Friday, 25 April 2014

The recovery has a delayed start

Strikes me that if I'm stuck here in bed for the next 12 weeks, I may as will bring you on my journey.

When last we left, I was discharged from the hospital on the morning of Sunday April 20, a day later than they thought I would get out. I went home via my pharmacy to pick up drugs and ask a bunch of questions. I was on 2 percoset every 4 hrs (plus gel ice packs), and got home in time for the noon dose.

As the afternoon progressed, I struggled to get comfy, and had to move a few times. My pain was climbing through the 3-4 range. The 4 PM pills didn't improve things. A friend came over to make us dinner, and by dinner time at 8 PM my pain was up to about a 7. I joined them at the table, leg elevated, and started to feel a lot worse. Immediately after dinner I laid down, and the pain just continued to get worse. The 8 PM pills achieved nothing. The pain after dinner was at a 10 and I was in tears.

At 9 I broke down and called our Provincial nurse on-call service. They took my info and said "get thee back to the hospital NOW". I was there just before 10, and taken immediately into an essentially empty ER. The on-call doc came and looked me over; because of massive swelling below the knee, he was extremely worried that I was showing classic signs of Compartment Syndrome, a very bad complication. So worried that he called in the on-call ortho doctor and an entire OR team to start getting prepped.

Around 11:30 PM, the team was there as was my ortho doc again. Ortho Doc 1 (the one who did my surgery) wasn't so sure that it was Compartment Syndrome. To test, he constructed a medical barometer, drilled a hole into my muscle compartments with a horse needle, squirted in some saline, and watched it rise in the tube as it squirted back out. I was at the extreme high end of normal pressure. Since Compartment Syndrome surgery is very invasive, he didn't recommend it, but did want me to stay.

It was an uncomfortable night with a whole lot of morphine. The pain came down to some manageable levels, but spiked in the morning, and I spent an hour or more at an 8-9 pain level around 8 AM during an ice bag change. Ortho Doc 1 was off for a week, but his partner Ortho Doc 2 came to see me first thing. He wanted me to start working my muscles to get the swelling down.

In came Physio Lady around 10 AM Monday to give me a list of things she wanted me to do, one of which was to increase my leg's elevation. She stuffed a huge wedge under my leg, and I started limited range of motion work. Within 2 hrs, my pain was off the map and I had used up all my self administered morphine. We pulled the wedge, and things took a couple of hours to get manageable.

In the middle of the day on Monday (while things did not feel that good), I saw a note from someone at the Friends of Kananaskis. The newsletter, for which I was responsible, and for which I had spent ~6 hrs getting ready to release the week before, and trained someone last month to release without me, was "done", and ready for final checks. I looked at it. It sure wasn't what I had put together. I talked to the person who worked it; they had made a mess and tried to recover, teaching themselves in the process. So I scrambled for an hour on-line through a slow connection on my iPhone's personal hotspot to fix it. I got the most egregious bits fixed, and got a lot of frustration in the process. This got Ortho Doc 2 mad at me, telling me at one point to "put down my computer and get better". Very frustrating since I put in so much effort to make sure this exact experience wouldn't happen, and trained someone exactly how to do it (someone else unfortunately did it instead, though I have to acknowledge they tried to step up and help).

I had a couple more pain spikes on Monday in the evening, including one call to the nurses for help -- though there's really not much they could do other than tell me I had pumps left on my morphine. I had hopes for a half decent night's sleep but it wasn't to be. I got a couple of hours between 4 AM and 6 AM and that was pretty much it. The morphine, I had concluded, wasn't controlling pain, but it was putting me to sleep.

I was cleared to shower on Tuesday morning. It was a complicated and painful procedure. Even shaving required hedge trimmers. I was a mess, and pretty sure I didn't smell all that good. Cleaning up made me feel much better.

And I got visitors Tuesday, so it's a good job I showered. Among others, my friends Don and Helen drove from Invermere to Calgary, bought Karen and me a take-out dinner from Lina's Italian Market there, and then came back to Banff to visit! The food at the Banff Mineral Springs Hospital is fine, but real food was a treat. Plus, the hospital serves dinner at 4:30 PM (4 hrs before my normal dinner time). Karen and I picnicked in the room at a reasonable 7 PM. My pain was mostly under control, Ortho Doc 2 happy with my progress (so long as I didn't spend time working on my computer). We discussed weaning off the morphine and moving to percoset again with the nurse. After Karen left, I got a nap, then at 10 PM the morphine drip was disconnected. At my midnight check, the pain was growing, but manageable and I was wide awake. I mentioned that I missed the morphine because I could have used it to go to sleep.

That's when my nurse mentioned that I had been prescribed Ativan, a sleeping pill. Sure, tell me now. At 1:00 AM, I took them, and the next thing I knew... was 7:30 AM Wednesday. I didn't know where I was. I was awoken by an oriental lady in a mask taking my blood. It occurred to me I had been kidnapped. I looked at my phone and knew from the display I was still in Canada. My leg was heavy and weighed down by bags; I couldn't move it without it hurting, and I didn't know why. I opened the drapes a bit with a crutch I found leaning nearby and looked out and saw trees and mountains. I couldn't imagine where in Canada had trees or mountains. It was quiet, and the room was a bit of a mess. I thought I was being held by Chinese invaders in a disused closet full of junk.

One of the side effects of Ativan is hallucinations.

It only took a half hour to figure out where I was and what I was doing there. Unique. Karen called at 8 AM and told me I sounded "chipper". The next 2 hrs is a bit of blur. Another of the of the side effects of Ativan is memory loss.

At 10, Karen arrived, and back to normal, I showered myself, and by 11, was ready for discharge -- except the hospital wasn't. They forgot I was being let go. I needed prescriptions to take home, and so there was a bit of a scramble to get those.

Home, fed real food, struggle to figure out how to be comfortable, and how to do stuff I needed to do to live. Wednesday night was a full of experimentation to figure out how to sleep, exacerbated by 1 AM and 5 AM wake up calls for meds, plus my cat visiting at strange hours to inspect and climb on this leg sticking up in the air where he usually slept.

Thursday morning Karen and I had a meeting regarding "stuff" we still have to do. We still have Africa flights to cancel, including the flights there and back. My roof is still leaking, due to skylights that need fixing. I still have to do our taxes. I was supposed to go to meetings this week, basically none of which I can physically make (Wildlife Ambassador training, Bow Valley Stewards project planning, Condo Board AGM, monthly Friends of Kananaskis Board Meeting, among others). And it doesn't help that I'm personally only running at 20% efficiency at accomplishing things.

Last night's sleep was better. We moved the med timing forward a bit, so for my early meds, I had not fallen asleep yet. I was ensconced in sleeping when at 3 AM...

...the cat came in. With a mouse he had caught.

I wrote last fall about us getting in an exterminator to get rid of our mice. They normally offer a guarantee of no more mice after their work is done, but couldn't in our case as they did not have access to see 100% of our foundation walls around the house because of a particular deck being in the way. We caught a mouse on April 12, and got the exterminator dudes to come back on April 15. They found another way for the mice to get in (that they should have found last time) and sealed that one up, too. So having another mouse show up (that my stupid cat could catch) was not on my list of "things to do". Now we have to get the exterminator dudes back a 3rd time.

Welcome home. Only 5 more weeks of zero weight on my leg.

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