Since I’ve written more than 1000 of these Health Tips over the years, you may not have noticed you’ve been reading re-runs this past month. Although I try to keep us both away from doctors and hospitals as much as possible, sometimes you’ve just got to bite the bullet, turn yourself over to someone else’s expertise, and hope for the best.
Obviously, since I’m writing this, my personal results were good. The fact that ten inches from my laptop is a flute of icy cold champagne is meant to convey a celebratory component, the celebration being I’m not dead.
I must say that when enough medical professionals tell you “You do realize you could have died” there’s a moment when your pain meds wear off, reasonable thought returns (considering the circumstances), and you realize everyone’s quite serious. You’re then left alone in your hospital room thinking, “Holy shit, they’re not kidding. I wasn’t hallucinating about the grave looks.”
And the next day you see the sun rising over Lake Michigan and you know you’re alive. In fact, you’re now talking to a “discharge planner” (which sounds like something to do with your bowels, but is actually the person who will send you on your way). Later still, on the way home from the hospital, life takes on a new perspective. The trees along Lake Shore Drive are a richer green. At home, you hear nuances in your new CD of late Beethoven string quartets that you hadn’t noticed before. And the juicy, dipped Al’s Italian beef sandwich you scarfed down on the ride home…ambrosial, your juice-stained T-shirt a new art form, perhaps a Jackson Pollack.
A couple days later, you’re outside on your deck on a warm summer afternoon, writing your Health Tips and sipping champagne.
So here’s what happened.
On the Thursday before Memorial Day weekend, unaware of a wet spot on our kitchen floor, I fell and landed mightily on the very hip I’d had replaced 11 years ago. Picture a cartoon character in pain, Road Runner or Roger Rabbit. You know how their eyes pop out in pain? Vroom, vroom. “Wow,” I said from the floor, “That really hurt” (what I actually said was far more colorful).
I figured I must have broken the hip and as much as I really didn’t want to have another hip replacement or even go to the emergency room, off I went to Weiss Hospital. Three reasons for Weiss:
- It’s an efficiently run emergency department where you can be seen in minutes rather than hours.
- It’s managed by professional ER docs, not medical students.
- I know the chief of joint replacement, Henry Finn, MD, who has done good work with both my wife and many of my patients. Surgery to repair joints that already have implants is very complex and, handily, this is Dr. Finn’s specialty.
However, to everyone’s surprise, the x ray of my hip was completely normal. The old implant was in perfect position and they said I just had a really bad bruise. I saw the x ray myself—it looked just fine. To say I was delighted is no exaggeration, but this delight, along with the Norco I’d been prescribed, definitely interfered with my critical thinking skills. You learn in medical school to never, ever diagnose or treat yourself, and it’s absolutely true. Your diagnostic skills, honed for decades, work only when they’re directed toward others. Self diagnosis for a physician can kill you. It certainly almost killed me
A long holiday weekend
So now I’m home and it’s Memorial Day weekend, leg elevated, unable to walk, waiting for my bruise to heal. WHC acupuncturist Mari Stecker came by and though her pain relief treatment was as effective as a Norco, like the pain med it just didn’t last. Our physical therapist Karen Meier also stopped by, encouraged some exercises, but added that if I wasn’t better I should just get back to the hospital.
Unfortunately, everything steadily worsened. By Memorial Day (Monday) I could barely walk a few feet, couldn’t go upstairs, and was peeing in a bottle.
On Tuesday, I called the emergency room and told them I was coming back.
Dr. Finn met me at the ER entrance. Amazing as this sounds, with a bedside examination alone (no tests or x rays), in less than 60 seconds flat he diagnosed that:
- Despite the normal x ray I did indeed have a hip fracture (confirmed by a CT scan).
- I’d developed a blood clot in my leg (confirmed by ultrasound, and not just any blood clot, but a 3½-foot monster, from my foot up to my belly button).
- I had “thrown” a piece of the clot, called a pulmonary embolus, into my lung (confirmed by a lung scan), which had sent my heart rhythm into atrial fibrillation (confirmed by an EKG).
Dr. Finn was surprised that I hadn’t noticed anything. “No chest pain? No shortness of breath?”
“Really, I didn’t notice anything. Except for my hip I feel fine.”
My wife, ever supportive, broke in with “He never notices anything.” They both looked at me like I was weird and I apologized again for feeling fine. I then heard for the first time how close I’d come to death. It had been a perfect-storm scenario for a blood clot to develop: when you don’t move (remember, I couldn’t without extreme pain), your blood gets thick and clots form. It’s why people drop dead after long international flights.
“If a larger piece of the clot had broken off, your wife would have awakened next to a corpse.” I was to hear variations of this theme over the next few days until reality sank in.
Good medicine
I was immediately started on blood thinners and a med to fix my atrial fibrillation. The next day, a specialist in interventional radiology inserted a clot-catcher into my inferior vena cava, the main vein from legs to heart.
While covered with huge paper sheets, leaving exposed just a small area of my neck, a needle was jabbed into my jugular vein and the doc threaded a wire down past my heart and through my chest, aiming approximately for an area just above the clot. The sensation of something sliding through your neck and chest, while not painful, is certainly memorable.
Finally, at about the level of my navel and just above the monstrous clot, he inserted a parasol-like device that would catch any pieces of clot that might break free. The procedure went very smoothly and these guys (who, being masked, I never actually saw) had obviously done thousands of them. They were from southern Illinois and cracked jokes constantly.
The cardiologist came by to tell me his meds had converted my heart to a normal rhythm. He reminded me how close I’d come to dying of a massive pulmonary embolus, but assured me that between the clot-catcher and the blood thinner I was out of danger. Because of the clot, he added “Don’t move your leg too much.” I assured him this was no big issue as my hip was broken (I think he might have forgotten).
And a new hip
The next day, exactly one week after my tumble, I was in the OR at 6 am for the new hip. That, too, apparently went well, but since I was asleep I missed out on the action.
The remainder of the day was a blur because my thumb was fixed on a morphine pump. Through serious creative visualization, my left hip felt as if Godzilla were chewing on my left butt cheek and only by pressing my morphine pump would the Big Guy loosen his jaws. Later that afternoon, the physical therapists came by to start me walking. “But…but,” I pleaded, “I just had surgery. Isn’t this a mistake?”
“Out of bed, Dr. E. This is the way Dr. Finn does things.”
And honestly, from that moment forward, all the drama behind me, I was just another joint replacement patient, quickly transferred to their rehabilitation unit, where I learned all sorts of exercises to get my strength back. It was just 11 days between surgery and seeing a full load of patients at the office. When my wife tenderly inquired about my resting at home rather than returning to work, Dr. Finn said, “Nah. He’s fine. He can go to work.”
How can you help but love hearing that?
So between the Beethoven quartets, green trees along the lake, a dipped giant Al’s (extra hot peppers), and a celebratory glass of Moet & Chandon, life’s pretty good.
Be well,
David Edelberg, MD