Thursday, September 24, 2009

getting out of the ER

So I got wheeled to another room and waited for the on-call plastic surgeon to show up. He finally did. He advised that I had a tripod fracture of my orbit. Three broken bones around my eye. The fractures were not displaced so there was no surgery or plating to do to hold the bones together. I asked him if I would have chronic headaches the rest of my life. He said lets not worry about that right now. I figured over a period of time the bones would heal, but I knew things would never be the same and wanted to know what the long term affects would be.

He proceeded to stitch up my forehead above my eye. About6 or 7 stitches, then my eyelid, those stitches were not melt away and would have to be removed in a week, Then my upper lip on the inside. none of this was very pleasant, the needle for the lidociane hurt, I had about 15 mg of morphine in me. My wife watched him stitch me up but then got light-headed and the plastic surgeon told her to go lay down on another gurney in the room There was a bunch of people in the room coming and going. My step-daughter was there, a tech trying to clean my knee, my friend and his wife, finally he moved to my elbow. Putting several internal and external stitches in.

My nice nurse who had been with me the last couple hours said good-bye as it was change of shift. I hated to see her go, as she was very kind and empathic. Now it was just about done, everybody left and I waited for somebody to come and discharge me. It was now about two AM. It seemed to take forever. Everyone had left except my wife and stepdaughter.

Finally some gung-ho guy in scrubs came in and had a bunch of paperwork. I said, "who are you?" I had to ask twice. He was the new nurse. He asked if I knew about Lorabs. I said I was a physician. He Said do you know about lortabs. I told him again I was a physician, he said, "so do you know anything about lortabs". Obviously we were in a power struggle.

I treat thousands of patients a year, who struggle with the addiction and problems associated with opiate pain medications. I did know about the pain meds.

I was already pretty beat up and did not particularly like this person who was being a narcissistic jerk. Like so many people that work in health care, he had a chip in his shoulder towards physicians, from what I could tell. Having a broken face, I was a pretty easy target to beat up.

He had me sign a bunch of forms, I could not see or read, then I went to the bathroom. I was dizzy and everything hurt. The nurse then decided to tell me about his sister who was in an psych hospital. In typical narcissistic fashion,the message was his pain and victimization was worse than mine. I just wanted to be left alone and go home.

but I had to reflexively be nice and tell him how sorry I was about his sister. Then I thought what a jerk this nurse was again. Unfortunately being a human being myself, the jerks stick out over all the good people that helped me at the ER. Being a narcissistic jerk who must dominate other people to feel better about himself, this health care worker nurse will never get it. He was too busy being victimized. Remember some great victims work in health care.

I had to go to the pharmacy on the way home, I was freezing and shivering, from the shock and the morphine. In the old days, not so long ago, somebody would have been admitted to the hospital for a week for something like this. I knew I had terrible road burns on my knees and arm and face. I knew that I would have to constantly drink fluids, since normally someone would have IV's for days on something like this. I was nauseated.

I made appointments that next week to see an opthomologist an ENT doc and an orthopod. I started spiking fevers every night. Finally a couple days later my orthopod put me on a week of antibiotics. He x-rayed my elbow and my chest, since I also had bad rib pain. My vision was OK, but I failed the visual fields evoked response test, which checks your optic nerve. I have to go back in a couple weeks to re-check since my eye was almost swollen shut.

I had to cancel about sixty patients, the problem with private practice, besides not having a 401-K or health insurance that costs 1000 dollars a month, when you work on your own, if you go down, your patients depend solely on you. I actually had to see one patient a few days later. I went back to work nine days later this past Monday at full time. I had to wear shorts because of the knee burns.

Now Things are healing a bit. I can't eat solid food, I have no feeling in my upper teeth or half of my lip. Basically on this type of fracture a branch of the trigeminal or fifth cranial nerve gets traumatized. The ENT doc was very confident that over time the feeling would come back.

My knees are still open wounds as is my arm. I get the stitches out of my elbow tomorrow.

My wife is doing OK except for her finger. It hurts very much. Her burns have cleared up nicely on her face. It is her right index finger and she is right handed, so that leads to problems. She has amazing fortitude.


karen said...

I'm glad you are back to work. And your wife is getting better. I was worried about your wife. Seems like I get behind reading and have missed anything you said about your wife since the wreck. I need to read all your post. I am glad you both are getting better.
I never like male nurse's I guess that is my age showing . I don't mind female docters. That is the female pride showing. But at least you had a good nice nurse in ER at first. good luck.

Anonymous said...

I loved your article – it was some great information. I think you and your readers might be interested in another article I found on Medical and Dry Eyes.

Talking about the book with the Lake Superior wind....... a calm day