Friday, October 26, 2007

Chapter Eight: Confinement, Part Two

Still in the Step Down unit, I had a very tough time adapting to my situation. Changing the bed sheets was an ordeal in itself, and going to the bathroom was far worse. I won't go in to much detail there! I was also on respiratory therapy for the first two weeks after surgery. A week after surgery, my IVs were removed and my morphine pump taken away. Unfortunately, I was given vicodin as an alternative, and I started going through those like candy. After taking two on an empty stomach, I was bordering on delirious and turned on the TV across the room for some background noise. Not being able to see it or fully comprehend what was going made it just short of irritating. The doctor ordered another x-ray to see what everything looked like, and Tanya, the x-ray technician, wheeled her mobile unit in. I didn't even realize that the TV was tuned to the Maury Povich show, which, on that particular afternoon, featured a few transsexuals with the audience guessing who was born a woman and who was not. Tanya immediately noticed this, and from that day forward, teased me about it.

The x-rays were taken and I was left to spend the rest of the day mostly in solitude. All I wanted to do was see something other than the bars surrounding my hospital bed and the tiles of the ceiling. I tried to count them several times, but the combination of vicodin and almost no food left me fairly confused before I could count to 40. I was fortunate to have a few visitors during my stay, including some distant relatives from Florida whom I hadn't seen in years and the teacher who took me to Orlando and helped me acheive my fifteen minutes of high school fame. Knowing that people out in the world really cared and wanted to see me recover made the trials and tribulations worthwhile and encouraged me to work a little harder on my therapy.

Day 11

The doctors decided that I could leave the Step Down unit, as I no longer required constant monitoring. I was moved to the room next door, still alone for the time being. Knowing that in a few more days I would be getting a cast, the Physical Therapy department brought up a "standing table" to assist my preparation. This particular device, at first, seemed like it would fit in nicely with the private collection of the Marquis de Sade. It was a thin and hard board, barely padded, with an extension at one end for my feet to rest against and straps down the length of it, vaguely reminding me of the bed one might find in an execution chamber. Removing my traction rigging left me with an intense urge to scratch my leg, although, to my disappointment, I was unable to reach it! This feeling would pop up regularly during the next three months. I was situated on the standing board for the first time and given the control to slowly tilt the table up so that I could eventually stand and support my weight on my left leg. The first try left me dizzy, panicked, and in great pain. More vicodin to the rescue! They kept me on the board all day and told me to take it slow. Since my body had been accustomed to one position for almost two weeks, it would take some work to tolerate standing up again. By the next afternoon, I was standing straight up on the board and finally able to see the TV.

Over the weekend, I spent most of the daytime on the board standing up. The nurses told me that I would need to be standing for a while when they put the cast on and that once they began, it would be unlikely that I'd have a chance to rest. After hearing the doctor's description of the cast, I had too many questions run through my mind.

Day 15

The nurses managed to get me out of bed early and wheeled me, on the standing table, down to the Physical Therapy department one floor below. Apparently the level of planning for this event was somewhere between the Academy Awards and landing on the moon. Sheets were draped around a set of assistive bars for patients learning to walk again. I was wheeled up to the bars and brought up to standing once again. After acclimating to my vertical position, I was given a few minutes to rest my left leg as it would have a lot of work to do for the next few hours. During this time, I was given the opportunity to find out how it feels to have staples removed from my skin. It was a rather unique feeling, but what surprised me was the fact that I only felt every other staple coming out. After a few minutes with a small cloth, the minor bleeding ceased and it was time to get started. Given the plan of the cast, it was necessary for me to strip down to a small piece of cloth that offered very little coverage or comfort. Once it was in place, I was once again brought to a standing position and told to reach for the bars. The straps were released one by one, with my father standing alongside me to offer support if I needed it and give me a little encouragement. Trying to hop forward on my good leg without moving my right hip was a painful and serious challenge, but somehow I managed to make it two feet. Maj. Ross and Dr. Haynes began the casting procedure with help from two of the orthotics staff. They started at my ankle, positioning my knee and hip at the correct angles and adding steel support bars around my knee. After twenty or thirty minutes, my leg was encased from the top of my thigh to my ankle. The next step proved to be much more difficult, as my arms were close by my side, hands gripped firmly on the guide bars to take some of the pressure off of my left leg. My father and one of the orthotics staff came in on either side of me and each took an arm over their shoulder to hold me up. The doctors then began to wrap my abdomen in the cloth liner, then in the casting material. An hour later, I had two disconnected casts and wanted nothing more than a vicodin with a vodka chaser, but alas, our task was not yet complete. The next task was to fit the upper portion of the cast to my arms so that I could comfortably hold myself up to complete the procedure. It only took two cuts on each side and a few pieces of padding before I was holding myself up again. Maj. Ross grabbed another steel support rod and placed it alongside my right hip, taping it to the two sections of cast already on my body. His trusty tool for measuring joint angles ended up getting a lot of use as they aligned the two sections and added another two support rods on the front and back of the casts. Now the fun would commence as they padded the section around my hip and began to wrap the cast rolls around my waist, across my hip, and down around my thigh to complete the contraption. Another hour later, the cast was finished and drying. By this point, my left leg was about to collapse on itself and I was once again in tears, hoping it would all be over quickly.

A few very long minutes later, the cast had dried and I started to inch backward, expecting to get back on the standing board to be returned to my room. Much to my surprise, however, an extra-wide wheelchair was brought up behind me. Sitting down in the wheelchair took the help of five people, and when I was finally situated, I was in much the same position I'd originally expected to be in. The wheelchair had a reclining back, and the doctors insisted that I be put as close to flat as possible to elevate my casted leg. The next stop for the day was another x-ray to check the alignment of my hip in the cast, and I realized it would be quite easy for Tanya to reposition me in the cast as any movement of my foot would rotate my whole body. The doctors were pleased with the work, and I was taken to the cafeteria for a late lunch. Unfortunately, being in such a reclined position, I couldn't get close enough to the table to reach my food. I had to reposition to where the table was to one side of me, and even then it was quite difficult to eat. Half of my sandwich ended up on my shirt. It took several more days to master the art of eating from such an awkward position.

The most fortunate part of being in the cast was that I could finally raise the head of my bed so I could see my surroundings. From room 702, I had a view of a small wooded area and some of Houston's urban sprawl. With binoculars, I could see the traffic on highways in the distance and be thankful I wasn't driving in it. I also started going downstairs twice each day for thirty minutes on the standing board. Sadly, I learned what it must be like to drive a car with the driver's seat fully reclined. It was impossible to see what was in front of me, and within the first three days I'd bruised my foot on furniture and walls, and I'd bruised a few other people by running in to them. Moving from the bed to the wheelchair and back was also quite an ordeal, requiring me to lift myself up on the bars over the bed and slide sideways into the chair or back across to the bed. I'd also continued to suffer the indignity of using a bedpan and developed a new respect for the nurses and orderlies responsible for helping me with that ordeal every day.

Chapter Seven: Confinement, Part One

June 7, 1998
Houston, TX

We drove to Houston the previous evening and once again spent the night at my father's friend's home. Every time I see their kids, I'm amazed at how fast they're growing and I realize that Hoppy must think the same about me and my sister. Sunday was not a very busy day for us. We relaxed and enjoyed the company for most of it, and later in the afternoon, we piled in the van and headed for the medical center. Houston traffic, as usual, sucked. I half expected a Sunday afternoon to be relatively peaceful, but I was mistaken, and part of me regretted that I insisted on driving as it would be my last opportunity for several months. Being checked in to the hospital seemed to take forever as well. There were several stacks of papers that required my signature as well as my father's. I settled in to room 708 and met my temporary roommate, a younger boy who enjoyed video games just as much as I did. We went back and forth playing Test Drive on his Playstation for several hours until the nurse told me it was time to get ready for bed. She reminded me of what I would need to do before surgery the next morning and offered me a sleeping pill. I took it, knowing full well that I'd never be able to get a minute's rest without it. There were far too many concerns and hopes running through my mind.

Five o'clock came quickly, and all I wanted was more sleep. There was some consolation in the fact that I'd have all the time I wanted for sleep over the next few days, but it wasn't enough to shake the grogginess as I stepped in the shower and bathed with the special sponge they'd given me. I dried off and fumbled with the hospital gown, and, not being able to get it right after three tries, enlisted the help of my father. He and my sister arrived just a few minutes after I awoke. The gurney was parked right outside my room, and as I approached it, my nerves went from zero to "HOLY SHIT!" in a time span not measurable by anything on this planet. I sat back on the gurney and was wheeled up to the nurses' station to wait for the surgical staff to arrive. One of the OR nurses arrived with two pills and a very small amount of water. I didn't think I could swallow anything with the few drops in the cup, but I managed. My father and sister reassured me that they would be waiting for me after surgery, and I began to nap for a few minutes. The movement of the gurney woke me up again as they wheeled me to the preparation room. The OR nurse charged with starting my IV and making sure everything was in order happened to notice my purple ankle and began to panic.

Both of the surgeons were called in to see my horrific sunburn and there was brief chatter about postponing the surgery for a few days to let it heal. Fortunately, it was decided that this was the best time to operate as they schedule was full for the next few weeks. The nurse injected the happy juice in my IV line, and again I had to question why it was given that nickname. Apparently it did something though, as I was told later on that my jokes got worse as they wheeled me to the operating room. I didn't remember much of anything after the injection.

Late that afternoon, I woke up once again, trying to figure out what had happened, what time it was, and who I was. I couldn't feel much of anything, and my vision was a solid blur. I quickly fell asleep, waking yet again to the moving gurney taking me to the "Step Down Unit", very similar to Intensive Care. I realized that my leg was hanging in a sling, suspended from a cage of bars around the bed. My father and sister met me in Step Down, and I was introduced to the evening shift nurse, a sweet older woman from Australia named Noel. She reminded me of my grandmother in Tennessee in many ways. My father and sister sat nearby as I drifted in and out of sleep, talking to me each time I woke up and wondered where I was.

At the time, my mother and her husband worked together driving an 18-wheeler across the country. They were able to arrange their route to be in Houston on the day of my surgery, although they didn't make it to the hospital until around 7 that evening. As my mother entered the Step Down unit, Noel was quick to stop her with the ferocity of a bear protecting her newborn cubs. I told her that it was OK for them to enter, and we visited for a few brief minutes. I was still drifting back to sleep every few minutes, and my mother decided it would be best for them to return next time they were in Houston. She said good-bye and attempted to hug me through the maze of the traction bars and IV tubes, but it wasn't easy for either of us.

I realized at that point that I was not going to be very comfortable flat on my back and pushed the button to call for Noel. My request to raise the head of the bed or get a few extra pillows was denied, however, as the doctors didn't want my upper body to be moved more than absolutely necessary so that I wouldn't change the alignment of the soft bone mush that was now my right hip. Thankfully I had a morphine pump, but it didn't seem to help that first night. I felt hot and sweaty all night and kept hallucinating that I was outside. Phil, the usual overnight nurse, brought in a fan, but it didn't seem to do much. I slept through breakfast that morning, but my sleep didn't last much longer. It was time for my first attempt at hanging from the traction bars so that an x-ray could be taken. I was still very weak from the previous day's anaesthesia, so every nurse and orderly in that section of the hospital came in to help get the x-ray film underneath me. After several very painful attempts, the pictures were complete. Dr. Haynes and Maj. Ross, the two surgeons who performed my operation, came in shortly after with good news. The x-rays looked very promising. I asked them how much longer I'd have to stay in "the infernal contraption", as I'd taken to calling my traction rigging. That news wasn't so pleasing, as I was told it would be at least two weeks, possibly three, until I would be put in my cast. Until that time came, I was to work with a physical therapist to build up strength in my arms and my left leg so that I would be better prepared for the creation of the cast.

The next day, my father and sister returned home. I was a little uncomfortable being so far from home with nobody close by, but I knew I would manage one way or another. I continued to complain about not being able to raise my head enough to even see the TV, a problem which would later create an ever-lasting joke with Tanya, the x-ray technician. It also made eating very difficult, and for the first week I think I managed to eat all of two bowls of cereal, not counting what I managed to spill all over myself in the first few attempts...

Chapter Six: Preparations

August, 1997

I joined the work program during my junior year of high school, and managed to arrange a job with the school district as their main PC technician. The arrangement was decent...at the time, $6 an hour seemed pretty good when my friends were making $5.15 at Burger King. I was responsible for 5 campuses at the time, and our technology wasn't all that advanced. I was still driving "The J-Rod", as Mike had taken to calling it, although quite reluctantly. It was embarrassing to be seen in the car, but at least it was mine. About three weeks into the school year, I came down with the worst case of tonsilitis I'd ever had. I used to get it every year at the end of school up through sixth grade and hadn't had it since. When I was in fourth grade, the local Ear-Nose-Throat specialist, whom I'd been seeing for this problem every year since kindergarten, told me that if it came back the next year, he'd take my tonsils out. Sadly, Dr. Davis passed away six months later, and when it came back in fifth grade, the doctor we'd seen told me that they won't do a tonsilectomy unless it's a very severe case. I heard the same thing in sixth grade from yet another doctor.

My father found a new ENT specialist in San Antonio. Dr. Henderson was all too happy to take a look at my tonsils, but was in shock during the exam as they were the largest she'd ever seen. I left her office with the usual prescription and a tonsilectomy scheduled for two weeks later. The antibiotics helped as always, but by the day of my surgery, they were still swollen. Dr. Henderson checked them before taking me in to the operating room. I expected it to be a short operation and that I'd be going home that night, but I was sadly mistaken. Instead of the 45 minutes to an hour that they estimated, I was under for about two and a half hours. When they woke me up, I was told that I'd have to stay overnight for observation. Dr. Henderson visited me in my room later and brought a glass jar with her. When she removed my tonsils, they were still the largest she'd ever seen, and she wanted me to see why the operation took so long. That jar sat in her office for quite some time.

I didn't mind eating jell-o and ice cream for a week. The immediate problem was that I could not have a cigarette, but this paled in comparison to what happened the week after. It was my grandmother's birthday, and we all went out to dinner. (Warning: Shameless Plug ahead!) Po-Po Family Restaurant is a little place in the middle of nowhere with some of the best food I've ever eaten. The appearance from the outside, a somewhat run-down building with a neon sign saying "EATS", is rather deceiving, but the crowds tend to give away the secret. It just so happened that my grandmother's birthday fell on a Friday that year, which, back then, was all-you-can-eat fried shrimp night. I'm a sucker for fried shrimp, and there's something about theirs that is horribly addictive. Sadly, I hadn't made it to solid foods yet. Rocky Road ice cream was still a challenge for me and it hurt like hell! I was quite upset, but I opted for a bowl of mashed potatoes and some chicken gumbo. Carol, our waitress (every time we've been there since the late 80's), was kind enough to get me a real strawberry daiquiri instead of the non-alcoholic version my sister usually ordered. I'm not sure if it was the cold drink or all the rum, but my throat felt better! I stole a shrimp from my sister's plate and tried to eat it...small nibbles at first, but I failed and almost screamed from the pain. No more shrimp that night. I sucked down another daiquiri and enjoyed the rest of my mashed potatoes, then told my father he was still on the hook for some shrimp when I was healed up.

After my tonsils had healed, it was time to get serious about the Shriners and my hip. My first appointment was in early October. I've never cared much for Houston, but my dad's best friend since high school lived there and I hadn't seen him in ages. Dad and I made the trek on Sunday and crashed out at their house for the night. The next morning was a long waiting game. We arrived at 7:30 for an 8:30 appointment, but were far from being the first in line. I was called in to see the doctor around 10, then waited another hour to see Dr. Haynes, the main hip surgeon for the Houston unit. He informed me that they'd never done a hip fusion at that hospital, but he was very familiar with the procedure and felt very confident that they could help me. I was sent off for x-rays, then returned to face the hospital board. After a short discussion about my current condition and the alternatives, it was decided that they would accept me as a patient for the hip fusion. I had another pre-operative exam scheduled in March, and they would schedule the surgery at that time so I could have it done during the summer and not miss as much school. We finally left the hospital around 3 and were both starving. My father, always the tour guide, went well out of the way to show me a few things and get us lunch. We ate at Furr's, which is an all-you-can-eat cafeteria restaurant. For you San Antonio folk, think of Luby's, but you can go back for more. As we left, my father told me that back when they lived in the area before I was born, the restaurant used to be an adult movie theater! I was a little shocked by that, but it didn't really surprise me after considering the layout. We then drove up to Humble to see the house where I lived the first year of my life. It was right on the edge of Houston Intercontinental Airport, and apparently I got used to the sound of jumbo jets flying overhead sometime in my first month of life. To this day, it still doesn't bother me in the least.

We made the trek back home, and I began to worry. I wondered how I would be able to do even the simplest things with a hip that doesn't bend. I even tried to do various things without moving my hip joint and was quite afraid of how it would change my life. The doctors said that I would be able to walk, albeit with a limp (which I was used to anyway for the last few years) and that I'd be able to do most of what I was able to do at that time. I started walking more often, trying to build up the muscles before surgery for an easier recovery.

The J-Rod continued to fall apart. One Sunday afternoon in early December, Mike and I were driving back to Boerne from San Antonio and I heard an unusual noise. My engine sounded louder, and I thought I could hear something scraping along the pavement of I-10. We pulled off, and sure enough, my exhaust pipe had rusted through just in front of the muffler. I'd been dragging the muffler down the freeway for a couple of miles! Mike was quick to pull it off and throw it in the trunk, and I learned a new trick. I found out that I could force the car to backfire at will! This was particularly fun in underpasses and while driving down Main Street in Boerne. I left the disconnected tailpipe in the yard that evening so my father could see our next project. We met at a mechanic's shop the next afternoon to have a whole new exhaust system put on, and I was still able to backfire it afterward. The speedometer was the next to go. It worked up to 45MPH, then it would start bouncing to the top end and leave me no clue how fast I was really going. To make matters worse, after my second carburetor replacement, the car would no longer idle without stalling. I was forced to brake with my left foot, shift the car in neutral, and rev the engine any time I had to stop.

The J-Rod came to its death shortly after the Super Bowl. On the way home from the party Mike and I went to, the car started shaking violently. I wasn't sure what to think, and when I told my father, he suggested I not drive it until his day off when we could meet at the mechanic's to get it checked out. The car sat in the driveway for two days, and on Wednesday, I drove to school at very slow speeds. Anything over 30 and it would shake so bad I thought it would fall apart. I made it to class, and when I left to meet my dad, it stopped permanently. The U-joint blew and the drive shaft was hanging from the rear axle. My father finally decided to give up on the car and donated it to the school's auto tech program, and I was stuck without a car for the rest of the year.

During the next exam at Shriners, my surgery was scheduled for the second week of July. I was told to expect about three months in the hospital for recovery, and at least a year of physical therapy after that. We got a call in early April about moving the surgery up to June 8, which we gladly accepted. School wound down again, and we flew off to Tennessee for the last few days I could enjoy before going to the hospital.

My aunt and uncle had, over the previous two years, taken up sailing. They bought a new sailboat during the winter months and waited until we could join to take it out on the lake. That was one of the most peaceful days I'd had in quite some time! We drifted around a rather large lake, jumping in the water occasionally, and my sister and I learned basic sailing techniques. Unfortunately, though, with my light complexion, I'm an instant target for sunburn. I thought I'd managed to get everything covered with sunscreen, but there was a small spot on my right ankle that I couldn't reach because of my hip. It looked fine all day, but the next morning it was bright purple! We all worried about it affecting my surgery the next week...