Saturday, April 21, 2012

Firsts and Such

The final Red River Sirens Roller Derby event for 2011 was a stunning personal finale.

Some people succumb to mid-life crisis by buying flashy sports cars and/or flashy jewelry. Some get divorces. Others take up overeating or drinking or religion. Some fight it with flat-out denial. Case in point -- I bought a pair of Reidells, learned to roller skate at age 49 and helped grow a roller derby team. I took the name 'shades deville' and focused on hydrating, stretching, endurance drills, technical skills, and attempting to cultivate and channel my aggression to help my team. After a year and a half of training and practicing, questioning myself, feeling like a misfit in a sport with a reputation for being dominated by misfits, and skating on the roster for a few bouts against other teams, things were finally beginning to gel for me. I was beginning to trust my skates more and second-guess myself less. I felt, for the first time, like maybe I could, with lots of focus and lots more practice, someday be good, and not just good 'for my age.'

About 45 minutes into the season-ending Zombies versus Commandos intra-league bout, I was propelled into a cannonball maneuver (I was the cannonball) at turn two that went not-quite-right, followed by a tangle or a Tango or something that resulted in me on the floor. I hit the floor a lot, and prided myself on getting up quickly, but this time was different. I felt my left lower leg snap, sort of like breaking a stick. This was not the usual spill, and my blood was spilling into a pool on the track.

Those few seconds resulted in a triumvirate of firsts in my personal and medical history. Spiral fractures of my tibia and fibula at the precocious age of 51-going-on-30 (or 12, depending upon whom is asked) marked my first documented broken bone(s). (The odd configuration of my 90-degree tailbone detected in January 2011 is still an unknown physical situation of unknown origin.) The multiple fractures required my first surgery (unless wisdom teeth removal counts, in which case my weekend of monumental firsts is minimized by approximately 33.3 percent). It was also my first overnight hospital stay (undisputed – and three nights!). The EMTs and hospital staff were incredulous that someone half a century old had not previously been broken and hospitalized, which had me feeling like some sort of freak. My camouflage patterned boys size 16 boxer briefs worn over fishnet tights and camo paint on my face only exacerbated the freak feeling. Out of context, commando derby attire is kind of, well, odd. I couldn't wait to wash the green and brown makeup off my face.

My first hospital food had me curious as to whether it would live up -- or down -- to the infamous reputation ascribed to it. It looked good on paper -- a visually appealing, professionally designed menu featuring breakfast, lunch, dinner, and "available all day" selections. At least twice (and possibly every time), the person on the other end of the food hotline asked, "Is that all?" after hearing my order for a scrambled egg and orange juice, or grilled cheese and tomato soup. Evidently, they are accustomed to feeding heartier appetites.

Even though it was delivered from a place called "Room Service," and arrived on a plate under a fancy lid on a tray carried by a person wearing a white shirt, black pants and black vest, (been there ... not a first) the trappings and presentation could not disguise the fact that the food was still mostly yucky. It turned out the flavor was directly improved, not by the tiny salt and pepper packets included with the napkin, but by activating the pain management button prior to, and while eating. It seems that Morphine makes food taste better. Each time my "Fresh Fruit Cup" contained cantaloupe, it required conscious and deliberate effort to block out the memories of the flood of news coverage of the recent spate of deaths from lysteria-tainted fruit. (Those were probably the times my blood pressure approached anything above super-low.) The veggie burger sounded promising but turned out to be an overcooked, sponge-like disc that was too spicy for even my spice loving palate -- another first. I choked down two bites before I gave up on it. The linguini with pesto, overcooked and mushy to the point of not requiring chewing, became another two-bite meal. The french toast was barely toasty and served with gross margarine spread. The scrambled eggs were actually edible. The clear winner of first prize in hospital Room Service roulette was the tomato soup and grilled cheese, but the overall winner for best meal during my stay was pizza from Michael's Pizza, prepared at a legitimate food supplier and delivered by a derby teammate. Perhaps Michael's could get a food concession at the Medical Center and perform a huge service to weak, hungry patients.

Gateway claims to practice Hourly Rounding, whereby nursing staff visit the patients every hour. They promote this in an informative brochure titled "Hourly Rounding and What it Means for You." There were clocks with movable hands opposite each bed in the luxury suite in which I was lodged (Room 4228). When the staff visits, explained in the brochure as hourly during the day and every two hours overnight, the clock hands are moved to the time of the most recent visit. Many of the visits included the recording of vital signs -- temperature, blood pressure and pulse. The staff almost always had to do my blood pressure twice -- the cuff on the portable equipment cart was too large and a reading couldn't be done successfully until they got "the small cuff." Eventually, someone left a small cuff attached to the rail of my bed so they could stop searching and commence with the reading and recording. Staff usually marveled at the low, low readings on my blood pressure. Perhaps the pool of blood left on the derby track had not been replenished yet, taking my usually low blood pressure to new lows.

Hourly rounding was great. It was predictable. As a 'guest,' I appreciated knowing when to expect the staff to show up to do vitals. It meant if I needed to use the bedside commode, I knew when someone would be around next, and might be able to avoid a call to the nurse station for help. On Sunday, Hourly Rounding worked like, well, clockwork. On Monday the system was just a fond memory and the place turned into a totally different hospital. It was anyone's guess when (or if) medical staff would be stopping by. Several times I had to buzz the nurse station because the IV machine to which I was attached was beeping frantically, which is rather unnerving and quite loud. When someone finally arrived, they'd casually comment, "Oh, that one is getting low," which probably would have been noticed with those regular, hourly visits.

When the same night nurse arrived Monday night that I had on Sunday, she asked how things were going. I said "Great," then asked if Hourly Rounds were just a weekend thing. When I pointed to my clock displaying "7" and said that was not from an hour ago, but from that morning -- 13 hours ago, she mentioned I was not the first patient to mention that in the hour since she'd arrived. Then she said she was going to speak with the supervisor, because the Hourly Rounding system was a quality mandate of the hospital, and supposed to be followed consistently.

On Tuesday I was discharged, which led to another day of surprises in the absence of information provided. I was told early in the day I would be discharged and that was the extent of the helpful nuggets of knowledge. Umm.... any idea what time this may be happening? Should I order another fabulous lunch from Room Service? I needed to arrange for a ride and a time frame would be helpful, unless that ambulance crew that delivered me on Saturday was planning to drop me off somewhere. I was handed two sheets of paper and two prescriptions, which required a line of questioning worthy of Judge Judy to learn that no, this hospital does not have a pharmacy on-site. (Maybe the tradeoff was between the lobby Starbucks or pharmacy?)

One sheet of paper was an official permission slip to leave. The other was a yellow carbon sheet bearing the previous day's date and a one sentence instruction to "Follow up with doctor on Wednesday, Oct 26." There were no written instructions about keeping my lower leg elevated for the next three days, as told during the surgeon's bedside visit. There was none of the timeline information I thought I remembered mentioned in my pre-surgery drugged state (when I was certain I felt the warmth of sunshine, beach breezes and sounds of the ocean) about stitch removal and putting weight on the affected limb. No info about keeping it dry. No doctor's name. No phone number to call to set up the aforementioned follow-up appointment. No helpful info whatsoever. This was becoming a mystery worthy of Nancy Drew. At least the Doctor's name was on the prescriptions. When we arrived at her house after a cross-town jaunt to the pharmacy, my gal pal Wendy conducted an Internet search to find the basic contact info required to call and schedule the follow-up, which, according to the office staff, was supposed to be Friday, not Wednesday. So the one concrete instruction I left with was not even correct. I had the feeling this was not a first-time occurrence for the establishment in which I was recently a guest.

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