Inquiring minds, online friends, and longtime followers may likely be wondering by now — “Where in tarnation have you been for so long, Jim? Sleeping like a bump on a log? Why the lack of new material lately? You missed Autumn and the Christmas Season, your favorite time of year. Where ya been?!?”
The short answer for those in a hurry is that I have been taking some time off for personal health reasons.
The longer version is more complicated, in that I went to have what was advertised as a simple repair type surgery and it unexpectedly turned into something much more involved, and then the hits just kept on coming, as the DJ’s used to say.
I suppose it is not exactly a plot spoiler to add that everything came out okay in the end because I am clearly back at the writing desk creating this piece for everyone now. So much for cliffhangers, drama, and plot devices.
Briefly, I went into the hospital on October 24th for what was expected to be a “minor” spinal fusion, adding on to previous fusion hardware already in place, but which then went quite unexpectedly sideways. A week later to the day I was in the Emergency Room (ER) being treated for an impacted bowel. Six weeks after that found me in the ER once again, with a fractured femur following a very hard fall while moving to a new apartment. All while still in a back brace for the spinal fusion. In short, that is where I have been for the past couple of months.
Having turned 70 three days after my hip fracture and having celebrated the milestone event with a new pair of crutches, as Bette Davis so astutely observed —
“Old Age Ain’t No Place For Sissies!”
But the interesting part is in the details and observations made along the way. For the not-too-queasy inquisitive folks, brave-of-heart, those about to enter the medical system in the near future, and those with nothing better to do, I offer the following information and observations from my recent experiences. Suffice it to say — nothing was as advertised in the brochure.
So if interested, I invite you to pour a cup of your favorite beverage, prop your feet up on the coffee table, and read on . . . .
As some know and others do not, I have dealt with the effects of various degenerative disc and joint diseases since childhood, with both hips replaced and two back surgeries, including a spinal fusion of L3 thru S1, four levels, and for the past twenty-odd years spinal stenosis. For the past few years, the next level L2 had become affected by the stress of overuse with all below already previously fused, causing a great deal of pain and discomfort, sciatica, periods of numbness from the waist down, and paralyzing leg cramps.
Not being a doctor myself, but as I can explain it a summer MRI revealed that the deterioration and bony overgrowth at the L2 level had totally closed off my spinal column at that level, with no spinal fluid at all visible on the MRI with resulting pressure on my spinal cord and adjacent nerves. The MRI, CT Scan, and a bunch of X-rays attested to all of the previous fusion work still being solid and intact, requiring no additional correction or work to be done. A decision was made to do another surgery to fuse L2 to L3, one that would be much less involved than the previous four-level fusion with its twelve assorted screws, rods, and plates, with this surgery requiring the addition of only two screws and two rods to do the job. A much smaller incision, clear out the debris, fuse L2, and done. Three hours or so. The surgeons enjoy a timely lunch and afternoon round of golf, and I take a nice nap, rest for a day in the hospital, and then go home in a back brace and get on with life. That was the plan.
Wiser people than me have observed throughout history that no battle plan ever survives contact with the enemy. True enough. When they opened me up to do the surgery, the neurosurgeons discovered that one of the metal rods used in the prior fusion had completely broken in half. How, when, where, or why the rod had broken, or why nothing was revealed on the MRI, CT Scan, or X-rays beforehand — I have no idea.
Completely unforeseen or planned, the broken rod then required them to remove all pre-existing hardware from the old fusion and greatly expand the incision from mid-back all the way down into my butt crack. Really. To such an extent that if I ever go shirtless at the beach again I risk being sued for defamation by a plumber, with a butt crack and incision now seemingly running up to my shoulder blades.
Afterward, I had surgical tape — on my butt. My story friend Little Red Bear found that part particularly hilarious for some reason, most notably when a nurse ripped off all the tape before going home.
I was going to share a picture of the incision, but three folks passed out in the focus group at this point during the pre-release of this post, so sharing an image of Little Red Bear’s reaction instead.
The original surgery scheduled for three hours suddenly became much more involved and stretched to just under five. My neurosurgeon was so impressed/taken back/stunned by the broken rod that he felt moved to take a photograph of it with his cell phone, just for the record. He kindly shared the image with me later in the hospital. A broken support rod. Who knew?!?
I am now fused at five levels, and what was to be a short, simple postoperative rehab period following, like the surgery itself was expected to be, became much more complicated and demanding. Here are some observations I noted along the way, in no particular order —
- Upon admission to a hospital, while busy signing all the permission and notification forms, they also make you surrender your Modesty Card, giving Carte Blanche permission to poke, prod, stick, inject, and insert whatever they feel necessary at or into whatever location they choose. Prepare to be humbled, as no intrusion of privacy or orifice seems to be off-limits once admitted. The invaders are massed outside the castle gate, and the admissions representative just lowered the drawbridge.
- It had been quite a while since my last fusion and in-hospital stay (my recent bicep rupture and repair in December 2018 was outpatient), back in the days of circling selections on a meal plan form and turning it in when collected the night before for the following day. Now, at least at my hospital, St. Luke’s Hospital on the outskirts of St. Louis, it was more like ordering from Room Service. Kind of like staying at a nice hotel, but with IVs. They hand you a master menu of what is available, and you call Food Service before each meal to order whatever you want from the menu. I am fortunate in that I have no dietary restrictions, so anything goes. Your meal is then delivered in forty-five minutes, hot and fresh. By far, the best hospital food I have ever had. For someone used to the old ways, truly amazing. It almost made the stay enjoyable. Almost.
- The food service was a little less amazing the first day, however, as the extended surgery time resulted in my having an adverse reaction to the anesthetic and me fetching up and dry-heaving into a barf bucket throughout the day. I had pointed out to the anesthesiologist beforehand that I had reacted badly once before to anesthetic, but four other surgeries had all been uneventful. Dude — did you even bother to check the hospital computer records and notes? Ugh!
- As with the prior spinal fusion, I came out of surgery with a catheter. A mixed blessing, to be sure. No need to hurry out of bed to the restroom the immediate days following surgery, but the day of reckoning and removal eventually does arrive. After my first fusion some years ago, a male nurse on the night shift had removed the catheter when the time came, and I was more asleep than awake from pain meds. No big deal, really. This time, the task fell to two young, lovely, female blonde nurses on duty when I was wide awake one afternoon. Suffice it to say, the experience turned out to be all of my lifelong threesome fantasies gone horribly wrong, and we will just leave it at that.
- If you sit up in a chair for a few hours, walk around the halls demonstrating that you are up and moving about, and utilize the proper techniques of getting up and out of bed on your own (“roll like a log”), and eventually manage to keep your food down, it seems that everyone wants to shake your hand to acknowledge your progress — the doctors, nurses, physical therapists, and three strangers you pass in the hallway. Please — easy does it, folks. Or did you not notice the great big blue IV port sticking in the back of my hand as you crunched down on it? Shake my left hand? Nah, it has an IV port and tubes running out of it, too. Maybe just nod and wave. That would suffice.
- Prior to surgery and to prepare for life after, I stocked up on a number of frozen dinners. Quick, easy-to-prepare. Minimal standing time and effort required to prepare a hot dinner. I am okay with the lower end, less expensive dinners, so admittedly went “budget first” on these. But, I should maybe have taken a few extra minutes in the frozen food aisle to more carefully read over the packaging and ingredient lists. Banquet Dinners — really? The Meatloaf and Salisbury Steak in both meals are — “Made with Chicken, Pork and Beef”. So, good for you for stating it right up front on the box and shame on me for not having taken the time to notice that “Beef” was actually the third ingredient listed in what I assumed would be All Beef dishes. In the end, what you are truly saying in the ‘magnifying-glass-required’ small print on the end of the box is that your Meatloaf and Salisbury Steak are “Mechanically separated Chicken, Pork, Beef, Water, . . .” — basically, just glorified hot dogs? Clearly, the lesson here was to take time to check the ingredients more closely. Hot dogs would have been even less expensive, quicker and easier to prepare, served in a bun, and easier cleanup, after all. If there is a next time, I will simply go straight with cheap hot dogs, some buns, and a bag of chips and call it done.
Moving on, it would appear that there are certain evidence of progress steps and achievements to be made along the recovery trail to earn your Healing & Recuperation Merit Badge, which ultimately leads to your official front door release and Life After Surgery On The Outside —
- The first, of course, and it should really go without saying, is — Waking Up. If you do not Wake Up in the recovery room following surgery, then none of the other convalescing steps really matter because you are likely not going to be leaving via the front door of the hospital after discharge anyway. So, Waking Up is a biggie, right off the bat. I cannot stress enough, you really do need to nail that one. Seriously.
- Keeping food down is nice. Food Service folk like to think that their work is appreciated. Nurses and attendants seem to greatly appreciate your not heaving and spewing, too.
- Getting off pain injections and/or IV drips and switching to oral pain medications is a must if seeking release. I was never on any pain shots or pain-relieving IVs following this surgery, beginning solely with oral meds, so this was a non-issue for me this time. However, another discussion about pain meds and their effects will follow later, below. There is more to be said on that topic.
- Getting out of and back into bed on your own and in the prescribed manner is important, especially if living alone and being solely dependent, as I am. “Roll like a log” and you get a checkmark on your merit badge card. Any noticeable bend or twist will send you straight back to Remedial Therapy for re-education.
- Sitting in a chair without hurling or passing out is followed by standing and walking unassisted. I totally failed the chair test the first day, but I still don’t think it was fair to put the chair in a spinning room like an amusement park ride.
- In my experience, physical and occupational therapists seemed to care a great deal about my being able to get up out of bed and a chair under my own power, walk around the hallways, brush my teeth, comb my beard and hair, and to generally function independently, but never gave a whit about whether I could dress myself or not, other than trying to convince me to order a nifty little Sock-Putter-Onner assist device from Amazon. Perhaps they just assume you have helpers to assist in putting on socks, pants, tying shoes and such, all under the overarching restriction of “No BLTs!” — therapist jargon for “No Bending, Lifting, or Twisting!” Of course, being in a restrictive back brace whenever out of bed for the next three months, one is kind of reminded about the “No BLTs” axiom naturally, it turns out. I was just relieved when assured that “No BLTs!” did not really exclude one of my favorite sandwiches, as I had incorrectly assumed at first, so readily promised not to Bend, Lift, or Twist before they changed their minds. And no, I never did order the nifty little Sock-Putter-Onner device, just relying on my trusty old Reacher to do the job. However, in all fairness, it should be pointed out that I am a Certified Reacher Master of the First Order, an accomplished skill developed over many years of use. If new to the “No BLTs!” game, one might want to consider ordering a Sock-Putter-Onner device (there are several styles available on Amazon) to have on hand ahead of time. Putting on socks with a reacher can be a challenge some days, even for the experienced and skillful, requiring a good deal of patience and practice.
- Speaking of walking around the halls for physical therapy, if wearing the latest in hospital gown fashion apparel, please remember to always check to make sure that the back flap is closed over before leaving your room. Omitting this step can turn handshakes and appreciation of your mobility efforts into snickers, jeers, gasps, and guffaws as you pass by hospital staff and visitors in the hallways, leaving them ‘cracked up’ as you pass by, so to speak. Take the extra minute to make sure you are not over-exposed. Just sayin’.
- Mentally preparing and properly timing pain meds for the potentially agonizing ride home is a good idea, when you are likely to be jostled and thumped like riding in a buckboard wagon, and your back feels every small bounce, bump, and pothole like the car just fell into and climbed back out of a sinkhole, registering each as a seismic earthquake. (Pausing at this moment to send a special shout-out and bear hugs to my daughter-in-law and son-in-law, who each took great effort to avoid potholes and bumps on the way home from the hospital — Three Times! Very much and truly appreciated. Masterful job, kids!)
Next, under the heading — “Sweet Mother of Misery, I Did Not See That One Coming!” — exactly one week later from the surgery date found me in the back of an ambulance and on the way to the Emergency Room of the hospital with a very different, dire, but somewhat related issue on Halloween Night — an impacted bowel. There may be some things the hospital staff were not totally forthcoming about regarding pain medications it would appear, and it was all much more Halloween Trick than Treat.
The combination of Opioid Pain Medications, Muscle Relaxers, and Inactivity turned out to be a three-headed monster in my case, resulting in an impacted bowel. After much effort and a few hours of agony, the first ‘movement’ following surgery two days earlier was successful. Although the ordeal took so much effort and time that I initially felt compelled to name what emerged and set up a college fund, certain that I had given birth — to “something”. The first bowel movement after surgery is frequently tough, but after finally achieving a break thru assumed I was in the clear. Once again, nothing of any of this was like the brochure.
Two days later, on Halloween night, it was like a determined Gandalf had taken up residence in my bowels, allowing nothing whatsoever to pass. After a few hours of effort with no results and coming close to passing out from cramps and pain, I decided it was time to call in the pros and summoned an ambulance. Thru it all, I came to realize that mothers do not receive nearly enough credit and appreciation for what they have been thru. Respect.
Sparing sensitive readers, those seeking more information on the subject and what followed at the hospital are welcome to “Google It”.
And yes, it is every bit as uncomfortable and painful as they describe and one can imagine, with the “digital” treatment having nothing at all to do with modern technology. The invaders were once again crashing the gates.
When the doctor says — “This is going to be as uncomfortable for me as it is for you” — challenge and call him on it. Ask if he would like to switch places. Chances are he won’t, and you will have caught him in a placating falsehood because there just ain’t no way that statement holds water.
As a result of the experience, on my own, I immediately stopped taking all pain medications and muscle relaxers at that point, vowing never to go thru that again. I made the quick decision that I would much rather be uncomfortable than immoveable, so to speak. Basically and as explained to me later, opioids on a scale of one to ten, are a “Ten Plus” in drawing out all moisture from your colon and causing bowel blockages, leaving concrete in their wake. I cannot imagine anyone being so desperate as to want to do Oxycodone or any of these meds voluntarily, and my heart goes out to anyone so affected. So, a cautionary warning about the side effects of pain-killers and why I chose to fly solo without them from that point on, and still am despite a fractured femur.
Someone once said that Southern fairy tales and the very best stories begin with — “Y’all just ain’t gonna believe this, but . . . .”
So then — Y‘all just ain’t gonna believe this, but — on the evening of December 13th, unbelievably (and I ain’t makin’ this up!) — a Full Moon Friday the 13th to be precise — I suffered a very hard backward fall, landing on my left elbow, knee, shoulder, and hip, and finally cracking the back of my head against the door on the opposite side of the hall where I live. Feeling something was not quite right in my left leg, I nevertheless waited until the following morning to see if things would improve overnight. They didn’t. Saturday morning found me once again in the back of an ambulance headed to the ER. The good news was that my left knee, elbow, and shoulder were merely battered and bruised with nothing broken, and that, having a notoriously hard head, I had not suffered a concussion. The not-so-good news was that I had suffered a Left Greater FemurTrochanter Fractured Hip.
As it turns out, the treatment for such an injury is a hip replacement. As explained above, I already have both hips replaced, so the fracture was being stabilized by the existing prosthetic rod already in place in my femur from the prior hip replacement. With nothing more to be done, I was discharged with no other treatments. “Time heals all wounds” as they say, and the fractured femur should accordingly heal all on its own over time. That’s the plan, anyway.
So, while still wearing the back brace for the spinal fusion until at least mid-January and hoping no damage was done to my spine or the fusion work in the “crash and burn fall” on Friday the 13th, I have been getting around on crutches ever since. This past Friday, the three week anniversary of “The Fall”, I progressed to using only my cane for short walks while still relying on my crutches for more support on longer walks. Literally, small steps but in the right direction!
With all that, it has been an unexpectedly much longer road back from what was anticipated to be a “no big deal” surgery at the end of October.
It recently dawned on me that in roughly the last twelve months I will have been thru a right bicep muscle rupture and surgical repair, spinal fusion surgery, impacted bowel, and broken left femur at the hip, and spent six months or more of the past year in one form of brace or another, with the hard cast and then arm brace following my bicep surgery on December 7th of last year, and now on crutches, while still firmly strapped into my back brace tighter than a mule in a packsaddle, likely to continue into mid or late January.
Going on at the same time as all of this was moving to a new apartment to become the Resident Manager of the Senior Community I call home while also bringing in and training a new assistant to help me catch up with things a bit. Her name is “Allie”, she has four legs and is faster than greased lightning whenever food hits the bowl. Or the floor. Check back to find out more about Allie in a coming post.
All in all then, I feel a bit less guilty about not getting more accomplished during the past year. While acknowledging that we can only do what we can during any given stretch as the life cards are dealt, still feeling somewhat disheartened about the lost time. A lot to catch up on now in the new year just beginning and looking very forward to getting back into it all with Little Red Bear and his friends very soon.
Thanks for reading and visiting, and for hanging in there during my absence from social media. We have actually not lost, but rather have continued adding new followers to the site here while I have been away, Little Red Bear’s books are entertaining new readers, and daily visits to the site have remained consistent at pre-surgery levels. That is truly amazing, heartwarming, and most sincerely appreciated.
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Though not actively writing as much the past few months with life issues interfering, a large stockpile of notes and ideas has accumulated, so watch for new material to come regularly again going forward.
And as always, a gentle reminder that in a world where we can be just about anything we choose, please choose to be kind and share your smile with someone. The world needs more of that. And if in hospital, it may very well lead to an extra dessert on your dinner tray now and then! — Jim (and Red!) 🤠 🐻
If you enjoyed this piece, you may also enjoy → “I Will Greet This Day With Love In My Heart”
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