When it Happens to You

It is Day 5 after the surgery, my father is recovering well but still trying to adjust to the pain. It was an unfortunate accident. However, I am glad that my father was not faced with a life threatening situation. Although, he could have been.

I knew one day I have to face a situation like this; with my parents being far away, and them getting older and more vulnerable as the years go by. When I received a text message from my mum, I immediately called home with tears in my eyes. I tried to be strong, but couldn’t hold back those tears of sadness … why did this have to happen to my father? I was overwhelmed with emotion, and did not sound my best when I spoke to my father on the phone. At the time, he was already in the hospital. I regretted not trying to sound more positive to give him encouragement. I consulted with my husband, and he said that I should return home. It was difficult to communicate with my mum to try and figure out what the status quo is. Her texts are not well put together with so much information at hand, and she was not allowed to use the phone at certain areas of the hospital. I know she was busy, flustered, and worried. In half a day’s time, I searched for flight tickets, finished up some errands at home, and packed. I was on the plane home the day after I heard about the news. It takes 24 hours (flying time) to reach home, and so with crossing the time zone change, I arrived two days later.

My father fell from an 8 feet ladder. He was changing a light bulb at the patio area of the house. His mistake was attempting to stand with two feet at the very top of the ladder. And not having someone to hold the ladder while he climbed it. Additionally, the ladder was super crappy, most definitely not to safety code. The funny thing was he had already changed the first light bulb and already he felt wobbly. Somehow he assured himself that he could do the second light bulb with no problem. The first rule of safety – never think that it won’t happen to you.

When I landed in Kuala Lumpur, I took a cab to the hospital immediately. Believe it or not, I haven’t been home yet. My mum and I have been staying with my dad at the ward. I had learned that my father was brought to the hospital by my mother. I was thinking to myself, how did she manage to get him there by herself? With a serious fracture like that, she should have called an ambulance, am I right? Although, my mum had her reasoning. The ambulance wouldn’t have made it from the hospital with the heavy traffic on the highway at that hour, but if she drove to the hospital on the opposite direction, she could make it there faster. The first thing she did, after hearing my father’s painful screams from the kitchen, was to ask him if he could move and get up by himself. My father was able to stand up by himself but when he tried to walk, it was very painful. Instinctively, my mother brought the dining chair out to let him sit. Once he sat down, my mother quickly brought some bread and drinks out for him to eat. According to my mother, traditional Chinese methods say it is important to get the person to get up by themselves immediately after the accident. Also, if he eats something and vomits, the victim’s condition is very severe. Modern day first aid practice is the opposite, whereby the victim should not be moved and advises the surrounding people to call for help and ambulance. Perhaps, in North America the emergency system is way better than in Asia. Since my father was not able to walk on his own, my mum pushed him using the dining chair all the way to the car. My father said the most excruciating pain was when he had to lift his injured leg into the car. When they arrived at the hospital, the emergency paramedics took over and brought him in.

He was checked in to the CCU ward initially. The orthopedic surgeon wanted to do surgery immediately, but seeing how pale my father looked and the blood pressure count was low he decided to defer it. They also suspected my father had a cardiac arrest which resulted in the accident. My father was in shock after the incident. He felt better the next day, and was transferred to a regular ward while deciding on the next solution for the fracture. The X-ray results showed a fracture at the hip bone (pelvic area) and elbow. Somehow, my mum wasn’t all that confident in the results, and was considering whether or not to get a second opinion. The complication with a second opinion is that he would have to discharge out of the hospital and head into another hospital. Then, the doctor said my dad will need to do a CT (X-ray computed tomography) scan to get a clearer 3D picture of the fracture. Apparently, medical doctors do not like it when you want to seek second opinions? The CT scan gave us, and perhaps the doctor too, a better idea of the severity. The elbow fracture seemed to be a common fracture type. The hip bone fracture, was more complicated. His front and back, bottom part of the ilium bone as well as the acetabulum was fractured.

Yeah, I know. I had no clue what these terms meant. Moreover, my mum sneakily took some shots of the CT scan photos and Whatsapp them to me while I was still in Houston. My husband and I were clueless as to the indication of fracture, and what these bones were. There is a common misunderstanding of hip, hip bone, and pelvis fracture. My husband intelligently went to search for an iPhone app, “e-Anatomy”, to help us decipher what was going on. It’s a really cool app, showing lateral and vertical images of the complete 3D anatomy structure. You’ll have to pay to utilize the full functions which include information on the names, nerves, etc… Below are two snapshots of a lateral rotation of the hip bone.

“The acetabulum is a concave surface of the pelvis. The head of the femur meets with the pelvis at the acetabulum, forming the hip joint”

“The ilium is the uppermost and largest bone of the pelvis” … – Wikipedia

20120409-130700.jpg 20120409-130732.jpg

According to the doctor, my dad has a rare case. The fracture of the acetabulum is not common. Perhaps the impact of the femur bone hit the ground and broke the acetabulum. Surprisingly, my dad’s femur bone is ok. due to the fracture, the acetabulum is now not round in shape. Since my dad’s condition is stable and not life threatening, they wanted to wait for me to come home before going ahead with the surgery. The doctor allowed only a delay of 5 days, as any longer would cause more complications (bone starts to grow back). The doctor is a well-known spinal cord orthopedic specialist. We consulted the help of a friend who is a GP, and she said that as long as the doctor in charge is an orthopedic surgeon, it should be fine.

Eventually, the decision was to go ahead with the surgery, and my parents did not wait until I arrive to make that call. The doctor did mention an alternative solution, but the risk is higher since there is no way of knowing if the bone will heal back properly with just a traction cast. It will also be a more painful process, and will take a long time. The thought of going through a major surgery is always scary, and it is always important to consider alternatives.

The surgery took 6 hours. According to the doctor, there are seven nerves that go through the hip bone, and so the first three hours of surgery was solely identifying the nerves before installing the metal plates. My idea of a metal plate is rectangular, but this doctor suggested the latest technology, in which one of the plates is actually a series of rings connected together forming a flexible, flat chain.

The waiting period is tough, and I understand the frustration my father feels, especially when tangled with regret over what had happened. But what can we do? It is a slow and painful recovery process. At least, the surgery was successful. What is more confusing is all the different opinion about what you can or cannot eat, and what you should or shouldn’t do after surgery. The traditional Chinese have a lot of ancient knowledge on “non-toxic” food and herbal soups. For example, drinking soup stewed from snakehead fish is said to close and heal big incision wounds very nicely. More common practices can be avoiding all seafood, especially shrimp because they can create pus and slow the recovery of the wound. Chicken and egg also have the same adverse impact. Apparently, there is a difference between rooster and hen meat, the rooster’s meat being more toxic. Certain Chinese herbs should be avoided as well. Only Chinese herbs that are solely for replenishing the body’s energy can be used. Nevertheless, we are very thankful and grateful for the support from family members, who went the extra mile to bring food for my parents and I.

The Western medical world insist that the patient should start moving the day after surgery while the traditional Chinese believe that it should not be so fast. Both have their rationales, and I can understand the need to re-condition the muscles as soon as possible if the patient has been bed-ridden for many days. Well, today there is a lot of good progress. My father’s arm is recovering well – I gave him a pen and paper to write, and he was able to do so.

20120409-131008.jpgThis afternoon, he managed to get on the wheelchair, and sat on it for about 45 minutes. His right arm is still weak, and unable to support his body weight to move himself onto the wheelchair. I am confident with time and practice he will be able to do so. This whole experience has given me greater insight into the medical working environment. I have a greater sense of respect for nurses now after seeing what they have to go through with my father. Nursing, is definitely not an easy career. Even the surgeon himself … I can’t imagine how he does it. Every day (except Sundays) he does anywhere from 4-7 surgeries. That’s insane working hours, must be mentally and physically exhausting! In a way, most job occupations are about solving problems. In the medical world, a doctor’s role is to solve a human body’s problem, returning it to a safe state. Just that the human body is perhaps the most complicated system. Amazing.

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