It is a dark and stormy night, twilight. A gray, tumultuous November sky brings the clouds down low, mist-like, ominous. The dark asphalt holds a darker secret – black ice…
No, too dramatic and I can never sustain present tense. Let’s see.
All for the want of a pizza, in my defense, a “meaty-meat” from Angelo’s. Marci was on her way to a meeting in Dayton and I was on my own and, well, pizza. Cheapass that I am, I opted for pick up and was heading to get it when Bam, Slam down I fell on the invisible ice.
Too flip, I’d say. I mean. Who says Bam, Slam and capitalizes it mid-sentence?
I should have just had it delivered, I should have known the snow melt might be iced over. I would never have taken the two tremendous dives I took had I just been more careful. I could have held on tighter to the truck, maybe walked around the rear on the flat part and…
Shoulda, coulda, woulda. No, that never works either. Well, listen, here it is unembellished:
I fell.
Horrifically.
Black ice on the sloped part of our asphalt driveway. Initially, I folded my left leg under me and leaned back and it really fucking hurt, screaming, help-yelling pain. No one answered. I’d slid to the edge of the incline and realized I was on my own.
I decided, through the agony, that I needed to get to the garage. I literally crawled up using the mortar lines in the brick to pull me up sort of crab walking and cussing the pain. I slid back down once losing my grip on the wall. This was all on the aforementioned black ice, mind you.
On the second attempt, I made it to the garage near the grill, side-climbing all the way. I called, in my wisdom, to change the pizza order to delivery.
I’m in the garage now and still - still helps - but I know I need to get inside and out of the cold. I felt strongly that I might be going into shock.
I was sitting up and attempted to pull myself up using the grill. I sort of half stood on my right leg, the good one, and attempted to put weight on the left one. The pain again excruciating, I crumpled and…
… my right leg folded under me and I fell back again and the same exact white pain seared across my mind. Later I’d find out I did the same thing to both legs in less than ten minutes.
It hurt so badly that I was pretty sure I’d broken both femurs which, in retrospect, would have been better. ‘Would have’ again.
Things are beginning to get fuzzy here, remembering-wise. I called Marci and then called the paramedics. Marci called our dear neighbor, a nurse who, God be thanked, was home.
Somewhere along in here I released the leg under me and laid straight out on the cold cement, still again, quiet. I recall thinking I could just fall asleep here, give up, pass out. It would not be the last time I considered giving up.
Deb, our nurse angel neighbor, arrived and assessed the situation, she’d seen a man in shock before, and kept me talking and prayed over me. Awakened into reality again, the pain sent me over and I fell into it fully, it was awful.
I am getting bogged down in the details here. Let’s see…
Ambulance, skeptical paramedics – I was about to face a lot of that in the next hours – a slow-mo drive to Bethesda North ER, feeling every bump and turn.
Marci is there, or not, exact timing is unnecessary. They roll me to a hallway where I became “the old man who fell and is overreacting.”
What happened in the ER is a mix of pain and rudeness, cruelty and pain, so much pain.
I am getting upset here, now, thinking of it all. I’ve been diagnosed with PTSD and telling you all this is difficult but, I want to carry on. I know it’s getting long here, sorry.
X-rays are taken, no broken femurs, that’s good right? After they determined nothing was broken the skepticism ramped up.
They tried to make me stand up three fucking times, I crumpled every attempt and they tried to get me to lift my leg and kick a hand a foot or more above my leg, screaming pain.
Oh, still no pain relief for me. I am quite sure they thought I was either faking it for drugs – yes, physicians are that petty – or was just afraid of the pain.
Here’s what happened next.
THEY WANTED TO SEND ME HOME!
They simply thought I strained my thighs. I was lying there with Marci next to me just flabbergasted and shocked at this.
Nothing was happening and one of those wondering clipboard people came by, an ombudsman it turned out, and asked how it was going. Marci let them have it, explaining it all in no uncertain terms.
For this, we got a time-out. Nothing for most of an hour, still no pain meds but at least I was still. Finally, one of the ER docs came in, and literally asked us what we wanted. Marci said to admit me.
Still without a diagnosis other than thigh strain, they started the admitting process which began our wild ride in the hospital.
This is where the story turns into a surreal journey for me and the whole of it gets confused and twisted and confabulated. That’s all because of…
…opiods.
You see, once admitted, I was finally given some blessed pain relief. Oxycodone.
Most of the following is from Marci’s recollections and from texts she was sending to update friends and family. I remember most but, well, sorta sideways.
It is near eleven, I get to the room, and they immediately try to get me up three times. My legs spasm and I am only kept from falling by the nurse and aide. CT scans and/or MRIs are ordered and somewhere I pass out until Tuesday. I fell on Monday, the tenth.
Marci arrives Tuesday, still no real diagnosis but they are indeed taking my pain seriously, nurses are good about that.
I vaguely remember going for a CT scan and there being a lot of very young technicians who seemed confused by their own equipment and my situation.
I later recall a MRI with better techs but they only did one leg and then being sent back to them with a better understanding of ‘bilateral’ which was quickly becoming the word of the day.
There is roast beef, hospital style, and mashed and brown gravy and a chicken salad on plain white – favorites.
There is AFib and talk of compartment syndrome with a very large, soon to become very dear, surgeon. I’ll call him Doctor Pettit because, well, that’s his name and if ever a name should not be changed, it’s his.
Maybe Wednesday?
Yes, a bad day. My eye is definitely weird but too much is happening to worry about it yet.
AFib, more, again, I dunno know.
Cardio floor.
Dropping blood pressure. Anxiety meds. More pain meds, more confusion.
“Rhabdomyolysis is caused by muscle injury or damage, which can occur due to factors such as severe trauma, high-intensity exercise, dehydration, certain medications, and prolonged inactivity.” It’s apparently something I do not want but I'm getting into it.
Same surgeon, insanely nice nephrologist, urine looks like Coke and an undercurrent of panic.
Transfusions, three. Muscles bleeding into leg cavity.
There is talk of immediate surgery after I ‘have enough blood’ for crissakes. Maybe two – surgeries that is.
More meds, lots of kidney talk, IVs and bags hanging everywhere.
A ham and cheese sandwich. Ginger ale.
And, so much fear from Marci and me and even those attending. Looking at Marci, hand squeezes, I love yous, next day, tomorrow or maybe just new today…
Saturday, Sunday, surgery, who knows?
Bilateral repair of detached quadricep tendons. Blood loss and long surgery, all explained to us by the sweet surgeon who gives my wife a hug.
I’ve no idea what he’s saying. I notice my legs are wrapped, cast-like but with gauze. The pain is body-wide and very inclusive, but the meds don’t care. Opiods don’t make the pain go away, you just don’t give a fuck about it.
Stable comes up. That’s good right. And Sunday it is.
I don’t know. My mind is failing in and out, things don’t make sense, nurses are kind. Turkey with that oddly yellow gravy and mashed potatoes.
Everything hurts it seems.
Monday, the day after surgery, after a long overnight recovery, is gone in my mind really.
Tuesday there is a wild ride on my gurney to an ophthalmologist - a fancy one – where an extremely well-dressed doctor in Gucci shoes shines very bright instruments in my eyes and mentions optic canal bruising and things. She was not pleased that a gurney and two attendants and Marci and a very sick-looking old dude were in her high-end waiting room. She dealt with us quickly and in the waiting room I might add.
Again, lost time but I am becoming more and more addled and frightened.
I am given a Lunesta before bed. Not cool.
I begin to hallucinate and get very paranoid, and I secretly call Marci and they also call and I hide my phone and spies and paranoia and… well, I just basically freaked out, too many drugs and too much pain and fear.
Thank God, Marci arrives.
“Hospital delirium” it's called.
On Wednesday I am still freaking out but they are talking about discharge to a rehab hospital, so I try to remain cool.
And they do transport me to a rehab hospital where they will put me in braces and monitor the pain and make me do PT and OT and the therapists are lovely and I cry a lot. I huge release of the crazy that was and the work that must begin.
My recovery is another story, I guess. Will I tell it? I am not sure; it’s been difficult and consuming and so very painful.
I will tell you that after visual field testing and a retinologist and finally a neuro-ophthalmologist, I was diagnosed with a seventy-five percent vision loss in my left, and dominant eye. Something called NAION or “Non-arteritic anterior ischemic optic neuropathy”, a serious eye condition often called an "eye stroke." It happens when blood flow to the front part of the optic nerve (the optic disc) drops or gets cut off, leading to sudden damage. This a result of the extreme drop in blood pressure when I bled out into my legs and suffered from the rhabdo. What fun, it’s most likely permanent and could happen to my other eye.
Yep.
I walked for the first time, in braces, the horrid, dreaded braces, on November twenty-fifth. I left the hospital rehab on the seventh of December. I was able to drive a car by my birthday and took Medicare in March.
I’ve had, at least one hundred and thirty therapy sessions, probably more. I was finally sent on waivers a few weeks ago so, the therapy is on me now. Just this evening I showed Marci that I could go up our ten steps without my cane. That’s big.
Oh, right, the cane(s). I started in a wheel chair where my legs extended like a ramming rod, went to a walker through hospital rehab, next, two canes and now one, which I must say will most likely be a permanent affectation. I’ve a lovely ash one with a silver ring.
The emotional and mental strain has been significant, to be true. The trauma and the violence and pain of it all is a hard carry. Therapy and medication has helped and I am doing better, not best, but better.
Two final thoughts and then I’ll let you go.
I think this has been harder for Marci than for me. What a terrible thing to watch, suffering and misery in your loved one. I am so sorry, dear one.
Ultimately – and I am glad you stayed to hear this – I think that this has been a positive(?) experience. I’ve been thinking on this for, well, probably a year now. When that thought first popped into my head I laughed and glared and it left. Now, all these months later, I have begun to welcome it.
I encountered so much kindness from the teams (except for the ER fucks) of medical folks everywhere I went. Nurses, aides, hospitalists, techs, surgeons.
I saw genuine encouragement and sincere pleasure at my gains from the PTs and OTs. These are very special people rebuilding very broken lives.
I could see the courage in my sons and Marci and those many folks who helped and suffered with, perhaps for me.
And, I saw courage from a most peculiar place: myself.
I have done things that I would never have guessed I could do. I found a way in my imperfect self, my scared self, my wounded self, to continue.
I am not sure the path I was on - leaning into Elderhood and easing out of life into the safe lane - would have been best for me.
I am better and more patient and kinder and courageous than I never thought I could be.
All for want of a pizza...
Thanks to you all, everyone who thought of me, all those thoughts landed.
As always, peace.
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