Wednesday, March 7, 2018

The Big Fall

The fall happened in a flash.  Rising took many weeks. 

Getting off the M79 bus at 1st Ave. on Sunday, 12 November, around 5:00, I took a fall. The bus was a bit away from the curb, not far enough where the pavement was flatter, but closer where the pavement sloped down sharply.  In retrospect I realize that my mind was undecided whether to reach for the curb or step down to the pavement. 

I fell on my butt, hit my head on the huge tire and my right elbow on the pavement. A woman tried to help me get up, then two men held my arms and brought me up to the sidewalk; but the pavement was bumpy there and I jolted backwards and fell backwards again,  The two men brought me on my feet again. The bus driver, a woman, came down and stood with concern.  In the meantime, a young woman called 911, I was given a massive binding to keep the elbow straight and delivered me home at my request. 

The pain in the elbow was tolerable, and there were spots of sharp pains behind the midriff. I had a dinner invitation that evening, and I took a cab to get there, enjoyed the dinner, and took a cab home. Next morning, Monday, I slept until 12:00 noon, hoping I'd be better. The pain increased; I called my doctor for an appointment; I later found that she could't get in touch with me as she didn't have my new number which I had changed a few weeks earlier to evade hackers and hadn’t had time to alert everyone. 

Tuesday, again, I slept until 12:00 noon.  The pain was unbearable; I managed to have for my breakfast two slices of challah and English Breakfast Tea.  I then called 911, and the ambulance took me to Lenox Hill Hospital Emergency, four city blocks away.  I was there from 12:30 to 6:30 and was thoroughly examined. There were cracks in some ribs, and a fracture in the right elbow, at the start of the ulna, and this called for a surgery to recover the proper movement of the arm. I rode a cab home, with a massive splint and binding; my right arm and hand were literally black and blue and swollen. 

Wednesday morning, I got up early for the appointment with the surgeon, who arranged the surgery for Monday, and later that afternoon, I went to my primary physician for the EKG (a good result) and her approval of the surgery.  I had a friend, whom I christened Clark Kent, to accompany me on these trips on foot, four city blocks to my surgeon and ten blocks to my physician. 

Thursday I spent another day of pain and drowsiness in turn. the latter from the medication -- Percocet (Osycodone/Acetamnophen) and Cipro (Ciprofloxacin).  I discovered how incredibly hard it was to work with my weaker left hand alone, the right arm in cumbersome sling, to do simple routine actions we take for granted, like washing, dressing, eating, carrying things, writing, etc.  One of the most challenging tasks was getting out of the bed to stand on my feet. Friday, late in the day, I expected a call from the surgeon's office, for the exact time of the operation, and I did. It was to be Monday at 6:30 a.m. The hospital is only four city blocks away; Clark Kent accompanied me again. I  continued to be either severely in pain or else, under medication, drowsy and groggy.  For the surgery I was on total anesthesia and when I woke up in the recovery room, I had no memory whatsoever of the actual surgery as though I had a deep sleep for two hours. 
A week after the surgery, on 28 November, I had the first post-surgery consultation with the surgeon; 20-odd staples came off the elbow but i was to keep the splint and sling for another week.  The surgeon instructed me to stop Percocet and Cipro; I was glad about it but suffered detoxication — increased pain and what I judged to be withdrawal symptoms. After that I was instructed to take Tylenol but that gave me a bad effect, and stopped. I was actually willing to suffer pain than suffer medication. But my physician then prescribed Tramadol, an opioid analgesic, which I had for two days. In the meantime I developed a bad case of edema in the ankles and up the legs, and concomitant with it incontinence, both I attributed to the lack of exercise being homebound day after day.   On 5 December I had the second consultation with my surgeon; the splint and the sling both came off, and I felt liberated though the use of the right arm remained very limited. 

In pain I reflected how fortunate I was that I did not injure my hip and legs, nor my head, neck, and shoulders, all intact and good.  I also gained a keen awareness of the body, its vulnerability but also its capacity for resistance.  I was fortunate, too, that a friend in Boston was a nurse when she was younger, and she contacted me everyday, morning and evening, on the progress of my recovery with advises.  During my worst weeks from November to December, may of my friends in the city visited me in turn to give me material and spiritual support. They brought me food, did housework I was unable to do, and ran errands for me. I was deeply moved by their kindness and generosity. 

I was far off the mark assuming I would be well enough by mid-December. On the contrary, I found myself at the nadir of my recovery process.  I was very weak. Six weeks of confinement in the small apartment took its toll.  My body suffered severely from atrophy, and the inordinate frigid days this winter made the situation  worse. The room was inadequately heated through November and I was freezing day and night; I wore a knit spring coat indoors.  It sometimes took me an hour or more to fall asleep after tucking in, and I often slept badly.  On 10 December, a friend thoughtfully brought me her room heater; placing it near the bed helped me sleep better.  In mid-December I got myself various amenities: a room heater of my own like the borrowed model, a little humidifier as I thought the heater made the room too dry, then four-prong walking cane to serve as a safety measure when I had to go out for medical appointments.  I also got a body thermometer that I did not have in the house for decades as I had no need for it.  Starting on 18 November, a friend in Boston, who used to be a nurse, called me daily, morning and evening, on the progress of my condition and gave me advises of all kinds.  Following one of her instructions, I paced the hallway some 300 steps a few times but didn’t keep up.  I missed all the nightly shows for which I had advance tickets, most regrettably Ariane Mnouchkine’s A Room in India at Park Avenue Armory.  I hired a young woman starting on 3 December to help me with housework, changing the sheets, doing the laundry, washing the floor, and hauling heavy objects.   On 15 December a friend who loaned me her room heater made a Christmas wreath to cheer me up and hang it up.  Her picture of me with Vif my cat shows me emaciated, looking  like a ghost. 


In mid-December I also resumed writing my journals that had been neglected for a whole month, starting with the 13 December entry. Toward Christmas improvement became visible.  I had a Jewish Christmas with a friend, who came to fetch me in a cab and joined his parents in Chinatown; it was delightful but a bit strenuous.  The next day I started my first Physical Therapy at E84th St. near 2nd Ave.; it required a 10-block walk each way but I justified it as a good exercise for my edema turning into lymphedema.  I spent the New Year’s Eve at a dinner to which a friend invited me; her sister escorted me by Uber both ways. 

            Sempre adagio
            Largo o lento talvolta
           Andante ancora no

I had a hope that January will be better than December.  The weather improved, at least occasionally.  I was able to go out and walk without anyone accompanying me. On 10 January, I dared to go to the dance concert at Joyce Theater all by myself, the first outing in two months.  Sitting in the theater, I felt like a fish back in water, totally myself.  I continued to go out nearly every night after that.  A friend visiting photographed me on 20 January, and I looked healthy enough though my movements were still slow.

The day to remember, however, was 11 January. For two months I avoided the bath and shower from the fear of the risk of another fall, as I know too many instances of a fall in the tub.  But I could no longer hold myself and early in the afternoon I had a hot soaking bath in the tub; after weeks of nothing but sponge bath, it felt heavenly.  That evening.I also showered.  I discovered that with the body warmed by the shower, I was able to fall asleep quickly, and had a restful night’s sleep though I awoke a few times during the course of the night.  Physical therapy continued three days each week, and the exercises helped strengthen my right arm.  On 25 January, I bought a 36” grab bar and had it installed on the wall adjoining the bath tub.  Another triumphant breakthrough came on 29 January, when I could finally wash my face with both my hands, the normal way, even though with some strain. I felt triumphant, just in time for my birthday, 30 January.  By then I was walking more briskly. 

Andante non più
Cammino fuori ora
Sempre allegro 

Physical Therapy continued through February.  The very last session, the 24th, came in fact on 28 February; I was given a set of exercises to continue at home, possibly for the next four months.  On 6 March I went into my surgeon’s office for a consultation and was told the same.  My arm stretches well enough but still incapable of turning adequately for full flexibility.  Now, there is the lymphedema to care for.  The echocardiogram done on 2 March was boring; so, my heart is strong, and my blood pressure was auspicious 120/60.  By mid-March, a series of tests proved that my kidneys were also healthy, and I had no blood clots in my legs.

These months of recovery process taught me great deal about my body, its strength as well as its fragility.  It also made me realize that accident, though obvious, occurs from lack of attention.  That day, 12 November, I spent the afternoon at the National Jazz Museum in Harlem where David Durrah performed; on the way back, somehow, I was a bit off balance.  Had I remembered it, I might have walked to the front to exit where the bus kneels for easier descent.  In my condition of atrophied body, I also thought that while the nightly outing certainly enriched my cultural life, the hidden but real benefit was the walk it required; it was a perfect daily exercise, and it kept my body in good shape. 


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