Vol. 234 June 15, 2020 “I’m B-a-a-c-k!”

June 15, 2020

Some readers of this blog may have noticed that I didn’t publish on June 1.

I was indisposed.

Having taken a head-over-heels . . . literally.  . . dive over my second floor hallway bannister into the stairwell  to the first floor during a disorientating pitch black power outage at 3 AM, I was in the hospital recovering. In the middle of my flip my back struck the stair bannister coming up from the first floor and I “bounced” away from the stairs landing on the first floor next to the stairs. My head and neck miraculously escaped injury, and I never lost consciousness. I was, as many have said, and I readily agree, very, very lucky.

I am now back home rehabbing from my 6 broken ribs, 4 fractured vertebrae, 1 fractured scapula, and a right artificial hip dislocation. I am currently walking with a cane and riding my tricycle on only an occasional couple of Tylenol. Two of my children familiar with my gait problems from a chronic neuropathy think that I am walking better now than I did before the accident.  Just another proof, I guess, of the value of two weeks of 3 hours a day of physical (PT) and occupational therapy (OT).

 Realistically I was “relatively lucky”. Two weeks in hospital and the loss of this summer in my boat because of spinal precautions; “BLT” (no bending, lifting, or twisting for 8 weeks) is a big negative. But, I did get two negative SARS CoV-2 swabs out of it; one before being admitted to the acute care hospital and one before the rehab hospital would accept my transfer. How’s that for a “new normal” definition of “lucky”.

Lessons learned:

  1. Always have your cell phone or flashlight in your bedside stand as a source of light.
  2. Always have your cellphone charged or charging bedside for easy access to call 911 if necessary.
  3. Always carry a list of your medications in your wallet and remember to ask the EMTs to grab your wallet and cellphone to take with you to the ER.
  4. Don’t be surprised if you are over 70 yrs. old and your first intravenous fluid bag in the ER is filled with multi-vitamins even though you registered a very low 0-1 risk level on the “How much alcohol do you drink?” questions. Some surgical services routinely order a “banana bag”, tinted yellow by the multi-vitamins, as an automatic move to ward off incipient DTs.
  5. Don’t be surprised if your pain moves around  “relatively”. Once the pain from my dislocated hip was removed by having it quickly reduced in the ER, I became aware of the rib pain when breathing. Several days later as that pain lessened, the low back pain of the lumbar vertebral fractures got my undivided attention with the slightest twist of my body. It was only when I could cough or, perish the thought, sneeze without rib pain that I felt the ache from the fractured scapula when I tried to rise my left arm to shoulder level.
  6. Speaking of “relative pain” I learned, once again, that the so-called “patient-centered pain index” of 1 to 10 as a guide to pain medication correlates quite closely with a “behind-the-scenes” nursing standard that can be deciphered by the patient. To wit, any number I gave from 1-4 got me Tylenol, numbers 5 or 6 got me Oxycodone 5 mg, and anything 7 or more got me Oxycodone 10 mg. At one point, before I was quite ready to give up the assurance of a peaceful overnight sleep,  I responded “6” when the evening nurse asked for my pain level. She then prompted me to say “7”. I asked her, ”Why do you bother to ask me for my pain level when you have a good idea of what I might need based on your experience?” She just shook her head, chuckled, and gave me the Oxycodone 10 mg. I slept very well, and successfully switched to 5 mg. the next night.
  7. I still marvel at the seemingly crazy schedules hospitals follow: They wake you up at 6:00 AM to take your vital signs, fill your water pitcher, empty your urinal, and then leave you alone for an hour and a half until breakfast. There’s 2 more hours after breakfast until the first round of meds. Twice I exhibited a bit of residual independence by insisting on at least a glass of orange juice before I did anything when OT showed up before breakfast. I  hesitate to even mention the weekly in-the-bed weight measurement which involved the sudden removal of strategically placed extra pillows from under my various painful parts at 5:30 AM. Those mornings were definitely the longest.
  8. Both PTers and OTers teach you different tricks and have their own, unique trade secrets about how to make you function better, easier, and more safely.
  9. If you are ever seriously injured and have a choice of having an MD physiatrist or a DO physiatrist, choose the DO one. Treating muscles, joints, ligaments, fascia, and your spine is a true expertise of the Doctor of Osteopathy . . . and they can always order pain medications if necessary.
  10. Rehab hospitals have better food than acute care hospitals. Acute care hospitals expect most patients to stay 3 or 4 days, so the food menu quickly becomes repetitively monotonous. The rehab hospital average length of stay is 2 weeks, so they deliver more varied meals.

Will my recent stint in two hospitals under my new Medicare Advantage policy with its lower premium but multiple, variable deductibles and co-pays cost me more in the long run than straightforward Medicare? .  .  . We shall see, TBD, and I will let you know.

Oh yes, that’s my Corona beard.


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