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Friday, April 03, 2009

Tales of the Horrorspital

Today I'm in a lot of pain, so why not tell how I got here, I asks meself. Why not indeed. Those of you who have been following my saga know that I ended up needing a knee replacement after I injured my knee. The fall broke my heart as well, as the year before the damage, I had hiked 20+ miles in one day and was planning to do a few more of those. In fact, I had my eye set on a lengthy nature trail which spans several counties and would have been a three-day hike altogether.

From thrice-weekly gym workouts, thrice-weekly workouts on the treadmill, and one or more lengthy hikes every weekend, I went to sitting in my bed, walking with a hideous limp, using crutches, canes, and finally just plain grumping in a seated or lying position. By the time I got the doctors and insurance jerks to agree that the knee ought to be replaced, five years had passed. Five years of no hikes and no workouts. For a pretty active person, that's torture. Plus, even as the joint and its surrounding cartilage deteriorate, one gains weight from the lack of activity, weight which can't be taken off except with activity. Catch-22.

So when I finally managed to get those eejits to agree to replace the knee, I thought I was in heaven. You know that old saying, "Beware what you wish for?" I could well have done to remember that.

My surgeon is top-notch, he trains other surgeons in the techniques of knee-replacement, and teaches at a top-notch hospital in an area filled with top-notch hospitals. Many famous people would be hobbling around if not for his surgical skills. He told me he was going to put me in the hospital where he taught, and I was thrilled.

But the gods of comedy and tragedy accompanied me there to ensure I would have some useful tales to tell, some, as it were, learning experiences. No, really.

The surgery probably went fine, although I wouldn't know squat about that. All I know is, he used the latest technique leaving a scar barely four inches long, and less than a month afterwards, it's hard to see the neat scar. This is impressive, because I tend to keloids and have impressive twisty ropes of scars from things as minor as blisters, scratches, minor knife injures garnered from cook-prepping, and so forth. All hail the surgeon. I did, however, notice that all the muscles around the hip socket felt agonizingly painful, as if someone had twisted the joint nine different ways. Pas de quois. It's just a leg, after all, and there's a reason we have a spare, yes?

The fun and games began upon recovery. Begin, if you will, with the spideriest of veins, in which the good nurses had inserted various needles for the transportation of fluids, blood, saline, anesthesia, and so forth. The problem with spider veins is, they pop, or, as the nurses like to say, "blow out." What this means is, the needle pierces right through the vein causing fluid to leak out under the skin and concentrate in the tissues around the vein. Rather than, for example, going where it needs to.

Mind you, the "pain management team" of the hospital had inserted a spinal and a hip catheter to manage pain. The hip catheter is a relatively new technique and, in my personal experience, utterly useless. If they suggest it to you, suggest you will insert it in anyone who tries to use it in lieu of proper pain meds. Srsly. I'm not going through that again. The spinal, or epidural block, I guess, was fine, but when it started to wear off the full worthlessness of the hip catheter made itself, haha, felt. And felt. And felt again.

A word of caution for those about to have surgery. Horrospitals in the U.S. are utterly worthless except for approximately 72 hours during and after surgery. Their sole purpose appears to be to provide a location for the butchery and medications that won't require major DNA samples from everyone handling them. When it comes to taking care of you after the surgery? It's preferable to have unprotected sex with a chainsaw for all the care and effort you'll get.

Now, this is not the fault of the nurses, most of whom are fine individuals who work hard to take care of way more patients than they should. It's a horrible job that I personally would never do, and wouldn't wish on an enemy. It's hard physical labour for a relatively inadequate salary that invariably ends up crippling the performer. If you're lucky you can last two decades and a little more as a nurse. If you walk away without carpal tunnel, permanent back problems, and various musculoskeletal disorders, you're a lucky soul.

So big kudos to most of the nurses.

Of course, with my luck, I wound up with Ilsa, She-Wolf of the SS. On the plus side, she didn't show her face till the night shift. On the minus side, she didn't show her face till the night shift. At least on the day shift, you can call other nurses, the supervisors, doctors, and senior staff are around, you can telephone (or scream loudly) for assistance, and with any luck, you have visitors who will agitate on your behalf. The night shift is called the graveyard shift, and I'm sure it's for the most sinister of reasons. Plus, Ilsa was the senior nurse, and made good use of it.

But I'm getting ahead of myself. My first day in recovery, I shared a room with a very sweet elderly Vietnamese lady who spoke not a single word of English. With gestures and smiles and variously-pitched grunts, we managed to make ourselves intelligible to each other, and I passed a relatively peaceful time, not even noticing that the venuous system on which I relied was busy distributing unwanted substances to unneeded areas.

When I finally noticed (thanks to climbing pain levels), I requested more pain killers. They gave me a patient-operated morphine pump. Well, screw that. The only time you operate it is when you're conscious, and the whole idea is to be conscious as little as possible, which means that you're constantly waking up in pain and pumping the thing like a bicycle tire. With scant effects.

By the time I finally got the "pain managers" to agree to something more effective, the right arm (with the recalcitrant vein) was beginning to resemble a turkey leg in size and consistency. Still being doped up, I only noticed when those fluorescent plastic ID bands they place on each wrist began cutting into the right one.

This caused so much pain and itching that the staff finally cut it off, replacing my meds with something that caused me to, mercifully, pass out. Unfortunately, I apparently passed out for over 24 hours, waking to the worst case of the junkie bugs, which is the crawly sensation your skin gets when you take too many powerful drugs. I began scratching even as they trundled my sweet little old roommate out, and by the time the nurses bothered to answer my increasingly desperate requests for something to take care of the pain and itching (yes, the pain was back, of course), had removed a dime-sized piece of skin under the other wrist.

Unbeknownst to me, the needle in the left arm was beginning to leak. Ilsa the She-Wolf was on duty by this time, and if ever you find a nurse you dislike, please hold your opinion in abeyance until after you meet Ilsa. I'd like to think you will dislike her even more. She invented the term bitch as a self-endearment. Rly.

Next installment tomorrow.

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At 10:57 AM, Blogger Lizzy said...

Oh, you poor dear!You story is very like what I've heard from others - that the last place you want to spend time in is a hospital. But I think you're leaking iv was nothing short of malpractice! And what is it about American medicine that seems to want people to suffer? Is that some old time puritanism coming out? Or just the insurance cos being cheap with the meds? I'm so glad you're home even if you still are hurting. Hugs some babes for me / sending you 922 luvs and such, L. (Hersts!)

At 10:59 AM, Blogger Lizzy said...

New captcha - Vowry! It makes you want to write a whole new comment... :)
Whoops - I must have screwed up Vowry - trying again with... plelr!


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