Apr 22 2014

The enemy is finally starting to show her face…

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Time to pay the piper

It’s 3 am once again and here I am back at the writing tablet. I was here at the same time last night but that was a very different experience. That was almost giddy fun in a way – let’s play this recovery from an injury as a comedy, milk it for a few laughs and get some sympathy at the same time.

Tonight is a very different game. Tonight is the start of a long new battle with a very old adversary.  I knew she was out there, lurking, just biding her time. She’s a very sneaky opponent always changing forms. She is pain. Not sharp, I stepped on a tack pain, although that’s in her repertoire, she is constant, overwhelming, unrelenting but yet still a little subtle in her own way pain.

Most people assume that if you have an experience like I did tumbling down a mountain that it gosh darn must hurt a lot. And while I’m sure for a lot of people in similar scenarios that is the case for me it initially didn’t . When I was falling everything was happening so quickly and I vaguely remember feeling my leg plant in a unusual but not searingly painful way somewhere during the ride. I can’t have tumbled more than 20 seconds and then I was upside down in the snow, knowing that I’ve been totally conscious during the ride, but that’s something’s not quite right – I can’t seem to move my leg but it’s not because I’m buried – my initial hope – but because something is wrong with my leg – it has been rotated far beyond what is has been designed to do. As soon as the guide makes it over he sees my leg pointing in the wrong direction and knows at the very least something is broken and starts the rescue.

At this point I know I’ve fucked up big time. But it’s not pain that’s my immediate concern. Yes it’s nasty and moving my body is rather unpleasant but this is not a searing, god I can’t take this, kill me now sort of pain. Maybe it’s the body protecting itself with adrenaline and maybe it’s just the the right biology but even while I’m screaming while they move me to the helicopter I know part of me is just being dramatic and that if some kind of reward for being quieter were available I could have chosen that route.

Now if you know me you know I’m not that tough, actually I’m a bit of a wimp and never hesitant to share my misery. This of course comes heavily into play in this scenario, where I am given full license to be the unhappiest person in the room and naturally I take full advantage of it. I chose to curse a blue streak and berate the gods for their callousness. Aaron, my buddy who has also taken a tumble of his own and gotten his own injuries (albeit far less serious upon initial assessment) takes a far more intelligent path and focuses on the fact that my god, somehow 3 of us have tumbled 1000 feet down a very nasty slope (your general worst case scenario) and we’re still alive – we have so much to be thankful for (we both have children) and everything ultimately is going to be alright – it’s a god damn miracle, and he’s right.

But that’s not what I see because I’m not a glass half full type of guy. No, what I see and start immediately calculating is how much a pain in the ass this injury is going to be, how much pain, how much rehab, how much inconvenience this is going to be. And I’m very good at this, having torn major body parts before and more importantly having long mastered the art of using my finely honed analytic skills to parse out all the different ways this is going to suck the fun out of my life for the foreseeable future. Am I an ungracious bastard or what? Here by some miracle my life has been spared and yet that’s the last thing I’m focused on.

But why that is and why anyone should care is a story for another evening. Tonight we’re talking about pain and while the ride to the hospital is rather uncomfortable, it’s really not all that unbearable and soon enough we’re there. This is where modern medicine kicks in, the nurses start firing questions and while they know it’s not good from the looks of it, they’re mostly concerned with making sure it’s not life threatening and after a number of quick assessments we know this is not the case. And really, I’m in Valdez, where in addition to the number of heli ops guaranteeing some good action, this is a major industrial port with major industrial accidents so nothing too exciting here.

Pretty soon I’m all doped up and that when any really significant pain ends until I go into surgery almost three weeks later. Yeah, it’s a a pain in the ass to lug your leg around in a cast but actually not all that painful – there is a definite distinction there and that’s what tonight’s story is all about. Surgery is painful. That’s why that got the anesthesiologist who’s sole task it is to keep his/ her eye on your pain. And modern medicine has more drugs and tricks for numbing that pain than hopefully you will ever need to find out. That’s great and has led to people recovering from all sorts of thing that would have been pretty much impossible in the past. But it can’t get rid of all of it and that’s what bring us to tonight.

So when I was in the heli/bus counting and ranking the list of unpleasantries this accident was going to incur, pain was high on the list. Because I remember that when I tore my ACL previously that when a friend accidentally bumped into my leg a few days after getting home from post op I wanted nothing more that to remove him and every trace of his past from the face of the earth for merely touching my leg – real pain, take me now lord kind of action. And given the severity of my recent injury and what would be involved in fixing it, I knew there would have to be some kind of reckoning for that.

I am nothing if not practical. Once you take out the option of not fighting the battle at all, I want to know immediately what I’m dealing with, what I’m going to have to do to get through this. I know I can deal with the rehab, I know I can handle all the logistics, but what I didn’t  know and have been wondering ever since I ended upside down in the snow, is can I deal with the pain?

You see, I have a little problem with narcotics. No I’m not the addictive type, but most of what makes them work well for a lot of people doesn’t work real well for me. Narcotics don’t knock me out, they wire me up – that’s why you got last nights giddy stream of consciousness. I can’t really sleep while taking them. And on top of all that they cause the same side effects that everyone hates – constipation, nausea and general unpleasantness.

This is why many of my friends who have had to deal with this have approached it in the same manner I have, which is try to get off of them as soon as possible or find one that is tolerable. My problem is that I find none of them tolerable and that with the amount of trauma my body is dealing this time with getting off them any time soon is not a possibility.

Which once again leads me back to tonight since up until now I haven’t been entirely sure what I was dealing with. You see since my last surgery they’ve added this new things called pain blockers – little bags of meds they keep attached to you after surgery that help fight/mask the pain. And until tonight I just haven’t been sure how much of a role they’ve been playing because the pain has been way up and down. One minute I think, hey this isn’t so bad, maybe I got lucky this time and then all of a sudden all I can think about is that throbbing in my leg. Turns out the pain blockers have been responsible for the “maybe I’ve gotten lucky this time” thinking because as the last drops work their way though my system my old nemesis has been rearing her ugly head.

The thing that really clued me into the possibility that this scenario might play out this way was the huge quantities of narcotics my docs prescribed for me for post op. Surely there must be some kind of mistake – why would I need week’s worth’s of painkillers – in the past, a couple of days, week tops for the prescription. And more importantly, why we’re there two sets – one for short term pain and the other for long – kind of a fine line there. And I don’t remember them coming with stool softener and anti nausea right off the bat because didn’t they take a while to develop and thus might not be necessary at all if all went well?

That because my old friend has a few allies on her side this time. Now that the pain blockers have worn off and I can actually feel my leg again I can tell just how much my love, support and most importantly, time my knee needs to become whole again. This is not a repair, this is a rebuild from scratch.

Now if you’ve hung in this long I want you to know that this is not all bad news for me. Yes, I’m pissed that I’m clearly going to need to be taking these narcotics for weeks. Which means lots of sleepless nights and more essays (oh lucky you, faithful reader) And yes, my knee needs a lot of love and tenderness but so far she’s responded beautifully. But now I know exactly who I’m dealing with – who I will be sharing my mind with till I can escape her grasp. And I have a new weapon too, one that they taught me about in school all those years ago. I’m going to use my words…