I broke my back

In earlier posts I wrote about the fall off the horse, the diagnosis of a ruptured spleen, the transfer to the big hospital for likely surgery, the good 1st night with the spleen holding up.  Now, it is the day after the accident (Thursday) and I was waiting to hear what they found, fearing the worst.

When I woke from my nap and saw all the commotion, I was gripped by panic.  I was telling myself:  "Here it is; I am about to hear I'm dying."  I had played this movie in my head many times.  The story of my end has different versions, but they all go like this;  a bad diagnosis, no cure, intolerable suffering and premature death.  Just horrible.

The head of the ICU came in together with the surgeon looking man.  One on each side of my bed.  My heart was pounding really hard.  The head of ICU finally spoke.  The spleen was fine;  but, vertebrae L1 was fractured; it was an unstable fracture;  a broken back; so they needed to do immediate surgery; the surgery was scheduled for Friday.   He kept talking and then introduced the surgeon looking man as the one who'd perform my surgery.

But, I was no longer listening.  I was trying to process what I just heard.  First, relief.  Yes, relief.  For the first few seconds, I felt weirdly elated; "yey, I just had broken bones, I'm not dying."   A little moment of happiness. 

Then: "What? WHAT?  Nothing wrong with my spleen?  So, this awful nose tube had not been necessary?"  Anger was boiling up in me.  "So, the angst of the ambulance and the whole night in the ICU was all for nothing.  These guys are idiots; total morons.   Get me the hell out of here."  I thought.  How was it possible to miss a diagnosis of a broken back?

The surgeon did not help matters either.  He told me (with a smirk on his face) that this fracture was quite something;  he needed to pull the vertebrae apart or something because the L1 vertebrae was crushed.  He said he had done many back surgeries, but this one was definitely not routine, he was proudly announcing that mine would be very difficult.  I was getting more and more worked up; like that was what I wanted to hear; that my back was some great challenge.  He literally said that my procedure would be a lot more difficult than heart surgery.   Really, unbelievable.  I hated him, he was everything I despise in people with power; arrogant, self important, narcissistic, with no capacity to empathize.  What the hell did he expect; that I felt special to be his challenging case?  And grateful for his greatness?  So, I told him "NO, absolutely no way, you are NOT touching me". No one in this stupid place was going to touch me again, I decided.

I was fuming and tears were streaming down my face.  The head of the ICU tried to calm me down and explain to me that I had no option.  It was an unstable fracture, which meant that any movement could result in paralysis, so no plane would take me home, not even an ambulance flight.  I didn't want to hear this.  I wanted to get out of there, it was all so infuriating.  But, it was also so pointless.  The head of the ICU felt really really bad.  He apologized profusely for the misdiagnosis and understood my reaction.  He showed real empathy.   I didn't feel like yelling at him.  But I was not giving up without a fight.  So, I held out on signing the papers.  I was not authorizing the surgery.  Yet.  I wanted to talk to David first.

I was crying hard and could barely talk when I spoke to David.  I was so angry and frustrated.  Typical David, though, he calmed me down by just focusing on facts; Could surgery be done there? When? What exactly would they do? Was the prognosis good, etc?  David did not want to get into how stupid and incompetent everyone was and he convinced me not to get too dramatic; "it is what it is, think ahead".  We had important decisions to make.  We decided that I needed to sign the papers.  We would both be in surgery on Friday.

We then focused on the girls.  I was not getting out of this hospital for at least a week.  David would not be released out of his hospital until Sunday (it was only Thursday).  So, who was going to stay with the girls, take them to school on Monday, etc.?  I insisted that David be with the girls after his release on Sunday.  But, what to do between now and Sunday?  I didn't know how, but I could not imagine the girls without at least one of us.  Or leaving the island without us.  They needed us now more than ever.  They must have been so freaked.  And poor Renee, she was so scared of flying.  David needed to be there for them, because I couldn't. 

David explained that the girls were going to be picked up.  There was no other option.  The girls would leave and David would stay with me.  I was fighting him on this.  I did not need David.  I was in the ICU; there is no place in the world where you get more attention than here.  I wanted him to be there for the girls.

But that was not the biggest issue.  It was not known yet who would be flying to Mallorca.  My younger sister Christina was the most logical choice.  But, she couldn't walk.  She had ruptured her calf the week before.  And my older sister, Geertje, was also incapacitated with broken ribs suffered from a fall down the stairs a couple weeks before.   My mother was out, she was not mobile.  So who then?   My niece or my brother in law, perhaps our US family?  Certain was that the girls would fly home on Friday; the day David and I were in surgery.

Then David told me that the girls were at the Rancho.  The owners had picked the girls up in the morning.  They would spend the whole day with horses.  I was not liking that either, I thought it was insane to let them go back there.  David was more rational;  he looked at it as a really nice thing; they would keep the girls entertained and preoccupied.  The girls still loved horses and they were really excited to go.

What an absolute mess.   I felt a combination of anger, frustration, fear, terror, powerlessness, and an intense longing for the girls.  But, I also realized that I was no longer making the decisions.  David was;  well actually my younger sister, Christina was.  She was talking to my family, informing them and finding a solution for the girls.  She was the liaison between Sos International and David.  She made it all happen.  She rocked!!

So, I had no control over anything anymore.  And to my surprise and quite suddenly, the negative feelings stopped.  Realizing that I had no control was somehow a weight off my shoulders;  an overwhelming feeling of calm followed, which was unexpected, and so welcome:  I resigned myself to the status quo.  It may sound weird, but I was and still am so grateful for knowing that in the midst of such a crisis there was this calm.   This is exactly what I'm talking about when I describe this ordeal as "it wasn't as bad as you think."  When I resigned myself and let go of the control,  there was this sense of peace.  There was peace even though I was alone in a hospital where no one spoke English, without loved ones near.  Such a comforting thought.

Maybe the pill they had given me had something to do with it.  Either way, though, after they'd taken out that miserable nose tube, I was relaxed and fell asleep.  A very deep sleep.

Even the longest day has its end

The ambulance ride to the big hospital in Palma was surreal.  I was put in a special ambulance, a mobile intensive care, with 2 nurses and a driver on board.  We left the hospital with sirens on.  They were blaring the entire trip.  "Serious stuff,"  I thought.

No one spoke English in the ambulance.  The nurses couldn't talk to me at all and they were chatting away.  So, I was just laying there, hoping that this would be over soon.  Then, the equipment started  beeping.  Oh oh:  "Is something wrong?  Is it life-threatening?".   I intensely studied the nurses' facial expressions trying to detect worry.  Luckily, they didn't seem too concerned.  At least that's how I read their faces and reassuring smiles.  I figured that this beeping was all quite routine because it happened a lot throughout the trip.    But, that did not relax me much; I was scared, real scared, in that ambulance.  I wanted to get there so so bad.  I wanted to be near the operating room.  Then I'd be safe.

When we finally got there, I was so relieved and felt sort of elated: "We did it, now I'm safe, I'm out of danger".  I smiled.

The Intensive Care Unit (ICU) of this hospital was in the basement.  The "rooms" were metal cages with almost no natural light. I got all hooked up and wanted to rest some.   It was going to be a long night; every 2 hours they'd check my blood to see if I needed surgery.  But the pain meds were wearing off.  I was hurting again.

Now, I've had surgery before in the US and know that high doses of pain meds can make you feel very peaceful.  And that 's what I had in mind.  But, I learned that things were very different in Mallorca.  Pain meds were not given so freely. I had to ask for more all the time, but they would not give it. They were stingy.  It still makes me mad; I suffered a lot, too much really and unnecessarily so.

And so did David.  We spoke on the phone later that evening.  He told me his nightmare story.  After waiting 5 hours, he saw the doctor, got x-rayed, and waited some more in triage.  The x-rays revealed that both bones in the underarm were broken.  A very complex fracture.  But, that was no surprise.  His hand and arm looked like a Z.  The bones of his underarm were no longer connected to his wrist. He needed surgery.

But first they needed to set the bones in place.  They took him to the operating room and gave him some local anesthetic.  To no avail, though.  He was still in lots of pain.  The nurses wanted to give him some more, but the doctor decided that it be best to just do it right there and then and get it over with.  It was a good thing that the girls were taken outside to the playground because he screamed so loud that the whole hospital could hear him.  And the doctor needed more than 1 try to set it right.

He was then admitted to the hospital.  The surgery was scheduled for Friday (2 days later) and he would need to stay a couple of days afterwards. Since the wrist is so anatomically complex, the surgery was going to be difficult.  But, David was such a rock.  He kept it together the whole time.  He told me the whole story in his upbeat way.  No need for me to worry, all will be fine.   He was confident that he would still be able to do the things he loved so much after the surgery, like playing his music (piano & saxophone) and biking.  I sensed that he was feeling less confident than he'd let on, though, I could hear it in his voice.

With all this going on, David still needed to take care of the girls.  During the day, the ranch owners had come to take care of them (such a great help), but they'd left at dinner time.  So now the girls were in the room with him.  There was nowhere for them to go.   It was obvious that someone needed to fly to Mallorca and take the girls back home.  What a mess.  Sos International was on the case, though.  These guys were awesome!  It's part of our health insurance and they coordinate everything, from being the liaison between me, David, the hospitals and my family members, to arranging flights, hotels, cars;  just everything.   Another thing to be so grateful for.

The girls had been so brave all day, but they were tired and bummed out; they didn't like being in the hospital; it was no fun, the food sucked, there was nothing on tv.  I talked to them briefly on the phone assuring them that I was fine.  They understood very well what was going on.  David and Helen, the nurse/translator, had done a great job explaining everything, without freaking them out.  Amazingly, they didn't seem scared, they didn't cry.  But they really missed their mama.  And I really missed them.

Things were looking up, though, on my end.  Although I was in constant pain, the pain meds did help some, they took the edge off.  And the blood tests kept coming back good.  Yay!    I was more and more confident that the spleen was going to hold up, which meant no surgery.   I think I even dozed off a bit.   But there was lots going on in the ICU, the lights were always on and my room was open to the main area, so I could see and hear the nurses' station, which was right outside.  I could also see everyone passing by.   That night, some drama was happening nearby because there was this priest walking around the ICU.  And different people were passing my room all night, most of them crying.   It was sad, but it did put it all in perspective; I was one of the lucky ones here, I was going to be fine.

By morning, I was all positive.  Blood tests had been good all night, so no surgery, I would be out in couple of days and home soon.  Yoohoo.  I  couldn't wait to get that tube out of my nose.  It'd bothered me all night, I never got used to it.  The head of the ICU, the only one speaking English, explained that more tests were going to be done to make sure it was all ok.  But, "it was looking good", he said "not to worry".  After the tests, we would talk about what was next.  So, I was wheeled around to the various places for tests, no longer worried and pretty relaxed.  I was tired, but good tired.  Back at the ICU, I actually took a nap.

I knew right away something was wrong when I woke.  I saw a different, surgeon looking, man at the other side of the nurses station.  He and others were looking in my direction, literally pointing at my room.  Nobody was telling me anything, though.  They couldn't.  The nurses didn't speak English.  I needed to see the head of the ICU.  He was the only one who could talk to me.  He was walking around the ICU.  I saw him.  But, he was not looking at me.  Why not? Was he avoiding me?   When I finally caught his eye I yelled at him to come over and demanded that he tell me what was wrong.   He didn't want to.  I could tell.  He looked nervous, avoided my look and said he'd talk to me soon.  Oh oh, this was bad, real bad.  I was sure of it.   So, my heart was racing,  I was shaking and in absolute terror;  something unimaginably horrible was about to happen and there was nothing I could do.
Panic had gripped me.  Again.

Ruptured Spleen

Thank you nurse Helen - you're AWESOME

I was waiting for a long time in the little hospital room.  Just me and my thoughts.  I was whimpering "please somebody help me".  I let it all go.  I was rehearsing, as I have so many times, the ultimate worst case scenario: "they're going to find something and it will be really really bad". I was wallowing in my misery.

Finally, the nurse came.  Her name was Helen and she spoke Dutch.   I begged her for some pain medication.   But, unfortunately, she said "not yet".  I first needed to see the doctor so that he could diagnose what was wrong.  Helen asked some basic stuff about what happened.  I told her I could feel my toes and that I had gotten up and walked.  "So, no broken back or anything", I said.

The doctor did not speak English, nor did any of the hospital staff.  So, all the communication was done through Helen.  She said that they'd would do a CT scan to see if there was anything wrong with my internal organs.  The one thing I will never forget about this part is the lifting from my bed onto the gurney; from the gurney onto the table for the CT scan and back.  It was done with a sheet.  Four people, one at each corner. I was SCREAMING with pain every time.

Then, finally, pain medication.  Aaahhh;  what a relief.  What a wonderful feeling;  my body finally relaxed.

But then the doctor and Helen came back.  My heart was pounding in my throat, panic again gripped me;   Here it was; my death sentence.  I could hardly hear; "ruptured spleen, life threatening only if there is bleeding and no surgery, probability of surgery is 50%."     Pffff, I was silently elated: "they found what's wrong; it is not THAT bad" and then "See, I am not a cry baby"

"I can handle this" I thought, feeling strong again.

So, basically they were going to monitor whether there was internal bleeding.  The hope was that the spleen would heal itself.  Best case scenario was an overnight in intensive care.  Worst case scenario; surgery (50% chance).

I was prepped for the intensive care, which meant even more tubes in my body.  Including one thru my nose, throat and into my stomach.  I had to swallow it and just wanted to pull that f**king thing out the whole time.  I couldn't get used to the horrible feeling, but I knew it was necessary to relieve the spleen.   After all this was done, we had to wait and see if the spleen was going to hold up.  Every 2 hours they would draw some blood to check.

Helen gave me constant updates on David and the girls.  From the outset she made me feel at peace.  "No need to worry; they're fine, just hanging in the lobby;  David's broken bones are not life-threatening".  She would tell me how hospital staff was taking the girls to the cafeteria to eat and to the little outside playground to play.  I was so proud of them.  They were such troopers.
But, I was concerned about David.  He was still waiting to be seen.  WITHOUT PAIN MEDICATION.   Helen explained that she and David were also dealing with the logistics of what to do with the girls, calling family, etc. now that I needed to stay in the hospital; and he too, most likely.

David ended up sitting on a steel bench in the waiting area, being basically ignored (bones are not life threatening), waiting and waiting for FIVE HOURS in excruciating pain. WITHOUT PAIN MEDICATION.  Really, FIVE HOURS just staring at the soda machine clock right in front of him.  Just inhumane.

It slowly dawned on me; our vacation was over; we were not flying back together; I would not take care of the girls;  neither would David; who would??  I was not going back to work on Monday; our world was turned upside down.  But, I did not panic.  And I thank Helen for that.   I surrendered to her expertise, but, more importantly, her warmth and comfort.   She was awesome.  Another beautiful memory that I am truly grateful for.

Then, after a few hours, things took a bad turn.  The doctor was concerned about the blood levels and wanted to transport me immediately to the big hospital in Palma de Mallorca; more than an hour away.   There was a high probability that I'd need surgery.  And there would be surgical staff available after hours in Palma, not where we were.  

Ok, that was really scary.  "What if the bleeding gets worse while in transit?  Will there be enough time to get me ready for surgery then?". I thought.   A ping of panic came back.  But, again,  Helen was there to comfort me.  We figured that it would be too scary for the girls to see me like this with all the tubes.   As I had to be wheeled through the lobby, we decided that the girls would be taken to the playground.  I did not get to say goodbye to them, or David.

Little did I know that I would not see David, or anybody else I knew, for 4 days.  And I would not see the girls for 3 weeks...


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Bumpy road

I didn't look at David.  I just heard him.  I knew he was hurting bad, but I was very focused on keeping it together, getting some control back.  I could not comfort him.  I could not ask him for help.  I suddenly felt really weak and shaky and my whole torso hurt.   But then again, I am somewhat of a p*ssy;  I don't deal well with pain.

Finally, the van arrived.   

Now I needed to get in the van, somehow.  Some people helped me up, but walking hurt, I really just wanted to lay down again.  But, we needed to go to the girls.  I needed to toughen up.  David needed to go to the hospital, NOW.  We needed to MOVE.  I got in the front seat; kinda upright leaning on the edge of the seat.   "Just get us out of here"  I thought.  "the hospital will give me something for the pain" 

The van started moving, but this was not a road, it was a rocky piece of land with big rocks and huge holes.  Every bump was UNBEARABLE.  "I can't do this", I said.  But, our chauffeur did not speak any English.  We kept going.  I was trying to reduce the impact by pushing myself off the seat;  "THIS SUCKS", I thought, but I had to be strong and not give in to the pain;  I had to be tough.

When we got to the ranch, the girls came running up to the van.  They were ok;  no drama, thank God.  David was in the back, hurting like hell, but dealing with the girls.  I turned away so that the girls couldn't see my face. I couldn't possibly deal.  I hated myself for being so weak.

After the girls got the jackets and stuff, we got on the road to the hospital.  It was the longest 25 minutes of my life.  I was starting to feel worse and worse.  David did all the talking and comforting;  he was in excruciating pain, but was able to rise above and he talked with the girls in a calm and collected manner, as if they were just having an ordinary dinner conversation. 

David and the girls were chatting away.  About what just happened; that we were hurt; that we were going to the hospital.  About that this was not going to change the girls' love of horses.  And horseback riding.  That they still wanted to get their own pony. About how Renee had seen David fly through the air when he was thrown off, "like Superman".  They were laughing about that.  And how Sasha held on by grabbing the horse's neck.  She was so proud.

At some point I looked over to the back seat.  This was the first time I actually looked at David.  His face was totally grey and sweat was literally pouring from his face.  Not because it was warm, but because he was in agonizing pain.   I cannot describe the feeling that overtook me at that moment; I LOVED and ADORED him soooo much.  He was so awesome.  He was such a hero.  That picture will forever be burned into my memory.  It was the first of many truly amazing gifts of this experience. 

The ride took forever and I was having difficulty keeping it together.  My pleas "are we there yet?"; "how much longer?"; "how many more minutes?", etc. were getting more and more hysterical.  Tears were streaming down my face by now;  I really could not do this any longer.  Something was really wrong with me, really wrong, it was not just because I had a low tolerance for pain.  I was so tired from trying to absorb the bumps and corners; tired of fighting the pain.  I was totally losing it and in full on panic mode when we finally got to the hospital.  

The chauffeur parked the van at the front entrance, he got out and left us sitting.  But, I was not waiting any longer.  I got out of the van by myself without even looking at David and the girls and walked into the entrance yelling "HELP ME".  Someone tried to sit me down in a wheel chair, but I yelled  "NO, I NEED TO LAY DOWN. NOW".  Someone walked me to a room where there was a bed and left me there.  I laid down.  And I waited.  And waited.  

I was relieved, though, that I was where I needed to be.  The worst was over.  Or, so I thought.  I started to think/worry again.  About how the girls must be freaked because I just walked off; because they had seen me in so much pain.   They were probably traumatized.  I felt so bad for them.  "I'll see the girls soon and explain", I thought.  "and everything will be fine".   But how would we get back to the hotel?   And who was going to take care of the girls that night?  David certainly couldn't.  I felt really really bad for him too. 

Then I was thinking about how embarrassing it was that I was still wearing my soiled pants.  I needed to get these off before the doctor came.  Pulling my pants off was almost impossible because I needed to bend over.  But, I was determined.  "Soiled pants are disgusting, I don't want the doctor or nurses to think I am disgusting."  So, I did it.   

In hindsight, it could have paralyzed me...

But then again, our whole plan was flawed, in hindsight.

The accident

Horseback riding on beautiful beach in Mallorca

May 2, 2012
Our girls LOVE horseback riding.  Even on vacation; that is the one thing they want to do.  So, I found a really cool family activity; horse back riding on the beautiful Mallorca beach.
And it was absolutely awesome until the very end.
We'd just passed a herd of pigs when suddenly there was loud squealing.  The horses got spooked and took off, really fast.  I fell immediately.  Everything around me was muted.  My mind was racing, trying to grasp what just happened: "ok, it's over..  good..  but I'm hurt.  How bad is it?  It's not bad, IT IS NOT BAD,  NO, please let it not be bad"
I panicked;
"F**K  this is bad.  NO, THIS CANNOT BE BAD.  THE GIRLS.   SASHA, RENEE; ARE THEY OK? WHERE ARE THEY?"
Then I heard David.  He was thrown 50 meters away.  "well yeah, my wrist is broken in at least 2 places" he called matter of factly.
But, I wanted to hear about the girls; "WHERE ARE THE GIRLS? ARE THEY OK?"
Then relief; they were fine.  They were back at the ranch, waiting...  for us.
"SH*T,  I need to take care of the girls"  I thought.  David is f**ked.  I needed to get it together.  I had to be ok.  But,  I'd peed my pants.  "Bad sign", I thought.  I got up.  Again, willing myself to be ok. I had to be.  I walked a little bit.  I was nauseous.  "Another bad sign"  I thought and asked David if he was nauseous.  When he said that he wasn't, I laid down again.  Hoping I would feel better soon.  I just needed a bit of time.
David had walked over to me and we just talked logistics; ranch guys were getting the van; they'd drive us to the hospital; we'd get the girls and jackets; we would all go to the hospital.
I don't remember how long it took for the van to come.  But, I was keeping it together.  We had a plan.

Really, who cares?

My awesome family - They care

This is so hard.

What should be my first sentence of my first blog?
Nothing I think of is cool, smart, or interesting enough.
I want to be courageous and not listen to the voices in my head; WHO DO YOU THINK YOU ARE; NOBODY CARES; YOU ARE SO LAME.
I'm doing it.
I am going to record my rehabilitation journey.
First step, set up Blogger and publish the first entry ...