My Left Foot - Part 2 - Surgery and Hospitalisation

Surprisingly, I felt very calm during the morning of my foot surgery. It was probably because everything was organised.

The kids were at school and would head to their dad's house in the afternoon. The dogs were at my brother's house and I had done 30% water changes on all of the fish tanks. The guinea pigs had fresh hay, water and food and the plants had been watered. My friend Darren was driving me to the hospital and my friend Jacky was picking me up. I had rearranged the lounge room, ready for many weeks of convalescence. There was food in the cupboard and ready-made meals in the freezer. There wasn't anything left to do, but I couldn't sit still and spent the whole morning on my feet pottering around the house.

I arrived at Epworth Hospital Hawthorn at lunchtime and waited on shaking legs for the admissions officer to call me to the window. When it was my turn, I was asked for payment of the hospital excess of $450. I had already organised to have the excess waived, and I took a seat while she searched for the right piece of paper to confirm it.

A nurse with a bubbly personality collected me from the waiting area and wheeled me into the pre-op ward. I was handed a surgical gown and a large paper bag and shown into a change room. Once I got the gown on I hobbled to the nurse's office where I was quizzed about what I had consumed that day and how I was feeling.

She left me alone with a stack of trashy magazines and after ten minutes or so the surgeon entered the office and greeted me. He asked if I was ready and I told him I was more than ready to get this show on the road.

"Ready when you are Doc,"

With a permanent marker he drew a dark blue arrow on my left shin, pointing at my left foot. "Now we're ready," he said. We laughed together before he left me alone in the room again.

Next to enter the room was the anaesthetist. He had warm hands and a gentle manner and he nodded sympathetically when I told him that, like just about everyone on the planet, I was terrified by the idea of general anaesthetic. He promised to look after me and changed the subject, asking me to climb up on the guerny and tell him about my work. I could feel my heart thundering in my chest as all of the anxiety I had suppressed all day came bubbling to surface and I babbled.

While I was part way through a despairing diatribe about union density in the Australian private sector the anaesthetist and his nurse wheeled the guerny the short distance from the office to the operating theatre. As the double doors were pushed open I heard myself say, in a fairly belligerent fashion, "they get all the benefits and the buggers still won't join their union!"

6 pairs of eyes stared at me, surgical masks hiding facial expressions. I sincerely hoped I hadn't been wheeled into a room full of Tories with sharp knives!

The anaesthetist asked me to sit up on the guerny and roll onto my stomach and said he was about to give me something to help me relax, as well as a nerve block.

I don't know who the other people in the room were, but they seemed busy fiddling with machines and murmuring softly to one another. I felt a quick sting in he back of my left knee and stayed face down for maybe 30 seconds more. The anaesthetist asked how I was feeling.

"A bit light headed actually," I told him.

He helped me sit up and the room started to spin. As soon as I lay down again, this time on my back, the anaesthetist said "We're ready to start now Leanne." A black mask was lowered over my mouth and nose and I was told to count backwards from ten. I don't think I even got to 9 before I was out like a light.

When I awoke a couple of hours later, my first thought was "It hurts."

My eyes blinked open and I saw a nurse behind a desk at the end of my bed. My elevated foot was resting in an open cast with crepe bandage wrapped around it, held together with tape.

"It hurts," I said, aloud this time, in a croaky voice.

She moved away from the desk and I closed my eyes. When I opened them again the anaesthetist's nurse was at my bedside.

"Hi," I said, "It hurts."

Then I cried a little She put her hand on my arm, to comfort me.

"We're going to move you into your room now and then we'll get you something for the pain."

I was becoming more alert and the pain was waking up too, growing in intensity.

"It hurts," I breathed, trying not to cry again.

The guerny was wheeled into an insanely large private room and I transferred to a bed with help from two nurses.

Now that I was fully awake I noticed how thirsty and hungry I felt and I could smell the hot meals that had been delivered to the other rooms in the ward. My stomach growled loudly. A nurse told me she would organise a light meal for me and handed me a cup of tablets, followed by a cup of water. I swallowed the contents of both before having a quick lesson in how to operate the bed and how to call for help. Before leaving the room the nurse switched the TV on and handed me to remote control, which I used to find ABC24. I watched the rolling news coverage through bleary eyes and it wasn't long before I dozed off.

When I opened my eyes again it was night and I could see the bright street lights through the window. I pressed the call button next the bed and a curmudgeon nurse appeared in the doorway. My most pressing needs were urination and food and she helped me get up on my right foot and pushed a wheeled walking frame within reach. I used it to hop to the bathroom and the nurse left to find me some food. The plate of sandwiches that arrived about 15 minutes later were gratefully received and I savoured all three of them.

When I had finished eating I was handed another cup of pills and a cup of water, and then I snuggled into the bed to watch Lateline. I slept well, deeply.

The pain woke up the same time I did and I buzzed for a nurse who told me the meds would arrive in half an hour. I counted the minutes, 28, 27, 26, 25, and tried to distract myself with emails and social media.

My first visitor that day was the surgeon. When he asked me how I was feeling I said "better than Campbell Newman," to which he looked perplexed - I'm not sure he got the reference, but he glanced at the television and said "Oh." (I can’t actually remember what was going on with Campbell Newman on that day). He told me the surgery went very well and the most important thing to do now was rest, and he’d stop by again the following day.

My next visitor was the hospital physiotherapist, who showed me a range of mobility devices I could use while in hospital and hire to take home. I took a knee scooter for a test ride up and down the hallway, moving fast on the smooth linoleum-covered floor. I chose the wheeled walking frame for in-hospital use and arranged to hire a knee scooter and a commode seat to take home. All three were delivered to my room before my next visitor arrive.

Darren was immediately drawn to the knee scooter and took it for a spin around the room before heading out for "real coffee". I was almost feeling like my old self by the time I finished that coffee.

I slept through the afternoon until my kids arrived, dropping in to visit me on their way home from school. I was so very happy to see them. We cuddled, held hands and shared a bag of lollies while they
told me about their respective days.

Mum's on Endone

After they left I tried to read, first a magazine, then a book, but I was struggling to concentrate and stared at the television instead.

The next day passed in much the same fashion, without as many visitors. Wake, visit the bathroom, take meds, eat, doze, repeat. The surgeon came again and Darren popped in to drop off a bottle of Vitamin D capsules and reassure me that the fish and the guinea pigs were all fine.

Day three of my stay was a Friday, the day that the acute surgical ward was converted to a weekend IVF clinic, meaning I had to move out. I was transferred to the rehab ward soon after lunch, for my final night in hospital.

There's a big difference in the level of nursing supervision patients receive in the rehab ward than in the acute ward - well, that's my experience any way. Things take a bit longer to get to you, nurses are more likely to be up for a chat (maybe that's why things take longer?)

I was in there for less than 24 hours and in that time a wheel fell off the walking frame twice - both times while I was using it, causing me to land heavily on my injured foot. The second time it happened, I was in the bathroom and had just finished using the toilet. The toilet blocked and overflowed and while I was moving away from the overflow - pretty quickly, I might add - when the wheel fell off for the second time. I was in pain, I was immobile and water from the toilet bowl was snaking across the bathroom floor toward me. I tapped the call button and was shocked when four nursing staff burst through the bathroom door.

I gestured, first at the toilet and then at foot, and asked "You're filming this right? Where's the camera?"

One of the nurses snarled at me "you pushed the wrong button - we thought it was an emergency."

I pointed at the overflowing toilet bowl, and my foot, and said "It kind of is."

Three of the four nurses turned their back and left he bathroom, one remained behind to get me back into bed and deal with the toilet situation. He unblocked it pretty quickly and mopped up, while I tried to get comfortable on the bed, bristling with nicotine withdrawal and indignation. I slept fitfully that night.

I'm just speculating, but the nurse who brought me my morning meds looked and smelled like she had come straight to work from a booze-fuelled all night dance party. Her long fake nails were decorated with glitter, her orangey skin peeped out over too low pants and under a too small shirt and her smeared make-up had a definite "morning after" look to it. She was nice enough though, and certainly wasn't going to take any crap from me.

She got me medicated, fed and showered and organised my take home meds from the hospital pharmacy. She taught me how to give myself injections of Clexane (an anti-coagulant, taken to reduce the risk of blood clots) and helped me get my things together, ready for departure.

The surgeon left a phone message saying he wouldn't be stopping by that day and that he was happy for me to be discharged.  He'd see me in a fortnight at our pre-arranged appointment.

Jacky arrived and gave me a big squeezy hug before picking up my overnight bag and the commode seat. The orange coloured nurse followed us to the lifts, carrying two pharmacy bags and yelling at me to slow down - I was scooting down the hall pretty fast and it felt great!

Jacky, who incidentally is the queen of parking, had found a spot right next to the hospital entrance. I got myself into the front passenger seat and waited there while Jacky and Nurse Orange wrestled with the knee scooter, trying to find the lever that would make it fold down. They found it (hooray!) and we took off, waving farewell to Nurse Orange.

I found my sunglasses, leaned back in the seat and lowered the passenger window.

It was time to go home.

#myleftfoot

My Left Foot - Part 1 - The Injury

I didn't really think about my feet very much prior to November 2013. Sure, they had done a good job of carrying me across continents, mountains and dance floors but they were also annoyingly wide and difficult to shoe.

Besides, there were other parts of my body that demanded the lion's share of attention, like the hip afflicted with severe osteoarthritis and the knee joint that has so thoroughly pulverised it's meniscus I can both feel and hear the bones grinding against each other whenever I take a step. I had grown used to living with chronic (often debilitating) pain for almost fifteen years and in the back of my mind I knew I would need to have both joints replaced some time in the future.

In the early hours of Monday 18th November 2013 my left foot made it's bold play, dragging me into a world of white hot pain and long-term limited mobility.

It had been a lovely family-oriented weekend. My son and daughter were with me (they have two homes and spend 50% of their time at the home they share with me) and we spent time with my father and two of my brothers and their families, celebrating my son's 16th birthday. Underlying the celebratory good cheer was a deep concern about my father's increasingly apparent mental decline, due to dementia.

Dad and I jointly purchased a new bed for my son, a combined birthday and Christmas gift for the young man who had well and truly outgrown his narrow single bed.  We completely emptied and cleaned his bedroom and my son and daughter assembled the new double bed. By Sunday night, the contents of his room were either gathered near the front door ready for collection by a charity or packed away again in his room - or so I thought.

On a middle of the night dunny run, with neither my eyes open nor the lights on, one of my feet connected with a box of action figure toys out of its usual place. I don't recall if I kicked the box or stood in it, but whatever I did caused a spectacular fall that resulted in my body slamming against a wall and my foot bending like a banana. While reaching out with my hands to break my fall I managed to pull a heavy electric keyboard onto my thighs and a basket of percussive instruments onto my head. Cowbells, rhythm sticks and maracas created a brief cacophony as they rained down on me. My brain did a quick assessment of my injuries - sore head, sore thighs, my foot. MY FOOT!

My long, loud howl of pain roused my thirteen year old daughter. In her levelheaded way she calmly lifted me from the floor and supported me as I hopped back to bed. She helped me into bed and gently rested my foot on a pile of pillows before heading to the kitchen for an ice pack. What a trooper! Did I mention she was only thirteen at the time this happened? #likeagirl

The pain was excruciating but I tried valiantly to give my daughter a reassuring smile as I sent her back to bed. It was just after 3am and she needed to get up at 6am to get ready for school. She returned to her room, but I discovered later that she didn't sleep again that night, so great was her worry about me.

I didn't sleep again either.

For the next three hours I quietly sobbed while my foot swelled and throbbed. I set my mind to the problem of how the hell I was going to get the kids to the train station and myself to hospital. I went over and over the plan I had nutted out - lie here until 6:30 am, call cab and call brother, drop kids at station and pick up brother, go to hospital.

As the hours passed I added another item to the list - lie here until 6:30am, hop to the bathroom, call cab and brother, etc. My tumble had derailed me from the purpose of getting up in the first place and my bladder was uncomfortably full.

At 6am my daughter returned to my room to check on me, and when the tousled head of my son appeared in the doorway and he asked "what happened?" his weary mother and sister snarled in unison "how on earth did you sleep through all the ruckus?" Poor fella. He dropped to his knees by my bedside and hugged me tightly. Eager to help, he kept asking what he could do for me. I laid out the plan for them and my son helped me get off the bed, then supported me while I hopped to the bathroom. Every hop jolted my left foot, giving new life to pain. I gritted my teeth and sank gratefully onto the toilet seat.

I couldn't bear to jolt my foot any more, so I crawled on hands and knees back to the bedroom, grabbed whatever clothes were within reach and after levering myself onto my right foot, I threw the clothes and myself onto the bed. I dressed myself lying down and waited for the kids to finish dressing, having breakfast, making lunch and packing bags. The pain was so overwhelming I was having trouble talking, so I booked a cab via an app and sent a text to my brother telling him to be in his driveway and ready to jump in a cab.

When the cab arrived I crawled out to the driveway and, using my elbows on the taxi seat and with a helping hand from the taxi driver I levered myself up on to my right foot so I could get onto the seat. The driver was very kind about my predicament.

As I looked at the worried faces of my children when I left them at the train station, I wondered if I would see them again that night, or if I would be spending the night in hospital.

I was relieved to find my brother waiting in the driveway at Dad's house as instructed. He was Dad's primary carer and there was every chance he wouldn't have been able to get away. Thankfully, Dad was still asleep when I arrived. Knowing that the Royal District Nursing Service would be along soon to supervise his morning insulin injection and make sure he ate breakfast, and also knowing Dad's habit of wandering off from home in search of his "other home" usually occurred in the afternoons or evenings, we felt we could take the risk of leaving him alone for a little while. All I needed Shane to do was get me into a wheelchair. Once he had wheeled me into the emergency department I told him he should head back to Dad, but he stayed with me and asked his partner to keep an eye on Dad. #dementiaadventure

At the triage desk I graded my pain as 10/10 and gratefully swallowed the morphine tablet handed to me by the nurse. After 20 minutes, when the morphine had merely taken the edge off the pain, I figured I had sustained a fairly serious injury. Although still in pain, my mood improved dramatically and I was able to smile and joke around. That's morphine for you!

I was wheeled into the x-ray department and the pain reared its head again when the radiographer insisted I bear weight on my foot. I waited in the short-term emergency ward trying to calmly breathe my pain out (some hippy pain management technique I had used successfully during labour and childbirth) and chatting with my brother. I sent an email to my boss and my staff, letting them know I probably wouldn't be coming into the office.

A doctor arrived at my bedside to let me know the x-ray did not show any breaks or fractures, so they were sending me home. A woman arrived with a pair of crutches and an equipment hire form, so I could pay the $30 hire cost before leaving the hospital. I was discharged without a prescription for pain relief medication and was advised to take paracetamol to help with the pain.

I spent the remainder of that week on the couch with my foot elevated, using my phone and iPad to work from home.

The following week I hobbled into the office for a day-long management meeting and spent the rest of that week working from my couch. When there was no significant improvement by the start of the third week, I went to my local general practice and asked for another x-Ray. Again, the x-ray didn't show any bone damage and the GP said that I should continue to rest it as much as possible, and it should be back to normal within a couple of weeks.

I felt frustrated with this advice and wanted to look into it more thoroughly, but there was so much intense, serious stuff going on in my life right then that I let go of the idea of healing and settled for carrying on and coping with a bung foot.

For the next seven months I hobbled around on my painful, misshapen foot while life went on. I hobbled to the Victorian Civil and Administrative Tribunal for the hearing to be appointed my father's guardian and administrator. I limped through tours of aged care facilities in the north and north east of Melbourne. I clomped around Dad's house, helping my brother's pack up his belongings after I moved him into a nursing home. I shuffled through airports in Melbourne, Sydney and Adelaide and dragged my foot along those cities' streets and throughout the north island of New Zealand. All the while, biting back the pain and discomfort. I almost managed to stand through an entire Polyphonic Spree concert, but I just couldn't make it through the eight song encore set and trudged outside the venue looking for a seat.

Stupidly, this injury also co-incided with my sudden and surprising obsession with tropical fish-keeping - an interest that involves lugging around heavy buckets of water and other heavy things like tanks and gravel. #tanktales

There wasn't much time to elevate my foot over those months as the demands of the campaigning work I was doing in my regular job, coupled with the work I was doing out of work hours on our internal election, saw me working fourteen hour days and working seven days a week. I can't be sure of this but I think my stress and fatigue left me in a fog so thick that the pain couldn't pierce it. I just kept stumbling on, knowing the end of this intense period would surely come.

Then two things happened in July 2014. We lost the internal election, throwing my job security into question, and the twelve month waiting period for the private hospital cover I had organised on the advice of a health insurance consultant I had met at a pub in mid-2013, expired.

I pushed my job security fears to one side and made an appointment with the sports medicine doctor who had diagnosed my knee issues a year or so ago. I told him I wanted to organise hip replacement surgery as soon as possible now I was eligible for private hospital cover. He had watched me closely as I walked into his office and he said we could talk about the hip but it seemed my foot was the obvious priority.

The MRI he ordered showed the ligament that normally holds the foot bones in their place was, in my foot, a "ball of grey mush". Arrows on the scan pointed to spots of arthritis and possible fracturing. The doctor referred me to two surgeons for urgent assessment and asked me to let him know which one I decided to go with.

The first surgeon I saw sent me off for a CT and CT-spect scan. The process for these scans takes a day and when I next saw the surgeon he was able to show me an in depth look at the damage to my foot. The ligament was beyond repair and there were little fractures and small loose splinters of bone.

In the fall all those months ago I had sustained a lisfranc (mid-foot) injury along with the ligament damage, and the only course of action available was a surgical procedure called a mid-foot fusion.

I was relieved to finally have an understanding of the injury and to learn there was, if not a cure, a procedure that could give me some relief.

Between the diagnosis and the surgery (about 7 weeks) I got through by having the foot strapped by a podiatrist (surprisingly effective) for four days per week, then wearing a soft ankle brace on the other three days.

On 5th November 2014 - almost a year after I fell - I was wheeled into surgery.

To be continued.

Tank Tales: A new blog by an amateur aquarist

I haven't been posting much here on RTFACM because I have been busy posting over there.

Over a year ago I was given a tropical fish. Since then I have developed MTS (Multiple Tank Syndrome) and I am writing about my adventures* as an amateur aquarist.

You can check out Tank Tales on Blogger and Tumblr.

#tanktales

Enjoy!

*sounds more exciting than it actually is

Medicare is worth fighting for

We had a health scare in the family this afternoon and after I picked up my family member I debated whether to head to the public hospital emergency department or a doctor's clinic. The health scare was serious but didn't seem to be immediately life threatening so I called my local doctor.

They had no appointments, so I headed to the bulk billing clinic in Preston to see how long the waiting time was. There were 20 people with appointments to see 5 doctors and another 10 people who were waiting for the first available doctor. The receptionist took one look at my family member and decided to have her assessed by a nurse straight away.

Within 2 minutes (I'm not kidding) the nurse was with us and my family member was assessed. We were told a doctor would be with us shortly. Within 3 minutes (again, not kidding) the doctor arrived, conducted the examination, asked questions and diagnosed a severe allergic reaction.

10 minutes after we arrived we walked out with a diagnosis (and peace of mind), antihistamine and a doctor's certificate. We weren't charged for the assessment and diagnosis. We didn't take up a bed in an emergency department, we didn't take the doctor away from other patients for very long and we got the care we needed at no cost.

I know that it doesn't always work this way and sometimes it is just the luck of the draw, but to me this is a very clear sign that Medicare works.

If there had been a co-payment (as our govt wants to introduce) I am certain I would have gone straight to the hospital emergency department and would either still be sitting there waiting or, more importantly, we would be taking up a hospital bed unnecessarily.

Medicare works and it's worth fighting for.
http://www.savemedicare.org.au/