Misadventures in Medicine, A Cautionary Tale

Travails in the Trauma Center

Upon delivery to Hospital #2, I was installed in a private room in the emergency department. "Whoo hoo!" I cheered, "I'm moving up in the world and have been promoted from the hallway to a private room!" It was now around 9 pm. That evening I was visited by the ED physician, a couple of residents from the trauma team, and a physician's assistant (PA for short) from the neuro-spine surgery team. Apparently, I had been assigned to the Trauma Team due to the fact that I had a Traumatic Injury, but I had been admitted to the hospital under the auspices of the Neuro-spine Team.

Trauma Team wanted to be sure that I had not sustained any other injuries besides the one to my low back. One of the residents commented "Oh, I see that your cervical brace has already been removed."

"Well, no, not exactly." I explained. "I never had a cervical brace on, as I did not injure my neck."

"Oh, okay. Did you injure your head? Did you hit your head?"

"No."

"Can you feel your legs and wiggle your feet? Do you have any numbness?"

"Yes. No."

And that concluded my evening trauma assessment.

Mr. Neuro-spine Surgery PA came in a bit later and got right down to business. He performed a rapid lower body neurological examination and then proceeded to explain some things:

· I would probably be discharged home in a rigid brace as it did not look like I was going to need surgery; the CT scan didn't show any apparent nerve damage and I didn't have any neurological signs or symptoms.

· I would need a lumbar MRI to make sure that my ligaments hadn't been damaged.

· If my ligaments were damaged then my fracture wouldn't be considered stable and I would need surgery after all.

· The next step was to order an MRI.

· If I went home in a brace, I would have to wear it ALL the time I was up out of bed for 6-8 weeks, including any time that I was elevated more than 30 degrees (like propped in bed, or sitting in a recliner).

· I would need to log roll into and out of the brace.

Mr. Neurospine PA didn't have the greatest bedside manner, but I appreciated the clear communication. Luckily, as it turned out later, I was not gronked out on narcotic pain meds. The fentanyl, the morphine, and later, the tramadol, did not make me high, loopy, drowsy or stupid at any point during my stay, which was a serious disappointment at the time. I mean, if you're going to be unlucky enough to break your back, the least you should be able to do is enjoy the narcotic side effects. However, in my sober state, I was able to pay close attention to the information that he gave me. This was going to prove important later on. The PA then left me to my own devices.

Between doctors' visits I called my husband, my daughters, and my son. My husband agreed that maybe he should come home early from his business trip (we already established that husbands can be clueless sometimes). My daughters were doing fine and at home together with the dog. Things were under control on the home front and I could concentrate of taking care of myself.

Around 10 pm I told the nurse that I needed to be fed and watered. Again, I found myself having to ask for the basics. What's the deal? It was concerning that they had to be reminded to take-care things like food and hydration as it made me wonder what else they might be forgetting. I had not eaten anything since morning and was getting a bit peckish. A doctor (I have no idea which doctor) authorized me to eat and drink that night (nothing after midnight though) as any surgery I might require would not take place until the following day, meaning that I would have plenty of time to digest the rather unappetizing hospital food by morning, so no risk of tossing my cookies while under anesthesia and inhaling vomit.