Home from the Hospital

Another wrong turn and I ended up in the hospital for 11 days - 11 days longer than I was counting on! Came home on Tuesday and am delighted to be here.
In the hospital I had 3 more procedures for a grand total of 6 times under anesthesia.  Among other things, an infection needed to be cured, anemia taken care of and low protein levels identified. The docs encouraged me to gain weight and then would remind me I couldn't eat after midnight since I was having a procedure the next day.  Needless to say I'm eating much better at home and even managing a daily protein drink.
Today was the day of terror - changing my dressing.  It turned out that removing the old dressing was tolerable but putting on the new one and then turning on the acti-vac pretty much destroyed the rest of the day for me since I've been unable to control my pain with the range of permitted medications.  Tomorrow I'll call the pain clinic for help.  Right now I'll do a little research on the internet.
Good news!  yes - I do seem to be going in the right direction now,  It will take a long time but the day will come when I'll be able to be an active person again.

Not going in the right direction

Due to the amount of pain I'm experiencing I need to return to the hospital for testing.  Sad to say, I'll be staying overnight - not good news for the weekend.  So I'll check in again in a few days when I'm home.

Advice and Suggestions

THE ACTI-VAC - YOUR NEW BEST FRIEND

Perhaps you will be better informed than I was when I left the hospital the 1st, 2nd and 3rd time.  Follow-up instructions were minimal.  I knew I'd wear an acti-VAC from KCI.  The person delivering this device to the hospital showed me how to turn it on and off, showed me the instruction books and assured me that there was  nothing much I had to do - it would work beautifully.  If not, there was a service number to call.  We did call several times and on occasion the person who answered the phone was helpful.  Here's what we (my husband and I) learned so far that might help others:

• Don't touch the machine itself unless you need to reset it.  
• Always keep it in the special pouch they give you (it's very attractive, black does go with everything).
• When you pick it up use the straps and be sure not to use the tubing to pick it up
• Wear the vac around your neck when walking or sitting - if possible.  If you want to take it off your neck, put it on the floor or another hard surface.  Don't put it on your bed, sofa or chair.  Usually I put it on the floor if I'm sitting anywhere for a long time.

Most of the above was learned only after using the vac for 2 weeks and experiencing numerous malfunctions.

DRESSING CHANGES

Soon I'll know more about this but for the time being I'll tell you what I'm sure of.  I learned all of this the hard way and hope I save at least one person some pain.

• Turn off your vac 2 hours prior to the appointment for the dressing change.  Your visiting nurse should let you know when she's arriving.
• Take a shower!!!!  You are allowed to get the dressing wet before it's changed and you can even wash your hair.  Make sure you sit in the shower as you are not as strong as you were.
• Get an order for lydocaine. The nurse injects the lydocaine into the old dressing and it helps numb your wound.  Also the nurse kept pouring saline solution on the wound as she was changing the dressing.  The saline solution felt very comforting. 
• I learned the hard way -  ask for a nurse who is experience in changing dressings for an acti-vac.  Twice I had to have my dressing changed a second time because the first nurse didn't get it right.  This is very painful so be insistent on experience.

I will write more as I learn more.

My Life (?)
Personally, my bad news is that the hematoma that was removed on Tuesday increased my pain as my dressings were changed today.  In addition to screaming I managed to use some unladylike language.  My day has been ugly since then.  I've barely eaten, can't do much and am feeling down in the dumps.  Especially since the nurse told me she that if I were her Mom she would have me see a vascular specialist.  Yes, my reaction is to feel terrified.

Time to take some pictures, pills and then watch tv until I'm off to sleep - my most favorite location.

Not my favorite surprise

We made to the doctor at 8:15 yesterday.  I followed my husband's advice and didn't wear any jewelry.  We both knew I would be admitted..  Everyone examining me was sure that the swelling and pain in the back of my calf was the result of muscle damage and needed immediate surgery.  We all define immediate differently.  In any case by about 2pm  I was finally taken to the OR.  A  very nice anesthesiologist made sure  I was gone quickly.  In fact today I've spent most of the day sleeping it off.
The unexpected finding was that I had a hematoma and not muscle damage.  Apparently it had been growing steadily since my accident and hence my surprising and unexpected increasing pain.
I woke up in agony.  I'm reluctant to say pain has reached a 10 on that weird 1-10 scale they use in health care. I wouldn't hesitate to call this a 10+.  The anesthesiologist offered me a pain block which took effect quickly and allowed me to remember that I had a lot to live for.
I was moved to a room on the orthopedic floor.  My husband had a few things to take care of so he left for a while since I seemed stable.

Now I'll list my reasons for loss of faith in hospital care read it or skip it at you own risk:

• I had to use the bathroom.  The call bell brought no results so I pulled my iv with me to the toilet.  No one noticed either that I went to the bathroom or that my iv was unplugged.
• At some point an aide arrived to ask if I needed help.  I thought plugging in my iv should be the 1st order of business and a bedside commode the 2nd.  I believe the IV did get plugged in quickly.  The commode took a few hours and quite a bit of nagging.
• I needed pain medication.  I was told my  2 hours weren't up (doc's orders) and my nurse was at lunch, dinner or break.  I can't remember. I lost it!  I said this is 2010 and I thought we knew how to control pain.  Apparently calling the doctor for new orders wasn't part of their plan.  Luckily my husband returned to distract me.   They came in to remove my iv.  I got my pain pills by not permitting any one to do anything until I was given percoset.  By this time no one like me too much except my husband.

Ira was concerned about my coming home that night since I was in pain and also my leg was numb from the pain block.  I was concerned about staying in the hospital since the care was worse than anything I could do for myself at home and I do have my devoted and competent husband to help.  We left the hospital at about 7 and it would be difficult to ever get me there again.   Since at some point I might need a skin graft - well let's not go there yet.

Despite some difficulty getting me up the steps I got in the house, ate some ice cream for consolation and  got into bed after talking to my son and my brother whose love and concern meant a lot to me.

At 11 I couldn't wiggle my toes because of the pain block.  We were both concerned.  I woke up at 6:20 and could wiggle my toes so we had a minor celebration.

Today I ate and slept, ate and slept, ate and decided to try to write this.  I can't imagine it makes sense. 

Our main learning is that my husband and I don't like to bother anyone if we can help it.  Hence we waited too long to call the doctor which led to unnecessary suffering.  I hope we can remember this in the future and act on it.

Once again, I am feeling sleepy.  Hope to write more tomorrow and will some day get my pictures in order.

night night 

Hurting again

Tomorrow I have an 8:15 appointment with the surgeon.  We're worried.  My pain, swelling and redness has increased.  This isn't the direction we expected to be going.  Hopefully I'll sleep tonight and will feel well enough to report in tomorrow.  Ira is concerned about some additional muscle damage.  Not a cheerful thought.

3 times a week new foam on my wounds - Are you jealous?

Of course you're not jealous.  Here's some better news.  I no longer scream and cry when my dressing is changed.  I do bite my pillow.  Happily, my pillow doesn't mind at all.  Here's how the nurse helped make it bearable.
1. I know when she's arriving so I take 2 pain pills and one valium
2. She pours lydicain on my dressing so it soaks into my wound and helps numb the pain
3. I bite my pillow when necessary.  I never draw blood!
It's not fun when she finally turns the acti VAC back on but I remind myself that it helps me so I try to work with that happy thought.
So little has been explained to me.  Today I asked the nurse about how much walking I should be doing.  She said right now the important thing is to get the swelling down on my leg so I should limit my walking.  I didn't know that but now will walk less frequently since it's not doing the good things I thought walking would be doing.

Sleeping is only a challenge on occasion.  Last night I slept well and only napped briefly today.  Everyone has decided to feed us so we now have a kitchen with more food than 2 people could consume in a week.  I choose to believe that food is an expression of caring and I appreciate everyone who is stopping by, making or bringing food, calling and sending cards.  It makes me feel better in my heart and soul so my blessings to all of you.

What now?

It seems that every evening my pain increases quite a bit and my calf swells more than during the day.  Usually the worst is when I get into bed and can't find a comfortable position.  Have adjusted my meds so that I'm taking Vicodin during the day and Percoset at night.  Of course I'm taking the generics to keep the cost down.
My new best friend is the acti Vac which I wrote about before.  It goes everywhere with me.  Yesterday I was surprised to learn that even when fluid isn't being evacuated the suction helps healing.  That was comforting.
Time to get ready for bed and to take pills.
Soon I'll post some really ugly pictures of my leg.

Learning More

Slowly my husband and I are learning more about recovering from a fasciotomy.   Not the easiest journey one can take but of course this is not a choice.  My acute compartment syndrome is the result of an accident that occurred on July 28th.  After 9 holes of golf, I was pinned between 2 golf carts while I was putting my glove and balls in my golf bag.  The person behind me was busy adding our scores and didn't watch where she was going.  Hence she smashed into me and severely damaged my left calf.   Initially we were all unaware of the seriousness of my injury even though the pain was excruciating.  My husband, a retired physician, knew exactly what the problem was and immediately took me to the ER.   I was diagnosed with Acute Compartment Syndrome and had a fasciotomy.
Few of us love  being in hospitals but I didn't fight that first night as I was in need of constant pain medication.  The next evening I was discharged with my new best friend - an acti-vac.
Will write more soon.  Over a week since my accident and I'm still unable to spend more than about 15' sitting still at the computer and concentrating. Drugs dull my pain somewhat but they also dull my brain.

Diagnosed with Compartment Syndrome - Twas the night before torture

Tomorrow the dressing on my fasciotomy gets changed.  This is the 3rd time for this wonderful experience since I injured my calf on Wed. July 28.  Saturday when the nurse changed the dressing for the first time, I screamed, yelled, cried, cursed and generally was really well behaved.  Tuesday the doctor. put me under to see what was happening with my wounds and I've been in horrible pain ever since.  Can you see why I'm looking forward to tomorrow  Soon I'll tell you more about this injury and hope someone with experience can clue me in as to what I can expect in the future.  Time for meds!