Dr. Sean Nork, Harborview Medical Center, Julie Lary, Motorcycle injury, Rajalary, Rich Lary, scribbles writing, surgery
Almost 9 weeks ago, our motorcycle accident occurred. After Rich and I were flown to Harborview via Airlift NW, we were triaged in the emergency room, and it was decided I would go into surgery first to repair my left leg while Rich’s amputation of his left leg would wait until the next morning.
With my femur fractured in two places, a rod was inserted into the bone, and secured with screws at by my hip and the top of my knee. This procedure resulted in maybe a dozen or so sutures. However, they needed to cut my calf from ankle to just below the knee to insert two plates to fix my tibia, which was fractured in two places. My fibula was also fractured, but they said it’d heal on its own.
In addition, the back of my calf was ripped open, which was closed with several dozen sutures. In total, I woke up from surgery with 60 or more sutures.
While my healing was progressing nicely, my orthopedic surgeon, the highly lauded Dr. Sean Nork, wasn’t pleased with my left foot, which noticeably turned to the left.
A week ago, Wednesday, he asked that I return to Harborview for a computerized tomography (CT) scanogam to examine the bones in both legs for discrepancies in length and formation. The procedure was painless with both legs being tape together and whooshed in-and-out of a large donut-shaped apparatus that captures 3D images.
I was already convinced my foot issue was related to weak muscles, and possibly the way I learned to walk after fracturing my hip in 2007 in a car accident in Austin, TX. It therefore came as a surprise when I received a call the next day from Dr. Nork, saying not only were the bones in my leg “wonky,” but I’d also clearly fractured the neck of my femur, the slender area between the femur socket that fits into the hip joint, and the femur bone.
Because he’d seen some healing around the fracture, he hypothesized, it may have been an indiscernible hairline when x-rayed in late May and separated sometime in June. I’m guessing the overly ambitious physical therapist at Providence Mount St. Vincent may have pulled the bone apart because I was in horrific pain for days afterwards (but, that’s a story for another blog post).
So, on Thursday afternoon, July 18, I got the jaw-dropping news that Dr. Nork wanted to operate as soon as possible and had already spoken to his scheduler to determine when an operating room would be available.
Scramble to get ready
Not wanting to wait-out the inevitable, I was willing to have the operation on Friday. Although, as soon as I said “yes,” I wanted to withdraw my affirmation.
My heart pounding, I called to Rich who was in the other room. I took shallow breaths as I told him the news. While supportive and putting on a brave front, I knew he was equally scared for me. Surgery, especially orthopedic surgery, is concerning with so many things that can go wrong, not to mention the pain, lengthy recovery, and setback in starting to walk.
After talking with the scheduler, and downloading the documents she sent, I understood the scope of the procedure, lengthy preparation I had to undertake in the coming hours, and when I needed to be at Harborview – 8:30 a.m. — which is a dreadful time if you’re coming from Whidbey Island.
To prevent the spread of germs, I had to take a shower with a special antiseptic, and then sleep in clean pajamas, and clean sheets. Sounds easy if you’re able-bodied, but the process of Rich and I changing the sheets on our king-sized bed can be daunting, using wheelchairs.
Plus, we needed to drive to a drug store to buy the antiseptic wash, pack some clothes and other necessities, get my papers in order, ensure the cats had enough food… and then it hit me.
The day before Rich’s aneurysm surgery, I was convinced it was the last few hours I had with the husband I knew. There was the possibility his personality and memory could dramatically change, or worse, he would have a stroke or other horrific medical event during the surgery.
Now Rich was in the same boat. The potential of not having a wife.
I tried to absorb everything around me wondering if I’d experience it again: The rooms of our house, pictures on the walls, view of the water and our gardens, sound of the cats racing down the hallways, comfort of hearing Rich’s voice, joy of tapping out an article on my PC, and much more.
With Rich having to refill a prescription and my needing the antiseptic, we planned a mini outing, first stopping at Starbucks for their happy hour. I savored a few sips of a scrumptious green tea Frappuccino, saving the rest to bring home, reasoning it would be waiting for me when I got out of the hospital. Rich enjoyed his usual caramel Frappuccino.
We then headed to Walgreens, slowly making our way through the store with our walkers to pick up what we needed. Upon getting home, we had an uncomfortable meal with me trying to finish a carton of yoghurt, granola bar, and piece of fruit, and Rich eating some leftover jambalaya, we’d been eating all week.
We barely spoke, reading magazines and staring out the window. Each lost in our own premonitions.
The rest of the evening zoomed by with our changing the linens on the bed, washing the dirty ones, packing what we needed to bring, and my taking a “cleansing” shower.
While Rich seemed to sleep, I tossed, turned, and ruminated. Around 3:15 in the morning, with both of us awake, we decided to get up and start the dreaded day.
Fear resolved to tranquility
While Rich loaded his wheelchair into the car, along with our backpack, I took a second shower, applying pink antiseptic goo, which I left on my skin for a minute before rinsing it off. Cold, I quickly threw on the clothes I’d laid out, then met Rich in the entry hall to help finish loading the car.
We were on the road by 4:15, easily catching a ferry an hour later. By 6:30, we’d parked at Harborview, and were wheeling ourselves through the corridors to the day surgery waiting area. It was two hours before our scheduled arrival, but at least, we didn’t have to wait in hours of Seattle rush hour traffic. And we were able to make a pitstop at McDonald’s so Rich could get some breakfast, which he gobbled too fast, making him nauseous.
The minutes passed like hours, and the hours like days as my trepidations multiplied. We watched as people arrived, were ushered into surgery then a few hours later, their families joined them in recovery. We’d been told, I wouldn’t be brought to pre-op until around 10 a.m. because there was a three hours surgery ahead of mine, which had started at 7 a.m.
Around 10:45, I went to the bathroom for at least the tenth time and returned to see a nurse standing by Rich. The time had arrived for me to be wheeled into pre-op. To my relief, Rich was able to come with me. I was told to change into a gown, put a fabric hair net on my head, and non-slip socks with rubber “treads” on the bottom before laying on a narrow gurney.
The nurse was delighted to see I had a decent vein on my right arm for an intravenous (IV) line but struggled to find another vein to draw blood. She also “swizzled” out my nose with antiseptic swabs that looked like mini tampons and smelled like orange creamsicles. She placed five electrodes on my chest that would be attached to an electrocardiogram (ECG) during the operation, along with a blood pressure cuff.
A hubbub of activities followed with a surgical nurse introducing herself, followed by energetic Dr. Sean Nork, bopping in to show us the CT scans from Wednesday, clearly showing the fracture at the top of my femur. He also explained my tibia bones were unusual, at odd angles, which turned my left foot out 40-degrees. He was eager to tweak the screws in the two plates, which had been used to fix my broken tibia in late May.
I explained that I’d barely slept the night before and couldn’t readily comprehend what he intended to do. His explanation sounded like my leg bones were akin to the Tower of Pisa that despite being cockeyed, managed to hold up my body. He simply smiled and said, “I slept great last night.”
Next, a nurse anesthetist arrived. A tall man with a calming voice, he was unphased by my remark that he was the person I feared the most. I’m terrified of waking up in the middle of a surgery and feeling pain. He allayed my worries, asking numerous questions, including whether I was nauseous the last time I had surgery and what pain medications I wanted.
“None. They all make me ill or produce horrific hallucinations.”
An anesthesiologist, who would be overseeing my anesthesia showed up, and further explained there wouldn’t be any issues. Very few people, nowadays, die because of sedation during surgery. In my mind, I thought, “That’s assuring, especially knowing I have oddball leg bones, and most likely have an equally funky respiratory system.
Poor Rich. He sat quietly in his wheelchair, ten feet from the end of my gurney, pretending I wasn’t really having an operation. I told him to find a place to relax during the surgery and go to the cafeteria to get some food. Although, I already knew he wouldn’t do much more than gnaw on his fingernails and fret.
After the physicians and nurses had finished their briefing, the nurse anesthetist injected me with a sedative, which I requested since I was chattering like a squirrel who just spotted a cluster of acorns. Although, once I put my head back on the pillow, even before the sedative, a wave of exhaustion spread over me.
The trip down the hallway took seconds. I was then wheeled into a large room, which was confusing in that it didn’t look like an operating room. There was a long table, piled with what looked like rack servers. And off to the corner, was a sizable console with numerous electronics and displays with several people sitting in scrubs. Nothing appeared overly sanitary.
It wasn’t until I contemplated what occurred in the room that I realized I must have been in another pre-op. Although, there wasn’t much to ponder. Once they put a mask over my face, and I was told to breathe deeply, I conked out in less than a minute. The only thing I remember was a nurse putting a large “squishable” cuff on my right leg to maintain circulation during surgery.
Drifting to beautiful places
In the past, when I was sedated to remove my wisdom teeth, I relished the deep peaceful, carefree sleep afforded by sedatives. This surgery was no different. I was awakened around 8:30 in the evening and told to drink some water. I took a few sips, heard commotion in the bed next to mine, then drifted back to sleep, only to wake up ten or fifteen minutes later, look around, and zonk out again.
There was no pain. No nausea. No worries.
The only thought that managed to ricochet in my sedated brain was “I’m alive. Rich will be pleased.”
Around 9, the nurse, who was still dealing with the woman next to me, said they’d found me a room, and I’d be brought to it soon. “Groovy….”
Finally, at 9:20, someone came to direct my bed – it’s done via a remote control – to the seventh floor of the East Hospital. Rich was waiting by the elevator, exhausted, and not particularly gung-ho to see me. He was simply relieved I finally showed up.
Within moments of getting settled into the room, Rich pelted me with questions, asking about the antibiotics he’d been taking and the extra shrinker for his “stump.” Both were in the car. Early in the morning, before we left Coupeville, he placed them, along with his toiletries and a pair of shorts, in his small computer bag, instead of the backpack with the rest of our stuff.
The computer bag was intended for carrying his iPad, medical paperwork, insurance information, and other lightweight items on his lap with the heavy backpack straddling the hand grips on the back of his wheelchair.
Early in the morning, while in the Harborview parking garage, I’d removed from his computer bag the items I knew he didn’t need during the day, and replaced them with granola bars, tangerines, and hard-boiled eggs.
However, Rich never returned to the car to fetch the rest of his stuff.
So, at 9:30 at night, with the tunnel that connected several of the hospital’s buildings closed, Rich had to go outside, and trek across several busy streets then make his way down to the parking garage to retrieve the items he needed.
Before setting off on his adventure, someone in housekeeping wheeled into my room a dreadful contraption that Rich was supposed to sleep on, which further incited his consternation. Fortunately, within a few minutes of Rich leaving, I saw someone push a chair/bed past my room. I immediately inquired whether it was taken.
“Can I have it for my husband?”
I felt victorious when a nursing assistant replaced the contraption with the significantly more comfortable fold-out chair. She then brought sheets, a lightweight blanket, and a pillow. I had a thicker blanket on my bed, which I knew I wouldn’t need, so I happily supplemented Rich’s temporary bed.
When Rich returned, he was still agitated, focused on his needs, wanting another pillow, complaining the bathroom wasn’t large enough to accommodate his wheelchair, and fretting over how to change his shrinker.
“Ah… take the shrinker with you to the larger bathrooms by the waiting room and replace it when you brush your teeth!”
I quickly grew annoyed with Rich’s focus on himself and seeming insensibility to my predicament. We exchanged a few heated words, then resolved to go to sleep, even though Rich was perturbed with having only one pillow.
With the light blaring over our heads, we both conked out until after midnight when Kathleen, my nurse for the evening, gave me some medications and check my vitals.
The hour of sleep made a huge difference.
Rich was less ruffled, revealing he’d visited me after my surgery, but he couldn’t stay long because there was an issue with the woman in the bed next to mine. Instead of being by my side, he was banished back to the waiting room, left to twiddle his thumbs while he waited nearly three hours until he could see me again.
I felt awful. I had no idea he’d visited me after surgery. Plus, I knew his sitting in a wheelchair for hours was not only exhausting, but uncomfortable.
After Kathleen fussed over me, and got Rich another pillow, we turned off the lights, and a few minutes and kisses later, we were both back to dreamland, comfortably sleeping.
Arrival of reality
Rich was so exhausted that he didn’t recall a surgeon coming into the room at 3 a.m. and standing at the foot of his makeshift bed. She was on the surgical team and needed to validate I hadn’t lost feeling in my toes, foot or leg. She also logged into a PC in the room and showed me my x-rays, pointing out the three screws they placed in the head of my femur, and how they’d not only adjusted the two existing plates on my tibia, but added a third.
“Wait! A third?”
I could feel her rolling her eyes, explaining absolutely no more hardware could possibly be added to my left leg. No kidding!
It hit me like a swinging punching bag that to adjust the existing plates and add a third, they probably reopened the ankle-to-knee incision in my calf. I had no idea what they’d done because my left leg was wrapped from the bottom of my foot to the top of my thigh with a heavy ace bandage to control the swelling.
Before the surgery, my swelling had substantially subsided. This new surgery, however, could rouse a round of elephantine inflammation.
Happily, my leg still looked svelte a few hours after surgery, but no doubt that would change.
A few hours earlier, I used a “lady urinal” to pee, but the urge continued every hour. Concerned, Kathleen, rolled in an ultrasound machine to see what was happening with my bladder. Evidently, during the surgery they gave me two liters of saline solution, half of which was still contently residing in my bladder.
Realizing I needed another way to rid myself of pee, because the “angle of pisser (AOP)” was amiss, I offered to get out of bed, and make my way to the bathroom, using my walker. The effort was successful, but it took at least 15 minutes of concerted effort to push out the last little bit.
Kathleen was very patient and supportive, concurring AOP was the issue.
With a less pesky bladder, I slept until 6 a.m. when another surgeon arrived. He’d visited me several times prior when I was initially admitted to Harborview, so I was glad to see him again. I commented Dr. Nork is a perfectionist. The surgeon ignored my remark, saying my bones were unusual. He said Dr. Nork called them “whack-a-doodle,” which made me smile because it’s a word I frequently use to describe wonky situations.
Around 7 a.m., Kathleen was replaced by Camryn, a cheerful nurse, originally from San Diego. She wanted to examine the sutures on my hip, which I’d ignored up until that point because they weren’t particularly bothersome. However, after Camryn, peeled back the layers of cotton and gauze, and I saw a row of sutures that were about 7-8 inches in length, I suddenly felt nauseous and was filled with anxiety.
“How long would those take to heal? Could I accidently rip one if I moved to much?”
Simultaneously, the painkillers from my surgery 13 hours earlier were now depleted. Pain was my new bed mate, and it was far worse than the pain from my initial surgery in late May. With each passing hour, it became more acute, impervious to the Tylenol I was taking.
A few hours later, a physical therapist visited. Her concern wasn’t my ability to get out of bed and subsequent mobility, but inability to “relax” my muscles. She worked with me to tense and relax just one set of muscles at once. However, I was too uncomfortable to completely “let go” and relax. My shoulders and head were tensed the entire time.
By the time she left, the only thing I could do was lay supine, and hope everything stopped hurting. Adding to my angst was the woman in the bed next to mine. While I couldn’t see her because of the drawn curtain, I quickly surmised she was from India, based on her visitors. Not only did she require assistance every hour throughout the night, but she was constantly making a clacking sound like she was shuffling through Legos or perhaps she was incorrectly using a spirometer, breathing in-and-out so the indicator noisily bounced up-and-down.
I didn’t want to say anything since I’d been disruptive during the night with physicians and nurses coming in-and-out of my room and checking on my progress. At 6 a.m., the woman staying with her, who I believe was her sister, tuned into a program, probably on her cell phone. For several hours, a man was either reading or chanting in Hindi. Thankfully, Rich slept through it, as I gritted my teeth.
The commotion continued for the rest of the day with her constantly calling for assistance, physicians, nurses, and other medical professionals arriving to provide care, and a hospital dietitian with his iPad trying to identify vegetarian options for her to eat. And because she didn’t’ speak English, everything took twice as long with translators having to be rounded up. Fortunately, her day nurse spoke Hindi.
As the day wore on, medical professionals signed off on my leaving, providing a stack of instructions, and arranging for me to pick up medicine in the out-patient pharmacy. Happily, I had all the medicines at home, which eliminated having to stop. Plus, not knowing what medicines I’d be provided, I brought my leftover Oxycodone from Providence Mount St. Vincent.
With it being Saturday, I was optimistic that we’d have a quick and uneventful trip home. Around 3 in the afternoon, Camryn and a member of the housekeeping staff – a cheerful, dark-skinned man with rubies in his ears, and perpetual smile on his face – wheeled us out to our car, several buildings away. We’d parked at the Ninth & Jefferson Building on Friday morning, spent most of the day in the Norm Maleng Building, and ended up on the 7th floor of the East Hospital that evening.
Already in horrific pain, I took 2.5mg of Oxycodone before I left. I’d only been taking Tylenol since mid-June. An hour into the ride, I took another 2.5mg of Oxycodone with the hope the pain would stop.
Squished in the front seat of Rich’s Honda Insight with the back seat flatten to accommodate our two wheelchairs, two walkers, and our backpack, it was impossible to get comfortable, and it didn’t help that we had to wait over an hour to get into the ferry lot. Fortunately, we had a document that enabled us to get onto the next ferry and not wait another 30 minutes. Even so, it took over 3 hours to get home.
Once home, I helped unload the car, put away a few things, then shuffled into bed, exhausted, in horrific pain, and dazzled from the reality that just 24-hours earlier, I’d emerged from major surgery.
Around 10 p.m., I woke up to go to the bathroom. Rich rushed over to my side with his wheelchair, and helped me stand up, using my walker. He then rolled into the bathroom, while I hopped on my right leg, using my walker. Halfway into the bathroom, groggy from sleep, confused from the Oxycodone, and still in uncontrollable pain, I yelped, then passed out, tumbling partially into our large walk-in shower. Fortunately, the glass shower doors had been removed weeks earlier.
The next few minutes were mayhem, mostly for Rich with me bouncing in-and-out of consciousness.
To be continued…
Thank you to LoboStudio Hamburg, Amanda Mini, Sergi Domingo, and Safar Safarov for their photos on Unsplash
Phyllis Brett said:
Wow! I live in Coupeville and would gladly come run errands or whatever is needed. My phone is 360-678-3107 I am retired (from Island Transit) and would love to help in any way I can.
Thanks Phyllis for offering to run errands for us. Since losing his leg in the motorcycle accident, my husband, Rich has become the errand-runner and housekeeper, while I work full-time, writing for Microsoft. I’m grateful, the accident didn’t deprive me with the ability to work. On the other hand, Rich, who drove for Island Transit, is now jobless. With that said, he’s looking forward to getting a prosthesis and tackling our numerous home improvement projects. When I went to rehabilitation at Providence Mount St. Vincent, the chaplain told me to document our journey for an entire year. Please stay tuned for our continuing recovery. Deeply grateful, Julie
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