Tuesday, December 17, 2019

#Nostalgia #Football #Injury A ruptured Spinal Disk and Giant Snowflakes – Part 9

Giant snowflake from Disney's Journey Through Inner Space attraction. Circa 1967. Read on, McDuff!

In Part 8, I described the first time I walked after my spinal fusion surgery. It's a good lead-in for this part if you haven't read it yet. Here's the link to that post.

 When the nurse came in with my 1:00 PM shot of Demerol, I asked if I had to have it.

“Are you sure? Most people don’t want to skip any doses until the fourth day or so.”

“It really doesn’t hurt that much,” I insisted. I was glad it hurt so much less than before that the idea of even less pain didn't mean anything.

The nurse looked skeptical, but she left. Everything was fine until about 4:15 PM. Then, my back began to ache painfully. I pressed my “call nurse” button.

“How can I help you?” the nurse responding to my call asked.

Aside: This is a different nurse from the one who did not give me the 1:00 PM shot. There was a shift change at 3:30 PM.

“Let me check,” she said. She returned with a syringe in hand. “It’s a little early for your next shot, but you’re a big person, so it should be okay.” She administered the Demerol.

For those of you who don’t know, Demerol is a narcotic. It is highly addictive if abused. It is stolen from hospitals because of its hallucinogenic properties. It’s also very effective at relieving pain. And relaxing the body.

Within seconds, it felt like my body was merging with my mattress. All pain was either gone or forgotten. I lay there enjoying the feeling for a bit. Then I closed my eyes.

Aside: A new ride at Disneyland at that time was Journey Through Inner Space. The essence of the ride is being miniaturized until you travel inside a molecule of water frozen in a snowflake. There was a myriad of GIANT SNOWFLAKES displayed in the waiting area viewed during the beginning of the ride.

You know how when you close your eyes, sometimes there are flashes of color? Well, it was almost Christmas, and the colors red and green were prominent all around San Diego. I saw red and green when I closed my eyes…

GIANT RED AND GREEN SNOWFLAKES! 

And, they were falling through the ceiling! 

I opened my eyes. The snowflakes disappeared. I relaxed even more. I closed my eyes again.

Once again, 
GIANT RED AND GREEN SNOWFLAKES 
were falling through the ceiling!


My eyes snapped open. The snowflakes disappeared. Now I could see myself lying on my hospital bed.

My eyes said, “Look! There you are laying in your hospital bed.”
My brain countered with, “Don’t be stupid! You are lying in your hospital bed. You can’t see yourself!”

The debate between eyes and brain raged. I tired of the argument and closed my eyes.
GIANT RED AND GREEN SNOWFLAKES 
were falling through the ceiling and getting closer to me!

Opening my eyes, this time, revealed me lying in my hospital bed. After repeating the mental dialog described above, I decided to ring for the nurse. 
I reached for the call button. My arm moved maybe an inch. It was obvious that the Demerol had relaxed me very well.

Over what seemed like the next hour (but was probably a couple of minutes), I repeated the closed eyes 
GIANT RED AND GREEN SNOWFLAKES 
falling through the ceiling and open eyes watching myself lying in my hospital bed cycle over and over. Until, finally, my hand reached the call button.

Now certain I was schizophrenic, panic struck! I pushed the button and held it down.

The nurse who gave me the shot of Demerol appeared at the door. I shouted a warning.

“WATCH OUT FOR THE GIANT SNOWFLAKES!”

The blood drained from her face. She turned and, based on the sound of her footsteps, she must have sprinted to the nurses’ station. Her return was quick.

Aside: I’ve not verified the facts in this Aside. These italicized paragraphs are based on what I remember. If the facts aren’t true, I don’t want to hear about it. What I remember makes for an explanation of the events that I understood then and still makes sense.

I remember being told that the body metabolizes Demerol quickly. As with many narcotics, it requires increasingly larger doses over time to ensure the desired effect. For that reason, each of my shots was customized to be slightly more potent than the previous dose. 

 December 2019 UPDATE. I told this story to the last group of nurses in the "Technical Writing" class I teach for PLNU. They verified that this is how Demerol works.

Assume my first dose of Demerol was given around 5:00 PM on Friday, December 20th in the Recovery Room. Also, assume that I had a shot every four hours from that time until 1:00 PM on Sunday, when I’d declined the offering. That means the shot I skipped was shot #11. Since I’d missed a shot and nearly eight hours had passed since my previous shot, I could have received the same dose as shot #10, which would have been effective. Instead, the nurse gave me my shot #12. That was two dosage strengths more than I should have received. Hence the hallucinations.

She sat beside me and held my hand for almost two hours. She alternated between agreeing that I was lying in my hospital bed, saying “I’m so sorry,” and dodging imaginary 

GIANT RED AND GREEN SNOWFLAKES.

I finally went to sleep. 

The next day, she told me that she hadn’t checked my chart before she’d given me the shot.

“That you would have skipped a shot never entered my mind. Nobody’s ever declined a shot after an operation like yours before.”

I left the hospital one week from when I entered. They kept me an extra day because I was running a low-grade fever. They finally decided it wasn’t bad enough to extend my stay.

Leaving the hospital with the fever proved to be an unwise decision. But, that’s for another blog, which details the of the post-catheterization mentioned in Part 8.

Also, in another future blog, I'll chronicle my follow-up spinal surgery:  Laminectomy & partial discectomy. 
It was done in 2005 to relieve pressure on my sciatic nerve.

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Sunday, December 8, 2019

#Nostalgia #Football #Injury A ruptured Spinal Disk and Giant Snowflakes – Part 8


Giant snowflake from Disney's Journey Through Inner Space ride. Circa 1967. Read on, McDuff!
When last we left our intrepid hero…

Disclaimer: The events reported in this story occurred in December 1968. Some liberties may have been taken in their sequencing. It all did happen, but maybe not in this order.
Note: There are three links to more information or illustration of events. I encourage you to explore them, too.

Once in my room, nothing of consequence happened until the next morning. During “rounds,” my surgeon, Dr. Laughlin, came in. His first words were, “Well, I guess it’s time for you to be up and around.”

I’d heard stories about spinal surgery. Weeks in bed with a massive cast. Horror stories of bathroom incidents. I knew I didn’t have a cast on. 

“Um, I don’t think I should be getting up yet,” I said. “You just did surgery yesterday. When do I get my cast?”

The Doctor raised his eyebrows and flipped open my chart.

“You won’t be getting a cast. I wanted to replace your ruptured disk, but your vertebrae are misshapen. So, I elongated the incision, shaved some of your pelvic bone, and fused your 5th lumbar vertebrae to your sacrum.”

An Aside: Later in life I saw a film [a film is a video precursor] of a different doctor doing my surgery. He took a hammer and chisel and began to beat on the pelvis and lumbar vertebrae, something like the reverse of this video footage. After cracking both bones, he took the slices of pelvic bone placed them on the damaged bones and sewed the patient up.
One screw is in L5, the other in the Sacrum in this photo of how they do spinal fusion now. Imaging a picket fence made of bone fragments in place of the screws. That's what I have.  

I wasn’t in a lot of pain at that moment. But, that was mostly the result of the heavy-duty pain meds. I realized how strong they were only after seeing the film of the operation. Cracking bones with a chisel causes pain!

“What about a brace?” I asked.

“You have a brace from before, right?”

I nodded.

“Just use that once you’re out of here. I’ll be back to tomorrow and we’ll get you out of that bed.” With that, he was off.

Every four hours I received a shot of Demerol to control the pain. More on that later— the illusive snowflakes are involved. The biggest event of the evening revolved around urine. More accurately, it revolved around the lack of urine release on my part.

I don’t know about you, but I don’t tinkle very well while lying down. Actually, I don’t tinkle at all. I hadn’t tinkled once since before my surgery the day before. By mid-afternoon, my bladder was FULL. I was given a bedpan. It remained dry. After another hour, even Demerol wasn’t masking the discomfort.

Long story short: They inserted a catheter and drained my bladder. 

Longer version: I knew exactly when the catheter reached my bladder. The relief of urine exiting is difficult to describe. Suffice it to say that I still remember it. Unfortunately, as is common in hospitals, that procedure led to unexpected consequences. More on that in a future blog series.

The morning after the use of the catheter, Dr. Laughlin entered during his rounds. He had the same opening line as the previous day.

“Well, I guess it’s time for you to be up and around.”

Again, I replied, “I don’t think I should be getting up yet. You just did surgery two days ago.”

The Doctor raised his eyebrows and flipped open my chart.

“Yep. It’s time to be up and moving. Let me show you how to sit up.”

With that, he looked at my roommate’s bed. My roommate was an elderly man suffering from leg thrombosis. They were afraid a blood clot would break loose and become an embolism. That could lead to brain damage or kill him, so they check his vital signs every two hours. That’s okay in the day, but nights were hard to sleep through. 

Dr. Laughlin unceremoniously shoved my roommate across his bed against the wall with a thud. Then he lay down on the mattress and demonstrated as he narrated.

“Turn on your side. Bend your knees. Use the arm under you to push yourself up while you pivot on your hip. Be careful to keep your back straight.”

He jumped off the bed and came to mine. He helped me through the process. Then he watched me do it. Then he left. 

I’m sitting on the edge of my hospital bed. Legs dangling. I don’t know what to do.

The diminutive nurse came in. Notice how I avoided the potentially in appropriate term short once again?

“So, it’s time to get you out of bed. I’ll bet you’d love to go to the loo by yourself.” 

The term loo was my first verification of her accent as English.

“Okay.”

She moved until she was standing directly in front of me. Without hesitation, she grabbed my hands and place on one each of her shoulders.

“Now slide up to the edge of the bed.”

I did.
“Good. Now use me as support and ease yourself off the edge until your feet are on the ground.”

I hesitated, but eventually complied.

“Now take a step.”

I carefully slid my right foot forward.

“Another.”

I carefully slid my left foot forward. And stopped. Something was different than before my surgery!

“Does it hurt?” she asked.

I had to think for moment before I realized—I wasn’t noticing pain. It was the LACK of pain that stopped me. My disk ruptured in early September of 1968. It was now December 21st and the first day I’d had no pain when moving my leg.

“No,” I said.

“Then why aren’t you walking instead of sliding your feet along the ground. Just walk. If you start to fall, that’s why I’m here.”

I looked at her. Under five feet tall. No more than 6.25 stone (100 pounds). I’m 6’ tall and 13+ stone (210 pounds).

“You realize that if I fall on you, you’ll suffocate before they’ll be able to drag you out from under me.”

She laughed.

“Don’t lose the ship for a ha’penny tar,” she said.

I was lost. It showed. She continued.

“It’s an English proverb from the time when ships were built of wood. To make them water tight, the builders would coat the interior below deck with tar. 

Unscrupulous builders would use the least amount of tar possible to appear the hold was tightly sealed. But, before long, the ship began to take on water. Many sank and men died.”

“Oh,” was my snappy retort.

“It means to do what needs to be done when you need to do it. Just walk and all will be fine.”

I did. It was.

Weather forecast for the Part 9 blog post: Snowflakes coming!


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Tuesday, December 3, 2019

#Nostalgia #Football #Injury A ruptured Spinal Disk and Giant Snowflakes - Part 7


Gurney circa 1968. Read on to find out why I was glad it had a foot board!

Part 6 ended with...

When I got a nurse’s attention the next time I awoke, things happened rapidly. 
  1. There was some accusatory discussion of who was responsible for my armboards still being attached before they were removed.
  2. I got water to sip through a bendy straw.

  3. I was shipped out of the Recovery Room.

 Let the saga continue!

I have to comment on #3 above. Remember, my day started before 7:00 AM with the not quite strong enough pre-anesthesia shot. By the time I was leaving the Recovery Room, it was close to 3:30 PM. At that hospital, 3:30 PM was when the day shift left and the evening shift took over.

I was on a gurney. A nurse and a male orderly were ordered to take me up my room on the 5thFloor.

Gurneys are not easy to steer. It’s common for the person at the front of the moving gurney—the foot of the bed—to be nothing much more than the propulsion device. (S)He pulls the gurney through the hallways. Steering was relegated to the person at the back of the gurney—the head of the bed. In this case, the orderly should have been at the head of the bed with the nurse in the steering position.

However, since it was time to go home, the quicker I got delivered to my room, the faster the orderly would be able to leave. He took the head of the bed. Having limited if any experience at the foot of a moving gurney, the nurse protested. The orderly prevailed. He began to pushthe gurney.

It was immediately obvious to me, as passengeron this rolling bed, that the nurse lacked precision control of the gurney from her position in the leading end of the gurney. Everyone in the Recovery Room became aware of that within seconds.

As we neared the double doors to the Recovery Room, the nurse darted away from the gurney to push the automatic door-opening button. That left… no one steering. 

The gurney hit the door frame at full speed. I slid down the bed with my feet clanging against the rail at the foot of the device. Remember, I’ve just had hours of back surgery.

The silence was immediate but short-lived. The Head Nurse of the Recovery Room spotted the departure from standard protocol. She informed the orderly that he and she would be having some one-on-one time before he left for the day. I sanitized that directive a bit. Okay, more than a bit.

After rearranging the driver and propeller, we made it to the elevator, up to the 5thFloor, and to my room without further mishap.

I was larger and heavier than most of the 5thFloor patients. After one feeble attempt to slide me off the gurney, there was a “y’all come” call for help in moving me from the gurney to my bed. Within minutes, five nurses and the orderly had arranged themselves three on a side.

Moving a patient from a gurney to a bed requires the two beds be placed side-by-side against one another. Half the movers reach across the patient’s in-room-bed and grab the sheet on the closest side of the gurney. The other half of the moving crew stands next to the gurney and grab the other side of the sheet.

After the obligatory, “One. Two. Three!” the movers on the in-room-bed side lift the sheet and pull the patient toward them. Meanwhile, the movers on the gurney-side lift and reach across the gurney as the patient rides the sheet onto the in-room-bed. That’s the theory.

5/6 of the movers were tall enough to perform the requisite actions. Mover #6 was a nurse who might have been 5’ tall if she measured her height in the morning in her nursing shoes. She was stationed on the gurney-side of the tableau and was responsible for the corner of the sheet closest to my right ankle.

Understand that the nurse in question was not on the in-room-bed side because the couldn’t reach across the bed, grab the sheet, lift and pull. She lacked the vertical dimension required for that. If you think about it, after the patient is moved, the people on the gurney-side end up in the starting position of the people on the in-room-bed side. 

I’ll wait while you visualize…
…
…

Okay, if you don’t have that visualization by now, you might never get one.

As I was pulled off the gurney, about halfway on to my in-room-bed, the vertically-challenged nurse lost her corner of the sheet. I kind of bounced into my final resting position.

Part 8 had another episode with the short nurse very near the beginning.

Oh, yeah. 
I GUARANTEE snowflakes in Part 8!
or 9

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Follow me on 
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My Blogs
Life as I see it. Topics rotate between those of general interest to lovers of life,  authors, teachers—probably you, too.  Posts on Tuesdays and some Mondays.  http://crdowning-author.blogspot.com/?alt=rss
My Christian Context.Posts M/W of discussion questions. Thursdays - Timeless Truths. Fridays - Expressions of Faith. https://mychristiancontext.blogspot.com/ 
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