Broken Ribs Hurt!

Two weeks ago, I celebrated the Autumnal Equinox by having a Great Fall, much in the style of Humpty Dumpty. As I am wont to say, laughter is great medicine but ice cream is better; but there is not enough chocolate ripple supreme in the whole world to replace morphine for the pain of broken ribs.

Very early on Sunday morning, I fell backwards onto the metal frame of my bed whilst attempting to return to bed after a trip to the loo . In hindsight, it would have been much kinder to my hubby to have turned on the light to find my bed at five in the morning, rather than wake him up with my screams.

Later that morning, I went to the ER. They x-rayed my ribs from several angles, none of which showed any fractures. The doctor sent me home with a prescription for Tylenol 3 and Diclofenac Sodium.

The next day, I finally read the product info sheet from the pharmacist; and discovered that Diclofenac is the generic name for the NSAID ingredient in Arthrotec, a drug that I already take. I called the pharmacy, and the pharmacist told me to discontinue the Diclofenac immediately.Since both the hospital and pharmacy have computerized safeguards against duplicate medications, I really have no idea how neither the doctor nor the pharmacist picked up on this error. This was a good reminder for me to always read the information that comes with prescriptions and to ask questions if something seems wrong.

Back to the saga. The details and chronology get a little fuzzy in my brain, but I think it was Monday night that I woke Hubby and everyone in earshot with my screams again. I told him I needed to go to the ER again, but when he tried to help me up, I started screaming again. He called 911, and it took 3 paramedics and a very snazzy wheelchair that can climb stairs to get me out of the house and back to the ER. My ribs were x-rayed again, and once again I was told that there were no fractures and sent home.

Then I think it was Thursday that I contacted my family doctor and requested that he take a look at the x-rays. He called me the next day to say that there were no fractures, and I just needed to be patient and let the bruises heal.

On Sunday, a week after my fall, I went back to the ER and insisted that my pain level was too intense for bruised ribs. I have had bruised ribs before, plus I gave birth without drugs twice, but I had never experienced pain like this before. So they gave in and x-rayed my ribs once again. This time the technician took a good look at the bruises and scrapes on my back, and the x-rays that he took clearly showed at least two fractures.

The doctor in the ER didn't know what to do for me. There were apparently no beds open, and I insisted on staying, so they moved me around from room to room and asked if I would be okay with spending the night in a treatment bay in the ER. I said that would be fine, but  the doctor finally found a bed and admitted me - almost 12 hours after I got to the hospital that morning.

Once they had me, the doctors were reluctant to let me go. My ribs had been "clunking" for a week now, and it took several days of morphine to catch up to the pain. I started to get a bit more relaxed once each dose kicked in, and I finally settled down and let the nursing staff take care of me. I rang the call button whenever I needed to get up. My doctor was reluctant to send me home with a prescription for morphine pills, but the doctor who saw me on Wednesday and Thursday when my doctor was off gave me a prescription on Thursday, and said I could go home if the physiotherapist agreed.

The physiotherapist had me climb a stair and get in and out of bed on my own, and pronounced me ready to go home. I slept well last night, and today the pain is bearable with regular help from my new friend, hydromorphone pills.

The End (for now).

DBS implant turned on at last!

Here is the last of a series I wrote in 2008 when I had surgery to implant a Deep Brain Stimulator to control symptoms of Parkinson's disease:

June 12, 2008: Yesterday I had my first “programming” session to adjust the settings on my implant. This experience seemed like something out of science fiction (as has this whole process). Renee, the neurological nurse who programmed me, used a remote control device to communicate with the implanted technology. She held the remote over the spot just under my collarbone where the battery pack was implanted. The battery pack in turn communicated with the stimulation device implanted deep inside my brain, with wires tunneled under my skin to connect the two. Renee then used a hand held tablet gizmo which somewhat resembled the medical tricorders used by the doctors on Star Trek. She tapped on the screen with a stylus to individually set the levels of stimulation of eight electrodes, four of which were hooked to brain cells on each side of my brain. The electrodes on the left side of my brain control the movement and sensations of the right side of my body, and vise versa. My Parkinson’s symptoms primarily affect the left side of my body, so she started with the right side of my brain.

As Renee activated each electrode with her tablet gizmo, I felt different sensations over my body. And no, unlike the woman in the TV commercial, I did not smell burnt toast. Mostly, it was like electrical tingling in different body parts. Sometimes my eyes would react and go out of focus, like they do when I try to stare at those 3D drawings in the newspaper where you have to stare until you see a 3D image. After about 2½ hours of this testing, she set the levels and sent me off for lunch. After lunch, I went back, and she showed me how to use my own remote control at home.

So now I can control my own DBS levels, within parameters that Renee set up for me. If I get dystonic (which means cramping muscles, unbelievable pain – where my toes curl under, my ankles turn outward, my arms raise up elbows first and I can’t lower them, my neck twists to the left and down – and I’m grateful because some Parkinson’s patients get these cramps in their facial muscles and that hasn’t happened to me yet), I can turn up the stimulation and get some dopamine flowing. When I get dykinetic (which is a side effect of my medication and results in uncontrollable swaying, dancing movements that my sister says looks like I desperately need to use the bathroom), I can turn down the volume. Either way, I get a quick reaction, which is impossible with pills.

I think I might enjoy living like a Borg (for you non-trekkies  out there, the Borg are an alien race who are part humanoid but have machine parts implanted). I still have Parkinson’s disease, I’m still in a great deal of pain, and it is still very difficult to do much of anything, but now I look cool! (Except for the patch of very short gray hair right on the top of my head and the inch of gray roots that I can’t dye until the incisions heal. Yeah – besides that, I look like a very cool 42 year old mom with my remote control.)