Thursday, October 6, 2011

Pain and Choices

What do you do when all your options suck?

I live with chronic pain. It's like a house guest who came over for a visit and just won't leave. Every morning, I wake up and I pause before getting out of bed. How bad will it be today? Will I stumble when my feet touch the floor because my leg has decided that, no, really, FUCK YOU, I'm not working today?

Understand, it's not crippling pain. I don't usually fall over anymore. Although sometimes I still do, generally after being in the car for several hours.

Over a decade ago, I was in a bad car accident; my gerbil rocket struck a full-sized conversion van. The airbag exploded in my face. My shoes were knocked off my feet so violently that the entire back of my heel was scraped off. My glasses flew into the back seat somewhere. The seat belt forces all the air out of my chest. Bruises flower from my shoulder all the way to my hip. The engine block came through the passenger compartment. I was trying desperately to brake; the force of the impact shattered my ankle in five places. And to cap it all off, my wrist is broken.

I like to tell people that I don't really remember the accident; that's partially true. What I remember isn't coherent. Disjointed flashes of panic, pain. I went into shock almost immediately. My couldn't find my glasses. I had endorsed checks in the passenger seat - it was the day after my birthday and I was on my way to the bank to deposit a few monetary gifts. The radio was still on. Someone was talking to me and I couldn't roll the window down. Why is the radio still playing? I was going to be late for work on the first day of a new job. Someone tries to drag me out of the car. My foot catches up under the mangled brake pedal. I scream. The radio is playing U2's Beautiful Day. It is, it is. The sky is blue and blameless. I can't see without my glasses. The man trying to drag me out of the car leaves to go tell the driver of the other vehicle that I wasn't wearing my glasses when the accident occurred. That's not what happened, I try to tell him. I can't stop crying. My car, oh my god, my car. And oh dear god, did I hurt someone? This was my fault; I remember from driver's ed. The colliding vehicle is always at fault. I don't have collision insurance. My fault. We're in so much trouble.

The EMT's arrive. They humor me. They find my glasses, my shoes, my birthday checks and make sure they're all with me before I'll let them take me out of the car. They cut the seat belt. I'm covered in a strange, odd-smelling white powder. This is from the airbag, they tell me. They're very nice. Reassuring. They won't let me look at my leg, though. This worries me. One of the EMT's covers it with a blanket. I'm not bleeding, I don't think. So maybe it's not torn off. I would know, wouldn't I?

Once I get to the hospital, my memories are even more scatter-shot. There have been nine other car accidents in the last 45 minutes. I'm put on a wheeled cot and left in the hallway. Eventually someone comes around to see if I know how to get in touch with my family. I tell them that the husband works at Gateway, and his supervisor is LaDreena. They go away again. I'm in the hall for a long time. The accident happened around two in the afternoon. It might be four-thirty before they take me in for X-rays.

I remember the X-ray technician. She was calm and gentle and grateful. Grateful? Apparently I'm the first patient she's had to deal with all day that hasn't cursed at her or been belligerent. I know she's not trying to hurt me, even though she is hurting me. I hurt. I cry, but I don't scream. She takes a lot of pictures and I thank her for her care. She pats me on the shoulder very gently. That hurts, too. She nods and thanks me for being a good patient, and wishes me luck.

Do I need luck? Didn't I already have some of that? Wasn't it all bad?

Finally I get a small cubical. A nurse comes by and gives me a shot. I promptly vomit. How lovely.

I argue with the nurse about my dress. It's my favorite dress and I don't want it cut off my body. The entire thing buttons down the front, can't we just unbutton it? I lose the green blouse that goes under it, but they spare my dress. I wonder what I'm going to wear home from the hospital. What the HELL was in that shot? I feel sleepy, and so I rest for a while. No one will tell me what happened. No one will tell me how bad my leg is. I know it must be bad. They set up a blue medical screen so I can't look.

At some point, my husband arrives. They told him I was complaining of slight ankle pain. He looks at my leg and his mouth goes gray. He stops looking, comes up, holds my hand, and talks about nothing important. I try to listen anyway.

A cop comes into the room. He looks angry. I'm terrified. I've hurt someone. My car is wrecked. Someone else's car is wrecked. I'm in so much trouble. Oh god. The pain recedes a bit under the wave of my fear.

"I've come for your statement," he barks. I don't know at the time, but he's just come from talking to the other party in the accident. They've been yelling and cursing at him.

"Can I ask a question?" I try to become one with the bed.


"Was anyone else hurt? I didn't - I couldn't see. Did I hurt someone else? Is everyone okay?" My voice breaks several times and I feel that tense prickle in my eyes and nose that means I'm close to tears.

The cop's entire demeanor changes. Somehow, he appears to shrink about three inches, rounding his shoulders a bit, and presenting me with a much less hostile persona.

"This wasn't your fault," he said. I almost get the feeling that he'd have patted my hand if it wouldn't have been entirely unprofessional. "Everyone else is fine. One woman has a slight sprain. You couldn't have avoided the accident; the driver made an illegal left-hand turn across four lanes of traffic."

Relief comes, and with it, more pain. Annoying, that. I wish they'd do something about this pain; this is a hospital isn't it? (I didn't know it at the time, but they already had. That shot that made me throw up? It was morphine.)

Reassured that I have not doomed the Husband and I to life in a cardboard box while we tried to pay someone else's medical bills and that there's a whole box of guilt that I don't need to pick up, I give my statement. I've read that statement in the years since. He wrote down what I said verbatim. While it's all technically true, and mostly follows an accurate timeline, it rambles and is inelegant. I like to think better of myself than that; but apparently morphine and extreme pain renders one a little less than well-spoken.

There's a long, not-quite blank period; a doctor comes in. They're going to set my leg. He doesn't bullshit me about it. "This will hurt," he says, "and quite a lot. We'll get you doped up first." The nurse comes in, gives me another shot. I used to hate needles and whine about them. I offer my arm gratefully. The doctor comes in again, looks at me, asks me how I am. "Better," I say. "Get her some more drugs, she's still coherent."

Oh. Goodie.

Eventually there's this gray mist over my eyes. I can still think - I think - but I don't actually talk anymore. For me, this is never a good sign.

It still hurts. I didn't know there was enough room in my brain for that much pain.

After, I remember hearing some big, forty-something construction worker whining about getting blood drawn. I feel superior. And annoyed.

They send me home. I'll see a bone specialist the next day. At least one surgery. Probably more than one. The Husband is angry, but I don't know why. A friend comes to pick us up. His car only has 2 doors and that's awkward. Getting into the house is a nightmare. I think I throw up again at some point, or maybe I only want to.

I don't sleep.

I feel like I will never sleep again.

I keep hearing the crunch of vehicles. See the brown side of the van I struck filling up my windshield. Every time I relax, I jerk away from these images, these sounds. Jerking away hurts. My wrist hurts and the entire thing is purple from my palm to my elbow. The ER tells me it's not broken. Sure as hell feels broken.

I don't remember how we got to the bone doctor's office. He orders more X-rays. I'm right. My wrist is broken. He looks at the film of my leg. From behind me, where I can't see. What is this, a vast conspiracy? He pulls out a cell phone and makes a call.

"I need an operating theater," he says. "Yes, I'll hold."

The Husband stares at him. Doctors don't wait on hold, they let people call them back. The doctor agrees to do an extra surgery, to bring his own team, and for them to do clean up if the hospital can get him in right away. The doctor hangs up his cell and snarls at the Husband, "She should have been in surgery last night."

"I know."

The doctor gives me some pills for pain. I take them. Everything goes away.

I must have gone to the hospital at some point, but I can't remember. I don't remember being prepped for surgery, although that must have happened too.

I remember a long bout of hallucinating as I came out of the anesthetic. I kept asking to talk to a fictional character; a role-playing character that belonged to a friend of mine. Finally, some form of coherency returned. My throat hurt. I found out later this was because I'd reacted badly to the anesthetic and had to be intubated.

"There's a good chance you may never walk again," the doctor said without preamble. His bedside manner sucks. "At the very best, you'll walk with assistance. And you'll probably be in pain for the rest of your life."

To condense the rest of the story; I did walk again. I don't use a cane.

But I am in pain.

Every. Single. Day.

I have a plate in my leg, several pegs holding it in place, and an anabolic screw right through the middle of the joint. Yes, I set off metal detectors. No, I still don't know what these things look like. Through the whole process, no one would ever let me look at a single x-ray. I didn't even know that the back of my heel had been scraped off until I got stitches out and saw the big black scab, the size of a tennis ball.

It's not bad pain, not all the time. I recognize that. The next time you slam your thumb in a drawer, after you finish cussing and jumping around, wait a few minutes. It'll throb and ache for a while, and eventually it stops. Take note of how you feel, after the sharp, immediate agony fades, but before it goes back to normal. That's how I feel most of the time.

It doesn't prevent me from walking, although sometimes it does make stairs a challenge. Particularly going down stairs, which requires my ankle to flex further than it wants. I regained 95% of my mobility in that joint. But that's 5% that just doesn't anymore. I literally can NOT run. I've tried. I can manage it, if I have to, but I'll have really bad pain that will last for days afterward.

Storms and weather changes make it worse.

Cold is bad. Jumping is right out. I can't catch myself. Impact jolts so bad that I fall.

I'm on pain management medication. Which makes me loopy. Sometimes it makes me vomit. I don't like to take it.

I come from a family with addiction problems. I'm frightened of my medication. I usually tell people when I've had to take a pill because I act... weird when I'm on them. Last winter, the pain was particularly bad and I was popping several pills a week. A friend accused me of being a druggie.

I've been scared of the pills since that happened. I resist taking them, even when I know I should.

The rest of my life.

I didn't understand at the time.

I wish I didn't understand it now.

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