Walking the razor's edge of fear, compassion and bravery

With great looking results from new tibia x-rays on Wednesday, optimism and good spirits still prevail in the Dupuis-Katz household!

Mornings or evening can be the toughest. It alternates because pain seemed to be at its worst as the afternoon/evening progressed for the last couple of weeks, but now pain seems to be subsiding overall. 

Yesterday morning and today were especially hard. I woke up just so damn soar and stiff all over, my low back feeling wrenched. I just wanted to jump out of my skin!

I breathed. I cried. I moaned. I breathed into the areas of pain, soreness, stiffness, discomfort... like they teach me in yoga. It kinda helped. I moved the CPM and lay flat on my back in bed. Savasana. 

I got up. I stretched. I lay down. I stretched. Spinal twists. Did PT. Made stuff up. Anything I could think of to relieve myself of these moments of discomfort.

Okay... that helped but I needed more. It had been almost 12 hours since my last medication dose, 7.5mg oxycodone/325mg Tylenol. See!? I'm doing better! So this morning I took 500mg of Tylenol and 5mg of oxycodone and 30 minutes later I was feeling "normal".

I talked to my sister, Bridget, for almost an hour and a half. We laughed and shared stories. She gave me advice and shared memories of her healing after her surgery about 9 years ago. I heard about her poor doggy's flee and dermatitis problems. I lay in bed, finally comfortable. With like four blankets on me (down, fleece, quilt, knit) because I was freezing with my ice pack on my knee for most of the night. Anyways, it all helped me feel BETTER.

Alon made me a beautiful breakfast... he has nearly every day, when someone else isn't here to help. Eggs, toast, tomatoes, cucumbers. Ahh. He is "the best in the west" my sister, Bridget, said. She is right! 

That all said, I cry at least twice a day. A lot of the time it feels like an emotional outpouring to regulate myself in a way. It might be dealing with some post-traumatic stuff, as folks say. It might be brought on by tiredness, inability to get and stay comfortable, or pain and soreness from one of my worst sprained ankles ever. The leg itself only has an occasional sharp shooting pain through the knee cap. I'm stretching the scar tissue on the CPM which is uncomfortable, but temporary. 

Mostly, I think, the teary moments are just from the sheer DESIRE and DETERMINATION to heal; the FEAR and the COMPASSION that are drawn so strongly out of me at times; the accompaniment of the PAIN and STRUGGLE and discovery of new INNER STRENGTH (bravery?) during physical therapy; and truly, the GRATITUDE I have for this body's ability to heal, my medical providers who continue to treat me with the the best of care, and my friends and loved ones, especially Alon, who continue to help me at every turn at all ours of the day and night.

Regarding PT, I am up to about 20 exercises per day I think. I haven't actually counted. I just had my last home PT visit from Deb yesterday. The exercises she has given me just keep adding up and I need to do them until I hit that 12 week mark (November 21st). This includes therapy for my left leg, foot and shoulder, since I fell pretty hard on it too and strength and range of motion have been compromised. In order to stay as strong and balanced as possible, I need to start throwing in exercises for the right side of the body too... sigh, it feels like a lot of work, but I'm going to get it all squared away this weekend I think.

My next step with PT is to make a spreadsheet.... since I miss doing them so much at work! This will allow me to track my daily progress... not have to think too much about what to do next... watch my ups and downs and give myself some recognition when I'm feeling beat or unmotivated. It will be similar to what I had going with my yoga schedule prior to the accident where I started with two classes per week and added a new class or two every three weeks.

Speaking of yoga, it's pretty cool what poses I've adapted to a walker! And what I've made up along the way just to get some good stretching in. Maybe I'll get Alon to take some pictures and post them here soon :-)

The morning today ended with a good dose of sunshine. I sat in the back yard, watching Ozy jump over rocks, hide, and hop through the grass chasing grass hoppers. She's all tired now and fast asleep in her bed next to Alon while he works. Anyways, I sat outside for about an hour, all propped up with a couple chairs and a few pillows, just taking it in. It was warm and good.

AND working on my short term disability paperwork with Gary, our HR Director at BCAP, over the phone. Alon scrambled this morning to pick up and drop off paperwork from the doctor's office to home to BCAP to home again. Let's hope that all goes through smoothly and quickly so I can at least get a portion (about 1/2) of my pay for the next couple of months while I recover at home.

Ooh! My left knee just "cracked" in the CPM! That was weird! Oh well, all is well I guess... that's just a new movement and sensation. Hm. Good I suppose!

E. Dupuis signing out... thanks for checking in again :-) xoxo

No break through pain, Ozy tries CPM

The good news for yesterday is that I had no break through pain during my 6 hours between medication doses! I went about 7 hours without any pain meds. I also took just half a pill at the 7 hour mark. So THAT is AWESOME!

Some more good news is a new friend, former board member at BCAP and volunteer there saw my request for help on Facebook. She has offered to come every Wednesday morning for a couple of hours to take care of me till I am back up on my feet. This type of generosity and help blows me away. Then, Alon and I contemplated how so many nice people lately make us (mostly me) cry. More AWESOMENESS.

This morning the Oz-meister, our kitty, Ozymandius, Ozy for short, alias KITTY... decided she would try out my Constant Passive Movement (CPM) machine while I jaunted off to the bathroom at 6am. When I hobbled back, this is what I found... of course the machine was off, otherwise she would not have been so brave...

1. Curled up like a little ball, like this hunk of medical machinery with a soft faux sheerling liner was made for her... Excuse ME!

2. Getting experimental. Ozy attemps to find a more comfortable position, poking her head through a hole, laying her soft white belly across the fuzzy liner... Success.

3. Close up. Ozy resting her face on the hard plastic base of the CPM. She has SUCH a hard time getting comfortable. Who needs vicodin or valium? I want what she's got!

That's pretty much been my morning so far. Other than excruciating foot pain, which does not seem to want to go away. Deb, my beloved Physical Therapist, should be here soon. We shall discuss the foot then. Love to you all! Thanks for checking out my blog.

Specific Requests for Help (in Boulder, CO)

I am trying to make a schedule of helpers for the next 5-10 weeks while I recover at home. I am requesting a couple hours of help in both the mornings and afternoons. We are taking this one week (really, one day) at a time. I hope to be doing things and walking on my own again by Thanksgiving! Please read on for details... thanks :)

My contact info:
erin.e.dupuis@gmail.com
508-479-4841

Schedule of Help Needed:

• Days: Monday through Friday
• Times: (slightly flexible)
• Morning shift: 10am-1pm
• Afternoon shift: 2pm-5pm 
• Duration: Tuesday, September 13th to Friday, November 18th

Any assistance or amount of time you can offer is helpful. Please be direct with me and Alon by saying what you can and cannot help with at anytime. We respect you, your time and your friendship.

Help at Home:

• breakfast and lunch
• change ice for my leg
• move my equipment from living room to bedroom (ability to lift 10 pounds) - usually in late afternoon
• refill my water bottle
• push me in wheelchair around the block when I feel up to it 
• light house cleaning
• other personal assistance (does not include getting dressed, toileting or bathing)
• keep me company
• laugh together
• ART THERAPY!

Help Outside Home:

• pick up biweekly farm share in Boulder, Thursday, 4-7pm (thru Oct.)
• run errands - examples: picking up ice or a few grocery items - we will give you money ahead of time or reimburse immediately

Asking for help is not an easy thing for us. Thank you so much for hearing and considering our requests. 

With respect, love and thanks,

Erin & Alon

Pictures: Hours 2 through 14 after my injury... don't look if you're squeamish!

Here are some images and x-rays, courtesy of Alon, from the Emergency Room and my Recovery Room at Boulder Community Hospital. 

DO NOT LOOK (at the first image) if you are easily made to feel sick, faint, or disgusted.

1. Here's my anatomically incorrect leg about 2 hours after the injury. I can hardly look at this. It's hard to see your physical body disfigured like this. Disclaimer: I know others have had it worse, and I certainly could have. But this is my story and it is all relative, and all I wanted to know the moment I hurt myself was that I didn't have any bone sticking OUT of my flesh. Fortunately, I did not. Below, I had just come out x-rays (then they ordered CT scan, which is when I started to go into shock). It took about 1 1/2 hours of administering various pain medications to get my pain from a 10 to about an 8 where I could turn over from the fetal position to my back and slightly straighten my leg in order to take the x-rays. The x-ray technicians, Mary & Paul, were outstanding, compassionate, helpful, and patient. I remember their names because I told them they were just missing "Peter".

2. Alon took this image to send back to my parents in Massachusetts... I look pretty terrible. My poor parents, just beside themselves with fear and frustration. But I was in really good hands at BCH and with Alon by my side. I don't know if this picture provided comfort for my parents to see me alive and drugged and in a hospital bed, but it's all they could get at the time. This was also pre-op, post x-ray. I believe I had just called them within the past 15 minutes or so with results from the x-rays, almost 2 hours after my injury. I can't believe I waited that long, but I sort of had to. I consciously did not make an earlier call because I had no information and was in too much pain to have a "conversation". I remember calling my Dad and saying, "Dad, I have bad news. I broke my knee." He said "Hold on," and put my Mom on the phone. I added a few more details and handed the phone to Alon. I could barely talk; I was losing my voice, shivering and going into shock, still in tremendous pain. I believe my sweet Alon was the best person to be with me during this difficult time, even though he didn't think he did such a great job. My family and I agree, ALON WAS AWESOME (not that he had anything to prove). Can you believe with me looking like this BCH almost had to put surgery off till the morning? I flipped out on the ER Physician Assistant, momentarily. Fortunately, the hard-working medical professionals and doctors at BCH put a specialist team together in about an hour and changed their minds... had me in surgery after about 30 minutes of seeing the x-ray and CT scan results.

3. Here we go... a more pain-free, fixed up, bionic Erin. This is probably around 7am on August 27th, about 8 hours after surgery was completed. I don't remember much other than I was glad that the pain was less and I had a wonderful night nurse, Bonnie, who was as fit as a body-builder and as sweet and calm as an angel. I remember some weird, random stuff from those first 14 hours. Like the anesthesiologist... for whatever reason I was giggling at him (under the influence of a ton of pain meds) with his curly brown hair popping out under a surgeon's cap, and thick black framed glasses.... telling him he looked like a cartoon! He never cracked a smile... he just put the gas mask over my mouth and off I went. At least I was making myself laugh.

4. First-person view of my leg in the CPM (Constant Passive Movement) machine from the hospital bed on the morning after surgery. This is pretty much the same set up and rig I have at home where I spend about 20 hours of my day.... moving every so slowly from 0-40 degrees. The purpose is to decrease the amount of scar tissue build up and maintain some range of motion while the bones and ligaments heal. Most folks with torn ACL and meniscus can add 5-10 degrees of movement with the CPM on a daily basis. Due to the severity of my injuries, Dr. Fulkerson ordered nothing above 40 degrees for several weeks. Aren't I special? I could work up to 50 degrees after a month or so when I feel able to do so. So far I toggle between 35-40 degrees depending on how tight my knee feels. It is subtle movement, but a significant and wonderful medical invention!

5. Below are a few of the best x-rays taken of my leg after the operation. I hope you can see them okay. Some are just kind of confusing, but interesting nonetheless. Alon and I got to see the top two at my follow up with Dr. Dolbear at Boulder Orthopedic (a very nice office, by the way) on Wednesday September 7th. They show a plate along the right side of the tibia (as you look at the photo) with screws going into the plateau and then down along the length of tibia to hold the plate in place. I think the plate kind of hooks at the top and there are about 6 screws that I can see. There was also a small medial fracture along the top of the fibula which was just reset and left to heal (an easy one they say). Alon snapped the photos of the other two x-rays in the operating waiting room when Dr. Fulkerson came out after completing my surgery. Word has it my tibia was crushed to mere fragments by about 1 1/2-2 inches! Then piled up and "glued" (bone graphed) back together with cadaver bone. In the top photos, you can see some of the metal staples trailing along the right side of the image, which neatly sealed up the incision along the outer side of my left knee. Based on the look of leg now, there also was some laproscopic surgery done through the inner side of my leg near the knee, for whatever reason. More to learn there when I see Dr. Fulkerson on Sept 22. This unique metal sculpture is a permanent structure meant to reinforce my severely crushed, fractured bones which will heal beautifully to 100% of "normal". Yes you heard me, 100%. Thank you, Dr. Fulkerson and the OR team.

First post-op follow up

On Wednesday Sept 7 (my sister Bridget's birthday - happy birthday!), a lovely orthopedic technician lady took 31 staples out of my leg, and saved them for me in a latex glove with a rubber band holding it shut. I said I'd like them to use in an art project someday. Who knows.

The whole staple-removing process was pleasingly painless. Felt like nothing or tiny little pokes with a pin. My surgeon, Dr. Fulkerson, was on vacation this past week so Dr. Dolbear stepped in to give me my post up check up. Basically, he said the incision looks beautiful, it is healing great. Dr. Fulkerson did an amazing job on the surgery (I saw another x-ray which was even more helpful and interesting in terms of understanding the procedure). I promise I will post pictures soon. It's a matter of compiling them from my and Alon's phones. ...And I am to continue with the Constant Passive Movement (CPM) machine as much as possible night and day, keep icing, and Dr. Dolbear told me at least three times -  ZERO weight bearing! Got it.

I also got a new pain prescription - less tylenol more oxy in each pill. The tylenol was hurting my tummy, and no wonder because I was taking too much. It was a second refill by an on call doc over labor day weekend whose name I will not mention here, but basically gave me the wrong pain Rx. Shame on him.

Water under the bridge. Funny thing...

Funny thing was the new oxy pill with 7.5g (or mg??) of oxycodone and 325mg of tylenol is amazing. So I took two pills every six hours starting Wednesday night at 5pm... it was fine because at that time of day my pain level increases and it also helps my muscles relax and for me to sleep. HOWEVER, I took two pills at 10pm, 5am, then two at 10am again. One hour before my first meeting with my occupational therapist, which was followed by my physical therapist. Big mistake! I basically was slurring my words and my eyelids kept closing. I acknowledged to them my situation and disclosed that I had taken too much of a new pain med for day time hours. And they just kind of shrugged it off. I felt like I was confessing to my parents about underage drinking or something. Anyways... I felt nauseous, tired, and couldn't really form sentences for about 4 hours. Regardless, PT went on and then I slept most of the afternoon. Alon warned me to take just one... he is right like 99.9% of the time... sometimes I still just need to learn it on my own.

Lesson learned.

Links people sent to cheer me up and make me laugh...

Don't worry, these links are all safe to watch where ever and when ever. Well, except for a couple F-words in #2:

1. http://www.youtube.com/watch?v=1RYt8gh388Y&playnext=1&list=PL7EC16C2835A397CB
2. http://www.youtube.com/watch?v=4r7wHMg5Yjg
3. Happy Pho: Not available in Boulder, CO Whole Foods yet but perhaps she could order through Amazon http://www.amazon.com/HAPPY-PHO-Ginger-Vietnamese-SERVINGS/dp/B003DXGN70/ref=sr_1_3?ie=UTF8&qid=1315329690&sr=8-3
4. two hour season opener on September 22... http://abc.go.com/shows/greys-anatomy
5. http://www.americangreetings.com/ecards/view.pd?i=544969516&m=5994&rr=y&source=ag999&c=emag63458

Day in the life...

Tomorrow, Wednesday Sept 7 I have my first follow up with Boulder Orthopedics. It is possible they will take out my staples. I will see my massive scars for the second time, and I'll get more information about "everything". 

I'm still working on managing my pain; I never knew how complicated that could be. On average, I am around a 2-3 out of 10 on the pain scale which still brings me to tears at times (that could also be the medications and general dealings with trauma making me more emotional). Nights and sleep are hard on both me and Alon. We are getting 2-5 hours of uninterrupted sleep each night for a total of about 8 hours (plus little naps when possible). I am going on and off ice (a loud "ice cuff machine"), on and off the CPM machine, having nightmares from the narcotics, and self-administering meds when my phone alarm goes off and tells me what to take (vicodin, valium, chinese herbs, laxative, etc.). The swelling and bruising from my hip to my toes is going down every day. This is nice to see. I have some concerns about a possible left shoulder and ankle injury related to the bike accident that weren't observed at the hospital.

Day time is a bit easier because the pain seems less during the day and friends, family, and heaers have come by to help me out. Right now physical therapy is hard and tiring. And yet still "minimal" in terms of what I know my healthy body is capable of. I am listening to my body which changes moment to moment in terms of what I can and cannot handle in terms of physical, mental and emotional exertion and challenges. I had a really amazing Tibetan healing with singing bowls, chakra healing, and guided visualization meditation last Saturday from one my yoga instructors who came to my home (thank you Shareshten). It was a blessing and I plan to have her back every week. I also had an energy healer come last week, who usually does Shiatsu on me, but did something more like Reiki instead (thank you Dale). Both were beautiful and helpful experiences, which elevated my physical and emotional and spiritual state of being.

Mom and Dad were here last Thursday through Sunday, and that immediately lifted everyone's spirits. They are the best parents a girl could ask for.

My best friend Candice started working with me on Monday to create a "needs" and "day in the life of" document for me and Alon. I am currently working on creating a schedule for folks to be with me for a few hours a day (in chunks) so that Alon can close the office door at home or go to a coffee shop and work at least 6 hours of uninterrupted time while I get the help I need around the house and with personal care. My friend Jesse has also been instrumental in cooking, cleaning, providing trashy magazines for my reading pleasure, and general support to me and Alon. My friend Mary came over to get some household chores accomplished and entertain me with stories, change my ice, and get my CPM up and running today. She walked to my house in the rain. Such a trooper that woman is. Solid as they come. Sarah, Celeste, Jenny, Wynn, Bree and others will be stopping by and filling in as "me" around the house while keeping me comfortable and fed.

What could feel like a very long 8-12 week recovery process is already feeling lighter and manageable with all of your help and the kind, healing words from my friends and family back East. Thank you.

I have spent a tiny bit of time journaling, blogging, and drawing. Mostly right now, it's sleep, eat, PT, manage pain, connect with my support group, pet Ozy my cat, bathe. I plan to start doing some watercolor painting in the very near future... note cards, tiny paintings, bookmarks, etc.

I am so grateful for the support, patience, and understanding of my co-workers and friends at BCAP, my network of healers, friends, and family. Love to you all.