Comfort Care in the Age of Opioid Abuse (Or “What Happened in the ER the Day I Broke My Face”)

Sometimes, enduring a bad time is about pain reduction, not elimination.

So, Visitors, I have these two little dogs that we rescued about a year after Chris died. My children were bereft at the loss of their father to cancer, and at the beginning of Year Two, I decided that they needed something else to love. Enter Mia and Gigi, a bonded pair we rescued from the local shelter. For dog lovers, Mia is an Italian Greyhound, and Gigi is a dachsund/IG mix. She’s an odd-looking little thing, sort of like a dachshund on stilts.

      I have this routine where I clip their little retractable leads to the support columns on the outside deck for short periods of time before I start my day. Being nervous little things, they often get entangled around the posts and each others’ leads.  That morning I squatted to untangle the mess, and had a lead in each hand. Unbeknownst to me, I had left about a four-foot portion of the tiny, threadlike, nearly invisible lead strung up between two of the support posts, about three inches off the deck.

This makes for a very effective tripwire. Boom! Down I went like a felled tree, catching myself with my face. I lay there stunned, face down,  as a pool of blood collected beneath my head on the deck.

As awareness returned, I realized I was very badly injured as I hadn’t braced myself with my hands. I staggered upright, hazily trying to locate my phone, blood gushing everywhere. I found my phone, and called the nearest daughter for help. She dropped everything, and headed over. I then called the paramedics and bled a trail out to the front of the driveway where I waited for them to arrive.

Now, here’s where it gets interesting, Visitors. For those of you who don’t have a lot of experience with trauma or illness, I want to tell you there is a great deal of MENTAL activity that is influenced by the PHYSICAL past and present, and vice versa. What happened next is also pretty bloody and descriptive, so be warned.

Before I called for help, I blearily tried to assess the extent of the damage in the bathroom mirror. To my dismay, I could see the outline of my teeth through the split in my lip. Instantly, I was catapulted back to the day in October where I helped a young boy through an automobile trauma that involved a massive hand-sized piece of flesh that had been stripped from his exposed skull. (See “On the Short, Sweet Life of Liesl Wiebe” in the search bar above”. ) The tear in my lip was that deep, and the triggering flashback was completely paralyzing for several minutes. Classic PTSD response.

After that waned, the wash of pain that flooded over me was simply dizzying. I grabbed a hand towel to press to my face as I went outside to wait for the paramedics, weeping uncontrollably. I tried to control my breathing, knowing that if I tensed up and made the pain worse, I would likely lose consciousness and fall again.

One first responder  arrived in his own car, and through tears I got out what happened.

“I am so sorry this happened to you!” he said, as he proceeded with the exam.

“Me too!” I wailed.

The next set of paramedics arrived in an ambulance truck. I repeated the story through the bloody towel.

“Good grief,” said a burly one, who seemed in charge. “Well, your nose is likely broken, which is painful as hell, and that lip needs quite a few stitches.  I’m so sorry!”

“Thank you.” I said. I could feel a bit of mental clarity returning.

“What’s your pain number now, dear?” said another as he pressed my neck and spine.

“An eight.” I said, muffled through the  blood-soaked towel. “Unaided childbirth was a nine.”

“Ohhhhh, shit! ” he muttered.

I laughed just a little, wincing through streaming blood. I could feel my body unclench a  bit with that tiny bit of empathy, and a voice in my head assured me that this will end, I will feel better in the not-too-distant future. I was certain I was headed for a cascade of ‘the good drugs’ if I could just hold it together a little longer. Opioid Heaven, here I come.

The men gave my daughter detailed instructions for the ER, and informed her that since I didn’t lose consciousness, an ambulance ride wasn’t merited. I was happy enough to ride in with her, and was loaded into a wheelchair when we got to the ER.

When I got assigned to a room, a friendly nurse bustled in and performed his assessment.

“Well, that looks like shit and must hurt like the devil. I’m so sorry! Let me tell you about my aunt who got tangled up in HER dog’s lead and broke her hip!”

He compassionately related a similar story of injury, concluding with his aunt’s bouncing return to good health. I could feel myself relaxing a tiny bit more. This will end.

“So you think I’ll live? They can stitch me up soon, right?”

“We see stuff like this all the time, hon. These doctors are good.” I could breathe a little easier.

So I waited, and shortly a red-haired, competent PA came in and did his assessment.

“OK, here’s the plan. We get you stitched up and we will take several scans to look at your head and neck to make sure that’s OK”.

OK. So, what followed was pretty gruesome. He injected several doses of lidocaine into the wound, and I crushed my compassionate daughter’s fingers into a powder during that.  She chattered away and held my hand until the medicine took effect.  Then, he gave me two internal stitches for the inside of the lip, and six to stitch up the outside.

After that horrible procedure, I started to feel a little more like a human being again, instead of a walking mass of pain.

I then saw two sets of imaging technicians, one for CAT scans and one for X-Ray. Each had a compassionate story to tell that involved freakish accidents with pets. I smiled at each one, grateful for the diversion. I felt a little more at ease with each one.

Finally, six hours after the stitches were in place, I realized that the lidocaine was wearing off, and a big bass drum was beginning to play in my head.

“Nurse, may I please have some pain relief?  This is getting bad.”

“Of course.” He promptly scanned my bracelet and dispensed 500 mgs of naproxen, and over the counter anti inflammatory drug, and a single Norco, one of the slightly weaker opioids.

Oh my, I thought. This will be an experiment in trust. I didn’t think that was anywhere close to enough to mitigate the chaos starting in my head.

I downed the drugs, and in less than an hour the pain began to ebb. The capable nurse came in again, and gave me the wonderful news that incredibly, my nose wasn’t broken!

Visitors, what can I say. I like to cook, I like to eat. The prospect of not tasting my food for months until my broken nose was healed was depressing. This whole freakish episode threatened to plummet me into incredible depression. The news that my nose wasn’t broken was welcome indeed. Then my boyfriend arrived – code name, Stockholm- hugged me and held my hand some more. I relaxed a little more.

Eight hours after those whole interlude began, the PA came back to my room. My nose wasn’t broken, my neck and spine looked normal, and I had one upper lip again instead of two.

Oddly, I discovered that all of the compassion and kindness had helped. The single Norco and naproxen had reduced the pain from a shriek to a dull roar, and with so many people around determined to help me, I discovered that I could handle this mess with a minimal amount of chemical intervention. It’s almost as if people are good medicine.

Go figure.

American Visitors, I’m sure all of you know someone, or of someone, who has been touched by this opioid epidemic.

MY particular set of problems that day produced an amazing amount of excruciating pain. The gentle touch, the encouraging word, the capable presence of professionals and friends, all of these things helped to de-escalate the pain to a point where a minimal amount of pain-relieving medicine was necessary. Isn’t that interesting?

I can handle this, as a group of pop philosophers once said,”with a little help from my friends”, and much less help from the opioid bottle than I thought.

The takeaway from this terrible day? Get messy. Call your friends. Offer to help. Go to the hospital. Hold a hand. Use swear words, feel for your friends, be sorry for them, you just might influence a positive  outcome much more than you think.

Much love,

Victoria

 

 

Sabbatical in a Teacup: Day Thirteen. Angels Among Us – Introduction and First Presentation

• Good evening from the French Riveria, friends. We had a wonderful trip to the medieval town and gardens of Eze, and toured the Fragonard parfumerie beneath. I am working on some lovely pictures for your enjoyment, because we truly had a nice time, and including you folks makes me happy.

But, part of my ‘bucket list’ for Sabbatical in a Teacup was to fiish my National Novel Writing Month book, and it is done. What a relief!

Here’s a little background though, because I’m actually a terrible cheat and poseur. The goal for NaNoWriMo participants is to crank out a 50,000 word novel in the space of one single month.

I’ll let you in on  a little secret: Big goals scare the hell out of me. I cut it in half.

50,000 words is around 200 pages, or a normal novel. I figured if I could crank out 25,000 words in a comprehensible story, I’d be doing pretty well. So I did. A little more, actually, not quite 26,000. It’s about a hundred and fifteen pages.

So here’s a chapter. The premise is based on Psalm 91:11, the verse where God promises to “give his angels charge concerning you”, and the Skillet song I referred to in a post a few weeks ago. (Looking for Angels -Skillet, 2008, I think)

Now, since Chris died, angels have been a source of interest to me. I do believe they exist in the spiritual realm, heck, I think there’s a lot more going on in the spiritual realm then most people, even Christians, care to acknowledge.

But I also think that angels can manifest in a more concrete form, mainly you and me. This first chapter is lightweight, and actually happened. You have to get the visual here, to truly get the magnificence of the action. So read along, if you will, and picture with me.

Angel Babies

Baby Cuddler Wanted

 

Larissa was only nine months old. She had just mastered the ability to sit up, and was reaching nicely with her hands for objects. She cried when Mom left the room, and smiled and stretched out her arms when Mom or Dad  came back.Erica was only a month younger. Their mothers were friends, college buddies, even. They had been pregnant together, given each other baby showers, even took vacations together.

Now, their baby girls were in the same preschool together, sharing the same schedule, and the same nursery.I was their teacher, if you can call it that. I had spent nearly nineteen years in a pediatric oncology wing, and that was way more than most. Finally, I had had enough of watching the smallest victims of this terrible scourge of childhood cancer.

Infant development had always fascinated me though. So when the local preschool advertised a ‘Baby Cuddler Wanted,’ I jumped at the chance.I didn’t need the money. Larry and I had plenty of pension cash every month, but I was beginning to get a little bored. But gonzo twelve hour shifts as a charge nurse? I think not.

Today was an easy day, and I sat both of the girls down in the fine motor play area. It was soft, lined with pillows, special seats to hold developing infants, and baskets of toys appropriate for little hands to dig through.

The “Bumbo” seat was a special, molded chair for infants like Erica. Shaped roughly like an inverted bowl, the idea was to sit the infant in a deep, pliable well, to support the developing stabilizer muscles. This left the hands free for reaching and grasping.

I sat Erica in the Bumbo, and placed Larissa a short distance away. A large part of my job with these children was watching. I used my professional eye to document these kids’ activities during the day, and gleaned a lot simply by watching how these children interacted with each other.

Erica started to cry. Larissa turned her head and noticed. Larissa looked at me, as if to ask “Aren’t you going to do anything about this state of affairs?”

I smiled encouragingly at Larissa. Aha! The green giraffe!

Erica loved that stuffed green giraffe. She loved to sleep with it, wave it around, gnaw on it, and now, couldn’t quite reach it.

She strained from her Bumbo seat. Strained and strained, but couldn’t quite figure out how to tilt her torso just a little bit to give herself the extra bit of reach.

Larissa watched this with interest. She rolled over to her side, and using her newly learned crawl, started to crawl over to Erica. Slowly, slowly, she inched her way over to her friend.

I leaned over to pick up  the green giraffe and give it to Erica, but something stopped me. Just wait a minute.

Larissa continued her determined crawl as Erica’s crying escalated.

Just give her the giraffe, part of me said. She can’t reach it yet!

Larissa finally reached the giraffe. Laboriously, as if telling every part of her tiny body what to do, she sat up next to the toy. Carefully, she picked up the green giraffe with both hands. Erica got even more angry. Larissa had her precious toy!

Larissa got a good grip on the neck of the stuffed animal, and very deliberately, handed it to Erica.

Erica’s cries stopped as if by a switch. Here eyes widened and she smiled at Larissa, and made happy cooing sounds. She grabbed the prized giraffe, and stuffed it in her mouth.

Larissa smiled next to her friend, and put her hand on the seat, as if satisfied. Mission accomplished.

(PS, My devoted readers, please don’t send me any Bumbo recall notices. I know, and I use them on the floor, and only around pillows, and with the strap. It’s all good. ) 

So there we are. Part of a series of loosely woven episodes. Mostly true, some explainable, like this one, some not so much.

Thanks SO much for getting to the bottom of this. Do me a favor then, if you liked the writing of this, would you hit the “like” button? I’d like to know what you think.  Authors can never tell if their own work is dreck, or pretty interesting. Thanks!

Look forward to hearing from you.

Eze and Nice are next.

Much love,

Victoria

On Intimacy, Touch, and Dates From Hell

So it’s 3:32 am,  and I just put my eighth grader on a plane for the East Coast. I drove through a pounding snowstorm to get to her school, and the possibilities for maudlin analogy are endless.

“Launching the kids”

“Unspooling the kite line”

“Letting loose and letting go”

And on and on. She’s going with her classmates at the local Christian school to see Washington. She danced around with her friends, and I waited in the car to see what would happen next.

Eventually, I hugged her goodbye, and they piled into the buses. The snow kept falling, and I tried to drive home. She’s launching, and I have to let go.  It’s a beautiful thing, and actually does get easier with each child. Slightly.

Tears streamed down my face as I got lost, and missed my daughter.  I am hopeless without Mapquest or a GPS. I found myself on the boulevard of broken dreams, somewhere around Sixth and Wadsworth.

I drove past the dim light of the weed shops, and the grey ghosts of lackluster motels and pawnbrokers.

What would it be like, I wondered, to park the Lexus at the nearest bus station, get on, and  be driven into the unknown? Just me and my computer, an electronic Jack Kerouac, or Least Heat Moon. I didn’t pull over. I continued to drive looking for the equivalent of a twenty first century diner. Starbucks, anyone?

Eventually I found myself at Simms and Union, and pulled into a Denny’s. Astonishing, only  Denny’s is open at this hour. It looked friendly, or at least familiar. Familiar. I grabbed my computer and set up, and was thunderstuck. Of course, this is the Denny’s that my family and I gathered at when my mom died in January. I snapped my computer shut and left.

I drove around aimlessly for a while, thinking about the terrible date I had had several hours earlier. Dante wrote “Abandon All Hope, Ye Who Enter Here” on the inscription to the first gate of Hell. How appropriate.

Previous that day I had received  a friendly call from a man I had met at a Meetup. I had spent a morning with him on a hike, and thought I might like to get to know him better.  We agreed to meet at a local coffee shop that afternoon, and I still felt dirty that night.

I started to time him, which is rude, I realize. Funny, but rude. He talked for forty seven minutes before asking me a single question. When he started to talk about the kind of birth control he and his wife used, I got out of there in a hurry. What a hopeless, arid waste of time.

It got me to thinking about the lush greenness of  intimacy. I am built to respond to intimacy, personal connections with other human beings. I think most of us are.

The word “intimacy” is a tricky one, like “love”. Most people don’t use either one very well, and Christians often don’t bother to unveil what God wants for us with intimacy. Sexual intimacy is what most people think of when they use the word, and that makes me scratch my head in puzzlement.

³ Do nothing out of selfish ambition or vain conceit. Rather, in humility value others above yourselves, ⁴ not looking to your own interests but each of you to the interests of the others.

-The Apostle Paul’s letter to the Christians at Philippi, when he wants to encourage them to be humble, like Jesus was. (Phil 2:3-4) 

Am I the only one with intimate friends? Friends who will very often humbly set their own interests and needs aside in order to consider mine? I can’t be. Chris’s death has brought me many surprises, and the discovery of intimate friends is one of them.  What does that look like, anyway?

As we can see, God asks us not to do anything out of selfishness or conceit. Instead, to value, or consider, others as more important than ourselves. Not that the other person is more important, but we are to act is if they are.

When I left the date I was describing, the man surprised me with a blind grab toward intimacy. He locked me in powerful hug and kissed me on the cheek. Yuck. Doubly offensive, as I am toucher by nature. I hug my friends,  massage my tired children’s shoulders, give footie rubs to fellow dancers, and walk arm in arm. But don’t you dare touch me  romantically unless you have an inkling that I have given you permission to do so. I felt like taking a shower.

This man professed to be a Christian, and was a selfish jackass.  What a depressing, arid waste of time.

I got to thinking about intimacy in detail.  How intricately intimacy and touch are intertwined. My children tell me what is hidden in their innermost hearts when I am scratching their backs as they drowse off to sleep.

My mother gave me some of her most precious memories when I massaged her sore feet before she died.

My coaches have evolved to be some of my most intimate friends as well. If you think about it, it  only makes sense. Brook, one of my first dance coaches, was a deeply caring, concerned man. I started with  him about six months after Chris died, and was in a very odd place. It was as if I was a burn victim, and simply couldn’t stand to be touched. Brook was a great intuitive, and a hard taskmaster.  I was determined to  heal, and one of the things I was going to reclaim was waltz. Those of you who have been with me for a while know that I love to waltz, and Chris and I were good. The first time I told Brook I wanted to waltz again, we made it about halfway across the floor before I soaked his shoulder with tears.

As you know, the ‘advanced embrace’ in ballroom connects the body centers, shoulders and hips, and is energetically drawn UP and TOGETHER. When you get good, the unity of purpose is energizing, and intimate. Partners joke around, ask about families, laugh, get irritable, and in my case, cry until wounds are washed away.  It’s really very safe, if you care even a little about each other.  Brook was the soul of patience, and the dialogue looked something like this:

Victoria: (weeping against Brook’s shoulder) I’m sorry, Brook.

Brook: It’s okay. Dance is like life, it can be hard. Do you need a tissue?

Victoria: Yes. Sorry about your shirt.

Brook: (chuckle) It’s ok. Let’s get back to work.

Brook never go of me, and nearly two years later, I waltz with joy.

Todd, my current dance coach,  often doubles as my therapist. I’ve long thought you can’t be twitchy about being touched if you want to be a better dancer, and the best coaches ignore those kind of boundaries completely.  Todd will adjust my spine, rotate my shoulders, tilt my chin, align my pelvis with my body core, all kind of things while talking a mile a minute.

It’s almost as if vulnerability is automatic, as someone that close to you physically will notice tension instantly. I had had a lesson with Todd a few days ago, and he noticed something wrong immediately.

Todd: (Warming waltz up with me to Seal’s “Kiss From a Rose” ) Victooooria, you’re all tense! What’s wrong?

Victoria: (Waltzing in tears)” I fought with someone I care about, Todd.” BOOM! Front and center. It’s hard to be guarded when someone is six inches from your face, and literally connected to your hip.

Intimacy is also a judgement call.  As a single woman, boy, is this difficult! When I was married, it grew easier and easier to read the man I loved as the years flowed by. Not that ours was an easy marriage, by any means, but I grew to be a student of Chris’s, and it got to be pretty easy to figure out what was on his heart.

I misjudged one of my new Meetup friends to be more concerned with me than he actually was, and he blew a cork. I treated him in a way that I treat the ‘top tier’ of my friends, those that I know, from the bottom of my heart, are concerned enough about me that boundaries of all sorts matter very little. I am concerned with them the same way.

Matthew and I are friends, but not for so long. A powerfully built man, he works an upside down schedule, and is often up at odd hours, like me. We have a lot to say, and can keep up.

Matt’s birthday is soon, and in my typical, take-no-prisoners, no negotiations allowed way, I thought about pulling a big, surprising birthday stunt to get a grin out of Matt. I did it surreptitiously, and Matthew got wind of it, and came at me with both guns blazing.

Suddenly I was a ‘plotter’, and a ‘schemer’ and an embarrassment to a new friend.

I was doing what came naturally to me, and trampling completely over what came naturally to someone else.

I related this to a handful of my intimate friends. As they love me, they used words like ‘over reactive’ to describe Matt. Perhaps.  But the few intimate friends also gently remonstrated me. He’s a man, Victoria, so by nature different than you. He’s allowed to be solitary, he’s allowed to be whatever he wants. Go and apologize.

^” Do nothing out of selfish ambition or vain conceit. Rather, in humility value others above yourselves, ⁴ not looking to your own interests but each of you to the interests of the others.”

Hmm. Some Christian I was. I apologized.

“If it is possible, as far as it depends on you, live at peace with everyone.” Paul’s letter to the Christians in Rome, Chapter twelve, verse eight.

I guess humility is a part of intimacy as well. Matthew did not humiliate me, and accepted my apology with grace.  He offered a humble apology for his own reactivity.

Whether Matthew and I will actually get to the point of being intimate friends remains to be seen. I couldn’t know this weak spot of his, but now that I do, I’ll protect it.  Perhaps he’ll protect me from my own impulsiveness. Or perhaps not.

As for me? What Jesus and my friends have taught me to do, I’ll do so for others.

We shall see.

Much love,

Victoria