Sunday, April 17, 2011

2011-What a doozie

**Warning** Long post

What a 2011 we've had so far. Just to recap quickly. In January, Lilly and Thatch had T&A's. From January to the Present, Tucker's nose hasn't quit running (this is a whole new post in itself). In February, we all got the stomach flu bug that his every other household this winter. And in March, Adam fell off a roof.

Yep, 2011 has been a doozie. On March 1 (I think), Adam hobbles in the front door with the help of Ryan and Brandon. My heart begins to race and I get all flustered. Now what happened, I think to myself. Not again, I think to myself. Oh Man, I think to myself.

I get the scoop: The guys were measuring some roofs for the Spring and Adam set the extension ladder up onto icy concrete at a not-so-good angle. All 3 men climb the ladder, do their thing Adam steps onto the first rung of the ladder and there he goes, along with the ladder. He remembers pretty much everything, he tells the guys that he's ok but just needs a minute to catch his breath but then realizes that he can't get up. With Adam unable to help himself and the ladder now laying on the ground, Brandon lowers Ryan to the ground-they are probably about 8ft off the ground. Good think Brandon is made of muscle and good thing that Ryan is as small as he is. They help Adam in to the truck and they ask him if he wants to go to the ER or home? Of course he chooses home. Adam starts to white out on the ride home and feels nauseous.

This brings me back to him hobbling into the front door. It was a cold day so as his hands are cold but now start warming up in the house which makes them extremely painful. His right hand is cut up pretty badly (probably from trying to catch himself on the gutters as he was falling). We get that cleaned up and then he tells the guys that his elbow feels kind of funny. We pry his layers off and find this...
Now don't let his face fool you. He's in extreme pain and can't stop shaking. I think he was in shock. We call Amanda, our friend who's an athletic trainer for the college, to come over and look at it. She looks it over and really suggests that we go in. She runs to get us some bandages and comes back to wrap it for us. She continues to tell us that she talked it over with another trainer while she was gone and he too thinks that it sounds like it could be a fracture so we should go in. Thanks again, Amanda, for helping us out. We wait around some more at home and Adam continues to shake so I say, we really need to go in. So we call Ryan, who's still working, and ask him if he can watch the kids. He graciously accepts.

We arrive at the ER and find out that Dr. Clemens will be the doctor. What a blessing! Adam goes for some x-rays. Dr. comes back in with some not-so-good news. His elbow is broken in multiple places. We think that he'll need repair in 2 different places. They make some calls into CNOS in Sioux City (to the orthopedic surgeon) and after some talk, they decide that he won't need Emergency surgery. Another blessing! In the meantime, I call Adam's parents to let them know what's going on. Connie decides that she's coming to Orange City and that she'll leave at 4am in order to get here by 8am the next morning (another blessing). Dr. Clemens also decides that he should get x-rays on his head (ended up just being a concussion), his right knee (ended up being just bruised), and his left hip (also just a bruise), more blessings! We decided that this fall could have been way worse. Imagine, a crushed elbow, a broken knee, and some head injury. After however much time passes by, Dr. Clemens puts a splint on his elbow and sends us on our way.

(This picture was taken the next morning or so but this is how he left the ER)

We left the ER hoping that we could get the surgery scheduled within a day or two. We were referred to Dr. Kensinger who is the trauma surgeon and and expert in that area for CNOS and Mercy Hospital. After a lot of waiting for the phone to ring and multiple calls from Dr. Clemens to check up on us and make sure we are being taken care of, we get a call that the surgery won't be til Monday (that's going through the whole weekend yet). Dr. Clemens finds this out and makes a phone call to CNOS to make sure that this is scheduled like this for a good reason and not just because it's a schedule reason and can't fit him in. Come to find out that the longer we wait for surgery the better it could be b/c the swelling won't as bad. However, Adam calls them back and says that we need to do it sooner than that (keeping in mind that Connie is already here in Orange City). CNOS totally understood so the surgery got scheduled for Friday, the 4th.

In the meantime, we end up calling Dr. Clemens to look at his elbow again because Adam's hand is kind of turning purple and swelling. He has us come back in, this is on the 2nd I believe. He unwraps is and checks it over and makes sure there's still no exterior tear. It was still swollen but now showing bruising too. This is what it looks like now...

Thursday afternoon we go to Sioux City for a consultation at CNOS. More x-rays are done and that's when we're really told that his elbow is just crushed. We got to see the images and you didn't need to be an expert to see that. It's now like a few minutes before 5 and we're told that surgery is being planned for tomorrow morning as long as they can get a MRI on the elbow and they close at 5. So we scurry to get that done (in a different building, but again they were gracious enough to let us in and do the scan). Dr. Kensinger uses the MRI as his road map for surgery. Keep in mind that this surgery is scheduled as Same Day Surgery.

I'm probably forgetting some details, but I think the main ones are getting covered.

We show up at 6am in Sioux City at Mercy Medical Hospital. Get all settled in the same day surgery center. The nurses ask if Adam's allergic to anything, "yep" I say, "he can't really handle codeine". "What happens?" they ask. "He just gets really irritable and dizzy." "Oh, that's just a side effect" they respond. Some more time passes by, they give him all the pills that Dr. Kensinger ordered before surgery-some for pain, some for nauseousness, etc, etc. I don't know how many, but it was a lot. He takes them and right away it happens. He feels light-headed and just wanted to crawl out of his skin. Before, he was really excited for the surgery just so that he could start rehabilitating but now he wanted to flee the building, that's how uncomfortable he was. He just has to close his eyes until they're ready for him to go into surgery. It's so hard to see your husband so uncomfortable and there's nothing I could do to help him but stay strong.

Surgery was scheduled to last 1.5 hrs. I waited in the waiting room and worked on taxes, that was a good way to keep my mind busy. I was updated personally by one of Dr. Kensinger's nurses. She came out at about the 1.5 hr mark and said that it'll be longer than expected but it was going good but just a lot of pieces to put together. It was a pretty big jig saw puzzle. She informed me that I could have a call into the surgical room for an update anytime I wanted. I did that once, I think. After 3 hrs, I was called and told they were done. I met with Dr. Kensinger and he told me that he got it all put together and then took an x-ray and found another piece of the joint that wasn't right so he had to take it all apart to fix it and then put it back together again. That's why it took so long. He said he wasted more screws on this surgery than he ever has. Adam ended up having 9 screws put in and one plate. There's a 50/50 chance that after 6 months the plate will bother him so it will need to be removed but I think otherwise it'll stay in.
Ok, so the surgery was a success (Blessing!) and he's recovering in the operating room right now. He's already very nauseous. So they're trying to have that subside before he gets moved to the same day recovery room and I can see him. An hr or so passes and I am told that I can see him. They couldn't even transfer him from his bed to the chair they usually use b/c he's too nauseous. He's so pale. The only thing he can do is sleep. He sleeps the afternoon away with them still medicating him with morohine through his IV and trying to treat his nauseousness with everything they can think of. Remember me saying that he doesn't handle codeine well? Well, now they believe me. I start to get frustrated at this point because it's nearing the end of the day and he still can't do anything but sleep and they just let him.

He finally wakes up and teases the nurse and asks if he can go home, and she believes him, she says, "yep, just ..." He stops her and says, "I was just kidding, I can't go home right now." Now, I am no nurse BUT, what nurse would just say yes to a patient who just had extensive surgery and can't even sit up without being nauseous and who has slept all day long just because he can't stand to have his eyes opened???? I was so frustrated! There are other details that had lead to my frustration at this point...
-a nurse who was frazzled right away when I came to see Adam after the surgery. As they were changing shifts she kept apologizing saying she's tried everything under the sink for him. this is the last thing I want to hear. I realize she was probably frustrated too but don't let me see that.
-the new nurse on duty now barely checked on him. I was in the room the entire time she came on shift and not once did she try to talk to Adam and see how he was doing. She just let him sleep. I realize also that he needed some sleep, but what they didn't GET was that the meds were making him sleepy, AHHHHHHHHHH!
-Once he woke up and was still nauseous, I finally had it. I asked for the patch they put on the back of his ear for the nauseousness to be removed-it was for motion sickness. Well, knowing my husband, he's tried motion sickness meds before and they just wipe him out--kind of like this.
-there were 2 nurses at the end of the day and they were very unprofessional, I asked for ice chips at one point, and watched her and she instead sits down at her desk and talks to a friend who happened to stop by, so I go out and ask again and she got the point that I was frustrated. They were also saying that they thought they were going to be out of their early that day, hello, we're still here and can hear you. We were the first ones there and are the last ones there too, I am a little frustrated too.

After a little more time passes by I convince Adam that he should try to stay awake and sit up since it's getting late, we try to stand. We didn't get too far, no steps were taken. He was too light headed. We did this a couple more times and just decide that he can't go home in this shape. We ask to be admitted.

I am still trying to be brave and strong for Adam. They take us upstairs to his room. The nurse there was WONDERFUL! I finally just totally lost it. She was very consoling and compassionate. I know I probably was more tired than anything. I knew in the back of my mind that this would probably happen but was hoping for it not to happen.

They told me that they usually don't let family stay overnight (Adam had a roommate named Howard, who was like 90) but that I could if I wanted since Howard wouldn't care (or wouldn't even know). We decide that I would rest better if I just stayed at a friend's house. So to Dave and Rebekah's I went. I slept so good.

The next morning, I show up at 8ish. He's still light headed but mildly better. He still just sleeps. We decide that the game plan is to have no more morphine since we won't be able to go home with it. He starts taking the first prescribed med (Lortab) and it just doesn't settle well with him. He gets a different pain med prescribed (Tramadol-50mg). This seems to do the trick. He starts feeling a little bit normal. The day goes well for the most part. My biggest frustration was that I felt like Adam and I had to figure it out all on our own and he wasn't even able to think straight most of the time. I told them right away that he doesn't react well to meds with codeine-all the meds they were trying to give him had codeine or codeine derivatives in them. I felt like they didn't take me seriously.

Anyway, we finally were discharged Sat. afternoon. He looked like this...
He was put into a 180 degree cast/more like a splint. Elevation was very important still.

On Monday, the 7th, we went back to CNOS and they took the splint off. This is what it looked like...
and had Adam bend his arm to 60 degrees. This was very painful for him. They just wrapped it up to protect his incision and put him into a locked brace at 60 degrees. Elevation still important.

(picture taken at Sioux Falls Surgical Hospital at Lilly's teeth procedure (another post in iteself))

Another 2 weeks later, March 21st, we had another appt. This time they unlocked his brace so that he could bend it from 30 degrees to 90 degrees. Throughout the next 2 weeks, he just worked on this movement.

Another 2 weeks later, the 5th of April, they took the brace away completely and Adam is suppose to try and stretch his elbow as far as he can (just so he feels a stretching feeling not a sharp painful feeling) to full extension and full flexsion.

He's doing well. Dr. Kensinger said he could be surprised but doesn't think that Adam will get full extension and flexsion back but as long as he's withing 5-10 degrees of that. If Adam can do most of that on his own over the next 4 weeks then he won't need any physical therapy, otherwise he will.

I don't have an updated pix now. But it actually looks like a pointy elbow now. I will update that soon.

No comments:

Post a Comment