Drinking from the Trough

by Mary E. Carlson, DVM

  “Suspensory motion” is the sweet spot as you round the top of the trajectory, right before gravity overtakes you and you begin your descent. It includes that fraction of a moment when the force of your upward trajectory exactly matches the downward force of gravity, and for the briefest moment, you’re motionless and weightless.

  I contemplated hang time; surely, I was almost to the top. What would suspensory motion feel like? Everything was happening in slow motion—another of those weird illusions we humans are prone to, this one due to the adrenaline surge—so perhaps there would be plenty of time to notice being weightless before time resumed its normal pace.

  I couldn’t see Hannah, but I knew she was somewhere below me. She wasn’t weightless. Or soaring, for that matter.

  Neither was I, I noticed; gravity was winning, and I was falling.

  I hit the dirt fully extended on my right side, squarely on my right hip. I couldn’t have nailed it better if I’d painted a bull’s eye on my hip and aimed for dead center. I didn’t exactly bounce, but the force of the rebound rolled me onto my belly.

  Cats are much better experts at dissipating the landing force than people. The two new kittens we’d adopted a couple of months earlier, brothers Frank and Cowboy Joe, were already masters at marvelous gymnastics moves that I’d never accomplished back in my heyday. They had excellent hang times too.

  I tried to get up. I got as far as my hands and knees and then discovered that my right leg wouldn’t move forward.

  “Earl, call 911!” I yelled.

  He squatted down beside me and said, “No, it’s okay—I’ll take you to the hospital.”

  I groaned and shifted over to half-sit on my left side. “No! I need 911!”

  No cell reception at the arena, thanks to the surrounding mountains, so Sue rushed back to her house and called the paramedics from the landline. There was a fire station close to Sue’s place; they sent a truck immediately and dispatched an ambulance from Poudre Fire Authority Station 2, which was only about a mile from our house but ten miles from Sue’s place.

  While we waited, Sue’s son drove their Mule—a type of farm vehicle that looks like a cross between a golf cart and a small but mighty pickup truck—to the arena. I grabbed the edge of the open bed at the back of the Mule and hoisted myself up.

  Oh, yes, I’d definitely broken a bone. I could feel the edges grinding together when I put a little weight on my injured leg. Trying to step on my leg felt like wobbling on top of a pond, only with a lot more pain.

  By the time the fire truck arrived, I’d made it onto the Mule’s padded bench seat, and Sue’s son had driven us to just outside the arena, where it would be easier for the firefighters to reach us. I drew on my years of yoga practice, using breathing techniques to stay calm. I had only one minor episode of nausea and dizziness.

  Before the firefighter had a chance to do anything, I barked out, “Whatever you do, do not cut my boot off!” It had taken me all my life to find a pair of English knee boots that fit. I’d used my late sister Natalie’s boots for thirty years, but at long last, I finally had a pair of my own. My beautiful brand-new, black, shiny boots were English field riding boots, the kind with shoelaces over the ankle and part of the instep. Injury or no injury, I wasn’t going to lose those boots.

  The firefighter smiled and promised no boot cutting. He was patient and worked with me to remove the boot intact and without pain.

  The ambulance arrived; time to transfer me onto the gurney. “Give yourself a hug,” one of the EMTs said.

  “What?”

  He demonstrated, wrapping his arms around his own shoulders. “That way, you won’t try to move yourself onto the gurney. That’s our job,” he said, smiling.

  The lack of control I had frightened me more than my injury, but I wrapped my arms tightly around myself, and they loaded me gently into the ambulance.

  “How about lights and sirens? And high speed?” I asked. If I had to ride in an ambulance, at least it could be first class.

  The answer was, “Sorry, no.”

  Bummer. I was hurt badly, but evidently, I was stable enough that I didn’t warrant that much excitement.

  I studied my injured leg. It was rotated, the foot turned totally to the outside, the classic position of a fractured hip.

  I noticed a few visual disturbances too. Sometimes, the clock in the ambulance had black spots on it, or only half of the clock was visible. I knew this was a sign of mild shock, but when I asked the EMT about it, he didn’t say anything. I suspect he didn’t want to scare me.

  I gave myself another hug as the EMTs transferred me to the emergency room bed. The ER staff took over my care, inserting an IV line and administering much-needed pain medication before sending me off to radiology. The ER doctor never touched me; he could tell just by looking exactly what my injury was. He did, however, bill me for the exam.

  X-rays were the worst part of emergency treatment. The room temperature was frigid, especially for a trauma patient. I swear the radiology technician was a heartless witch. She insisted that Earl leave, and then she left me alone on the X-ray table with no safety railing. I couldn’t correct my balance because of my injury, and I had just been pumped full of strong narcotics. I worried that I’d fall a second time.

  Moving my leg into the position the tech wanted caused such horrific pain that the tech had to call in other aides to hold my leg. I was shaking and crying by then. I didn’t know my husband was just outside the door; they never asked me if I wanted him beside me in between attempts at X-rays, and they never asked him if he wanted to join me. I thought he was waiting for me back in the ER bay.

  On the way back to ER from radiology, I overheard one of the techs say, “Surgery.”

  I already knew I would be heading for surgery because the ER doctor had ordered a chest X-ray, which is a mandatory precursor to surgery.

  I said, “Stop!”

  The gurney stopped. I explained that I was aware of confidentiality rules, but since I couldn’t see their faces, could they please tell me what was broken.

  “The femoral neck,” one of them said.

  The femoral neck is the thinnest part of the largest bone in the body. It attaches the long shaft of the femur to the head of the femur so the bone can fit into the pelvis, creating the hip joint.

  Since I wasn’t critical—this wasn’t a life or death situation—I was transferred to a room on the orthopedic floor, where I spent the rest of the day waiting for the orthopedic trauma surgeon. I’d launched from Hannah at eleven in the morning. I had a long, uncomfortable, scary wait, offset in part by powerful pharmaceuticals, before it was time to transfer me to the pre-op area at six o’clock.

  By late afternoon, my body was reminding me that I hadn’t used the bathroom since before we left home for the riding lesson. Between that and a day’s worth of IV fluids, my bladder started talking to me. I couldn’t get out of bed, of course. The nurse tried to help me use a bedpan. No way—moving was agony.

  By the time I was moved to pre-op, my bladder was screaming at me. I was gritting my teeth to prevent an explosion of urine.

  In pre-op, the nurse noticed that my hands still had some blood on them from the IV insertion. She began to wash my hands with a warm, moist towel.

  That did it! My bladder could not wait any longer.

  I informed the nurse that I had to be focused to talk to the surgeon when he arrived, and I couldn’t do that with a basketball-sized bladder. I understood that bladders are usually catheterized under anesthesia, but I didn’t care how much it hurt; she had to do it immediately.

  She didn’t argue or question my reasoning. She gently inserted the catheter—painlessly too, I might add—and nearly a liter of urine gushed into the collection bag. I have never felt such utter, joyous relief.

  That evening, I underwent surgery to put my hip back together. Three screws—$500 a pop, each one 85 millimeters (3.5 inches) long and sturdy enough to be used on farm equipment—were installed acr
oss the fracture line.

  I could have been featured in a John Deere calendar.

  Physical therapy began the next morning. The first exercise was to get out of bed with the therapists’ help and hold on to a walker. I couldn’t move my leg; the therapists had to move it for me. The pain was excruciating.

  Before I could be discharged from the hospital, I had to learn to walk using the “touch-down weight-bearing” method, which would be how I’d get around for the next eight weeks. I advanced with my injured leg barely touching the floor, no weight on it. Then I moved the walker and then moved my uninjured leg. My arms trembled from the exertion, and I shook with pain.

  Simply standing and hanging on to the walker was the first task. Next, I had to learn how to use the walker to actually move myself and, after that, learn how to use crutches.

  Did I mention the excruciating pain?

  I quickly reached the point where any time any hospital staff person came into my room, I startled in fear of impending pain. “Mary, no one’s touched you yet,” they’d say, trying to reassure me, but that didn’t help.

  My morphine drip compounded the pain issues.

  Research shows that when patients are able to control the delivery of their pain medication, they use less medication. I controlled my morphine delivery by pushing a button on a special pump attached to the IV apparatus. Push the button, and the PCA (Patient-Controlled Analgesia) pump delivers the correct dose of morphine directly into the vein. Then the machine locks you out for ten minutes. If you need more painkiller, you can push the button again after the ten minutes are up.

  Morphine is an effective pain medication, but it made me itch all over, talk like a crazy woman, and hallucinate. (It’s now on my medication “do not use” list.)

  I had no clue that I was hallucinating. I just thought I was in a different room every day for my six-day hospital stay. One day, my room had a kitchenette. The next day, I wondered where the kitchenette had gone. Over the weekend, I was sure my room was on the first floor. I was actually “the hip in 3029,” on the third floor of the hospital, during my entire stay. And my room definitely did not include a kitchenette.

  When I closed my eyes to try to sleep, I saw visions of my childhood home on Indian Tree Drive in Highland Park as façades for new condominium buildings. I watched animals morph into other animals. I have to admit that was pretty cool, and it was in Technicolor too!

  Not all of the hallucinations were enjoyable. In one especially disturbing vision, I saw Marcie walk across the corner of my visual field. Marcie was twenty-nine that summer, and I always worried about her health, even though she was doing well. I was terrified that she would die while I was hospitalized because she’d appeared in my waking dream. I cried and cried, convinced Marcie was about to die, while my wonderful night nurse, Sara, comforted me. After I’d cried myself out and Sara left, I was finally able to sleep for the first time in three days.

  The hallucinations became quite complicated when I had the TV on. Certain channels made things worse or more intense. When I listened to the Spanish channel, the hallucinations were more relaxing. When I turned the TV off, the hallucinations gravitated toward mild subject matter—not exactly relaxing but not especially disturbing.

  A couple of teacher friends visited Saturday morning, and I told them about the weird visions I was having. They’re the ones who told me that my visions were hallucinations, laughing so hard that they nearly fell off their chairs. I had no idea. In my college days (clearly different from theirs!), I’d been a field hockey team member, too busy being a pioneer for Title IX to want to do drugs. It took a twenty-first century hip fracture and hospital stay, complete with tubes sticking out of my body and screws holding the broken parts together, for me to have that experience.

  Friday, the day after my surgery, I called the school district’s director of human resources in a panic to tell him that I wouldn’t be able to start school in the fall. He arranged everything, including notifying the benefits department to start my long-term sick leave so I wouldn’t lose any pay. He asked permission to tell others about my accident. I was a little hesitant, but he pointed out that I was a former board of education director and a longtime teacher, and people would want to know. I agreed and gave him the go-ahead.

  Gary, the acting superintendent of schools, stopped by that afternoon. He was so kind. During his visit, I took my scheduled dose of oral narcotic painkillers. “Uh-oh, now you’ve seen a teacher taking opioid drugs,” I commented.

  Later, a giant flower arrangement was delivered to my room, courtesy of the superintendent and the board of education. I was a survivor—I mean alumna—of the school board, and I felt like an honored member of the club when I saw that bouquet.

  The weekend in the hospital was dreadful. I developed a fever from the inflammation in my fractured leg and felt even worse. I would have appreciated an opinion from the doctor, but my temperature was a few tenths of a degree shy of the point where anyone would call him. The only bad nurses I’ve ever had—one who was hearing-impaired and was shadowing another who had a speech impediment—assisted me with my first in-hospital shower. They seated me precariously high in the air on a special stool and did nothing to help me feel secure. Instead, I felt like I was in danger of falling any second. I was so embarrassed by my fear that I wrapped a bath towel over my head and face when they wheeled me back to my room. I felt mostly clean, but then I noticed dirt and hay still packed into my belly button, leftovers from hitting the deck in the arena.

  Fortunately, Jean, my dear friend and fellow vet school classmate, came up from Denver to visit me on Saturday. She did some relaxation exercises with me, then taped acupuncture seeds to important meridian points to help me with the pain and to relax.

  My nurse that afternoon was fascinated with Jean’s acupuncture work. She had a little headache, so Jean applied seeds to the nurse’s hands, which alleviated her headache.

  The best—or funniest—part of Jean’s visit was when I used the orthopedic triangle pull-up bar while giving the classic middle digit salute. We both giggled, and she took my photo. I keep that photo in my date book to remind myself that things do get better with time.

  Things improved when the morphine pump was removed, and I was allowed to switch to an oral narcotic. I was finally able to sleep. I became a rock star at physical therapy. I started eating, although it was uncomfortable because the outer edge of my tongue had a gigantic ulcer on it, probably from biting it while coming out of anesthesia. I also had a sore throat from the too-large endotracheal tube that had been inserted to help me breathe during surgery. I coughed up some bloody stuff that was really gross, directly from my injured trachea.

  Friends left tons of chocolate for me to enjoy, but chocolate never tastes good to me when I’m sick, and I was having a hard time eating anything because of my sore throat and mouth. The chocolate piled up until there was so much that we converted an entire table into an official “chocolate table.” It didn’t take long before nurses I’d never seen began wandering in to ask, “Is this the room with all the chocolate?” and pluck a goodie or two from the colossal stash.

  Ortho docs are really busy, and while I saw my trauma surgeon daily, there never seemed to be enough time to ask him about my prognosis. I was feeling better now that I wasn’t hallucinating, but I was still worried. I finally had the nurse put a sticky note in my chart: “Patient requests that Dr. Lundy please sit down and talk to her about her injury.”

  It worked.

  Doug Lundy, a fine doctor, sat down with me to assuage my fears. We developed an excellent doctor-patient relationship, one that would last for two years, until he moved with his family back to his home state of Georgia. Doug made me laugh with stories from his med school days, including one about dropping an old guy on the floor that cracked me up. Laughter is great medicine, and laughing during adversity has always been important to me—enough so that I had the nurse add a note about it on the white board near my hospital be
d. Next to “Mary—R. hip—a ‘rock star’ at PT,” she wrote, “Humor works well.”

  I was scheduled to be released on Tuesday.

  Monday, a woman who worked in some office (I never found out which office, specifically) barged into my room and announced that my insurance program paid for only four nights in the hospital for this type of injury, and if I “insisted” on staying an extra night, I would have to pay for the room and all associated services myself.

  “I haven’t even learned to use crutches yet!” I sputtered. “My doctor isn’t releasing me until tomorrow.”

  She shoved a paper at me, demanding that I sign it. The paper said I would be responsible for the extra day and its costs.

  I refused to sign.

  She insisted.

  My irritation blossomed into rage. I told her that I wouldn’t sign anything and to get the hell out of my hospital room.

  She left, paper unsigned, and I called the school district’s benefits office. The wonderful experts there straightened out the mess, and I was allowed to stay one more day.

  What should have been a quick goodbye after physical therapy on Tuesday turned into an all-day process. I remember very little of it. I know that whenever food came, someone pushed it away for unknown reasons. I had no clothes at the hospital, so Earl and his mom, Beverley, who had arrived from Texas while I was in the hospital, went home and brought back something for me to wear. I did have the presence of mind to take the remaining chocolate—a single bag of Hershey’s Kisses, which were a gift from my principal, Mike—home with me.

  It was late afternoon when I arrived home. I made my slow way from the car to the house, supporting myself with my youth-sized walker. Earl followed behind, carrying my new crutches.

  The first thing I saw when I made it through the door was new kitten Frank. I sat down, picked him up, and began to cry.