Monday, March 26, 2007

The Long Recovery

I get to go home.
After more than 38 hours in hospital (4 of them in surgery having my left shoulder rebuilt after a bicycle accident), the nurse says I can go home. She pulls out a bag of my clothes and says, "Here. If you need help putting these on, I'll be back in a few minute."
I have a new 22cm-long surgical incision in my left arm and shoulder, freshly sutured and covered with a large bandage. My arm is tightly held in a sling. I'm loopy on morphine. How the hell am I supposed to put clothes on?
I can start by removing my hospital gown. It's practically falling off anyway. Because of my arm, it can't be fastened properly around me. Every time I've gone to the bathroom, my ass has been hanging out for all to see.
One little shrug and it's off. Modesty dies quickly in a hospital.
What's first? Well, underwear, I guess. It normally goes on first anyway (unless you're Madonna). Don't see why a busted shoulder should make any difference.
I'm not going to be able to reach down and hook the underwear over my feet while standing up. Bending over hurts. Doing much of anything hurts. And I have no balance. While I might able to get the right foot in the right hole with the right hand, getting the left foot in the left hole with the right hand will be impossible, and trying it with the left hand would probably leave me kissing the hospital floor.
The last thing I want to do is fall down again.
I sit on the bed. In a sitting position, I can hook my underwear over my feet and pull it up my legs with my right hand. Near the top, I can stand up and pull it over my butt.
Ta da. Blue Fruit of the Loom boxers are on.
Well, this procedure worked so well for underwear, it ought to work for pants, too.
And it does. Mind you, I have to figure out how to buckle them and my belt with one hand. It's not as easy as it sounds, but not so hard either.
Socks and shoes go on at the same time, too.
Now comes the shirt. My left arm is clearly not going into any sleeve, so I put my right arm in the right sleeve and then toss the left half of my shirt over my left shoulder. With my arm against my abdomen, I button it (one-handed) as far down as I can go.
When she returns, the nurse seems surprised that I was able to do it all myself. She pretends not to recognize me -- who is this well-dressed man and what have you done with my patient?
Thus beginith my recovery.

My sister is playing taxi driver for me today (as she will for many weeks to come -- thanks, sis!).
The first order of business is to get me out. I have no idea where I am in the hospital. Left to my own devices, I might have been wandering the corridors for years trying to find the exit -- the Flying Dutchman of Jubilee Hospital, ending up a crazy old man who mutters, "I beep at airports -- wanna see my scar?" to anyone who will listen.
But no, my dreams of becoming a human derelict end quickly as my sister finds the way out.
I walk gingerly. Falling down would be a disaster right now. But my first few haltingly hesitant steps are soon replaced with more confident paces. I'm not setting any records, but I start to feel safe on my feet.
Sis has brought the van -- a good thing. I don't think the MG would have been suitable. Climbing in isn't so bad, but the next stumbling block is the seatbelt -- I can't fasten it. I can pull it around myself, but sis has to snap it into its latch.
Can't do up a shirt properly, can't fasten a seatbelt. What else can't I do?
She drives me home, apologizing the whole way for every bump, stop, turn, braking maneuver and acceleration that occurs. Actually, it's not too bad. The right turns hurt the most as the inertia pulls at my left shoulder.
Finally, home. What does a man look like arriving home after major surgery for a crunched shoulder? Like this:


The first thing to do is to make me comfortable. The obvious place is the couch with lots of blankets.
My left arm is useless, so I have to sit on the right end of the couch so that I can use my right arm on the arm rest to help push myself up when I stand. I also need some pillows to support my battered left arm.
The downside is that now I can't curl up with my cat Linus, who has missed me and clearly realized something was up. In fact, we pile up extra pillows on the left side to keep Linus at bay; he's a large cat and likes to walk on me, and god forbid he should walk on my injured shoulder. Still, being home with my cat is a great start to my recovery, and he even seems to understand that although I am injured and can't really snuggle him, I did miss him and am glad for his company.


This is pretty much how I stayed for a couple of days. Sleep was impossible. Between the dull ache in my arm and my back stiffening up, there was no sleep to be had. In fact, I considered it an improvement when I was able to move to various chairs around the house during the night and not sleep in any of them. At least I was moving. But before I worried about my first night's sleep, there was another problem that I needed to face.
I needed to pee.
My bathroom is small. Tiny. The toilet is in a small alcove with little if any maneuvering room. And the transition from standing to sitting is painful and uncomfortable. And I am still wobbly. Pulling up my pants is awkward. So I have little choice. For the time being, I'm going to pee in the sink.

A couple of sleepless nights later, I was starting to smell. I needed a shower.
The only restriction I had about showering was to try and avoid having the shower spray directly on the incision. A little collateral water damage okay. I would also have to change my dressing afterwards. My dressing looked like this:


In order to have my shower, I would have to get undressed and get my arm out of the sling. Then I would gently get in the shower and somehow do all the necessary hair and body washing one-handed, then dry off, then get dressed again. My sister volunteered to stand by if needed. I told her that if she heard a splash and a thud followed by screaming, chances are that I would be in need of some assistance.
In actuality, the shower went well. Slow and steady wins the race.
The only problem was that I couldn't get my underwear on. Because of the aforementioned limited space in the bathroom, I had not yet managed to sit down on the toilet, and sitting down was the only way I could get pants and/or underwear on. Getting tired and a little frustrated that I couldn't devise a plan for my underwear, I had no choice but to call my sister through the closed bathroom door.
"Sis, I have a problem."
"What is it?"
"I can't get my underwear on."
"How did you get them on in the hospital?"
"I was on morphine. I don't remember."
"Oh."
"So I thought you could hold them in front of me. I'll step into them and you can start them up my legs. I should be able to grab them when they reach my calves and I can pull them up myself."
My sister reluctantly agreed. I opened the door a crack, and passed her my underwear.
"Are you ready?" I asked. She nodded.
I opened the door, naked as a skinny-dipper at Mackenzie Bight. She knelt in front of me, holding out the underwear and averting her eyes. I stepped in and reached down to grab the waistband.
"You'll have to lift them higher. I can't reach down that far."
She leaned in a little closer, and lifted them a bit higher. Now I could grab them.
"How's that?"
"That's great, sis, thanks. I got 'em. Don't hit your head on anything on your way up."
"Okay, glad I could--- oh, oh, you...."
She turned red and ran.
I went back into the bathroom and chuckled.

Then we changed the dressing. What did my incision look like? It looked like this:

I'm guessing 17 sutures. It's hard to tell, and they were dissolving sutures, so after a couple of weeks they were all gone anyway.

I had two big problems that first week. One, my arm was swelling up. I expected swelling around my shoulder and upper arm. That only made sense, that's where the injury and the surgery was, but the swelling was going down my arm towards my fingers, too. In fact, my fingers soon became giant white sausages. My whole arm was swollen and I was concerned, but the swelling soon passed and my arm returned to normal, Or what passes for normal these days.
The other problem was sleep. Or the lack thereof. After a couple of days, I moved off the couch and tried my bed. But nothing worked. I could not find a comfortable position or place to sleep. Worse, I was getting pretty wired from the Tylenol Extra Strength I was taking. I spent a couple of nights absolutely tripping out on the stuff. I took this picture at 3:00 one morning. Why? Because when you're basically immobile, dead dog tired, and hopped up on Tylenol, there really isn't much else to do at three AM except take your own picture.



My first physio appointment was a week after surgery. It snowed that day. Yes, my first trip out of the house with my busted shoulder and arm was on a day it snowed six inches.
At the rehab clinic, I meet Jim, my therapist. "Bike accident, eh?" he says. "Let's see what you did to yourself."
He consults my chart. "Uh huh, uh huh, hmmmm, uh huh, uh huh. Now that's interesting. Usually you don't see both of these injuries together. Usually, it's one or the other. But not both. Very unusual."
My elation upon hearing this knows no bounds.
There's not much treatment during this first session. Not much can really be done until the swelling in my arm starts subsiding. But he does ask if I have any problems.
"Can't sleep," I mumble between yawns.
"We can fix that."
He asks me to lie down on my back on the examining table, and he grabs some pillows. He sticks one under my head, a couple under my knees, and slides another one under my left arm, between it and my body.
Oh my. Suddenly, I'm totally relaxed.
That night I set up the pillows on my bed the way Jim did. I'm worried about Linus. Our ritual the past few years has been that he always jumps on the bed and curls in between my left arm and my body. If he tries that, it's going to hurt. I settle in with the light off and await Linus's arrival.
He hops up on the bed. Somehow he knows that the left side is off-limits. Without hesitating, he curls up in the crook of my right arm.
We both sleep for eight solid hours.

*****

When I first came home from the hospital, my biggest disappointment was that I could not easily snuggle my cat Linus. Whenever I sat down, my busted left arm and shoulder needed to be protected and propped up with pillows. And my right arm needed to be beside the arm of the chair or sofa so that I could use it to push myself up. I couldn't lower myself down onto my bed at first because it's so low -- it has no legs and sits on the floor.
After a couple of days, I figured out a way to finally properly snuggle Linus.

Only then did I feel like I was finally on the road to recovery. For those first two weeks, Linus stayed near me and watched over me. There wasn't much he could do to help me, but knowing he was there made a difference. When I walked aimlessly around the house, he walked with me. When I came back from the doctor or from physio, he greeted me at the door to ask how I was feeling. When I rested after my exercises, he rested with me.

Three weeks into my recovery, Linus suddenly stopped eating. He seemed mostly okay, he just wasn't eating or drinking. Then he began staring mournfully at his water and food dishes as if he just couldn't remember what he was supposed to do. His urination, what little there was, became more painful. He became weak and his legs started giving out on him. The vet was stumped.
The only choice became sadly obvious.
Linus passed away on December 19, 2006. He was almost 17 years old.

I really miss him.

*****

After the swelling in my arm started going down, physio began in earnest. My first exercise was what's called the pendulum. It's exactly what it sounds like. I lean with my right arm on a table or counter-top and let my left arm out of the sling and let it hang like a pendulum. I swing it forward and back, side to side, then it circles, first clockwise, then counter-clockwise. I swing it for about three or four minutes, twice a day. The idea is that it gently pulls on the muscles that are now super-tight and holding my arm in my shoulder socket. All those muscles have been traumatized and many surgically reattached. They were, and are, extremely tight to say the least.
Funny things were happening with my arm. Suddenly my left arm began drying out and flaking. My right arm was fine, but my left arm suddenly developed a taste for vast amounts of moisturizer.
And I could feel strange sensations in my arm as all the new hardware rubbed against flesh and bone. Sometimes, it even feels like it gets caught against a tendon or ligament [shudder]. It's a strange, strange feeling.
Slowly, time passed. Days became weeks. Weeks became months. Months became years. My writing became a pattern of clichés.
But seriously, time did go by slowly as I was mostly housebound. If it wasn't for the fact that I had just ordered the first two seasons of Voyage to the Bottom of the Sea on DVD, I might have gone mad.
I couldn't even write or surf the Internet much as it was too uncomfortable to sit at my computer for very long.
Christmas rolled around and I began to venture out more. Thankfully I had done most of my shopping before the accident, and Amazon did the rest.
At physio, I got to do more exercises. I got to lie on my back and, gripping it with both hands, I had to raise a cane over my head. At first, I could barely raise in 90 degrees, or just above my head. Now I can get it about 150-160 degrees over. Still got a ways to go.
Next came The Violin. Still lying down and with my forearms straight out in front of me at a 90 degree angle, I gripped the cane and moved it from my right to left, trying to move my left forearm away from my body while keeping my elbow in place at my side. This works to stretch my shoulder were the Bankart repair took place and the flap of muscle was sown over my shoulder socket to keep my arm in place. This I can only do to about 35 degrees. More work needs to be done here, too.
You're not reading this over dinner, are you?
As long as you're grossed out, here's how my scar was doing after about seven weeks.

Other exercises were added to regime like Walking Up the Wall. Simply put, I stand in front of a wall, put my left hand on it and use my fingers to "walk" my arm up it until my shoulder screams out "Enough already!"
However, the physio is going slower than expected. All these exercises that I've been doing are passive exercises, meaning that the injured area is not doing any work during the exercises it's all being done by the other arm, gravity, or in the case of my physiotherapist, someone else entirely. The normal recovery protocol for a Bankart repair would allow for active weight-bearing exercise at this point; however my arm is still too sore and stiff for this, so we are continuing with just the passive exercise. This will make for a long recovery period.
At least now I'm out of my sling.

*****

It's funny how I can suddenly discover that I can do something without even thinking about it, or that I can still find that there are very simple tasks that I cannot do.
For instance, last week after physio, I ran for the bus. Not that the running itself was a surprising thing -- I'm not much of a jogger, but up until my accident I was riding my bike five days a week, so I was in shape enough to run if need be -- but the fact that I was running and my shoulder seemed pretty okay with it was an unexpected surprise. It wasn't until I got on the bus that I realized that I had run a couple of hundred metres with little discomfort.
Mind you, later that day I couldn't get my socks off. As I stood in front of the laundry hamper, I decided that the socks I was currently wearing were due a wash. So, still standing, I bent my left knee, lifted my left foot, reached down with my right hand and pulled my sock off. After lowering my left foot, I lifted my right foot and without thinking reached down with my left hand and did not have the strength to take off my right sock.

The good news is that I am feeling more and more human and I'm venturing out more. Here's me last week at Gyro Park. Dig the "physio beard."


*****

This was a week of firsts.
Monday, I had my first bath. I decided that it was time to try to get in and out of the tub. Getting in was okay, but getting out still remains a little haphazard. However, I didn't fall, and it was very relaxing. Heck, I may even have another one tonight. (Long-time followers of my misadventure will recall that due to the tinyness of my bathroom and the awkwardness of my injury, I was forced to pee in the sink for a short while after my release from the hospital. I would like to state for the record that for some time I have been able to pee in the usual manner and into the usual bathroom fixture, although I still occasionally pee into the sink because I am a lazy and gross bastard.)
Tuesday, I tied my shoelaces for the first time in three months. After getting home from my accident, the first phone call I made was to my niece who works in a discount shoe store to ask her if they had any sneakers with velcro instead of laces. And lo, they did, and they were delivered unto me, and I've been wearing them ever since. But after a recent long walk, I discovered that discount shoes aren't designed to be walked in over a lengthy distance, and since my plan is to walk home when I return to work, it was time for more comfy (and more expensive) shoes. And so it was that on Tuesday morn, I took my old expensive sneaks out of the closet, placed them on my feet and tied the laces with no discomfort in my battered left shoulder. Huzzah, huzzah.
And today another first: my first day back at work. What a, er, um, thrill it was to be back. Makes one hanker for the days when I could just sit home, rest, watch tv and get paid. And that was just last week!
Actually, it felt good to be back, if for no other reason than it represents another small step along The Long Road Back. The shoulder seemed to survive the day fairly well. And when I did my exercises in the evening, it seemed a lot less tighter than usual. Perhaps being back at work did it some good.
I stuck up a copy of my x-ray in my cubicle. Most people were shocked at the amount of metal in my arm.
"Is that permanent?" they gasped.
"Yes," I replied, "until someone figures that the going rate for titanium is worth digging up my cold and rotting corpse for."
I walked home, as per my plan, and although I was jealous of every bike rider that passed me and every kayaker in the harbour (there was only one, and he had to be crazy to be out on a stormy day like today), at the end of the day I feel a little more confident that one day soon I'll be back on my bike and in my kayak.

*****

Time munches on.
Now over four months after my bike accident, my once-broken arm and shoulder still have a road to travel before they could be said to be recovered.
That said, a lot of progress has been made over the last few weeks.
First, I have graduated to what is referred to in physio lingo as "resisted exercise." You and I call it pulling giant rubber bands. This is significant because my range of motion, while still not yet in the normal range (and may never fully be), is certainly in the range of motion for getting by. The problem is that I have no strength in the arm. In fact I have more range than strength. If I left up my left arm in front on me, I might get 130-135 degrees of rotation. But if I use my right arm to push my left arm up further, I'll get 175-180 degrees of rotation.
So now we're into strength building and re-activating the muscles that haven't had to work in months. Hence the rubber bands. I have eight exercises to do with the bands, plus one exercise with a free weight, a whopping three-pounder!
Other good news: I don't need to do stretches with a cane anymore. I'm flexible enough now that I can do some new stretches that do the job better and don't require the cane. And I'm now down to once-a-week visit to the physio dude.
So now the question is when do I get back on my bike and into my kayak? That remains to be seen. The Victoria Day weekend marks about six months since my accident, which was sort of the time frame mentioned by my surgeon, so that is a target that is on my mind. Sometimes I feel that Canada Day is a more realistic time frame, but we'll have to wait and see. The point is that I WILL be back on my bike and on the water this summer.
Woo hoo!

Monday, January 1, 2007

The Big Ouch - Why Kayaking is Off the Menu for a While

It's an odd sensation, realizing that your bicycle has suddenly stopped but you haven't. That your handlebar has suddenly snapped to the right and stopped your bike cold while momentum is still carrying you forward. That not only are you flying over your handlebar but that you are twisting in mid-air to the right and are now travelling sideways, a change of direction that will probably save your life, but in this moment only adds to the disorientation.
Then you realize that the ground is getting closer. You barely have time to register that this is going to be bad. And that it's going to hurt.
It is bad. And it hurts.

In late November, I was riding my bike home following the path I do everyday. Part of the journey is a short trail connecting Burnside Road with the back of Tillicum Mall. On this day, dusk, 5:00 pm, water had washed out a pothole that had been filled by gravel back in the summer. Was the washout caused by all the rain we had received in November? Or was it run-off from the watermain that had burst in Tillicum Mall an hour previously? I don't know. All I do know is that as I went down the path, my front wheel caught the pothole and I flipped off my bike. There was a small culvert ahead of me with a concrete pad over top of it. I landed on the concrete pad with all my weight on my left shoulder.

"Ummmfph!"
The air rushed out of my lungs on impact. I bounced off my shoulder and onto my back (my backpack, actually). My legs swung up beside me and ended up in some bushes just off the trail. I'm not sure what happened to my bike. At least it didn't run over me.

I knew right away something was wrong with my left arm. It didn't feel "attached" properly. Still, I tried to gently move it, but the pain toldme that I had probably broken it. There was also the disquieting sensation of things rubbing together that should not be rubbing together.

Okay, so the left arm was clearly an issue. What else was broken? I hadn't hit my head (and yes, I always wear my helmet). I wiggled my toes, they seemed okay. My right arm seemed fine. It felt like I might have a scrarch on my left leg, but this was minor. Everything seemed up and running save my left arm.

I needed my cell phone which was in my backpack, and was now underneath me. Okay. This was gonna hurt, but there wasn't much else to do. Cradlling my left arm as best I could, I swivelled on my butt, getting my legs out of the bushes. Then I sat up.
Yes, it hurt.
I rested a moment, then cradled my left hand in my lap, then slowly unbuckled and removed my backpack.
I somehow managed to get my left arm out of the straps, then I opened it up and fished out my phone. I turned it on, hoping that it still had some juice. It did, I dialed 911. The operator was cool and professional and able to figure out what trail I was on. He asked if I was bleeding; I said I didn't so. He asked if I could get up and walk along the trail. I said I probably could, but I'd just as soon sit where I was.
I hung up and started to call family members to alert them to my plight. I told my mother that Louise would call soon. (I was supposed to help Louise move some furniture that evening -- clearly, I would do anything to get out of that.)
Just as I finished calling my mother, my first guardian of the evening arrived. A gentleman named Ollie rode down the trail and stopped to assist me. He picked up my bike from across the path and offered to wait the ambulance came.
When the ambulance arrived, Ollie, who as it turned out lives just a couple of blocks from me, offered to take my back home.
The bike was fine. Of course.
The paramedics checked me out. They cut away my bike jacket and jersey from my arm. I'm no doctor, but I could see that my shoulder looked wrong. Instead of curving down, it suddenly dropped off, and there was a large bump where there shouldn't be a bump. This was the ball joint at the end of arm sitting in a place where it shouldn't be. They checked my arm for numbness and I had a big numb spot on the outside of left arm. This indicated possible nerve damage.
They immobolized my arm by wrapping what looked like a life preserver around me, they got me to feet and we walked down the path. I climbed into the ambulance and sat down. They moved me over to the stretcher later as they tried to put in an IV line in my right hand. The paramedic kept failing to find a vein and apologised profously for continually poking my right hand in vein, er, vain. We went to Victoria General Hospital.

The one nice thing about being seriously injured is that you go to the front of the queue at Emergency. This was probably a good thing, as by the time the ambulance got me to VGH, my arm was really hurting and I could feel myself getting more uncomfortable. I was probably going into shock, perhaps not deeply, but going there.
As I was waiting to be admitted, one paramedic noted my discomfort and offered me a blanket. Being a stoic male, I declined the offer.
"Let me give you some advice," said the paramedic. "When a paramedic offers you a warm blanket, you should take it."
"Golly," I said, "maybe I'll take that blanket after all!"
It was now about 6:00, about an hour after I fell off my bike.
Soon, I was wheeled into a cubicle, where they quickly started me on an IV. A doctor came in, took a quick look and very quickly determined that at the very least my shoulder was dislocated. He asked if I had any numb patches and I indicated I did, on the side of arm. This could mean nerve damage.
Then he uttered the one word that I was longing to hear: morphine!
But soon I was left alone, and I reflected on my situation. I would need help tending to my sick cat. Someone was going to have to call work and let them know I was going to be off for a few days.
I looked at my arm. Man, I really wrecked it.
By this time, more of my guardians began arriving. First, my sister Brenda arrived, followed by my girlfriend Louise. Each time, the nurse mistook them for my wife.
My memory of events during this period is somewhat fluid, but somewhere between the blood tests and the IV drips, they took me to X-ray.
This was not an experience I'd like to repeat.
The x-rays taken while I was standing up weren't so bad, but I had to lie flat on my back for a set and this really hurt. I never saw any of the "before" X-rays until much later, but lying flat was excrutiating and I could clearly feel bones floating around in there. That was 20 minutes that I never want to repeat.
But interestingly, the numb patch in my arm regained feeling after the x-ray ordeal. I surmise that something moved just enough to take pressure off the nerve, and there were (and are) no more concerns about nerve damage.
I was taken back to my room to await judgement. Brenda and Louise both commented about how cold my hands were.
Soon, a young woman appeared, the orthopedic intern. She'd looked at x-ray, and reported that my arm was broken in three places and my shoulder dislocted. Worse, I had broken ay arm at the ball joint, making repairs all the more troublesome.
Here's the x-ray:



Now, I'm no doctor, but clearly you can see that the shoulder is out of the socket, and the ball is broken, and not in the correct shape.
She said there were two courses of action. I was going to need surgery on the arm, no question. But do we fix the dislocation with surgery at the same time, or do we fix the disocation manually, then do surgery on the arm later?
This didn't seem like much of a choice to me. If I'm going to go under the knife anyway, must as well do it all in one go.
But she wanted to call in some experts, so who am I to argue?
Somewhere along the way, the paramedic's gear was removed from my arm and replaced with a sling which I am still wearing. (I'm typing this one-handed, so please read this at half your usual reading speed to get the full effect.)
The intern returned with the verdict.
"When I suggested we fix the dislocation first, everyone laughed at me."
There were two problems with her plan. First, the ball was broken off. It was not attched to the rest of the arm. There was no way to re-insert the ball into the socket. It probably would have caused more damage. Secondly, even if it was safe to proceed, she probably couldn't have done it.
I'm a big guy, and she was not a big girl. (She made Chantelle at work look like Shaq.) She physically could not have done it and the last thing my broken arm needed was someone heaving and hauling on my shoulder.
She said she would start on the paperwork and took a felt pen and initialed my injured left shoulder.
So it was surgery, a one-stop fix everything chop. Sort of like Midas Mufflers.
Surgery was set fot 7:45 the next morning, not at VGH, but at Royal Jubilee Hospital. The only question was, could they find a bed for me there? An ambulance was ordered anyway to transfer me. Louise and Brenda said their goodbyes and headed out to spread the word that I would, in fact, live. They noted before they left that my hands were warming up.
A nurse returned with the paperwork for me to sign, but stopped herself before handing it over. It seems that the intern, despite having examined and marked my injured left shoulder, put down on the forms that it was my right shoulder that was to be operated on.
Oops.
Once the paperwork was fixed, I signed. Good thing I'm right-handed.
So there it was. I was facing my first surgery since having my tonsils out when I was 5.
The orthopedic surgeon, my newest guardian, drove over from the Jubilee to examine me. He explained that the surgery would take about two and a half hours. I've heard since that he is the best "shoulder man" on the Island. So far, I'd have to agree.
Around about 11:30, an ambulance arrived to transport me to the Jubilee, they found a bed for me, so we were all set. They loaded me up, and away we went. It was a quiet night for emergencies, the paramedics said. The quietest night they'd ever seen. They'd been on duty for six hours, and I was their first call. And I was just a glorified taxi ride.
By 12:30, I was safely tucked in my bed in Jubilee. Surgery was mere hours away.

"Go towards the light," said the voice.
I could see the light, beckoning, calling.
I have not had any surgery or anesthesia since having my tonsils removed as a child. I have no recollection of being under.
"Go towards the light."
Sometimes things go wrong in surgery. You don't wake up. Could this be happening now? Could the surgery have gone horribly wrong and now I was to find out the answers to the ultimate question of life, the universe and everything?
"Go towards the light."
Or was something else happening?


1:15 am.
The nurse comes by and offers me a drink of water. It will be my last drink before surgery. She asks when the last time was that I went to the washroom. It's been hours, so she suggests that I go.
She helps me out of bed, and I stagger along the floor, my busted left arm and shoulder in a sling, my right arm dragging my IV rack. I make it out of my little area, but I have no idea where the washroom is.
"Which way?" I ask.
She points to my left. A door is open, with a light shining behind it.
"Go towards the light."
"A fine thing to say to a person hours before surgery," I harrumph.
"Oh great," she mumbles, "it's going to be one of those nights."

It's amazing how much your life can change in an instant. This morning, I was dreaming of an 18' kayak. Now, after tumbling off my bike, I'm wondering if I can go to the bathroom without screaming.
Kayaking is a distant memory.

There was no screaming. In fact, the entire process was mostly painless. I return to bed, and sleep in fits and starts. I awake around 7, about 45 minutes before surgery. Breakfast arrives for the other patients, but not for me. The nurse warns me that should a breakfast accidentally arrive for me, I shouldn't eat it. I haven't eaten in 18 hours now, but I'm not hungry. In fact, I will go about 30 hours between meals. I was never hungry.

The nurse returns to explain the procedure. Around 7:45, the anesthesiologist will come and sedate me. (This never happens.) They will wheel me into the waiting area, then the operating room. The anesthesiologist will then inject something into my IV and put me out, and from my point of view, I will wake up right away in the recovery room. No time will pass for me. I may be a little disoriented, but it should pass quickly. No dreams.
The anesthesiologist does arrive, with questions for me, plus papers for me to sign. Then an orderly comes and wheels me into PreOp.
I don't give it a lot of thought, but it does occur to me that I may be facing my last conscious moments. Mistakes do happen. Things sometimes go wrong. But I'm resigned to my fate. It's in the lap of the gods.
I'm wheeled into the orthopedic surgical room. The operating table is narrower than I thought it would be and there's some discussion of how to transfer me from my bed to the table. Finally, I say that I will walk over to the table. Someone helps me up and off the bed, and I cross over to the table and lie down.
It hurts, of course. Lying down on my back is the most painful position. Someone calls for "shoulder extensions"; the bed is so narrow that my shoulders hang off the sides, and for my mangled left shoulder, this isn't helping.
I'm not aware that the shoulder extensions ever arrive, and now the anesthesiologist has my attention. He explains that during surgery, they will be freezing the areas they operate on. This will reduce the pain when I come around. I'm all for that.
He starts by poking something between my left shoulder blade and neck. He's trying to find a certain nerve or muscle group, I guess. He wants me to tell him when I feel a tingling like a mild electric shock.
"Feel anything?"
"No."
"Feel anything?"
"No."
"Feel anything?"
"No."
"Feel anything?"
"No. Wait. There's a bit of tingle. By the shoulder blade."
"Okay, good. That tells that I'm in the right area--"

Then I open my eyes.
Which is odd because I do not remember closing them.
But my first sensation is a good one. My left arm, even though it feels sore and swollen, also feels attached and whole again.
I focus on a clock on the wall. It's almost noon. Four hours have passed in a blink.
There's a machine beside me automatically checking my vitals. I can feel it inflating to check my blood pressure.
I glance over at my left arm. I have a long bandage stretching from above my shoulder to half-way down my arm.
A nurse appears. She says everything went well, but the surgery was four hours, not the planned two and a half. They found additional damage in my shoulder to repair. They kept re-locating my shoulder and it kept falling out. So in addition to screws and a plate in my arm, they also performed a Bankart Repair. This is a procedure that ties a strip of muscle across the joint to hold the arm in place in the shoulder socket. I don't know it at the time, but this will slow down my recovery, and probaly permanently decrease my range of motion.
The nurse leaves as she tries to find a bed for me; they did the surgery even though they did not have a room to put me in afterwards.

What else did they do to me? They put in a plate and screws to fix my arm. They repaired a small break in the shoulder socket; unfortunately it was where some tendons and ligaments were attached so they had to be repaired. Also, a lot of muscle had to be re-attached as it had come away from the bone. Here's what my shoulder looks like now:

Why I'm Not Kayaking Very Much These Days
Yes, the plate and pins are permanent. I will never have an MRI and I will beep at airports.

The nurse returns, they found a bed for me. I ask for a drink of water. My throat is killing me -- it's raw from the breathing tube they had down it.
I'm wheeled to my room, pumped full of antibiotics and morphine. I'm tired and I feel like sleeping, yet I also don't want to sleep. Mostly, I just sit dazed, occasionally nodding off.
Karl will visit me around 5:00 PM -- I spent more of his visit asleep than awake. Others will visit me. Louise, Brenda, my niece Kai all stop by. Paula and Bernie visit. For some perverse reason, Bernie is mostly concerned that my right hand still works. Paula thinks I look like I've been hit in the face with a sledge hammer. Not that there's anything wrong with my face, but because the shock of this life-altering moment is still sinking in.
Dinner arrives around the same time Karl does. It's a fish patty thing, which wasn't very good. The mashed potatoes are excellent. The nurse tells me to go easy -- it's my first meal in 30 hours. I nibble at it.
Details are a blur, but I am constantly poked, prodded and checked by nurses. Everything seems to be normal.

I'm sharing my room with three other patients. Across from me is a young guy who's here for the long haul. He's just ordered a tv. He knows all the nurses by their first names. They are asking him for advice on his course of treatment. I'm guessing dialysis.
Beside me is an old lady. I'm never sure what is wrong with her, but she seems to have all sorts of ailments. She is constantly being taken out for tests.
The third roommate is an older man who's left left hand got into a fight with a table saw. I give the victory to the man only because all his fingers are still attached.

Afternoon fades into evening, and into night. It's early in the morning now. And I need to pee. There's no nurse around, so I slowly sit up. My back is killing me. I carefully stand and walk to the washroom, dragging my IV rack. A nurse has already helped me do this a couple of times, so I already got the hang of it. When I return, I stop at the window and look out. I can't see much -- most of the view is blocked by the roof of another part of the hospital. But I can see the tops of some trees, some streetlights, and clouds.
I miss being outside.
And it will be along time before life becomes normal again.
I carefully climb back into bed.
Sleep eludes me.

In the morning, I go down for x-rays. It is there that I see for the first time the steel and pins that are now part of my arm.
Holy jeez. I'm bionic or something.
The rest of thr day is a blur. More drugs, more pills. More blood tests. They want me out -- they need the bed. In mid-afternoon, I get the word. I can go home.
My long recovery begins.

Sunday, October 29, 2006

2006.49.64 - Cowichan Bay

What a lovely day -- or so we thought! We started early, some of us earlier than others as they forgot to set their clocks back an hour. (I won't mention names but their initials are Paula and Bernie.)
We knew that there were some wind warnings up, and this made us a little apprehensive of what we might face. But we wanted to try Cowichan Bay, about an hour north of Victoria, so we decided to go anyway and if the weather was good, we'd paddle. If not, we'd still have a fun day having lunch out and hitting the tourist traps.
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But when we got there, the sun was out, the wind was calm, and the water flat.
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Sure there was the odd cloud or two...
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...but if the jellyfish weren't worried, why should we be?
Jellyfish
Jellyfish

So we got ourselves loaded up and hit the calm water. It was Lousie, Paula and myself in singles, while Bernie rented a double with his friend Richard.
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There's no beach; all the waterfront buildings here are on pilings.
Look how flat that water is.
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And away we go! And no sooner do we get literally thirty feet from shore, the wind came up and suddenly we were in heavy, heavy chop!
And Then the Wind Came Up

We weren't going to cross the bay today (that had been our plan)...
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...so we instead we paddled along the shore into the wind.
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It was a good chance to practice in bad weather.
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Rough Day on the Water

Amazingly, it didn't rain on us...
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...although we were surrounded by it.
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We headed back...
Rain
...and naturally the weather cleared up by the time we got back to shore.
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Once ashore, we found some other boats that had decided to stay out of the water, This is a Triak, a small sail boat/kayak. It can be yours for about $5000 US.
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Here's a homemade kayak. The builder decided to add his own built-in sponsons on the side, This creates a look which someone else on the pier described as "the worst-looking kayak in the world."
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And here is an old First Nations canoe. It looks like it would been very fast, but you'd need to have good balance to not tip it.
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My pictures are here.

Sunday, October 22, 2006

2006.47.62 - Witty's Lagoon

And away we go! We're off from Albert Head Lagoon to Witty's Lagoon at high tide where we hopefully will make into the lagoon this time. The last time we tried this, the tide was on the low side and we couldn't make it in. It's Paula, Louise, Alison, Bernie and myself today.
You can tell that winter's coming. It's 9:30 in the morning, but the sun is down low in the sky.
Sunny Day

We paddle past a couple of old gun turrets of WWII vintage.
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While everyone else goes around a small island, Paula and I take a shortcut.
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The Shortcut

I'm pleased with the result!
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We were traveling with a good current going in to Witty's Lagoon. We even did a little mild surfing on the gentle swells.
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Alison must be hanging around in too many hip-hop bars. Yo, she got the phat bling. Word.
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Right around here, I saw a shark. Okay, so it was a dogfish. But a dogfish is a shark. Isn't it? We were in pretty shallow water and I looked down and HOLY #$%@, there's this four foot-long shark down there. Well, maybe three foot-long. But it was a shark! I swear! The water was so shallow that it looked like we still couldn't get into the lagoon. Bernie spotted a good spot to stop for a break...
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...so we did.
Witty's Lagoon

Bernie goes looking for my shark.
Solitude

We didn't see any more sharks, but we did find seals!
Seal
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While we were playing with the seals, Alison sneaked back to see if she could make it into the lagoon. The tide had come in a bit more and she found a channel that she could paddle up through and get into the lagoon. Unfortunately, there was a dog running around and it was jumping all over her kayak, so she turned around and left. You don't often hear about dogs harassing kayakers, do you?
A Flock of Seals

This guy had an itch that needed scratching.
Itchy Seal
He seemed quite pleased with the results!
Happy Seal 8x10

Call Mulder and Scully -- it's a super secret military base!
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Everyone decided to take the shortcut on the way back.
Thisaway!

Bernie decided to take an even narrower short cut. Don't worry, he lived to tell the tale.
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Who says we don't get fall colours on the we(s)t coast?
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My pictures are here.