we'll have to bring him to the hospital." I quickly informed everyone that I had decent insurance through my wife so that was not a concern. They briefly discussed trying to hoist me on to the bench and carry the bench out to someone's car to take me to the hospital. In the end I told them that the pain was just too intense to think about having these guys try to move me so I told them to call for an ambulance. Good decision.
When the paramedics arrived (preceded of course by a fire truck) they immobilized my lower leg with an inflatable bag and then cut my sock off and began to remove my shoe while one EMT started an anti-biotic IV and prepared to give me Morphine. Up to this time quite a few guys were making frequent comments about how stoic I was being. They were saying things like, "Tom, you're handling this great, man that looks bad, it's gotta hurt." When the shoe was removed these comments changed to, "Oh man, you are handling this unbelievably well, oh god!" I figured that this meant the bone went through the skin, which it had. The paramedics did a good job getting me stabilized in the exact position that I seemed to want to hold my mangled foot. Then after a small dose of morphine through an IV, which did absolutely nothing to dull the pain, got me into the ambulance without too much jostling and I was on my way to the hospital.
On the ride over I had lots of questions for Lori, the paramedic who rode in the back of the ambulance with me. She asked me repeatedly about my pain level. "On a scale of 1 to 10, 10 being the worst pain you have ever experienced, where are you right now?" "9-1/2, I had second degree burns when I was 9 years old that were worse." "Ok, I need to check your blood pressure between every 10 miligrams of morphine I give you." I was told that the ankle was dislocated and tendons were probably torn, and that I had a puncture wound which she could not be sure about but was a concern since bleeding and infection could cause problems. I asked if having the ankle remain dislocated for a prolonged time was a problem. She said that tendons have a "memory" and so it was always good to get things back into place quickly because that would tend to help them heal faster. The problem was that I had eaten three hours before and they liked to wait 6 hours after eating to give patients the powerful conscious sedation that they would give me prior to popping the ankle back into joint. She told me that not only was it important that I not see, or feel the ankle being popped back into the mortise joint it belonged in but it was important that I not remember it either. Conscious sedation lasts only long enough to accomplish the task but during it the body shuts down to the point where any food or liquids in my system could cause major problems. I could drown in my own puke.
When I got to the hospital I received immediate attention, which was terrific, and started getting the same questions over and over, "rate your pain on a scale of 1 to 10." "Nine." "When did you last eat?" "3 hours ago, but it was a small amount." I started getting pretty impatient and the pain was getting no better. A lot of hospital staff seemed to be interested in walking past my emergency room gurney to look at the curiously bent foot. After repeating over and over my answer about when I last ate a doctor leaned over my bed and explained for the fifth time that the conscious sedation could not be given within six hours of eating. I said, "Well you are not seriously suggesting that we leave the ankle alone for another 3 hours right." She said, "No because we really need to see what is going on with the puncture wound." So I said, "So what are we waiting for, pump my stomach and lets get this over with, how bad could it be, I am sure that anything is better than how it feels right now." When I said this a nurse standing over my right shoulder looked at me and her expression told me that she was about to get sick. I could tell that she knew something I didn't know and she wished her shift was already over. I told her, "Don't worry, I'm sure it's uncomfortable but the ankle feels worse." "You don't know what you're talking about you poor dumb bastard," her face told me.
The nurse measured out a length of plastic tubing from my nose to navel and then extended it slightly and got ready to fish it up my nose, down my throat and into my stomach. I asked her to use my right nostril since I had a little cut that had been bothering me in the left nostril. "I want to go home now," her face said. She had me hold a glass of water and told me to wait until the plastic tubing, which was slightly thicker than a number two pencil, reached the back of my throat. Then I should take a swallow of water to help pull the tube down my throat. A strong numbing spray was used to numb the throat. I do not have a problem with gag reflex and I have a pretty strong stomach so I thought, "no problem."
Then she hurt me real bad. For the first time since getting hurt I cursed and cried as she tried to ram this tube into my nose. "Ugh, f__k, damn," I said as my hand shook trying not to spill the cup of water. "I'm sorry, I'm sorry, I have to try the other side!" "Aaah, damnit,damnit," I whimpered as she tried to force the tube into my more narrow left nostril and I felt blood running from my nose and tears streaming down my face (my eyes were closed during this delightful interlude). Now she switched again to the right nostril and rammed it through my nasal cavities with all her strength, when I felt it in the back of my throat I swallowed some water as my hands shook so much I was sure that I'd spill the whole cup in my lap. "I'm sorry" she said again. "No problem, even though you did make me cry." I told her. As soon as the tube made it to my throat I felt much better because I knew that my ankle, which by now felt like it had swollen to 4 times its normal size, would soon be back into its joint. The stomach pumping part was not a problem but the removal of the tube did hurt. As the tube was being pulled out the doctor told me that they were going to quickly sedate me, so relax ...........
The next thing I knew, I was groggy, could not really feel my ankle and was told that the ankle was in place and I was going to surgery. I was wheeled to a spot on a hallway where an anesthesiologist told me that she was going to knock my ass out cold so a surgeon could cut open my ankle and looked around for mangled tendons and bone fragments. She warned that all anesthesia use contained risk, blah, blah, blah ..... This was the informed consent speech, as if anyone would insist on having the surgery with no sedation!
"Goodnight".
In no time I was in my room in a plaster cast and the doctor told me that he repaired two severed tendons, removed a small fingernail like piece of cartilage that had broken off my talus bone (part of ankle) and had found no actual broken bones. The surgeon told me that he made a second incision in my ankle in order to drill a small hole in the talus bone to promote bleeding which could help form new cartilage. The fact that no bone was actually broken was a very positive sign and I should make a full recovery. The bone protrusion through the skin was not a broken bone but probably part of the intact talus bone or the lower part of my fibula bone. I was told that I needed to wear the plaster splint for two weeks followed by a hard cast for 4 weeks and a soft cast for 4 weeks after that. Within six months if all goes well I should be as good as new.
I spent three nights in the hospital where the pain was worse than I expected (never broke anything before) and yesterday I finally got the heavy splint off, the nylon sutures removed, and a hard, lighter weight, fiberglas cast put on. I have been given Rush Limbaugh's drug of choice "Oxycontin" for pain management which I am using conservatively - mainly only at bedtime so I can sleep. I have found it very difficult up to now to spend anytime reading, on the computer or hopping around on crutches due to the pain and an energy level of near zero. It is finally getting better but I am frustrated about being dependent on family members for such mundane things as carrying my dinner plate to the sink.
Will write more soon. Happy Holidays.
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