Thursday, March 20, 2014

A series of mostly positive events (broken feet, part 2)

The saga continues...

After crash landing into a rocky berm in Thailand and the surprise of very painful feet, my paragliding friends circling above me came on the radio and asked about my status. For the first time ever I reported, "I've landed hard and my feet really hurt. I need help." Oh, how I would have loved to give my normal report: "This is Michelle. I've landed safe and sound. Cheers!"

But my call for help put my friends into action. One volunteered to land in a safe place near me. My hubby opted to land in the main LZ and fetch the retrieve truck parked there, while calling another friend to bring the truck down from launch. A couple others requested the a-okay to keep flying and it was delightful to know that they could still fly and I hadn't ruined everyone's day. I was relieved that everyone seemed to know what to do.

It took a few minutes for my friends to get to me. In the meantime, I hollered at the local guys to not move me or take off my shoes, which although they couldn't understand my English was assertive enough to get them to stop "helping" me. And I drank all the water in my hydration system. I also called to Josh over the radio, asking him to talk to me because I was in a lot of pain and didn't want to go into shock. He obliged, like a good hubby.

Once my friends got to me, they set to work with great precision carefully extracting my wing and harness from me, cooling me down by pouring lukewarm water on my chest and face, removing my gloves and eventually my helmet when we were certain that my neck was okay, and doing a full body pressure exam to see what hurt and what did not (luckily, just my feet and ankles).

All was going really well until the local ambulance arrived, having been called by an onlooker, and proceeded to try to make me do all the things I knew they shouldn't.... Like trying to take off the tennies that were keeping my swelling feet from exploding, repositioning my head, and trying to make me lie flat with my legs not elevated. Luckily I didn't go into total shock and my wilderness first aid training proved helpful, giving me the courage to yell at the guys until they stopped doing the things I knew they shouldn't. At one point I even sat up and slapped an EMT's hand away when he tried to unlace my shoe -- something the doctor I saw in Hua Hin was glad I'd done.

Eventually, the EMTs put me on a back board, and with my friends' assistance, carried me to the ambulance over rockier terrain than I had remembered flying over. Josh joined me in the ambulance, where the medics seemed to forget their training and didn't take my vitals or help us get my feet elevated. Things were just as unimpressive when we got to the local hospital. So Graham came to get us in the truck (after swopping it for the other truck which had gotten a flat tire). Josh wheeled me out of the ER on a stretcher and then gently placed me in the backseat of the truck, legs elevated, an ice chest under my head as a cushion, and an ice pack on my foot -- courtesy of a quick-thinking friend who'd bought ice and Advil for me from 7-11.

Can I just say how amazing it is to have a husband who is calm and collected in tough situations and strong enough to lift me in his arms like a baby! And having awesome flying friends who land early to lend a hand, get you pain meds from the 7-11 and rearrange their afternoon to drive you to the ER an hour away! I owe all these great people a debt of gratitude, although I hope to never have the opportunity to repay the favor in kind as I don't want to see any of them getting hurt. Perhaps there will be some pie-baking in my future.

Once I was loaded up in the truck, we set off for Hua Hin, about an hour's drive to the north. With two Advil as my only pain relievers, I sounded like a whimpering dog crossed with a pregnant woman in labor. Josh even held my hand during the tough spells. And, genius that he is, lent me his iPhone with earplugs so I could listen to a podcast (yay, RadioLab!) to keep me distracted during the somewhat rough ride. (Yet another reason why potholes should be filled!)

With the sage advice of a kitesurfing friend, the boys took me to Bangkok Hospital in Hua Hin, a private hospital with lots of English-speaking doctors and nurses who are good at what they do. As soon as we rolled up outside the ER, the medics were there with a stretcher... Just like in Grey's Anatomy, minus the rain. Again, Josh lifted me like a baby from the truck and onto the stretcher. (Serious workout for him today.) They wheeled me into the ER, getting my vitals, asking me about the crash and just generally showing me they cared and would help me.

Legs elevated in room 504. Robot foot on the left, Elephant foot on the right.

The rest is sort of the blur, so here are the random tidbits I remember:

  • The peach privacy curtain that went around my ER "room" was so solid-looking that I failed to realize other patients were lurking on the other side, prompting Josh to shush me several times -- although never when I was wailing in pain.
  • The nurses gave me an injection port and started giving me IV pain meds right off the bat. So thankful for that!
  • The X-ray techs were super efficient, taking about a dozen X-rays in less than ten minutes, including 3-4 angles of each foot, my knees and legs, my pelvis and my lower to mid-back. And they were gentle with my feet which were unwrapped and swelling by the minute.
  • Less than an hour after the X-rays were taken, the doctor (an older wise looking gentleman) gave me the diagnosis, wrapped my left foot in a soft cast, and started talking about next steps (surgery on both feet, preferably in about 10 days when the swelling had gone down, and also the possibility of being inpatient that night).
  • The doctor also warned me that the pain would be getting worse as the swelling would increase over the next 24-48 hrs. As the pain had been steadily increasing despite the provision of pain meds, I opted to stay so that they could keep me drugged up on morphine and keep my pain hovering around a 3-4 instead of rocketing back to a 10+ on the 1-10 scale of pain.
  • At one point, the pain got so bad that I was crying, writhing, whimpering and hyperventilating. (Who knew writhing is a real thing?) It feel like hours, but probably it was just a few minutes before the nurses arrived with a heavier dose of pain meds prescribed by the doctor. Meanwhile, Josh kept coaching me to relax my muscles and breathe deep.
  • In Thailand, they use metric so I got to figure out my height in centimeters and weigh in kilograms. A good distraction from my achy feet.
  • The inpatient room I was in had TV with a few English channels, including one with a Grey's Anatomy marathon on (so fitting). It also had a lovely bathroom, a mini kitchenette, a chair, a couch, a dining table with two chairs and a painting of a boat on the ocean.
  • On the door to radiology was a graphic of two kids playing soccer with the standard red circle with a slash through it, communicating what I believe to be: "no rough housing around people with broken bones." I wanted to take a photo but was camera-less.
  • Josh stayed over night with me and we both slept little. Every hour it seemed I had to pee (bedpans suck) or it was time for my next dose of pain meds.
  • Once I thought I'd be proactive and ask the nurse giving me the pain meds to also give me the bedpan. After dosing me and setting me on the pan, she left and did not come back. After a few minutes of awkwardly holding myself up, I had to ask Josh to remove the bedpan -- hopefully for the first and last time. Also, for all you who have never experience the pure delight of using a bedpan, let me just say that is really unnatural to pee lying down.
  • They set me up with a Physical Therapy consult and I got to try walking between two bars, using a walker and hobbling on crutches. Let's just say that all my aerial circus classes paid off as I actually have some upper body strength. Still, I don't have the balance to use crutches, so an old lady walker is what I got -- paired with an inflatable walking boot for my less broken foot (which Josh calls the robot foot, as opposed to my other, swollen, elephant foot.)
  • Mid-day on Monday, they switched me over to a narcotic patch which is good for 3 days and worked quite well. I also started using the walker to go to the loo and soon got impatient about being inpatient. I wanted to leave but my doctor was no where to be found.
  • Eventually Josh pestered the nurses and I rang the call button enough times that the doctor appeared and we set to work getting me released.
  • The total bill (which we'll submit to insurance for reimbursement) was less than $2,000 USD! An amazing price for high quality care, all the X-rays, pain meds (including meds to go), walker, boot, soft cast on my bad foot, PT consult, doctors time, overnight stay, meals, etc. I wish good health care was this affordable in the States.

As all these things were going down at the hospital, Josh and I had to make some decisions quickly.

> Where would I go to see a doctor in the States and recuperate? We had sold our house and most everyone we know has lots of stairs in their homes, plus who could we impose on with such short notice and who might actually be happy to have us there for a few weeks? We asked my folks and they agreed. Next destination: California.

> Would Josh come with me and postpone his work engagements in the Republic of Georgia and South Africa planned for the next week? Or should he just go and get home to me before the surgery? After talking with his boss, we decided on the latter option. Josh would fly to Georgia, while I flew to CA.

> Josh found me a great ticket on United Airlines to San Francisco via Japan, with first class seating and wheelchair assistance. All paid for with miles. My first flight in first class!

> And I found a couple orthopedic doctors who do foot/ankle surgery near where my folks' live and are covered by my WA State insurance -- with my first appointment booked for the day after I arrive in CA.


With these things accomplished, all that was left was to get me back to rental house in Pak Nam Pran, again in the back of a friend's car. The next two days passed pretty quickly, between naps, potty breaks and takeout meals from my favorite local spots. Josh even showered me, so I would be sparkling clean for the adventure to CA. More about that in the next post: Flying the Friendly Skies with Broken Feet.


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