Thursday, December 12, 2013
Be Careful What You Wish For
After my head-on collision with ineptitude at the nursing home, I was thrilled that my insurance company allowed me to transfer to my local hospital’s rehab unit. It was a brand-new, clean, and beautifully designed facility just minutes from all my friends and loved ones. I thought it would be the ideal place to let my wound heal in preparation for skin graft surgery, which was the Holy Grail of this entire medical melodrama.
See, once I received skin graft surgery – and if there were no complications – I could continue on to more physical therapy and then, eventually, I would get to go home.
If I remembered correctly, home was that place where I could make myself a cup of tea whenever I felt like it. It’s where I could laugh with my kids, play with my two ridiculously goofy dogs, have people over for dinner, snuggle under the flannel sheets, listen to music while I tidied up the kitchen, and sit in the sunshine on the front porch and chat with my neighbors. Home was the place where the real Susan used to live, not this hollowed-out, barely-there shadow of a person I had become. I hungered for that simple little life in that simple little house, and I figured that my local hospital was the closest I was going to get to it at the time.
I was assigned a lovely private room with a big window through which I could see the actual sky. There was seating for visitors and a large, sunny rehabilitation facility down the hall. (There was also an en-suite bathroom with a big shower, but I was nowhere near ready for that great leap toward normalcy. I could only stare longingly at the indoor plumbing while giving myself a sponge bath or requesting a bedpan.)
The first night in my new digs was difficult, because I was still coming down from the narcotics overdose. And though I was immensely grateful to be anywhere other than the Pit O’ Despair Nursing Home, I wasn’t able to relax. It soon became obvious that the kind and attentive nurses and doctors on the rehab unit weren't used to dealing with an open wound like mine. And that terrified me.
As you might have noticed in previous blog entries, I’ve made an effort to gloss over the gory details of my medical ordeal. But this is where I need to explain the reason for my terror. Not only was I was weak, exhausted, confused, drugged, and in intense pain, what remained of my left leg was essentially raw meat. I’d never even dared look at it. It was an act of self-preservation – I didn’t think I’d be able to handle knowing what my amputation site looked like. So while at University of Maryland’s Shock Trauma Unit, I put a sheet over my face when doctors or nurses needed to do something with it.
But since most of the wound was on the underside of my leg, I was able to watch when Shock Trauma nurses applied fresh bandages every morning and night. It’s a damn good thing I did, too, because some of the nurses in the rehab unit had no idea how to bandage it. On my first night there, I had to talk the nurse through the process step by step. (First, you place sterile gauze on the open wound. Then, you cover the surgical staples close to my groin with at least two layers of sterile gauze. Next, you wrap the whole leg, starting at the amputation site and . . . )
Though this completely freaked me out, I tried to be tactful as I told this very sweet and kind nurse how to do her job. I didn’t want to piss her off, but I also needed my leg properly bandaged to protect the wound from infection. I was, essentially, at the mercy of these nice people. I was helpless. And though I knew they were trained health care providers who knew far more than I did about tending to the sick, this was my life. And the very nice nurse wasn't sure how to bandage my leg!
W. T. F?
After everything I’d been through – the surgeries, the the pain, the nursing home from hell – I now had to worry that these well-intentioned people at my local hospital might undo much of what the University of Maryland Shock Trauma team had achieved.
My concerns continued. The bandage would fall off every time the physical therapists would work with me, and sometimes that meant the amputation site would touch the plastic upholstery of the therapy table. I’d cry when that happened. I came to dread physical therapy, not because I didn’t want to do it but because I worried about my leg being exposed.
There were other problems. I had no wound vacuum, so the amputation site wasn’t being drained. The hospital had no heat lamp available to use on my leg, either. I asked my attending physician if my family could buy one and bring it in. He said no, that any equipment used on the premises had to be hospital-issued because of safety and liability concerns.
So there I was. Bandages falling off. No heat or drainage to aid in healing. Worried about infection. Worried that the wound wouldn’t be ready for the skin graft. I expressed my concerns to my kind but exhausted and overworked doctor, who patted my hand and told me I worried too much.
After a week in my hometown, my orthopedic trauma surgeon at University of Maryland wanted me shipped back to Baltimore so he could assess my progress. My belongings were packed and I was waiting for medical transport to show when my attending physician came in. He needed to examine me prior to discharge from the rehab unit.
“Hmm,” he said, poking around. “I’m afraid the wound is infected.”
Later that afternoon, when my trauma surgeon looked at my leg and heard about my nursing home debacle, he got angry. “I’m readmitting you. I’m not letting you out of my sight until you’ve had your skin graft, and if your insurance company doesn’t like it they can come talk to me.”
So that’s how I ended up back on the Shock Trauma unit, worse off than when I’d been shipped out ten days before. But, hey, I finally got a wound vacuum and heat lamp, so I had that going for me.