7 - Premature Discharge

I awoke this morning with one thing on my mind: discharge - not the kind oozing out of my knee but a discharge from the hospital. I was being released today.

I called Tesia and after an endless number of rings, she answered the phone. I heard a feeble, "Hello?"

"Hey, I'm just calling to see when you'll be here."

There was a long pause and some rustling. "It's six o'clock."

Well of course it was six o'clock. My knee was shot, but my ability to tell time was still intact. "Yeah, I know, I just wanted to make sure you got here in time to take me home. Are you coming"?

"Cameron's still asleep, John. I need to let him sleep in. Yesterday was a rough day.”

Exactly whose day was rough? "Well, I'm sorry you had a rough day. I've been lounging around here chatting with the nurses and watching TV. Oh, yeah, that's right. They also cut me open and put screws in my knee cap. I knew there was something I forgot to tell you!"

"I'm sorry, John. I really am. That didn't come out right. I meant it was rough for all of us. I thought maybe we could sleep in a little."

“Sleep in? You want to sleep in? Tess, I tossed and turned all night and every time I moved, pain shot through my leg. God, what I wouldn’t give for one solid hour of sleep.”

Tesia said, "It's snowing out."

“Oh my God! It’s snowing out? What the hell?! How can you talk about the weather when I’m telling you how much pain I’m in? What does the weather have to do with me? We were talking about me, Tess.” I had no windows in my hospital room so the snow was news to me. I took a long slow breath and exhaled. "Well look, I don't have any control over the weather. Maybe you should come get me before the snow gets too deep. Why don't you come now? I'll give you my breakfast." I didn't have an appetite and the oatmeal looked like hell. "They're serving oatmeal,” I said, “you love oatmeal and they’re serving coffee with Hazelnut syrup – it’s delicious."

"John. I don't want hospital food for breakfast.” Tesia was starting to sound testy. “Don't worry, I'll be there in time to check you out of the hospital."

How would she know what hospital food tasted like? She never set foot in a hospital. Even when Cameron was born she avoided the hospital and opted for one of those dimly lit birthing rooms where sterile stainless steel is traded for gentle guidance and primordial pools of warm water.

"Fine. I get it. I really do. You just lie there in your comfy little bed while I lie here out of my mind with pain. You don't like hospitals. You’ve got an issue with hospitals and you can't get over it to be here by my side. That’s very mature, Tess, very mature of you." I really had to calm down. "OK. All you need to do is bring a little bag with brown sugar, cinnamon and raisins. You can sprinkle it on the oatmeal – just the way you like it."

"John. I will see you. It's too early. Call me when you think the're ready to let you go. I need to sleep. Please."

"I have to go. Coffee's getting cold. Bye" I hung up. Just when I needed a little support, my wife needed her beauty rest.

I buzzed the nurse.

The nurse popped her head in the room and asked what I wanted. I thought, it's not what I want, it's what I need. "I need some of that Hazelnut syrup."

"Excuse me?" She looked confused – probably just graduated from nursing school.

"Do you have any of that Hazelnut syrup for my coffee? I saw some at the coffee stand on my way in yesterday."

"Oh, that's not for us to use. You get whatever the cafeteria has." She was showing her bad attitude again. I could hear it in her voice. She always started out being nice and perky but our conversations seemed to quickly devolve.

"Oh… well...do you have any packets of hot chocolate?"

"No, we don’t."

I couldn't let her defeatist attitude get me down. "Well if you could find me a packet of hot cocoa somewhere, pour half the packet into my coffee, stir it really well and then microwave it for 40 seconds, I would be eternally grateful." I smiled my most charming smile.

The nurse cocked her head a bit and stared at me as if intrigued but then, unexpectedly, she came into my room and grabbed my coffee cup. This was remarkable since I had never seen more than her face up to this point. Stepping into the room must have been a commitment she had difficulty making. "No," I warned her, "don't bring it yet, I'll buzz you right before my wife comes. The ' mochalato' is for her. She likes it that way." The nurse wheeled around and left the room.

******

By the time I could smell lunch being handed out on trays, Tesia walked into my room. “Hey there, it's really snowing." She leaned over and kissed me."Our car doesn't handle very well in the snow. It took a long time to get here."

“You’re not kidding, it’s almost lunch time. You should have left earlier.”

Tesia studied me for a second then smiled and said, “Well, I’m here to take you home. Are you ready? Did they discharge you? C’mon, let’s go, let's go!” She clapped her hands like a coach rallying her soccer team.

She made her point but I didn’t have a good comeback. All I could offer up was my tired lament, “My knee hurts."

Tesia said, "I know, I know." She reached down and gave my neck a little rub.

"What does that mean? 'I know, I know'. If I can't complain to you who can I complain to?"

"Well, you already told me your knee hurts quite a few times. What I mean is I know and I sympathize."

"Sorry, I thought you were minimizing my pain. I hate it when people minimize my pain. My pain is about all I have right now."

Tesia leaned closer and said, "You have me, sweetie. I'm here."

"Yeah… where the hell were you? I was afraid you weren't coming."

Tesia sat down across the room and stared out the open door. Maybe she was hungry. "I'm sorry. I promised you breakfast and Hazelnut coffee but they took away my breakfast tray when I was in the bathroom."

I buzzed the nurse who eventually poked her head into my room. I winked and told her I was ready for the “coffee mochalato,” hoping she would remember our little deal. I don't think she remembered because she stared at me blankly and then disappeared. I felt embarrased. Where were my manners? I should have invited her in to my room to meet my wife. On the other hand, this nurse seemed to prefer written invitations well in advance of her visits. At least she respected my privacy.

Tesia sat there shaking her head. She looked unusually tired today - probably not taking her iron again.

"Don't worry about it. I already ate," she said.

Apparently my efforts to hunt, gather and provide had been in vain.

******

Tesia started to gather my belongings and pack them up for me. I enjoyed watching her go about her business since this was about the most interesting thing that had happened since I woke up. “Don’t put the CDs in there,” I said, “that’s the clothes bag. Put them in the blue bag – it’s down here. Hold on, did you alphabetize them or just stick them in the sleeves?” She had no idea how nice it was to finally have her by my side.

Tesia said, "I have to leave by two o'clock. The roads are getting worse and I have to get back home."

Now this was news. My wife, who vowed “in sickness and in health” to drive me home from the hospital was trying to bail out. “What do you mean you have to leave by two? You're here to take me home, right"?

I had to pee and this took precedence over speculating about slippery roads or wedding vows. The problem was that every time my left foot touched the floor, all the fluids in my body found their way down my left leg, caused all kinds of pain and for some odd reason immediately sent a pee signal to my brain. I hated pain so I avoided walking to the bathroom until the last possible minute which meant that my bladder was absolutely full when I finally gave in to the forces of nature.

So, here I was again with a bursting bladder as I was mentally preparing to lurch with crutches flailing toward the bathroom. I only had to travel ten feet or so but I had to accomplish this in 3.5 seconds or I’d end up with wet and warm sweat pants. I made the journey just in time and the relief almost outweighed the excruciating pain of standing upright.

While in the bathroom, I could hear a nurse come in and talk to Tesia. I could hear the word "discharge" and was encouraged. Finally, I was going home!

I opened the bathroom door and heard the nurse say, "Workers are starting to call asking our van service to come pick them up.You might want to leave before the roads get any worse."

"Excellent idea." I said as I exited the bathroom, "Let's go!"

Both the nurse and Tesia turned to me.

"John, it looks like they aren't going to discharge you today."

"Why not"?

"You have to see the physical therapist before they'll discharge you and you’re in no shape to see the physical therapist."

While I soaked this information in, the nurse and Tesia discussed the details. By the end of the conversation, the two of them had decided my fate – I would spend another night in the hospital.

Tesia stood up and grabbed her pocket book. "All right, I need to get out of here. Apparently the roads are bad and they’re getting worse. I'll be back tomorrow." She kissed me and was gone.

******

Exactly one hour later, the resident doctor came in to my room with my fugitive nurse in tow. He informed me that I was being discharged.

"My wife sat here for two hours waiting to drive me home and she left an hour ago."

The doctor asked, "Why did she leave?"

"Because we were told that I wouldn't be discharged today and that the snow storm was getting worse and she should go home. I don't have a ride and I'm not asking my wife to come back and get me."

The nurse added, in my defense, "I think he is in too much pain to go home right now."

The doctor looked at the nurse and asked her to step outside my room. It was like a bad movie. They both stood right outside my door within perfect 'earshot' and ‘privately’ discussed my case. The doctor said, "Look, I can't control the weather and he can manage his pain just as well at home as in the hospital. Insurance will only cover one night."

I had to agree with the doctor. He certainly couldn't control the weather and the hospital staff had proven without a doubt that just about anybody, including my five year old son, could manage my pain better than they could. The doctor and nurse walked back in. I expected some back-peddling from the doctor but instead he said, "You’re being discharged right now. You will need to arrange for transportation."

I was floored. "You mean to say that I’m in too much pain to get out of bed and see the physical therapist yet I'm fit to be discharged?"

The doctor appeared startled and looked at the nurse, "He hasn't seen the physical therapist yet?" Not only was he unable to control the weather, apparently he couldn't read a chart.

As the nurse subtly pointed to a particular section in the chart, she said, "No, he’s been in too much pain to go down to physical therapy. See." The doctor read the chart, shifted his weight and adjusted his glasses. For some odd reason, I felt good for the first time since my operation. I had never seen a doctor show discomfort.

The doctor studied his clipboard for a moment then said, “If you haven't been certified by the physical therapist that you are safe to go home, your insurance will pay for an additional night at the hospital. You’ll be discharged tomorrow. I'm sorry for the mixup." With that apology, he escaped.

The nurse lingered in my room for a moment trying to hide a funny little smile. This was new and certainly an opening I hadn't seen before. I took the opportunity to writhe a bit, moan a lot, and do some Lamaze breathing while stroking my knee. She came back in with two Percocets without my having to ask. A little bit later, I slipped off to sleep basking in the knowledge that my powers of persuasion were evolving.

6 - Paper for Pain

Ever since breaking my Patella, my life has been a series of replacements. When I think I have conquered or at least have come to terms with the obstacles that were handed to me, life trades them out for new and different obstacles. I have very little control over anything that happens to me yet I crave that control every minute of every day.

To begin with, life replaced my perfectly good left knee cap with two smaller and mostly dysfunctional knee caps. Although these two knee caps belonged to the same leg, it was as if they were both pulling away from each other and were trying to find their own place in the world. I knew they were seeking a place of comfort and security where insults could no longer inflict damage or pain. But, nothing I said or willed would bring them back together and I knew it was time to seek the help of a wiser being who could guide me in this journey and help me down the path toward healing.

The first old soul I consulted was an EMT who rode in the back of the ambulance with me. "I'm an 'EMT-Intermmediate/99'" he informed me once he strapped me down securely. This impressed me terribly since I knew intuitively that "intermmediate" was much bigger than "small" or "tiny" and the "99" part was very close to "100". I relaxed, breathed deeply and trusted myself to his care. His wisdom belied his tender years. He spoke to me in measured tones with cadences that brought new meaning to familiar words. “You’ll be OK. You’ll be OK. God knows it could be worse. You'll be OK.” Pretty soon I too was learning the chant that brought so much comfort to my soul. I began uttering the mantra from deep within and an other-wordly sound emanated from my lips, “God knows it could be worse. Ohhmygod!... God knows it could be worse. Ohhhmygod!” My body and soul were comforted and lifted up.

I realized I was being lifted up so that they could cut my pants off and examine the true nature of my injury. The mantra was replaced with “Oh my God, take a look at that!” This was not as comforting nor did it flow easily from the lips of the old soul in a young EMT’s body. But, being wise and having the experience of many previous lives, he followed up with, “Hey, no problem. That doesn’t look so bad. Really. They’ll fix you up in no time. You bet.” It sounded like the chants were over and I didn’t trust the new message.

To my surprise, I was offered a new mantra as I entered the emergency room, “Could I have your insurance card?” I stared at this woman who appeared above me from behind a pane of glass as if from another dimension. I was not quite oriented to the "here and now" since I had just reached “the inspired self” on my way to Nirvana and the Hospital. The good woman repeated her question, “Could I have your insurance card?” I intoned her chant, “Could I have your insurance card?” Her eyes opened wide and I stared into her soul.

I found this new chant less comforting or rhythmic, but it was entirely to the point and it gave me a needed focal point for meditating and blocking out the pain. I was working through the deeper meanings of this exchange when my wife gave the good woman her insurance card. “I need to see his card. Doesn’t he have one?” asked the woman. “Well,” answered my wife, “his is the same as mine except he has ‘0-2’ after his number and I have a ‘0-1’ after mine. I’m the primary insurance carrier.” The not-so-good-woman-after-all said, “I need his card – not yours.”

My wife looked down at me to get the insurance card out of my wallet and realized I was sitting in my wheelchair in my underwear. She wheeled around and ran outside to find the ambulance driver. He had bagged what remained of my pants and was about to turn them in to the hospital. My wife thanked the old soul and fished out my wallet and insurance card. I contemplated an entirely new chant, “Do you have your pants and your wallet and insurance card,” but it just didn’t work.

At the time, I had no idea that the insurance card exchange was signaling the imminent replacement of physical pain for the eternally painful world of paperwork.

5 – Pain management Part II

Once settled into my hospital room, I found myself hooked up to the now familiar but inadequate PCA morphine pump. I thought we had clearly established the advantages of mainlining Dilaudid over a morphine drip way back in the recovery room. This couldn’t possibly be happening.



The little button attached to the PCA lit up at regular intervals indicating that I could push the button for my next dose. Knowing that all available peace and goodwill on earth were currently flowing from the morphine pump, I developed an instant and deep seated fixation on the button. This prevented me from doing anything remotely useful such as transcribing Braille or making cold calls for the Democratic National Committee. I started playing clever little games with the button such as trying to push the button milliseconds before the light came on to see what the reward would be. Sometimes I’d push the button in rapid fire succession and other times I’d just push it really, really hard. Perhaps I’d fool the machine and get an extra dose. Sounds crazy, but in my mind, it was definitely worth trying. I sat there contemplating how it was possible that once again I was feeling unbearable pain yet my only response was to push a little button at regular intervals for a less than adequate reward.

For a brief period, I became a lab rat pushing the button… pushing the button… pushing the button while the doctors and nurses stared down into my cage. “He is a persistent little bugger! I wonder how long he’ll continue in this manner before he develops alternative strategies?” asked a nurse. A doctor replied, “oh, I’ve seen the brain injured subjects push the button until they wear their little paws to the bone. I hope this one tires before that happens.”  I awoke to the sound of the PCA emitting a longer than usual beep and then I realized my knee was about to combust and my pain scale was at an 8 – or was it a 9? I was so confused. One thing I was fairly sure about was that those titanium screws in my Patella were working themselves through the bone and scraping against my tendons. I buzzed the nurse who finished up her dinner, went to the bathroom, washed her hands (thank God!), went out to the vending machine, finished her charting, chatted with Rosie who I had caught, just moments before, eyeing my untouched pudding, and then rushed breathlessly into my room. I cried out, "my PCA is broken, I swear to God, it's really broken, it doesn't work, it hurts, it hurts!" She looked at the morphine pump and told me it was working fine and left the room before I could muster another volley of complaints.


I sat there stunned but the nurse did eventually come back to look at the PCA again. “Well,” she said, “you have maxed out your morphine drip. Looks like you won’t get any more for an hour.” I thought she was joking and then realized that not only was she serious, she wasn’t presenting any possible alternate solutions such as acupuncture or music therapy and furthermore, it appeared that the punishment for morphine gluttony was deprivation for an entire hour. The nurse walked out of the room.


I buzzed the nurse once again. This time I convinced her that I needed something stronger than the morphine drip and the alternative she was presenting, no pain meds at all, was not acceptable. She called the doctor who thought that a 12 hour slow release pain med might do the trick. In the meantime, she gave me two Percocets in the hopes of keeping me off the buzzer. I took the Percocet and then settled back to watch the clock. After three hours and fifty nine minutes, I buzzed the nurse and asked for the 12 hour extended release pain med. “Oh no”, said the nurse, “the doctor has that scheduled for nine o’clock and it’s only seven. You will have to wait for two hours.”


“OK,” I said, “I started by asking for better pain management than the PCA provided and you told me that I would have to wait for one hour with no pain meds. Now you tell me that I have to wait two hours for a better pain med. The more I ask for pain meds the less I get. Is there some logic operating here that I’m missing?” That is what I wanted to say. What I really did was beg, cry, and plead and finally closed the deal with an offering of chocolates. The nurse agreed to ask the doctor if he could move the administration of my meds up two hours as she walked out of my room with an entire box of Belgian chocolates. The rest of my hospital stay was tolerable – which is all I really wanted.


Lessons learned:


• Nurses work with people in pain all day every day. They are not easily impressed by your sorry tales of woe and, depending on the seriousness of your condition, they are not easily convinced that you are able to trade sex for pain meds.


• When a nurse leaves your room, don’t assume she just got interrupted and will be right back. They do that when they don’t want to hear you whine anymore.


• Doctors hold the drugs – not nurses. Figure out ways to get the doctor on the phone or in the room. They are very busy so if you start on a long-winded explanation of why you need more pain meds, they will very quickly break down, scribble a script and leave. They feel good, you feel good – truly a win-win situation.


• If the hospital staff gives you control of your own drug administration, you can safely assume the drugs are absolutely and unequivocally ineffective. Why else would they give them to you to self administer? The reason that PCA has become popular is that doctors know most people will not yell at themselves when the drugs they are giving to themselves are not the least bit effective.


• Even though there are no signs prohibiting it, don’t try and take apart or increase the throughput of the PCA. The resulting long tone and flat lines on the display are not signs that the gates are open and the drugs are flowing… and those machines are expensive!


• Try not to talk about getting more effective pain medication too much or people will think you are becoming dependent.


• One of the best ways to show your support for friends and family members who are recovering from surgery is to bring small meals and small envelopes with left over pain meds you may have found in your medicine cabinet. Don’t worry about expiration dates. This lets the hospital off the hook and lets the doctors focus on more important things like golf.

4 - Pain Management Part I

I awoke in the recovery room after my anesthesia wore off. I was immediately overcome with a sharp and unrelenting pain in my knee that only got worse as the seconds passed. Nothing had prepared me for this level of pain. I underwent back surgery twenty years ago and time certainly dulls the memory of pain but I didn’t recall ever demanding more pain meds and screaming viciuously at the nurses after my back surgery. I suppose age has given me the ability to clearly, if not inappropriately, express my needs.

I dominated my nurse’s time and she eventually had to call for help since I wouldn’t allow her to leave me in order to attend to the other cooperative, clean speaking, comfortable, quiet and apparently painless people lying in beds on either side of my mine. As I writhed in pain and blurted out all kinds of obscenities, my nurse kept trying to get me to breathe and relax. I tried my damndest to comply but controlled breathing and relaxation would not come to me for more than a few seconds before I started crying out again.

My nurse asked me what level of pain I was experiencing. I was dumbfounded. I thought I had been screaming my exact level of pain from the moment I regained consciousness. Did she not hear me? Perhaps she was a volunteer from one of the local group homes. But I wanted medication and only she could provide it so I stopped and pondered and decided that if I were on the battlefield and all my limbs had just been blown off, I would have to be at a pain level of 10. I, on the other hand had all of my limbs and I was still able to use language (be it filthy or not) to communicate and was not in shock so, to be fair, I gave myself an 8. “Well that’s not so bad”, said the nurse. “You are acting like it hurts a whole lot worse than a pain level of 8.” “OK,” I countered, “I’m at a  9.” “But you just said you were an 8,” she replied, "which one is it?" I thought maybe, just maybe, I was in kindergarten hell. “My pain meds are not working!” I screamed.

They had me on a PCA morphine pump which lit up to indicate I could press the button like a good little rat to get another burst of morphine. Nice idea, but to work effectively on my pain, it would have had to light up every 20 milliseconds or so. Finally another nurse came over and held my hand and stroked it gently as if I were a little kid and I responded like a little kid. I wanted her to hold and stroke my hand for the rest of my stay. I was able to calm down enough to tell them, without interjecting a single swear word, that I needed some pain meds that worked – NOW. The nurse called a doctor over who said, “It looks like his nerve block wore off a lot sooner than we expected. Let’s put him on Dilaudid.” Finally, a voice of reason came down from the heavens. Yeah, what a great idea! Maybe I could use some Dilaudid. Twenty minutes later I started breathing more regularly and I was able keep more of my thoughts to myself. My nurse noted my newfound disposition and said, "See, all you had to do was relax and control your breathing." I tried to respond but all I could manage was a little smile as I slipped into a restful sleep.

3 - Expectations

My surgeon had the X-rays of my left leg up on the wall and was explaining to me, “see, here is one part of your Patella and look down here, there’s the other part!” I was so glad he found it. I didn’t want to start rooting around down there for lost bone fragments. My confidence in this doctor was jacking up by the minute.

My injury occurred Sunday, I was talking to the doctor on Monday and would be in surgery on Friday. I had no idea how long the next four days would be or how much worse the post surgery pain would be than those days preceding surgery. But, in the meantime, I wanted to know what my future would hold since I had some plans that definitely included bringing my knee along.

I told the doctor that I didn’t have much paid time off coming to me and short term disability only pays 60% of my salary so I was eager to get back to work in about two weeks. He should have laughed hysterically and, to better make his point, he should have rolled around on the floor and guffawed. But, I guess he is the kind of guy who doesn’t like to “dash one’s hopes” so he said that going back to work within two weeks was within the range of possibility. He then told me about a fellow orthopedic surgeon who had his Patella surgically repaired and was back doing surgery on others within two weeks. I was impressed and motivated. I too wanted to do surgery on others.

Much later in my rehab, my doctor told me the rest of the story about his fellow surgeon. Yes, he was back at work in two weeks only in the sense that he was resting and icing his knee up until the point where he hobbled into the operating room, performed his surgery in 1.5 hours and then had to lie down, elevate the leg, ice his knee and rest. Kind of what I was doing at home except I was allowed to take pain meds. And in fact, the doctor’s knee started to tighten up while keeping up this schedule, rehabilitation slowed to a crawl, so to speak, and some adjustments in his scherdule had to be made. Basically he managed to cut the surgery time down to ten minutes per patient without increasing his mortality rate more than 10% - well within the state surgical guidelines. I was disgusted with my doctor’s slow revelation of the “real” story and immediately cancelled my medical degree correspondence course. I thought the doctors were gods but really, they are a bunch of guys who feel pain like the rest of us.

My next question for the doc was about my prognosis further into the future. I had a backpacking trip planned for April first – three months down the pike - and I wanted to know if this was absurd or could I still look forward to this as a possibility - a goal to work toward. The doctor was speechless and just stood there staring at me. I knew then that he saw something special in me. His eyes seemed to say, “John, you are no mere mortal. I can sense in you a force far beyond anything I have ever known. Your strength will return and you will climb that mountain and you will throw off the burden of self-doubt and cast off the yoke of weakness for that mountain top will be yours”! I returned his gaze with an intensity that acknowledged his assessment and I nodded to show I understood. He laughed and I too laughed – we both laughed in the face of pain for I knew not what it was.

2 - Cancellations and adjustments

Two nurses came into my hospital room and one began to examine me. I could tell something was amiss when they started whispering to each other in hospital code – clearly they intended to cut off my leg and didn’t want to alarm me or cause undue distress. While one of them traced her finger along what now revealed itself to be the jagged edge of my Patella I started to understand that just maybe we weren’t dealing with an errant but adorable little Patella here. Maybe, I thought … and then I saw the other nurse move her hand much too quickly toward my knee and I grabbed her wrist in a death grip before she could touch me. My eyes locked on to hers and sent a very clear message that I could snap her forearm at will. She calmly asked me to let go so that she could help examine the line of fracture. So that was it: I had a fractured Patella – it wasn't dislocated after all.

As I sat with my family waiting to be discharged from the hospital, I used the time to prepare my son for the possibility that I could lose my job, rack up debts, go bankrupt, and end up homeless and living on the good graces of all those friends and relatives I had been ignoring for so many years. Things looked pretty bleak but I have never tried to shelter my family from the cold hard truth or at least my unbiased interpretation of that truth.

When I got home, I started to cancel some travel appointments. My son heard me cancel my trip to Washington DC before Christmas and my trip to Connecticut immediately after Christmas and he looked like he was going to cry. My heart really went out to him but I seized the moment - this was my chance to show some generosity and love without having to spend a single hard-earned dollar, “You know Corin, I really wanted to surprise you but this January, Mommy and I were going to take you to Disney World right after Christmas.” He couldn’t hold back any longer and tears burst out all over but I couldn’t help myself. “Yeah and then we were going to take a hot air balloon ride down to Cuba for a day. Now we’ll have to cancel all of those plans. I’m so sorry.” I torqued my knee a little to help muster up some tears of conviction.

Nice work! I could chalk Disney World off the list.

1 - The fall - the beginning

So now that I have passed through the initial phase of healing, I have the energy to write about my experience shattering (that sounds so much more dramatic than "fracturing") my Patella. I learned that way cool name for "knee cap" on December 13, 2009.

Yes, I slipped on some black ice five weeks ago and all 215 pounds of me landed squarely on my Patella. I didn't experience the fall in slow motion or later on have flashbacks of slipping and falling while desperately reaching for support.  Nope. I just slammed my left knee into the sidewalk and knew in a split second that this was serious. The first clue was the overwhelming and excruciating pain, the second clue was that my knee cap had worked its way up into the section of my leg normally reserved for my quadriceps and that it was also bulging just a bit out the side of my leg.

When I tried to move my leg, all hell broke loose.  After a quick consultation with my family and a "Good Samaritan" who had pulled over to help, we came to an understanding that I would kill the next person who tried to touch, move or even glance at my leg. So I lay there on my sidewalk in front of my house with cars whizzing by and with rain coming down on me while my wife called an ambulance and grabbed an oversized umbrella, the Good Samaritan reassured me and my son procured some camping pads for me to lie on.

The guy in the ambulance did a good job of distracting me from my pain with stories of other accidents that were far worse than mine. "You should have seen it, her bones were poking right out the side of her leg", or, "this guy was so cut up he had to hold his own liver all the way to the hospital", etc. My knee cap was simply dislocated. The doctors would snap my Patella back in place in short order. What a relief! This would all be over in no time. The doctors would give me some good drugs and send me home to trim the tree in the company of friends and family. Not a bad way to spend a rainy, if not slippery, Sunday afternoon in December.