I was helping my
aunt with some construction on her house in Northwestern
Pennsylvania, ~30 miles south of Erie. My brother and I took a
break to throw the Frisbee while she went to retrieve a load of
insulation from the local home improvement store. When she
returned, I positioned myself on the deck of her house's porch,
BEHIND her Ford Escape to 1.) direct her as she reversed to this
docking point and 2.) to be there to immediately unload the
insulation once she stopped.
Unfortunately, she
didn't stop. Distracted with the many changes that have taken
place with the family lately, she simply confused the accelerator
for the break and FLOORED the accelerator. In a flash the Escape
pounced up onto the porch deck and smashed into the wall at the
back of the porch--with me in between.
For those
Mechanical Engineers in the audience, it can be said that my
femurs were instantly subjected to a radically destructive
3-point-bend test. The Escape's bumper applied the load at the
bones' center span, and the house wall supported both the hip and
knee ends. The bumper drove through to the point where it
fractured the bones. It continued further to misalign the
fractured ends (compound fracture), and continued even further on
the left side to push the one of the fractured ends THROUGH the
skin on the back side of my thigh (open fracture). Muscles were
obviously crushed as well--later at the hospital they would refer
to the entire injury as a "crush" injury...not just broken legs.
But the knees, pelvis, arteries, and nerves were entirely spared.
It could have been much, much worse had any of these thing been
damaged also.
I screamed
immediately, she pulled forward off the porch, and I collapsed
into a heap on the deck. With twisted, smashed legs, I curled into
the fetal position on the deck. They felt like useless masses
strung from my pelvis. There was a splash of blood on my shorts;
there was lots and LOTS of pain. 911 and a tourniquet were
instantly invoked, but the tourniquet was soon dashed after the
911 folks instructed to simply apply direct pressure. I never once
lost consciousness, although I wish I had. At one point it felt
like my entire quadriceps had
spasm'd/cramped/contracted/bunched up into my groin. It was
really, really bad, but I was really, really grateful to have my
brother, sister-in-law, and aunt there with me in the
clutch.
The ambulance
arrived in 10-15 minutes, however a medic was not among the crew,
so they could not administer any medicine for pain. With adamant
instruction from me--"DO NOT TOUCH MY LEGS"--they were able to
sort of roll me onto a stretcher board. Eventually I would have to
be stretched out and strapped down in order to be transported to
the hospital, but not yet...NOT without something for the
pain.
It was at this
point that I notice one of the volunteer paramedics was quite
young. Wide-eyed and green this kid was--he was certainly of high
school age. I could just tell that this was his first experience
on an ambulance crew. And what a way to inaugurate a potential
career as an EMT: bi-lateral compound femur fractures, one of them
open, with victim fully conscious.
I would later
learn this was indeed a bran -new ambulance service, initiated
that very day (August 14th), and I was their first emergency call.
This was actually a fortunate thing, for if this service wasn't
available, I would have had an even longer wait for advanced
medical support. Also, to be fair, the entire crew was not
inexperienced, for there were several older guys there helping
out. It turns out that their captain was actually the rookie's
father.
They told me to
brace for some pain as they hefted me into the ambulance. They
weren't able to secure my legs at all, so I yelled my pain
utterances as they loaded me in. And of course, when I was about
half way there, the rookie contacted my right knee. I responded
with heap of curses toward him, for which I almost immediately
apologized. Some day that kid will become the best paramedic
ever.
They were able to
give me pure oxygen in the ambulance, however my injuries caused
me to breathe franticly, too deeply and quickly for the apparatus,
so I'm not sure that it did much good. An IV was administered with
a saline drip. They started to cut off my clothing: my black
t-shirt, my double-seated Dickies shorts, my sneakers. I recall
seeing parts of my shorts being passed around, and I *believe* I
remember the back thigh part being nearly soaked in blood. On the
up side, they only needed to snip the laces to remove my shoes, so
the kicks were spared.
Finally the medic
showed up with the drugs. She administered a seemingly hefty dose
of morphine, and their first order after it took effect was to
straighten my legs. Left leg first, the worse of the two. Even
with the morphine, it was still excruciating when they started,
but once the legs approached straight with a little traction
applied, things sort of cracked and popped in place and then
everything felt much better--the way it feels when you "crack"
your knuckles, ankles, or back. They applied splints to hold the
traction and I was more-or-less ready for transit...by
air.
The medevac
helicopter landed in the field directly across the road. This was
our softball field when we were growing up, and it was the same
field where my brother and I were tossing the Frisbee no more than
1 hr before. The side of this field that faced my aunt's house
(where all the action had taken place up to this point) was
boarded by a relatively deep drainage ditch. As a final solution
to them many less-robust bridging solutions that had deteriorated
over the years, a formidable earthen bridge had been constructed
to span this gap. Quite conveniently, the ambulance needed to
simple move straight forward over this bridge to hand me off to
the helicopter.
As they were
transfe ring me to the helicopter, I asked if they were going to
strap me to the outside like in M.A.S.H. They said no, but they
did load me in through the rear end of the aircraft, which,
in retrospect, is kinda funny. It was a tight fit (as would be
expected), my nose just inches away from the helicopter's tail
section.
Once neatly
packed in there, the two flight medics hopped in and we were off.
They gave me some more pain medicine in route. Just minutes later,
the pilot executed a landing that was like sublimation
backwards--seamless--I was surprised that were on the
ground.
This is getting a
bit long, so I'll try to end it quickly with just a few bullets of
significant events that happened at the
hospital:
- I asked for the
stretcher [on which they brought me into the ER] to be removed
prior to my family coming in to see me--the bottom half was
smeared with blood.
- They operated on
me almost immediately. It was a 4 hour procedure in which they
completely took apart my knees to gain access to the knee-end of
the femur. This is where they inserted solid titanium rods
through the length of the fractured bones in order to re-align
them. I now have titanium where a large portion of my body's
red-blood-cell-generating marrow should be. As I write this, the
area of the fracture bothers me very little compared to my
knees. My "re-built" knees, NOT the fractured femurs, are
hands-down the biggest contributor to my present discomfort and
immobility, and the largest impetus for rehabilitation.
- I slept
on-and-off the first night--a half hour here, 15 minutes there.
They gave me a "pain pump"--basically self-regulated intravenous
doses of morphine. After a while, the opiate was doing nothing
for my pain and serving only to make me feel really weird,
constipated, and nauseous (those that have seen Trainspotting,
recall the scene where Ewin McGreggor's character's begins his
post-rock-bottom attempt at detox.).
- After the
surgery, my resting heart rate was about 100 BPM. This was
primarily due to all the blood loss from the injury, however the
problem was compounded by my body's weakened ability to generate
blood due to the loss of marrow from the surgery. There were too
few red blood cells to carry oxygen to the rest of my body, so
amazingly it compensated by shuttling more quickly what little
red blood cells that were available. Eventually, the red count
was so low that they had to transfuse me. I took two bags of
hemoglobin on August
16th.