Next Steps: The Plan

Post-op, 8:30PM Saturday

I awoke in the recovery room briefly, like a dolphin surfacing for air. Three brightly chattering lights orbited my head, nurses, asking if I knew who I was (mostly) or had pain (not much). I wondered mildly if I still had a leg, didn’t care much either way.

That’s a sign they’re giving you the goooood drugs.

On Friday night, Sept. 16, 2016, I fractured my left femur just above Elmo, my replacement knee. I lived in a wheelchair, facing hip-high amputation of my left leg, for about two years while I fought health care bureaucracy, cost-conscious HMOs, and myself to figure out a way to walk again. (Spoiler alert: Elmo won!)

I documented my adventures in remobilization in this blog. They’re awfully self-indulgent, occasionally icky, and probably only of interest to me, but on the off-chance that they help someone else with a catastrophic injury, I’m keeping them together here. If you don’t want to read them, that’s OK; I still love you. If you do, you might want to start from the beginning, on the archive page that lists all posts.

I slipped back under, and emerged in my room. The Kaiser Westside orthopedic rooms are electronic marvels, with floating computer/Internet connections and a giant LED screen on one side to tell me who I am, who’s bustling about with my body parts, and my goals for the day:

1. Rest and heal
2. Rest and heal
3. Rest and heal
4. Rest and heal

More than happy to comply. It was a little more than 24 hours post-fall. Happy crashiversary, Elmo…

I peered blearily across the room and saw Mom making a berth on the room’s sofabed, lying down to sleep. Kaiser kindly allows your caregiver to sleep on a sofabed in your hospital room, and Mom did just that during my knee replacement. She says it’s better to sleep on top of the sofa than risk your back on the pull-out bed.

Me, I just slept. The nurses woke me up occasionally to check my vitals, cluck over my lack of oxygen (Dilaudid and I don’t get along), and put the oxy tubes back up my nose.

Sunday, September 18: Letting go

Glorious visitors. Beloved family, Westside nurses who’d taken care of me before, with my knee surgery, and my wonderful, wonderful friends. I flung witty repartee around the room: Lola and Nikki and the house and work and what was going on in the wide, wide world.

I think.

More likely, I was too blurry (Lord knows I can’t remember who all showed up) and those kind, nodding faces were just humoring me. Even awake, the world beyond my bed didn’t really exist.

People with severe nearsightedness have a luxury denied you fully sighted people: We can take off our glasses and make the world go away. I didn’t even have my glasses, so my eyes drew a curtain of calm around my bed.

My brain became a zoom telephoto, narrowing my field of vision to only what I could handle right now. IOW, mostly Elmo. It slid me back to sleep like grease slipping down Teflon if I tried to contemplate, say, the shape of my new back patio, or the product taxonomy I was supposed to be doing for work.

Teflon thinking was terrifying when I’d had knee surgery; now, I understood and welcomed it. I knew that when I was ready, my brain would bring them back.

So…concentrate on critical, let everything else go.

The cats: I’d texted Tami from the ER on Friday night, asked her to feed Lola and Nikki. Carol volunteered, too, and later Bob, so the cats and house had a whole brigade of helpers. Catfood and other supplies wouldn’t run out until I was lucid, and could order more.

The cats are OK, you can let that one go (thanks, dear friends).

My car, still sitting at the Beaverton MAX station; Kaitlyn and Aaron volunteered to return it to my driveway.

Car is OK. Let it go. (thanks, guys).

Other injuries. My leg would be encased in layers of medical stuff, not much to see. As for ancillary injuries I’d sensed on Friday night; a painful ankle, tender chin, sore left wrist…

If they think it’s serious, they’ll tell me. Let it go.

Contractors. I’ve got a lot of renovation going on at the house, but my contractors are nice guys, and I am the money. I can pace this as necessary.

Let it go.

Work. I’ve texted my boss and team-mates, told them where pertinent files can be found. They’ll take it from there until I can slide back into the routine.

I’ve got a great team, great people, great friends. Let it go.

Morganica. I know there will be story after story coming out of this. I should document it, get it into the blog, because I’ll want to read it when I’m lucid.

Are you nuts? Later. Let it go.

Electronics. Tami and Kat and Aaron brought my iPad Mini, and gave my laptop to Mom. They couldn’t find the right transformer for my Android phone (it needs a USB-C), so Aaron donated his. (Thanks)

You’re connected. Let it go.

Next steps. STOP. Don’t let this one go. What does “long, slow recovery” really mean and how do I do it?

Dr. Kroger said he was happy with the surgery. “It went really well, we accomplished what we set out to do, but…” hesitating, “The bone was a lot more fragmented and crushed than it looked on X-ray.”

“I think we’re looking at eight weeks or more for healing,” he said, “We added plates and rods to hold bones together around the implant, and filled in the gaps with bone graft. There were, ” and he brought his forefinger and thumb together to make an opening maybe the size of a quarter, “some pretty big gaps.”

“So we’re still on the same course, but it’ll be slower recovery, eight weeks minimum. The social worker will be in to talk about that part,” he said, looking serious, “We’re going to send you to a skilled nursing facility for the next couple of months.”

“Remember, The Leg must remain absolutely steady, non-weightbearing. Don’t do anything that will jar the site and interrupt bone growth.”

Well, it’s not like I was planning to turn cartwheels, Doc… “I understand. At least 8 weeks of rehab.”

Picture me, in a wheelchair, toiling like Sylvester Stallone in Rocky, getting stronger and stronger until I beat up all the bad guys. 56 days of nothing to do but the gym? I’m gonna look like Ahhhhnold. With breasts.

The social worker popped in, bright, cheerful, and rushed. “Where would you like to go?”

“Home? To the bathroom? Wait–you want to discharge me NOW?”

She giggled. “Not today, it’s only Sunday, you’re hardly over your surgery yet.”

Whew. I laid back and focused on NOT moving The Leg.

“Monday or Tuesday.”

Tomorrow?

“Here’s a list of post-op facilities paid for by your Kaiser insurance; I need two choices in case one doesn’t have a bed. You have zero co-pay so don’t worry about the price, but the transport to get there is out of your pocket.”

“I’m not…I need…Can I take some time to research…”

“Certainly! Sure! Take all the time you need! I’ll come by this afternoon!”

Joseph, on my medical team, breezed in. I liked everyone at Kaiser (except maybe that overamped social worker), but Joseph and I were kindred spirits. He dealt humor in my situation where most everyone else dealt reverent pity.

“Hey, Cynthia,” he grinned, “Guess what? I get to give you your first ever glimpse of your expensive new leg decorations.”

Huh?

“We’re taking off your brace–you mean you haven’t even TRIED to look? I’m surprised. Let’s see if there’s any leg left.”

I grinned. This was why I liked Joseph.

He laid out scissors, a big red biohazard trash bag, some forceps and other tools, filling up my little bedside tray. He peeled back the covers, moved aside a bunch of tubes and wires (catheters allow you to just lie there while vacuum-sucky things dispose of bodily fluidy stuff), and introduced me to Hector.

Hector the Protector

AKA “immobilizer brace,” Hector the Protector is the modern-day equivalent of a plaster cast and kinda like my old knee brace, except that he never, ever bends.

He’s a charcoal grey concoction of Velcro, foam, and stabilizing bars, quite comfortable, really. Joseph pulled away Hector’s Velcro braces, gently folded back the flaps, and revealed enough batting to make a king-sized quilt.

“Whoa,” he said, obviously impressed, “I’ve never seen THAT much batting on a single leg before. Well, it’s all got to come off…” and he determinedly set to work.

He unwrapped. And peeled. And unwrapped, halfway filling the whole hazmat bag.

“This may never end,” he sighed, but of course it did. Underneath, there was a big black sponge embedded in the top of my knee and a lot of aquacell (this very cool silicone-like bandage you can even shower with). The sponge, Joseph explained, was attached to a drainage vacuum thing, busily sucking out the nasty.

“But you’re not sending it much to eat anymore,” he said, pointing to a near-empty tube, “So we can take it out.”

Ouch. I slept.

The Fortress

Finally awoke around lunchtime Monday. “All set!?” asked the social worker, “We’re transporting you to the new facility at 4:30!”

Great, I’ll just hop over to my closet and pack a bag, lady. Call room service to get my things.

I felt dispossessed, disconcerted, disgruntled. They’d (gently) yanked my catheter, treated me to my first ever bedpan experience (something I would absolutely wish on my worst enemy). A rollicking ambulance ride to Vancouver during rush hour seemed the perfect cap to the day.

Color me grumpy, with a shading of terror.

One of the nurses ran after us with a gorgeous vaseful of flowers and balloons. Absolutely no name on the card. “She can carry them,” the driver decided, handing me the vase, “She can hold it on her lap in the wheelchair.”

In the wheel...”Wait, you’re not taking me in a gurney, lying down?” This was my first time in a wheelchair since the surgery; just sitting up in bed had me considering trading in my rump for something in a size “comfortable.”

Driver Dan smiled, “It’ll be fine, you’ll see.”

And it was. They wheeled me downstairs, past the grand piano and the smiling doorman, propped The Leg on extra pillows, and ushered me up the liftgate. They bungee-corded me into the back of that van like a fly in a spider web, and we spent the next hour and whatnot on the road.

Driver Dan told jokes–bad jokes–to set me at ease, asked about my family, and softly, softly told stories I never heard because I fell asleep. When I awoke he was parking on a narrow side street; Mom was waiting with my scant possessions.

We wheeled into The Fortress, a nondescript 60s-looking building; Driver Dan asked for my stateroom (26-Door). A bunch of folks transferred me gently into a hospital bed, answered Mom’s anxious questions, made sure I was ok (yep, well, mostly), and set my flowers on a nightstand I couldn’t reach.

A nurse named Andrew asked me a bunch of stuff, did what’s called a “skin check,” handed me some literature, explained things that I promptly forgot. He had the patter down, hadn’t been on this earth long enough to temper it with hard-won compassion.

He gave me a hard shot in the belly (an anti-coagulant, because bedridden folk tend to throw blood clots), and asked if I was hungry.

“No, not really.”

“We’ll get you dinner directly,” he promised. He was a nice guy who kept promises. I got dinner.

Thank heavens I’m not hungry but please, tell me this isn’t what I’ll eating for the next two months…

My new neighbor snored in the next bed, behind a curtain wall–26 Window–while my eyes grazed the room. Beige wall with a TV and writing on a whiteboard, too far away to read. Beige curtains. Beige closet. Beige furniture. Beige bedclothes.

I’m slipping down desolation path here. Beam me up, Scotty.

How do I “recover” in this place for eight weeks? Would they do what they did with my Alzheimer’s-ridden dad, wheel me into a corner, let me fall down, and leave me to rot among the filthy clothes piled on the floor? (OK, the rotting clothes are pure hyperbole; at the moment, my entire wardrobe consists of a hospital gown, Lafayette 148 jacket, and a tomato-crusted tee.)

8 weeks. 56 days.

One of the surgeons told me not to be afraid of The Leg. “You’re going to make a mistake every once in awhile, accidentally touch a toe to the floor. Relax. It’ll heal. You’ll be fine.”

1 down. 55 to go.

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The Saving Elmo series covers my adventures after crashing to the ground on Elmo, my replacement knee, sustaining an “open, comminuted fracture of the left femoral shaft.” It’s a tad more dire than it sounds; if my bone doesn’t grow completely back and return me to normal function, there’s a new, more painful, less effective femoral replacement in my future…with eventual amputation. You can view the entire story series (there are a LOT).