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Angela_N : A vacation to remember...
Diary entry posted Mon 8:46pm 19 January 2009

I need to go into my medical history for this story to make sense. See, I have dealt with orthopedics all my life, being diagnosed with scoliosis at eight years old. I learned then that it was never safe to actually believe in your imagination especially if you think you can fly. Anyway, to make a long and involved story shorter, I had the braces, I had the surgery and then I had more problems. At age 12 my hips began disintegrating out from under me, so by 14 I had a hip replacement after other surgeries had failed. I think in 1984, I was the youngest to have a joint replacement, but who knows?
Anyway, I have been pretty active through my adult life, running, doing aerobics, waterskiing...all kinds of things. I had worn out the plastic cup liner, and surgeons would go in and fix it, like routine maintenance. And in fact, I thought I wasn't at all limited. Only by age 30, my prosthetic hip failed for good, and a new cup was put in. This failed too. So, it was done over with a bone graft in my pelvis. Everything was fine for a few months...until I dislocated it...and then again...and again...and again...
So, thinking life sucked, I moved to the Caribbean to scuba my life away. I was attacked and fell on my already ailing hip, and I broke the femoral head holding in the stem. I moved back home and decided while I was down I would have my right hip replaced. Why not, right?
Now starts my broken leg story. I finally decided to take a long overdue vacation to Bahamas this past December. It had been 2 years since my hip surgery, and why not? It had been a whole year since I dislocated last. Two days before my trip...I tripped and broke my foot in 2 places (oh, and this is not the first time I broke this foot). I begged the doctor not to put on a permanent cast because I really wanted to dive and to get a tan. I got a Cam-walker instead. This was a great alternative until I became overconfident. I decided that my friends and I should take motor scooters around Nassau because walking hurt my foot. I got my own scooter and before I knew it, not 3 minutes into the ride, I wiped out because I could not stabilize my bike. I broke my tibia and fibula, and since I had on the brace, this was a spiral comminuted fracture. And despite the friendly commercials with Bahamians with big, toothy smiles and outstretched arms, getting hurt in the Bahamas is a nightmare. They would not even breathe on me until I forked over $1500 as deposit (they said). I had to argue with the doctor to get morphine, telling him I knew it was broken. He said, "Der is nuttin wrong wit ya layg. Tent broohken if tent swollen." As he jerked my leg around to x-ray it, he told me to "Hush!!! Hush!!! We kent elp ya if ya doont shah tup!" as I screamed and spit out expletives. I found out then that all those nightmares that I screamed and nothing came out were just that: dreams...as I have some good lungs! Wait! Wait! Wait! It isn't over yet. And I can't say anything about Carnival because this is being published, in public. Lawyers don't like that kind of thing, you know? Trashing a cruiseline's medical expertise is just not....what's the word? Um...

Anyway, I can trash Jackson Memorial Hospital in Miami. I went by ambulance to this hospital's ER. There I was in the the beginning stages of compartment syndrome, but luckily for me, I had the ships doctor help me loosen the cast I got in Bahamas. My toes were blue and getting paler and colder. I was in the most intense pain I'd ever experienced. The ER nurses looked at me, and then continued their conversations about each others' kids and Christmas plans. The nurse practitioner told me she could not give me anything for pain until she got blood work back, so some other person drew 4 vials of blood and placed them on my stomach. I then was wheeled in to x-ray. I had tried to give the NP my DVD of my x-rays from Bahamas, but she ignored me. Oh, and this happened many many more times as I sat in the ER alone and in pain. I got the x-rays done, and when I moved over onto the original gurney, I noticed something under my butt. My blood was still on it. I didn't break the vials, luckily, and I caught the attention of the NP (well, a milisecond of it)...and I must interject here that I work in a hospital as well. She ignored me again, but thankfully did order 2mg of morphine. I then asked the nurse who gave it to me to tell the NP (in case she did not read what I wrote down) that I take opiates for chronic pain and that the small dose may not help me. Being a medical professional, I knew this might get a little hairy. Boy, did I underestimate how hairy. The next thing I know, I am wheeled in to the cast room, which they referred to as the "resident's work room." The first resident told me I definitely had an unstable fracture that required surgery. I felt relief wash over me, like I was now in the hands of an expert. Then another resident strutted in to the room, and the two whispered a bit while examining the x-rays. The second resident came up to me and said, "This fracture does not need surgery. You just need a cast." So, I said I wanted another opinion, like that of the resident. I also asked him if he read over my history. Then he tried to back-peddle and say that because of my history (which he said he had not read) it would be too risky for surgery. I stuck to my guns, but it cost me another 2 hours in pain with no pain medicine. I then talked to my dad, an oncologist, who told me, "Just get the cast and get the hell out of that place." So, I submitted and got the cast.
The next thing I know, the first resident came back to me and asked me if I would consent to surgery. I said of course I would, and he wrote on my cast "YES -AE."
I asked him what that was for, and he said it was my consent. I then wondered why he thought I would not be able to speak for myself. A wave of panic came over me. I asked to be discharged, and the NP told me that I had to wait. I said I want to leave AMA. She said that in Florida, when patients do that, the insurance does not pay. I got scared, and I decided to stay. The resident came and told me I was to stay in "observation," and that it was a private room, not the ER. This was not true at all, it was the same set up as the ER, but on a different floor. I began to text my dad, and he told me he was trying to find me, but no one knew who I was or where I was. No one had heard my name or anything, so my poor father was about to have a heart attack.
This "observation" room was a large room divided by curtains. The nurses here were more caught up it conversations than their patients. I told a male orderly that I needed to use the restroom, so he plopped a bedpan next to my food on my food tray and then left. So, I grabbed my crutches and went to the restroom, hoping no one noticed that the back of my gown wasn't tied. When I opened the door to the restroom, I almost gagged as wreaked of "rancid, urine soaked, gas station, nursing home gross." I noticed then that I had one bare foot. I thought I had thick enough skin there to ward off any cooties. My crutches began to slide on the urine soaked floor. Well, I should try to be fair, it wasn't just urine. There was a smudge of something else, like vomit that someone had attempted to wipe up. I noticed bile coming up in my throat, but I had to pee so badly that I had to choke it back. I went to sit down on the toilet seat I had covered with 5 layers of toilet paper. I gingerly lowered myself on it and CLUNK! The toilet seat was partially broken and shifted, and as I readjusted as not to fall, I ended up sitting on the rim in God only knows whose bodily fluids. Then I barfed...and then again...When I went to wash my hands, I noticed there was no soap. I thought "How fitting."
Finally, I got the text from my parents that said my cousin's boyfriend could come and get me. I could not wait to get out of this hell hole. I told them I was leaving, and the next thing I know, the attending that I never saw had signed my discharge paperwork. My cousin's boyfriend made his way to me, and the next hurdle was how I was to get down to his car. The nurses said they had no wheelchairs, so I was wheeled out to the parking lot...on my gurney-with the 4 vials of blood still on it after 36 hours. This is Miami's finest!!
I learned several lessons this trip! Only fun within your limits is golden! Fun outside your limits is risky and may ruin your vacation. The rest of my lessons, I can't say yet as my lawyers have advised me not to :)

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 Mon 8:46pm 19 January 2009
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