What Happens in Vegas...

I'm going to document my last 24 hours so that I can come back and laugh at it someday.

The timing was somewhat of a whirlwind later in the day so I’m not 100% clear on exactly when things happened.

On Friday (May 20th) I ate a light brunch in Las Vegas at approximately 11am and drank at least 4 large glasses of ice-water (actually kind of unusual for me).

It was last day of Vegas after 4 good days at a work conference. There was a pretty packed schedule with the usual amount of wining and dining. After brunch, I stopped into a few niknaks for the family.  I checked out of the hotel, taxied to the airport and I arrived a little earlier than 2 hrs before my flight and sat down around 4pm to have something for dinner before I get on my 6:20p flight.  

Knowing  I had some time on my hands, and was still a workday, I popped open my Mac and was chatting with a coworker when I got I got a stabbing pain in my left arm (felt like someone was poking a finger into my arm.  I joked to myself that I’m probably having a heart attack.  About 20 seconds later I started to have waves of dizziness and it felt like I was being pushed downwards.  I fought the feeling (like you do when you stand up too quickly) and it mostly went away. This was at just after 4:15p (I can tell because I messaged my coworker saying I wasn’t feeling right).  I felt very disoriented but the wave of dizziness had gone.

Moments later the "passing out" wave came back, this time much worse. I could feel my head drooping down and it was going dark.  I fought it again, mostly regained composure but my my hands were clammy and shaking, I felt flushed in my face and I was very disoriented.

I called the server over and told her I wasn’t feeling well and she offered to get “a medic”.  I said that would be good and updated my coworker and let my wife know what was going on (via chat).  The manager came back pretty quickly to let me know that “a medic” meant calling 911 and having an ambulance come out. I checked with my wife and we agreed that it was not something to mess around with. 

They called 911 and I paid for my dinner (which had been delivered to my table) but I wasn't up for eating it. I was assisted out of the restaurant by the manager who wished me luck.  I was then introduced to an official in the Airport Authority who said he would be in contact with my airline, ensure my bags were taken care of in Seattle, informing them that I wouldn’t be on my flight,  etc.  The ambulance arrived pretty quickly and I was in an ambulance by 4:50p.  They did a lot of triage before we left for the hospital.  The EMT were really funny. The younger guy tried 3 times to put in an IV.  The older guy had him do the 4th under his explicit direction (to go for the vein you feel and not the one you see, how to hold the needle thing correctly etc.) Suffice it to say, he got it and we were sorted (except for quite a large mess of blood on me and my clothes). 

We arrived at the hospital at 5:45p and I was registered and in a room very quickly, then hooked up to lots of monitors.  I was seen by a bunch of people, they took an ekg (using a cool mobile unit), took bloods and I was seen by a Physicians Assistant who told me my heart rate and blood pressure were abnormally high; all done by 6:30p. I waited quietly while my labs were being worked on and at 8:20p the Dr came in to let me know that he would be reviewing the labs, x-ray and ekg and 'we'll be go from there’. At 8:30p I was put on a Saline drip and the nurse indicated  that the Dr suspected I was severely dehydrated. At 9:25p the Dr ordered another saline IV for me. (Each were 1000 ml of saline).  

The Dr came in at about 9:40p and said that he suspected that my heart rate was because I was severely dehydrated and the blood pressure was probably mostly caused by the trauma/drama of being in the ambulance, hospital etc. Somewhere close to 11pm, I was informed that all labs came back as normal. With the final verdict as probably just severe dehydration.  Blood Pressure is high but not enough to treat it at the ER and the DR recommends setting up appt with my family Dr next week. I was cleared to fly but obviously it was too late to fly out on Friday night.  All of the final discharge activities took a little bit of time and by the time I was out of the ER, I spent about 45 minutes on the phone with our corporate travel people getting a room for the remainder of the night, having them work with Delta to get my original ticket reworked so that I didn’t have to pay a change fee, etc. I caught a cab to the South Point hotel (where I was technically booked in for Sat/Sun but really early arrival).   I was comfirmrd on an 11:20a flight on Saturday.

Update: Hotel was fine, airport was uneventful (this time), and flightand journey towards home was fine (but long)  I will be having a very low-key weekend and arranged to take Monday and Tuesday as sick days to recover from the experience as I am still not fully back to normal.

Update 2: Spent Saturday night in the ER close to home after a repeat of the "passing out" wave.  Lots of the same tests which all came back as normal. Blood Pressure and Pulse still way too high. Next steps are a follow up with my family Dr and hopefully something to get control of my blood pressure. 

Catch up

Well, as with many of the things that I take on, my blog fell by the wayside to my busy life.  My busy life seems to be a constant excuse to do things that should get done.  Sometimes is seems that my life gets in the way of my life.  This is not designed to be a "woe is me" entry, just an acknowledgement that sometimes the things that seem important are superseded by things that are just, well, more important!  I guess this blog entry is an exercise in stating the obvious.

Since I last blogged, I went to the county fair in a rented wheelchair (actually not a bad way to go to the fair given that I was able to sit and watch and not stand about while the kids played on the rides).  Once I got the cast off, I was able to drive again.  Not long after that the pin got caught around a loose wire at the back of my dashboard and it pulled the pin almost completely out!  It was quite sore and the pin (amazingly long) was hanging out of the tip or my toe.  I went straight to the urgent care and they removed the pin.  Thank God the pin didn't come all the way out in the car because when he removed it... boy did it bleed!!

Once the pin was out, I was basically ready to start physical therapy.  My toe was completely straight and had no movement in the joint at all.  The Ortho was happy with how the healing process had progressed.  I got a stitch abscess in my toe which hurt like the bejeebers but eventually it all healed up.

Unfortunately the physical therapy was basically useless and my toe is now fully stuck in the extended position.  This isn't a bad thing though because the alternative would have been a fully stuck tow in the bent position which would have been pretty tough to deal with (imagine putting on a shoe!).

Since then, my life has been busy with home life and work.  Stay turned for an update on some weight loss items - I probably should have been blogging about it but .. well I was busy.

Knee Walkers and a New Cast

A full week of being back at work is not over.  DW is done with her work too until mid-September.  The past few nights have been... not so good.  My cast (the replacement to the original which was removed after I fell) has started to hurt around my ankle and heel.  My foot lies on both of these places depending on whether I'm lying down or sitting.  This is actually causing me more pain the the incision and pin!

Last week at church, a few people told me that I needed to get one of those knee walkers:

So I diligently investigated who stocked them in my neighborhood and made some calls.   Each of the stores that I called had them in their inventory, but they were all being used (you rent them by the month) but I could be put on various waiting lists if I was interested... One store had one of the three available model types in stock, and suggested I come down to try it out.  In the meantime, they told me to contact my insurance with a code, and see if it was covered.  I called the insurance, they said it was covered, so I called back the place to tell them that I would come down.  At that time, the guy mentioned that I would also need a prescription from my doctor.  So I called the ortho, got them to fax a prescription down, and made arrangements to visit the store in the late afternoon.

I've been to this same store when they had a location closer to our house and it was a bit... odd.  The store is devoted to home health products like walkers, scooters, bed pans, rubber sheets, colostomy bags etc.  The air inside of the store was stale and the furnishings outdated.  The sales people were friendly but just a little creepy (in a sort of undertaker way).  The new location was no different.  When I went in, I let them know that I had spoken with someone earlier and that there was a knee walker on hold for me.  He wheeled out a blue walker with 4 fixed wheels (i.e. none of the wheels swiveled to aid turning).  The walker had a longer bench than the one in the picture above and had a single brake lever on handle-bars.

I put my knee on the walker and my cast hung off out to the back. It felt comfortable except that it was slightly low and I felt like there was not sufficient support on the back of my leg (my cast wast hanging off end of the bench and I could tell that was going to hurt over time).  He showed me that in order to turn, I needed to lift the front wheels off the ground and pivot the walker in the new direction.  He said that the major problem (that was not going to be fixable) was the height.  The walker was already set to the highest setting and if I was to use the walker for any length of time, I would develop pain in my hips.  He had two other walkers that were on hold for other customers but he wanted me to try those out instead although in hindsight I have no idea what that was going to accomplish given that he was clear that I wasn't going to be able to leave with either.  Both of the other two had small seats and my cast is so heavy that they were clearly unsuitable (although the walkers felt more stable with the swiveling (as opposed to fixed) wheels.   He told me that they could probably get a walker in that was taller, and that had a larger bench but that it would be 2 or 3 weeks before they got it.  That wasn't going to be much use given that I am planning to be done with the cast by that time.  I thanked him for assisting me and went on my way.

My cast continued to hurt my ankle and heel and it was starting to keep me up at night. On Thursday I called the ortho's office and arranged to see the cast tech the following day. When I went in, the cast tech peeled off the cast and took a look at the skin on my foot.  Everything looked fine (which of course made me feel like a big baby) and he set about putting on a new cast.  This time he decided to use fiber-glass (instead of plaster) and paid special attention to padding around my ankle and heel.  The new cast is lighter but bulkier.  Time will tell how it fares for comfort.

A Busy Weekend

Saturday was a day packed with activity. We started the morning at a local bakery, then ate our donuts etc at a coffee shop across the street. On to the farmers market, then to Best Buy, Target, Cost Plus and our neighbor's church. All before noon!  In the afternoon we went to Pet Smart and Fred Meyer.

There was quite an array of accessibility options during the morning.  Obviously the bakery, coffee shop nor farmers market had any facility for mobility.  Best Buy had a wheelchair which my kids enjoyed pushing for the first few seconds then I took over because of the extreme danger to me and others around me while my kids were in control.  The foot plate on the left side was loose, so my cast kept slipping to the floor.

Target had a motorized cart. I picked up the only available one but there were at least 3 others that I encountered in the store (it is funny how you are more prone to notice these things when you are faced with the prospect of using them yourself). This experience was somewhat better than my first except that the route we took around the store ended in going through the clothes section which was too tight a space for the cart and I pulled to the ground an entire line of clothes.

Interestingly Cost Plus had nothing. No motorized carts, no wheelchairs... I hobbled around the store successfully but had I not had someone with me, I would not have been able to carry any merchandise!

I stayed in the car for the Pet Smart trip so I'm not sure how I would fared there.  Fred Meyer wins today with about 8 motorized carts at the entrance (one of 3) in through which I went.   The cart was a little jumpy (it started and stopped abruptly) but it was fine.

My new cast is tighter than the old one. Not tight enough to cut off circulation or anything, but tight enough that my foot and lower leg have no wiggle room at all. This makes it more comfortable during the day but more difficult to find a comfortable position at night.

Sunday we decided at the last minute to have breakfast at a favorite restaurant before church.  After church we came home, but later we went back to Best Buy and then on to our local mall.  I was impressed with the mall facilities for the disabled.  I crutched in the main entrance and a security guard came over (on a Segway) and asked me if I would like her to have a wheelchair brought from the guest services (in the middle of the mall).  I agreed and within a few minutes, they had the wheelchair for me.  It pulled to the left (so my left arm was sore by the time I was done) but they looked after my crutches while I had the wheelchair and returned them to me when I was done with the wheelchair.

Praying for a good night sleep as this coming week is busy at work and Dear Wife is back to work until Thursday but we are thankful for the wonderful friends and family that we have surrounding us who have rallied around us with offers of meals (we accepted two meals this coming week) and dear friends who are willing to look after the kids during the few hours each of the 4 days while DW is at work.

The Fall

A week had now past since the procedure. It was been quite tough. In some sense I feel guilty saying that, because I have been very lucky with how my family has rallied around me, how my co-workers and boss have been understanding and how supportive my friends hand neighbors are yet I still feel somewhat entitled to a pity-party. Shame on me.

On the whole the most unexpected part was the reaction to the drugs and how I felt while coming down off them. I know it was just for a few days, but it was thoroughly unpleasant. On Monday I sat on the deck outside our bedroom and watched a sprinkler. While I watched, I convinced myself that the drugs were not having any effect on me and that I was still my normal self. It wasn't until my family arrived back from wherever they had been that I realized I had been sitting watching the sprinkler for over 30 minutes. I had drool coming out of my mouth. Yeah.... they were not having an effect alright....

On Thursday evening, I had my first (and hopefully last) fall. I was crutching through the kitchen and must have hit a wet patch or something. The crutch slid off yonder and I was in free fall. I remembered that they said at all costs not to bear my weight on my foot, so I spun around so I would land on my butt. Moments later, my casted leg hit the ground (on the heel) and I had a shock wave of pain resonating up my foot toward my toe. Not fun. The pain stayed with me most of the evening but seemed to mostly subside. It is really hard to judge pain that you are in now with pain that you were in previously. I simply can't recall if the burning that I felt last night was worse or better than it felt the previous day.

We had a bad night, some due to my foot pain but mainly due to bad news received about a dear friend of ours. Having had a complete cardiac arrest at the gym, he is in far worse shape than me and my toe. On Friday morning when I woke up, my toe was still hurting so I decided to contact the ortho and see if I could come in for a quick check. They have an urgent care facility so I was able to be seen without a previous appt. We all got in the car (I still can't drive) and packed into the surgery. The kids and dear wife went to the plush waiting room with coffee shop, which I found out later closes early on Fridays (it was 11am and it was closed already), kiddie area etc and I went to the urgent care area. Given how recent my surgery was, they were hesitant to do much with me but s it turned out, my ortho had an opening in his schedule just about 30 minutes after I arrived so he agreed to see me (instead of dealing with the urgent care dr).

They took some more xrays to check that the wire was still in place (it was) and the dr came in and had my bandages and cast removed. He looked at the wound and poked, prodded and probed and declared it all fine. My original post-op appointment (for next week) was to be cancelled and I am to see him again in 3 weeks. I asked about driving and his recommendation was to hold off until the remaining 3 weeks. He also said that if all looks good, he would put me from the cast to a boot at that time too. He said that the pin will come out at 6 weeks post op. Apparently that just 'wiggles out' with no anesthesia.

They bandaged me and casted me back up. It was quite the production. They use cool plaster-embeded strips of gauze that are wetted down with warm water, then they fix the strips in splint shapes around the leg. Within 15 minutes, the strips were rock solid. The new cast is a little different in position to the old one. My foot it at a more acute angle and slightly twisted down. I assume that was what they were aiming for... My only complaint with the way my foot is held now is that my calf muscles are a pulled a little tight - I assume that it will setting out in a day or two.

Perambulation and Paninis

I've been feeling well enough to head out with the family for the past few days. Yesterday we went to the grocery store and I rode along in one of those motorized shopping carts. I have to say that it took a few minutes to figure out how to get it unplugged, switched on and ready to use. The first one I sat into (and got configured) had a left foot pedal to make it go. I assumed that it would have pedals on both sides, but alas no. So I had to switch to one with hand controls. It was all a learning experience (not the least of which was where I was going to put my crutches). Once I got settled in the hand-control cart, with my crutches to my side, I took off at top speed (maybe 3 mph). In the time it took me to get on the road (so to speak) my wife had wrangled the 3 kids out of the car and into the store. My kids were fascinated by the motorized cart and had to be told on multiple occasions that they could not ride along with me.

I'm sure that I had been guilty in no small part of being oblivious to people in wheelchairs and motorized carts but something that never occurred to me until being in the situation myself was the situational perspective that you have while seated. It really puts you at a communication disadvantage because you are not at eye level. Even saying "excuse me" is more difficult when you are not being looked at in the face. So as I scooted around, I found myself in several situations where I couldn't proceed forward and the barrier was a shopper who was completely unaware of my presence. I tried excusing myself, I tried beeping the horn, I even said loudly to my children "we can move forward when this lady gets out our way". Most of the time, they just moved on without so much as a tip of their hat. It really amazed me that sitting in this big cart, I suddenly became invisible!

Sleep was OK - each night for the past few nights I have been having nightmares. I'm not sure if this is related to the way I slept each night or if I still have some odd chemicals in my system. I used to believe that I had nightmares when I slept on my back and that would seem to have a ring of truth to it given that I seem to return to my back as it is the most neutral position for my foot/toe. Last night was must the same as those before it - I woke up in the middle of the night with discomfort in my toe, mainly joint pain. I suspect that in my dreaming, I'm wiggling my toes which is irritating the whole toe and in particular the pin in my joint).

Talking about chemicals in my system, I've gotten quite a ribbing from my friends relating to what seemed to be an almost immediate physical addiction to the narcotics and the related withdrawal thereof. I still feel like I have rogue junk swimming around my bloodstream. In particular I'm still suffering from occasional nausea, sweating, tingling, not to mention my entire gastrointestinal works which haven't been right since the operation. (Too much information?)

Today, my wife had arranged to bring the kids to a museum for kids (with fun exhibits for kids to interact with). They have free admission on the first Thursday of the month. The original plan was to take the kids away so that I could get some rest, but I was feeling good this morning and decided that I would tag along. It is fun to see the kids play around and learn at the same time. It was a bit crazy there (because it was free admission) and on multiple occasions I had to swipe my cast away at great speed to avoid a child stomping on me. When we were done we went to a bakery for lunch. We had been there once before and thought the food was good.

I asked my wife to order me a Ham and Swiss grilled panini. Assuming that it came with a bunch of other items that I didn't want, I asked my wife to specifically say "just ham, cheese and bread". I was sitting over at our chosen table but overheard the conversation so I know for sure that my order was meticulously communicated. More than 10 minutes went by and we received our order. Dear wife's salad, the kids' simple sandwiches and my grilled panini were all delivered to the table. Right away I noticed that my panini had sliced tomatoes. I have to say that I am a very picky eater but having had to wait for our sandwiches to arrive, and the kids were already tearing into their meal, I chose to remove the tomato slices and put up with whatever taint would be on the sandwich (not much I grant you). I bit into the sandwich and immediately tasted very strong mustard (I guess it might have been a mild horseradish either). This was the deal-breaker. I could deal with the tomato but not the dressing. I hobbled over and one of the kids brought my plate. I explained that I wanted only ham, cheese and bread but that it had come with tomatoes and mustard. I said that I had removed the tomatoes but unfortunately the mustard had ruined it for me. She apologized, seemed to understand what I was saying, and told me that she would have a new one made immediately and it would be ready in 5 minutes or less.

15 minutes later, they returned with panini #2. This time it had Ham, Cheese and Bread only. Oh and mustard..... I returned to the lady at the counter and explained that the replacement sandwich also had mustard. She gruffly muttered under her breath and stormed off to the kitchen. At this point I should mention that my 3 kids were done with their meals, my wife done with here salad and I was done with my coffee. The kids were ready to go home. When she appeared back, a member of the kitchen staff followed her with a sandwich which was loaded into the grill:

"I watched them make it this time, and they didn't put anything but ham, cheese and bread in it."

Hmm - I thought about it for a few seconds. She had clearly gone in and told the kitchen staff that the guy from table x was complaining again and why had they put mustard on his sandwich. They probably said that they didn't so she decided to "watch them" make another one so that she could be sure it was just sill Mr X and his odd taste-buds.

"My family is ready to go home now, they have finished their lunch and I don't have time to wait until this sandwich is ready. I will just take a full refund please."

Interestingly she was completely taken a back at my request. It was though I was the first person ever to ask for a refund! She went off and consulted with coworkers (who all looked bemused) and eventually went to the register and punched in some numbers, and withdrew cash from the drawer.

"Sorry about that."

Being of the analytical type, plus having had some experience in the hospitality industry, I dissected the entire situation with my wife on the journey home. We both agreed that I was the victim of a poor system in place for communicating orders from front of house to the kitchen. For the record, the other sandwiches, the salad and the beverages were all very good and yet I suspect that we will not give them any more patronage in the future.

Oh, another fun TMI activity for today was a bath. I'm not providing any details except to say that it is very difficult to bathe while keeping one leg completely dry.

Feeling a Little Brighter

Yesterday was not pleasant. I was resigned to the fact that I was not going to take Norco anymore. Even though today wasn't as bad, I still felt like I had the drugs in my system.

When I woke up this morning it was clear to be that I was not going to be ready to return to work the following day. While I felt significantly clearer, there was still a heaviness that was unusual and not just related to the 8lb weight on my left foot. I was feeling good enough to get up out of bed and come out to the sitting room.

My family were going to a "story time" at the local library, and by the time it came to go, I decided to risk my sanity join them. It was fun and I appreciated being out of the house.

At lunch time I felt up to eating something more substantial than crackers and took a nap after lunch which seemed to help too.

I was actually feeling pretty good by about 4pm and decided that I would prepare dinner. I made up a meat sauce from scratch and boiled up some pasta. I even used tomatoes from our yard. I have to say that I probably over-did it because I was feeling a little "off" while the dinner was cooking. After eating and getting the kids to bed, things have calmed down. I think that a cup of hot tea will top off the evening and tomorrow I will be ready for feeling better again. I'm not returning to work until Friday afternoon - hopefully I will not need to reschedule that again.