Saturday, 17 January 2015

Recycling Can Be Hazardous To Your Health

I'm not joking :-)

Some time ago, a local neighbourhood miscreant decided it would be fun to steal our Council -issued huge  blue bag used to store recyclable tins and plastic containers, which we put outside our house to be emptied every week. While we were waiting for the Council to deliver our new recycling containers, recycling day drew round once again.... and consequently I ended up using a black box (which should be used to recycle paper) for the tins and plastic containers. We had far too much plastic to fit in it, so I decided, in a fit of uncharacteristic lunacy, to stamp on the plastic bottles in the black box to compact them further and enable me to load more in.

 This was not a good move. At all. The black box slipped and I slipped with it, landing very heavily on the floor of the kitchen with a sickeningly audible crunch and a howl of anguish mixed with some choice expletives. Luckily my husband was in the house at the time and came thundering downstairs to my aid as I screamed, for I was in so much pain  I could not move. I knew immediately I had broken a bone in my arm somewhere, and ten minutes later, a kindly paramedic was administering Entonox and arranging an ambulance to take me into A&E.

As the journey progressed, I began to feel more and more unwell, and by the time the Triage nurse saw the extensive bruising to my elbow as well as my woefully mis-shapen lower arm, I was taken to Resus to have, in her words, "some proper pain relief". This consisted of an IV drip of paracetamol, which predictably, did nothing to help with the pain and I was utterly dependant on the Entonox when they wheeled me to Radiology to x-ray the arm in all its grotesque glory.  To say I screamed the place down as they moved my arm to get a variety of shots was an understatement and I am embarrassed to  recall it even now. The shame.

Result: one very definitely broken wrist. I had completely removed and displaced the distal head of the radius, but luckily had not damaged my elbow as well. And yes, my x-ray did look like the bottom left one :-)

Once all this was identified, I was doped up to the eyeballs with IV Morphine several times and then the fun really began; my brain decided to tell my body that breathing was an optional extra and I really did not need to bother. I was happily dozing when I was aware of someone shaking me and shouting at me to breathe.

 Breathe? What did I need to breath for? I was FINE. And too sleepy to bother breathing, so I didn't.

 The shouting continued and then a very brisk sternal rub (the doctor's knuckles rubbing along my breastbone, which is normally a painful stimulus) was performed, which merely felt like a slight tickle. Even more shouting, then a much brisker sternal rub, which felt ever so slightly uncomfortable and a voice telling me I needed to breathe.  So I did, and woke to rather more pain than I expected. Needless to say, I ended up on lots of monitoring equipment to  make sure I did not stop breathing again due to the respiratory depressant effect of Morphine.

I was deemed suitable to have a closed reduction of the fracture - i.e. they would pull and manipulate the arm till the bones were properly realigned and then plaster cast to keep them where they should be. It hurt. A great deal. And I was very noisy :-(  When they had done it, off I went to x-ray again, only to be told that it wasn't in good enough alignment and that either I allowed them to manipulate it once again or I would  need surgery to plate and pin the fracture. This seemed rather a "between the devil and the deep blue sea" scenario, but after some negotiation, I agreed to let them re-manipulate it but only if I would not really be aware of it as opposed to screaming my head off in pain.  The decision was to give me more morphine IV and then IV sedation, so I would be conscious but co-operative and would have no recollection of the procedure afterwards, even if it did hurt. This struck me as being acceptable, so dose number 3 of IV Morphine was injected.....

"Was that supposed to set my arm on fire?" I asked the doctor. "No," he said, looking surprised and then unhappy as he looked at the IV site to see it was all swollen and then enormous red blotches appeared all around it. The IV had tissued and the drug was irritating the tissues, rather than being safely in my bloodstream. He sighed, re-sited the cannula, showed me he was injecting dose no 4 of Morphine, simultaneously telling the junior doctor with him that it was imperative to do these procedures with Morphine as well as the sedative drug, as not to do so was cruel and inhumane. "I quite agree!" was the last thing I remember, as once that sedative Midazolam (Versed) hit me, I remembered nothing till I woke up with my arm in plaster, pain-free and en route to X-ray once more.

This time, Doc was happy with the successfully completed reduction and once I was properly awake, my husband was able to drive me home, with instructions to return to Fracture Clinic next morning to see the Orthopaedic Consultant. I will gloss over the subsequent 24 hour inpatient stay on the Ortho ward because they thought I might have Compartment Syndrome, plus numerous additional x-rays, to the point where we were joking that I would be glowing in the dark soon. Mercifully I did not have Compartment Syndrome and was able to go home, returning to Fracture clinic weekly for the next three weeks to make sure the fracture had not moved at all, which would then require surgery to fix. It did not, thank God, and although I was in plaster for Christmas, it could have been so much worse.

I am now ten days out of plaster, having physiotherapy to regain use of my wrist, and although there is some pain, it is fading and life is slowly returning to normal. Needless to say, when I did the recycling for collection this week, I was extremely cautious indeed!