Thursday, July 9, 2020

"At Least I'm Wearing Underwear"

Broken Arm, part 3 (of who knows how many parts)

Part 2 is here.

So I was taken to a small examination/hospital room.  Someone helped me off with most of my clothes and put on one of those awesome hospital gowns.  Eventually a nurse came in to take some information.  Everyone had a mask of course (including me, still) but this nurse had the most elaborate mask of anyone I saw.  I think she could have gone scuba diving in it.

She ask me about my meds and what happened and all that fun stuff. She hooked me up to a blood pressure monitor and an oxygen monitor.  And then she left, saying that the "doctor will be right in."  Ha!

It was again quite awhile for before the doctor came in.  She finally showed up, she asked me a bunch of questions like what happened, where does it hurt, etc.  I described my pain and my fall and she gave me what I thought was a rather cursory examination. I mean she touched me but not as much as I would have expected.  She said that someone would come by to take me for X-rays of both my arm and leg. She left.

But she did come back to ask me about my pain—did I want something for it?  I said yes, rather emphatically. At first she was going to give me Norco (oral) but then she decided I needed something that worked faster, because when they were going to be taking X-rays, they'd have to move my arm and it would be quite painful.  Oh boy, something to look forward to. Spoiler: It ended up taking so long to get into X-ray that there was no need to give me morphine just because it worked faster.

So she sent a nurse in to give me a shot of morphine.  That would of course make me drowsy but that wouldn't be a problem, I wasn't driving anyway.  But she didn't warn me that it would make my stomach a bit queasy.  In fact, I did feel nauseated on and off a little while I was there through the afternoon. And in fact when I woke up (at home) the next morning, having taken the Norco she prescribed for me the night before, I did throw up a little bit. 

Anyway, now there was nothing to do but wait.  And wait.  And wait.  I really had no idea that it would take so long to get taken to X-ray, but it did.  By this time, all my worldly possessions, my pants, my shirts, my t-shirt, my keys, my wallet and my phone were in that plastic hospital bag they had given me earlier.  And that bag was on a chair that I couldn't reach.  There was a TV in the vicinity but I couldn't reach it to even turn it on.  And I didn't have any water and hadn't been offered any.

So there was nothing to do but just lie there in pain and wait, and stare off into the distance.  There was also no call button in case I needed anything (like assistance in turning on the TV, or getting my phone).  They had the curtain to my little room closed.  The only thing I could have done was shouted at the top of my lungs to try to get someone's attention if I did need help. 

I stayed silent, but after it had been more than an hour since I'd last seen anyone (the nurse who gave me the shot) I was seriously considering shouting to find out what was going on (and maybe ask for some water).  But I waited.  I did that thing where you stare at the clock on the wall and say to yourself, "Well, when it gets to be 15 minutes to, I'll start yelling."  Then that time comes and goes and you say, "when it gets to 10 minutes to.."  Well I dunno how many times I let it slide but I can tell you I really was about two minutes away from screaming when an orderly finally showed up to get me X-rayed.  It had been close to 90-minutes since I'd been in that room before they came.

It was a welcome trip for a couple of reasons.  One I was bored and ready to get going, and two, that little room was really hot. The mask was making me even warmer and sometimes I was having trouble breathing through it.  I admit I had to lower the mask every now and then so I could breathe. The trip through the hospital to the X-ray department was nice and cool.

There were a bunch of techs helping with the X-rays.  I was on the wrong kind of gurney (whatever that meant) so they had to have several people actually lift me from that gurney to the table where I needed to be for the X-rays.  That was fun (but probably even less fun for the orderlies who had to lift me up)..

And the Doc did not lie.  It was quite painful as they moved me so they could take the proper X-rays. Hell, when they lifted me from the gurney to the X-ray table it hurt pretty much all over, especially in the arm and leg.  Morphine can only do so much.  They took pics of my leg and my arm and moving the arm for them was sometimes excruciating. 

The first person moving me around actually needed help from a senior tech to make sure I was in the proper position for the X-rays to come out right.  But eventually they got what they needed (or so I thought) and they took me back to my room.  Note, from what I learned during my hospital stay for my heart problem in 2016, I knew to insist that I take the bag with my wallet and phone with me to the X-ray room).

When I got back to my room, the orderly was about to reconnect me to the blood pressure and oxygen monitors when I stopped him.  "Before you do that, can I go the restroom first real quick?"

I should have known this outside his purview.  "Let me get the nurse."  So I had to wait in the bed, unhooked up, until the orderly got the nurse.

Well, it was a different nurse than the one who had cross-examined me when I first got to the room.  It made a difference.  She asked if I wanted a urinal.  I said no, I could walk to the restroom.  She said, "Are you sure….you're here because you fell, what if you fall again?"  Sigh. I knew I could make it to the restroom, it wasn't that far.  I said I couldn't relieve myself lying in the bed.  She said she would put the back of the bed up.  OK, I relented.  Between the drugs and the pain I was not interested in arguing with her.  As she went to get the urinal, I realized the problem was that she didn't know I had been perfectly fine until I tripped and fell.  She probably thought I was some old guy who had trouble keeping his balance in general.  I mean my leg did feel lousy but I could definitely walk a little bit on my own.

Well she brought in the urinal and raised the bed.  But she didn't raise it enough.  It was very difficult for me to go, especially cuz I was also trying hard not to piss myself, or the bed, or my underwear.  Naturally, just as the flow started, I was startled by the doctor showing up.  Well she was more embarrassed than I was but you never want to interrupt someone in the middle of taking a piss. She said "excuse me" and disappeared.

I was pretty sure I wasn't done but I couldn't get anything more to come out (TMI?), so I closed up and then I had nothing to do with this damn urinal with my urine in it but just hold it!  I couldn't reach anything to put it on and I didn't want to risk spilling it, for obvious reasons.

I held it with me for who knows how long until a nurse finally showed up to hook me back.  In the meantime I had missed my window of opportunity to actually get a report from the doc as to what was wrong with me.

So that was another 10-15 minutes of time lost before she returned.  She brought with her several bits of bad news.  The main thing was that I had a fractured humerus. That's the bone at the top of the arm that connects to your shoulder. They would have to put an "immobilizer" on me.  She said that around 80% of the time they don't need to do surgery, it heals on its own.  Oh, and my leg was fine.  Then why did it hurt?  Well, it's like a pulled muscle.  No treatment needed, it will get better all by itself.  The issue was my right arm/shoulder.

The other bit of bad news was that the radiologist wanted to take a few more pictures.  He wanted pictures below my knee and also of my shoulder to make sure it wasn't separated.  The ER doc was pretty sure I didn't have a separated shoulder.  She also wasn’t worried about my knee but the radiologist wanted to be sure.

Then she told me what would happen going forward, assuming the additional X-rays didn't have any nasty surprises.  They'd send me home in the immobilizer and refer me to Orthopedics.  I'd hear from them in a day or two, and eventually get an appointment to see an Orthopedist. 

Really?  They weren't having me see an Orthopedist right away, right then and there, when I was already there?  Did that make any sense?  I didn't ask.  I just assumed it had to do with new procedures in place because of COVID-19.  Maybe they didn't even have an Orthopedist around.  Maybe they stayed home now because of fear of getting sick, and came in only on a limited basis.  After all, it was well known that hospitals were not doing "elective" surgeries and procedures any more.  It didn't seem right to me but that's what I get for breaking my damn arm in the middle of a pandemic.  Next time, I should plan it better.

In the meantime, I was to wear the immobilizer and keep my arm still.  But she did say that after a couple of days, I should start moving my arm a little (rotating it a bit) so that I don't get a frozen shoulder.
Well, getting ahead of my story, let me tell you, when I finally spoke to an orthopedist, about a week later, he told me no way should I be moving my arm at that point!  He said something like, "That's why you listen to your orthopedist, not an ER doctor."  I didn't say anything but I certainly wondered why an ER doctor, who would often see people for broken limbs, didn't know not to give such potentially ruinous advice.  By the way, thankfully I had not taken the ER doc's advice, not so much because I thought it was wrong but more because I was in too much discomfort to even try it, figuring it would be safer to have an Orthopedist tell me what to do.

So they came in and put an immobilizer on me.  I guess this is what they do instead of a cast these days (depending on the nature of the injury, I presume). I had no idea what it was supposed to look like when it was done but the last thing they tried to do was place my right arm across my chest (or maybe stomach) and put it in a sleeve that attached to the piece around my chest by velcro.  But when he tried to move my arm up like that, I let out a scream that would wake the dead.  So he left my arm "immobilized" down by my side.  But there was some other piece there that kept me from moving my arm (too much).

But I wasn't done—I had to wait around to be taken back to X-ray.  And waited.  It wasn't as long as the first wait for X-ray but it was good long while.  They took the immobilizer off so they could take X-rays, took a pic of my knee (or below the knee) and sent me back.

After a bit, they said I was ready to be discharged.  Wait, what?  What about the second set of X-rays?  Nothing there, you can go.

Well good to know I didn't have a separated shoulder.  But I wasn't satisfied. I didn't think I'd gotten enough information from the Doc, I wanted to see her again. So I insisted she come by before I would leave.

So more delay.

In the meantime, they had to figure out how to get me home.  There was no way I could lift my arm to get any kind of pull-over shirt on. The nurse had been looking at my t-shirt to see if there was any way she could put it on me, but gave up.  But she did notice my t-shirt was not exactly new, shall we say.  She said something like, "this t-shirt is pretty ratty."  That was kind of needlessly nasty under the circumstances.  I said, "Well, when I got dressed this morning, I didn't know I was going to undress for anybody.  At least I'm wearing underwear."  She laughed and said, "Yeah, that's a good thing."

They had put the immobilizer over my bare skin, but I couldn't be sent home shirtless. They finally realized that I was going to have to go home wearing the hospital gown.  So they took off the immobilizer, put the gown on me, put the immobilizer on over the gown.  I said, "How am I ever going to get this gown off by myself?"  They said I would be able to pull it through the immobilizer and then off my bad arm.  Yeah, right.

I wondered if they were going to charge me for the hospital gown they gave me (they did not).

I waited around for the Doc and she finally came and seemed surprised I wanted to talk to her again.  "You needed to see me again?"

I said I just wanted to make sure I knew what was going on.  "Yeah, yeah, you can be moving the arm a little in a few days, and you'll hear from Orthopedics in a day or two."  I kind of suspected that she wasn't telling me everything, like maybe because they had minimal staff to deal with anything not COVID-19 related. Like she would have Orthopedics give me the bad news.  But that was pure speculation.

In theory I could have walked out of there, but I had to go down to the pharmacy to pick up my prescription.  So they insisted that they have someone wheel me down there, then wheel out of the hospital to wait for my Lyft. 

So let's leave it right there for this chapter, and you can read the conclusion here.

Thursday, July 2, 2020


Broken Arm, part 2 (of who knows how many parts)

Part 1 is here.

And we pick up right after I managed to pick myself off of the floor, in tremendous pain.  It didn’t take long to realize I had to go to the ER.  I really, really didn't want to go to the ER, I assure you.  I figured that most of the patients there would be for the Coronavirus.  And who the hell wanted to be around them?

Not me.  Nor any of my friends or relatives.  I knew I was on my own.  I was going to have take Uber or Lyft to get to the hospital. But I still had this grocery order coming.  I texted my shopper and asked if I could just cancel the order.  It seemed like they didn't have half the stuff I wanted anyway.  But he responded that he couldn't do that.  He had already processed the items he had (or cashed out, or something).  Apparently once he had them in "my" cart there was no way to put them back.  I told him I had just broken my arm and I needed to cancel, I was going to go to the Emergency Room.  He said there was nothing he could do and suggested I text the Instacart people directly.  It was thru the Instacart app that this delivery had been arranged.  I checked the app and didn't see any way to text them.  I asked him how to do it.  He had no idea. With only one hand to use, I really wasn't in a position to start searching online to see if I could reach them.  Great. So I asked if he could just stop picking up the rest of my order and cut it down to what he had already put in my cart and couldn't return.  That he could do.

Note: this turned out to be a useless achievement, as he had already picked up all my perishable items and only had non-perishable items left to shop for.  In other words, items that would be ok if left out in the sun for a few hours.

He also told me that he was doing three different orders at once, so it was hard to estimate how much longer it would be before I'd get my stuff, or what was left of it.

Damn.  If I knew he'd be there in 10-15 minutes, I'd wait, put the stuff that had to be refrigerated in the fridge, and then call Uber.  But it could take longer than that, I was in a ton of pain and I wanted to get rolling on doctor checking me out so I could get home (assuming I'd be coming home) before it got too late—or dark.

I decided not to wait.  I was just in too much pain.  I thought about putting on some decent clothes but realized there was no way 1) I could take off what I had on or 2)put on new clothes.  I was stuck going to the ER in what I was wearing at the time of the fall.  Fortunately I was adequately covered, but not exactly presentable.  I was wearing sweat pants, a worn undershirt and two sweatshirts (and of course underwear).  And I even had socks on, which was good because in my current condition there'd be no way for to put them on myself.

Why two sweat shirts, I hear you ask?  Why even one?  Well, Southern CA weather is weird that time of year.  It starts off quite chilly in the mornings and then gets hot in the afternoon. It is not unusual for me to use the heat in the morning and the A/C in the afternoon and evening.  This was my normal winter-at-home outfit, which this time of the year lasted until after lunch, when I would have to take off the sweatshirts. In fact, I was realizing I needed to take off the sweatshirts when I got up from the couch to fetch the water.  Maybe if I had done that first, I wouldn't have tripped?

And lucky for me those shoddy sweat pants had pockets in them, so I could stuff my wallet and my keys in them (I'd just have to carry my phone with my one good hand).  Unfortunately, the sweatshirt I had on, the one I always wear around the house, was covered in stains.  Actually I had just washed it the previous weekend.  But those stains had been on that shirt since prehistoric times and just won't come out.

I couldn't tie shoelaces, but I have a pair of slip-on dress shoes I could get into.  They didn't exactly go with the rest of my outfit.  I looked like a total slob who had stolen some nice shoes.

Thus, I was not at my most presentable.

But at least I was dressed.  I grabbed my stuff with my good hand and proceeded to order a Lyft (for some reason I usually end up using Lyft instead of Uber, don't ask me why). Amazingly enough, I somehow had the presence of mind to remember to put on a mask.  Luckily I had just received my mask order a few days prior or I would have been in trouble.  I don't think Lyft would have picked me up if I didn't have a mask.  Nor would Kaiser have let me into their ER without one (although I think maybe they would have given me one, if I could have gotten there).  It was the very first time I'd actually worn a mask.  It wasn't very comfortable, especially since by this time it had gotten hot (and in my panic, I was already sweating).  Plus I kept fogging up my glasses.  But the damn mask was the least of my issues.

I managed to make my way out of my house and considered not locking the door.  You see you have to lock it with a key from the outside and the lock is all the way over to the right and fairly high.  No way could I lock it with my right hand as I usually do.  And it was awkward as hell trying to use my left hand, not only because I wasn't used to doing it left handed but because my body got in the way of me trying to get my left hand all the way over there.  I managed to do it but it was quite the struggle.

I had to unlock my gate which was also a challenge, again the lock is high up and very conveniently located for my right hand to do this.  I left the gate open so the Instacart shopper could drop off the stuff—and perhaps more importantly, so that I would be able to get through it when I got back home.

By the time I got to the gate of my townhouse complex, the Lyft driver was just pulling in.  Somehow I managed to open the car door with my left hand and very gingerly got in the car.  I explained to the driver I had just broken my arm and couldn't put my seatbelt on.

My healthcare is provided by Kaiser, a huge HMO.  The facility is located approximately 20-minutes from my house, not too bad.  There they have a hospital with an ER, along with medical offices (my primary care doctor is located there as well).

We were about five minutes into our trip when my phone rang.  It was the shopper at my complex's gate, with my groceries.  Jeez.  If I had known he'd be there that soon I would have waited.  I buzzed him in but not before telling him that my unit's gate was open and to leave the groceries right at my front door (this was another mistake, as you will see many posts from now). 

The Lyft driver was getting directions form Google Maps which were exactly the same directions I would have given him, including how to access the ER entrance.  But when we got to the street that we needed to turn on, it was blocked off.  And that was the only street from which you could access the ER.  There was someone there at the corner who looked like she might be a Kaiser employee, but she was talking to someone.  My driver didn't care.  He started yelling at her, how do we get in?  She ignored him at first but the driver kept screaming at her and eventually she told him he had to enter from the other side, so he had to go down the block, turn onto the street that would connect with the street which would allow us to turn on to the street we needed from the other side.  I guess in order to limit exposure to the virus, they had limited access even to the damn ER 

My driver was pissed and it happened to be a fairly long drive away from the ER but he finally found a street he could turn on to get back on course.  Eventually we found the same damn street we wanted in the first place but from the other direction which we able to turn onto.

From there we should have been able to have made a quick left turn into the driveway for the ER so he could drop me off—but not so fast.  There were still barriers and traffic cones preventing us from doing that.  And in fact, there were a couple of Kaiser employees, in scrubs, standing in the street by the barriers checking any cars that approached, including ours.

One of them came over to the car to talk to us, asking what we were here for.  I explained that I had fallen and was pretty sure I had broken my arm.  I think he asked us some questions about any Coronavirus symptoms then asked me if I wanted to go to the ER or to Urgent Care.  In hindsight I realize what a dumb question that was.  I mean, if I really did have a broken arm, why would I go to Urgent Care instead of the ER?  But at the time, in great pain and feeling otherwise terrible, I just said, "Well, I dunno, what do you think?"  I mean this guy was out there doing triage, isn't it his job to determine that?  He said, "Well, it's up to you."  I said I didn't know, which would be best for my situation?  So he said, "You really think your arm is broken?"  I said, "I think so."  He finally said, "OK, let's go to the ER then."  So he opened up the barriers and let the driver take me into the driveway for the ER.  With some difficulty, I was able to get out of the Lyft car and head toward the ER entrance on foot.

Of course I had to go thru another screening process.  I stood six feet away from the nurse at the door.  What are you here for, any cough, shortness of breath, etc.  I think they were supposed to take my temperature but at this point they did not.  They let me in and I was able to sit down in the waiting area.  Which was totally empty.  I think there was one other person.  I don't know if this is true but my assumption at the time was that anyone that was coming in thinking they might have the virus was being screened in an entirely different part of the ER.

As I was sitting there waiting, I started noticing how much my knee and my leg hurt, in addition to the arm.  I think I walked as far as I did on adrenaline alone.  I was also quite warm and was having trouble breathing thru the mask.  I had to pull it down a few times to get more air.

I also noticed that when the other patient left, they didn't immediately sanitize the chair he'd been sitting at, which I would have expected them to do.  Disappointing.

Finally they called me over to this very tiny area where there two people quizing me and taking vitals.  The three of us (all wearing masks of course) were not exactly practicing social distancing.  Then a third person showed up.  She was the person who was supposed to be at the door, doing the first screening.  But it seems her thermometer had somehow been switched to Centigrade and she need the guy was working with me to reset it back to Fahrenheit. So now there was four of us jammed into this very crowded space, three of them who had been seeing people coming into the ER all day.  I should have asked if they had seen anyone with COVID-19 symptoms yet today but I did not.

They were done with me and had me go back to sitting in the waiting room until they could get me into an ER hospital room.  They had pulled off one sweatshirt so they could take my blood pressure (which had been surprisingly good—I would have thought that under the circumstances it would be off the charts).  So they gave me one of those plastic see thru hospital bags to keep my stuff in.

All day at the hospital, I was mindful to keep track of three ultra important items:  my wallet, my phone and my keys.  So I put my phone, my wallet and my keys in the bag and held onto that bag for dear life. My sweatshirt was also in that bag.

Since it was so non-busy, I put my phone in that bag thinking it wouldn't be long before I was taken to an exam room.  I just sat there quietly with nothing to do but to think about how dumb it was that I had missed that step and hurt myself so badly. I was quite pissed at myself for that.

Instead of it being a short wait, I was sitting there a long time.  I got bored and wanted to do something to take my mind off how stupid this whole thing was. But with only one good hand, it was going to be difficult to get the phone back out of the bag.  Finally though, the boredom took control and I had to fish the phone out of the bag to amuse myself.  Of course, just about 2-3 minutes after doing so, the orderly came to take me to a room.

When I stood up, my leg and knee felt really bad and I struggled to keep myself upright.  So they asked me if I wanted a wheelchair.  I said yes.  Well of course that meant waiting another 5-7 minutes.  But eventually they showed up with the wheelchair and they wheeled me into an examination room (which I guess was more like a small hospital room).

And we'll leave it there for this chapter.  I'm sure I'll get to the doctor in the next episode.  Stay tuned.