At my final follow up Dr. Marcotte left me with good wishes and a warning that my thoracic spine problems were fixed for now. The future might see something different.
My knees, never properly rehabbed, continue to get worse and cause walking problems. They are at least manageable. The main problem is arthritis, exacerbated by my weight. Both knee joints are now (2012) pretty much bone on bone.
I go back to work in this month. The IRS is willing to let me and many others come and go pretty much as we wish as long as we work the tax season, which for us is roughly the first six months of the year . Each year starts with classes for everyone. There are always changes in the tax code and new forms to learn. Training can be as short as week for experienced workers or for new hires, many weeks. I have good speed and accuracy ratings, which is what counts in my area, Document Perfection, so I get early call backs. Plus I'm developing phone contact and foreign tax skills. Not many like the phone work, but I do and I'm surprisingly good at it. And virtually no one, but the other Steve in my unit , likes non-resident (or NR) tax work. Since I sit next to the other Steve, who is" fondly" known as Grumpy Steve, I become Happy Steve by contrast and I learn quite a bit about foreign taxes.
In September Hilary suffers a very minor heart attack at work, "the world's smallest," as she describes it, and is taken to Lower Bucks Hospital. She's there for only 2 full days, but on the last one, a Saturday, she undergoes a cardiac catherization. It shows that she suffered no long-term or permanent damage during her event and given rest, will be fine. Unfortunately, the room where the procedure occurs is rather open and doesn't appear really sterile or antiseptic. She can only hope for the best. The doctors also for some unknown reason totally revise her blood pressre medicine dosages, increasing them substantially.
The morning after she comes home, she goes down to let the dogs out for a run in the backyard and on her way back in with them she faints and fall to the floor just inside the mud room. She tries to get up and fails, smashing her face into our kitchen island, and really hurting her back. I'm blissfully asleep upstairs. She yells for me, but I'm out. It takes her an hour to attract my attention. I finally run down, thinking heart attack and that's what I tell the 911 operator.
The special heart paramedic unit arrives and determines that she hasn't has another heart attack but is suffering dangerously low blood pressure. When they try to get a differential pressure, they simply fail to detect anything at all while she's standing. She's promptly packed off to the spiffy new ER at DCMH. Some lamebrain architect has paved the ambulance forecourt with cobblestones, I guess just to torture the injured on the their final 50 or 75 feet on their way to the ER. Brain dead.
During the exam in the ER the doctors confirm no new heart problems, but strees fracture in her back, some serious bruising, and a blood pressure condition that needs monitoring and fixing in a hospital setting. She's admitted.
After a couple of days, it's clear that not all is going as planned. The catheter entry wound in her groin has abcessed. That's not all good. She has to have an operation to fix that.
The infection is a serious staph infection, fortunately not MRSA, but still bad. It has become systemic and even her knee joints are affected. She winds up in the ICU for a few days. One day, an orthopedic resident comes in to aspirate some of the fluid build up from her knee. There's enough there to cause a lot of pain. It's a simple job. Get a huge syringe with a big horse needle, push the plunger to get all the air out of the syringe, stick the needle in the right place in the joint, and pull the plunger back out drawing the fluid along. He manages to do all that and then, in spite of Hilary's vehement protests and warnings (offered three different times), he throws the aspirated fluid away. He should have sent a sample to the lab for cultures to see if the drugs have killed the staph there.
A few hours later, the head of the infectious disease group, Dr. Walker, catches the resident in the ICU and proceeds to, very much in public, rip him a large new asshole. I didn't know people could get that red faced. However, Dr. Walker was right in what she did. It was a stupid, and potentially serious mistake. I must say, however, it sure enlightened a rather dull day in the ICU.
After what becomes a very long hospital stay, the staph is defeated, and Hilary is released. Her first night at home doesn't go well. She is in incredible back pain and there doesn't seem to be anything that helps. Finally at dawn I call the paramedics and she returns to the emergency room.
She's installed in a tiny treatment room way in the far back corner. After a quick exam, some serious pain meds are given. About a half hour later, her pain is quite manageable, and a nurse asks her to carefully stand and see if see can walk. If she can, she's off to home.
Hilary stands and all of sudden there's blood everywhere. The nurse yells for help and at the same time literally picks up and tackles Hilary back onto the bed.
A small doctor comes tearing in, his hands loaded with clean towels he grabbed from a storage cart with any slackening of his speed. He immediately goes to the site of her groin operation wound and folding a towel to a small size applies pressure and I do mean pressure to the wound. He leans over Hilary so his arms are straight up and down and using both arms and all the weight he can muster, pushes down as hard as he can.
Meanwhile the nurse clears out all the spectators who had coming running, and then, I guess goes to change as she's heavily blood splattered. Everything in the room has some blood on it including me. This is going to be one hell of a clean-up job for someone. We find out the doctor, who is of Indian descent, is called Dr. Bob as his real name is fairly difficult for Americans.
Someone at main desk pages Hilary's surgeon using a calm voice: "Doctor M to ER, STAT!" A few minutes later the call, slightly modifies and less calm, is : "Any vascular surgeon to the ER, STAT!" And maybe 4 or 5 minutes later, and far from calm: "ANY SURGEON TO THE ER, STAT!!" Just like TV at last.
Meanwhile Dr. Bob keeps up the solid pressure and we start talking as Hilary isn't in any new pain and in very serious condition. It seems best not to dwell on what's happening, which is the repaired femoral artery (repaired after the cardiac cath at Lower Bucks) has ruptured. These ruptures can be fatakl if the bleeding is not stopped in a few minutes. The femoral artery is big and can dump a good part of your blood supply quickly if it ruptures.
There's not much new blood to be seen after the first few minutes of pressure, but Dr. Bob can't relax even a bit. A surgeon comes running in, takes one look, and grabs the bloody phone on the wall. He immediately orders an operating room prepared for major vascular surgery. It's near 10AM by now and all are full. Apparently there's one with a patient in it, but the operation hasn't started and the patient can safely wait. It'll take 45 minutes or so to get the patient out, and the room cleaned, sterilized and ready for Hilary.
Meanwhile the three of us continue to chat. Dr. Bob' arms are trembling from his efforts, and I know how to do what he's doing, so I offer to relieve him for a few minutes. He declines. We find out he is trained specifically as an ER doctor and he really likes the job. His wife is a pediatric opthamalogy surgeon and makes far more than he does. (Eventually she gets a great job in Southern Cal and he goes with her. DCMH loses a truly great doctor.) We talk about movie trivia and Hilary and Dr. Bob swap bad jokes, of which both have a seemingly endless supply.
About an hour after the rupture a team of transport aides comes in and, with Dr. Bob maintaining pressure, off she goes up to the OR. We're later told that when Dr. Bob finally released his pressure in the OR the wound did not start bleeding again as expected. Dr. Bob did an amazing job.