A Broken Story

Grandma Vallo fell off the ottoman she was standing on to clean the curtains and broke her ribs when she landed on a coffee table. All I can say is I guess the apple doesn’t fall too far from the disregarded step stool. I fell in the kitchen a couple weeks ago and broke my ribs.

I would like my story to be:

I was buried alive in an avalanche while heli-skiing. The rescue crew digging me out hit me with a shovel!

Instead, I have the adrenaline junkies nightmare of saying…I fell in the kitchen. I was standing at the sink, spun around to grab something off the counter behind me, turned back around, the pain tweaked my knee…My leg jumped and I went down. On the way I tried to catch myself…which put a little extra momentum into it…I slammed my side into the edge of the counter and landed on my back.

People generally cringe here and offer their sympathies, story over. What they don’t get to hear is what happened next…

I lay there, stunned, confused, like the tuna I’d just watched on Netflix. Every evening Ava and I spend time together on the cuddle couch. I like watching sports she likes nature shows. Tonight we compromised. In tonight’s pick, “Battlefish” boat captains n crews slightly more evolved than pirates flew into trash talking, woofing celebration as they yanked in their prize–20lbs. behemoths landed splattering blood on the target, a giant butcher’s block, then slid down a chute leading to an inglorious end in the bowels of the boat. 

I wriggled my way across the hardwood to the kitchen threshold and lay with shoulder bolstered against the wall.

I had a good viewing angle of Ava. They say if one person can remain calm amidst the storm it avoids escalation to panic on the boat. I like to think that’s what she was doing. Ava hadn’t moved. She lay with her head propped on the armrest of the couch struggling to keep eyes open. 

Hey, Ava…Lassie. Timmy fell in the well! 

She, sighed, shifted head one paw to the other.

Could you at least pretend you’re concerned? Look for my phone?

Lassie continued her nap. The response however did tickle my funny bone and inadvertently assisted in my maintaining calm until I could collect myself, gather and use a good boost of numbing adrenaline to get to my feet!

Four days later, I decided to call the doctor when I realized it hurt to breathe and I’d peed myself two nights in a row not being able to get to the bedside commode in time. Best not to try to play hero ball here…and what if Ava decides peeing in the bed is a thing? Four days after the fall, I finally decided yes, I need to go to urgent care! I dare say Grandma Vallo probably hadn’t peeped a word and was still trying to run the vacuum for a week!

At “Not Too Urgent” urgent care, I was the only person in the waiting room area. I had made an appointment in the morning and now three hours later the front desk person said “Hi, Amanda!” She recognized my voice and handed me a clipboard full of forms to fill out.

“What about all that paperwork I filled out on-line ahead of time?” I said incredulously.

She smiled sweetly and said, “I’m new here. Someone will be with you shortly. Can I get you some water?”

I frowned. Shook my head and went away to work on my forms.

A man in his late 30’s, early 40’s with athletic frame in mint green scrubs walked in from the parking lot…He went straight through the waiting room and made witty banter with the lady at the front desk. She buzzed him in through the door…

Did he fill out his forms? I’ve got like 5 extra over here if he needs any…

It was the attending physician who’d been away for lunch.

Maybe now I thought, a sense of urgency?…No. I was without my wingdog to keep me company. When my help finally arrived I sat staring into a blackened TV screen now serving as a bulletin board for Covid safety precautions.

“Amanda?”

“Oh, yep, that’s me.”

Never trust a nurse in black scrubs no matter how soft the cut. She wore the wispy summer robe type that involves a “V” neck, crosses smartly at the waist, and secures with string ties. The color choice suggests they a little bit don’t get it. They’re a little bit dead inside.

She was late 20’s, sported a wrist tattoo, and had a few more that said how much she loves her kids. There were hearts and angels with delicate scripted names and dates. She was work-nice and nailed all the new patient protocols. Blood pressure, temperature, pulse/ox… check, check, check.

She sat on a roller stool, safely distanced behind a tray table and open laptop. 

I had completed intake and registration forms on-line AND a small stack in-person and was in no mood…

I had the cleanest family medical history in history…Nope. Yep. Everybody’s fine. Yes, my grandpa had breast cancer. Don’t make me explain it.

When we got to What pharmacy do you use?”

I was downright salty.

If I were bleeding out of my head would you be asking me this? I do not want to talk right now…call Ava. She’s been there.

I said, “It’s a CVS in Target…I don’t know the address. You know the one. It’s a CVS in Target in CORNERSTAR!” (shopping center) and just kept repeating myself.

By the time we got to reason for my visit, some part of me…the pain deep inside was talking.

Listen. I can’t push to get up off the commode without wincing, I about face planted in some dog poop because crawling to pick it up hurt so bad…positioning in bed hurts, breathing hurts, sneezing and coughing, laughing, crying, walking, sitting, dressing, undressing…HURTS! NOW WOULD YOU GD GET THE DOCTOR IN HERE SO WE CAN GET ON WITH THIS!

“What’s your pain level?” In some way, I think she heard me. 

“Well, if I sit completely still like a statue and don’t breathe it’s like a 6? But if I move…starts at an 8 and has moments much higher than that…like eye watering.”

Finally, she left and the doctor who must have been sitting right outside the door entered.

The man with athletic frame, in his late 30’s early 40’s entered. His bouncy step and enthusiastic interest suggested it had been a slow day and he was eager to have a purpose.

“Ok walk me through it. What happened?”

“I fell in the kitchen. On the way down, I grabbed at the sink with my elbow…that exposed underneath my arm. I spun and slammed my side into the edge of the counter and landed on my back…”

It was funny watching his reenactment. He looked like a big time wrestler flailing, rebounding off the ropes.

“So then what happened?”

“Well…it hurt so I lay there.”

“Did you lose consciousness? Hit your head?”

“No, no. definitely not.”

He began pushing on the back of my head, neck, down spine, upper back…

Hey nope, I’m doin pretty good. Alright, false alarm!

He traced the fifth rib around to the front. Right around the armpit I let out a cry of a roaring elephant. I must have given a look just as bad. The doc said, “Ok ok…won’t do that anymore…Let’s get you x-rayed. I found it.”

Anywhere else, I decided, what just happened in here was assault! 

A common problem of an incomplete spinal cord injury is that the brain has trouble regulating the pain signals from below the level of the injury. My injury is in my neck so as the result of the gentle probe of my rib all the muscles in my torso clenched into a tight spasm. 

This is how I arrived in the x-ray room. A bright smiley technician, a middle aged woman in sea green scrubs greeted me at the door. She looked like the type who keeps regular salon appointments and always shows up to work with just the amount of product in her curls to make them look freshly showered all day.

She had dark blonde shoulder length curly hair and pleasant voice.

“How are you today?”

Don’t talk to me.

“Can I get you some water?”  

What is it with these people and the water?

“No.”

I sat looking at the x-ray table feeling all the ways muscles hang on bones under the full pull of gravity. I imagined lying flat on the hardest surface on earth, an x-ray table, and offered what makes me a favorite wheelchair patient to a technician, “I can stand! I’m able to transfer myself!”

She did not look like she spent a lot of time in the weight room so I added the discourager “I can get down but right now don’t think I can get back up.”

“Oh no, that’s fine. I was going to have you stand if you could.”

I could and I would! 

The x-ray technician had very cold hands.

I completed an exhaustive number of positions and poses each to the instruction of “Now take a deep breath and hold it!”

I settled for how about I stand as still as I can and we see what you get?

Music to my ears, I completed the series of YMCA poses and she said, “Ok those came out great!”

Pretty soon she was holding up what Jockey calls a “bralette”…what I would technically call my bra.

I was gritting my teeth contemplating how I was going to raise an arm to get it back on…it’s not a back strapper with hooks n clasps, just slips right on overhead…She held it at arms length, truly perplexed by a thin shoulder strap, and watched as it dangled n twisted showing all sides…She asked, “Is this the front or the back?”

I don’t care who you are, how you identify…never a good feeling. Something should distinguish your front from the back…worse, I had to answer her question… “I don’t know. I do know I see lettering so you have it inside out.” With very cold hands, she help me put it back on. 

As Grandma could tell you, there’s really nothing to be done for a broken rib. Even TLC isn’t always advised. We were not allowed to hug Grandma on our holiday visit. I was very disappointed at the time but now know the sudden impact of a kid torpedo to the chest could’ve been fatal. 

After a bathroom break, I wheeled down the hall and was surprised to hear the doctor with athletic frame call out…

“Congratulations come here let me show you, you have a fracture in your rib!”

Thankfully for his HIPPA cred it was a slow day with no one else in the nurses station. He pulled up an image on a desk monitor and used a pen as a pointer while the x-ray technician did her best Vanna White alongside. “See the disconnect this is what we look for right along rib five.”

I looked closely at my ghostly insides at a small dark spot that could’ve been a bug or grease stain about the size of a dime at the end of his mark. I leaned close but couldn’t see whatever the excitement but felt the explanation…

“It’s what’s called a pivot fracture.” He clasped his hands and folded them like the roof of an A frame house. “In a pivot fracture, the bone doesn’t float around loose, it snaps and bows like a twig. Inside the break there are some jagged edges…nerves run along the rib and rub against them…he demonstrated sliding interlaced fingers back n forth like a cheese grater…”the worst of the pain is typically for the first two weeks until a big sac of connective tissue forms over them.” He clasped hand squeezing over fist “holding them together so they can start moving as one…”

I think I blacked out. “Ok then…what do I do for it?”  

“Well, it’s going to hurt when you do these types of movements…” He lifted arms wide and high “or these I would try to avoid…” He said dropping elbows into short thrusting motions.

You’ve just basically shown me how to push a wheelchair.

The puzzled look on my face registered and he said in sheepish recognition “Yeah but that’s going to be hard for you.”

“yeah.” 

The good news was once the goop sac formed the worst of it would be over. He added, “It’s typically two weeks but with your bone health…” He trailed off trying to soften as he again realized not the best news “it may be more like 4-6 weeks?”

“Like this!?!”

“Yeah, I know sorry.” He threw in “With the way you responded to the exam palpitations, I expect you might have fractured one or two more. It’s very common.”

Ok ok I’ve heard enough. This is what’s called piling it on.

“So is it just rest and manage the pain?”

“Yes, sorry, pretty much.”

I left with prescriptions I knew I would never fill…pain meds come with gut issues and a handout “Broken Rib: Care Instructions”

Your Care Instructions

…Even if it hurts, try to cough or take the deepest breath you can at least once every hour. This will get air deeply into your lungs. This may reduce your chance of getting pneumonia…Hold a pillow against your chest to make this less painful. 

That’s all you got? Well that just…just…sucks!

Today I can say I’m 90% recovered! After six weeks the physical pain was largely gone. I’m not so sure the emotional part.

I can admit I’m scared medicine doesn’t have all the answers…I know like many others…Grandma, individuals with SCI, vets with PTSD I live on a thin line of independence. I know I have an awareness I don’t want. As we grow old, as the body ages what was once life’s hard knocks, life’s road map, a history to share…if left untamed quickly becomes the race horse who snapped an ankle.

I know I am not saddled to fate.

I know anything that seems permanent is not permanent…like pain.

I rest in the reassurance there was a little easy chair that went with Grandma’s ottoman and she learned to use it. She rocked, she read, she slept…so deep she even had a little snore…and maybe had a dream for her grandchildren where there’s no toughing it out. Tonight I embrace the words of a spiritual friend–rest is a sacred act. 

Namaste. The end.