Depression Marathon Blog

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Diagnosed with depression 19 years ago, I lost the life I once knew, but in the process re-created a better me. I am alive and functional today because of my dog, my treatment team, my sobriety, and my willingness to re-create myself within the confines of this illness. I hate the illness, but I'm grateful for the person I've become and the opportunities I've seized because of it. I hope writing a depression blog will reduce stigma and improve the understanding and treatment of people with mental illness. All original content copyright to me: etta. Enjoy your visit!

Tuesday, January 28, 2020

Post-op ER

After sitting together for more than 10 hours, my friend Wendy finally felt okay to depart. On her way out the door she wryly smiled and said, "This could only happen to you." I laughed and said, "I know." After 10 hours we could find some humor in my situation. It wasn't so funny earlier. Thirteen hours after I checked in to the ER Friday afternoon, I got home. It was 5:20 AM Saturday morning.

My right hip surgery went "perfectly," according to my surgeon. He did a lot of bony work, constructed a new labrum out of a cadaver tendon, and sewed it neatly into its new home in my hip. I was discharged from the surgery center before noon and arrived home around 1:15 PM Friday.

My brother helped me set up a few things prior to leaving for his home. I sat in my recliner to ice my hip and rest. A few hours later I made the 15 foot walk from recliner to kitchen, got a bit to eat, opened my computer and sat down in the very spot in which I am currently planted. It was 4:15 PM. All was well.

Well...maybe not well. Within a few minutes of sitting down my right leg began to feel odd. My right groin, where much of my surgical pain was located, felt tight and full. I tried to adjust my right leg and shockingly discovered I couldn't lift my right foot off the floor! With panic setting in I tried again and again to move my foot. Nothing. I had lost all ability to dorsiflex (pull my foot up toward the ceiling, as you do when walking on your heels) my right foot. As a PT I knew this could be a medical emergency. I could be having a stroke!

Numbness began setting in to portions of my right leg as I made my way to the bathroom to check my face. I looked for telltale signs of a stroke but fortunately found none. I did a quick scan of the rest of my body. Again, fortunately, my symptoms seemed to be confined to my right leg.

Foot drop is typically caused by neurological impairment--stroke and nerve impingement most commonly. But I didn't appear to be having a stroke. I also had no pain so a lumbar disc protrusion was most unlikely. I know what a disc exploding feels like. In fact, I still have a bit of foot drop on my left side as a result of my disc extrusion in 2017. This was not that. Nothing hurt.

I called the surgical service, left a message, and then called a friend to take me to the emergency room. The surgeon's PA phoned as I was en route to the ER. His comment, which I will never forget, was, "In over 6000 hip procedures, we've never had anything like this happen. Keep going to the ER."

I could write a whole book on my frustration with Mayo Clinic's emergency room, but I don't think I have the energy to relive it even 4 days later, so here are the low-lights.

*When I arrived the entire waiting room was full and there were 3-4 people at the check-in desk complaining about how they had been waiting for 6+ hours.
*Despite my protestations that this could be a serious emergency, that my nerve could die if compressed too long, the staff could only apologize and send me back to the waiting room.
*I waited with my friend Wendy for 7 hours, as my symptoms worsened, before I got called back to a treatment room.
*It took 8 hours to actually see an MD.
*The MD was good and did put in a neurological consult.
*The ER was too full, they said, so they moved me from my treatment room to an "observation area" in the bowels of the ER. I agreed to the move, but later discovered this dark corner of the ER where there was one nurse sitting at a computer, where I wasn't checked on unless I initiated the contact, and where I had no access to a call light is exactly where they place "behavioral health" patients to live, sometimes for days, when there are no psychiatric beds available. Coincidence? I'll never know.
*The neurologist, who remarked he had "never treated anyone back here before," was excellent. He listened to me, performed a complete and thorough neurological exam (where we discovered I could now move my foot a bit), talked to me like a professional, discussed several possible causes of this weird set of symptoms, and ordered an MRI. It was just before 2:00 AM.
*I laid alone in that room in silence for another hour before I dragged myself out of the bed to inquire. The nurse knew nothing about an MRI, and in the next breath informed me they don't perform MRIs overnight in the ER. She said I'd have to stay there overnight in order to have an MRI "ordered" in the morning.
*After I protested, a CT scan with contrast dye was ordered. I got a CT at 3:00 AM. By the time of the CT I had been lying flat on my back for approximately 4 hours and my symptoms were thankfully, though still inexplicably, resolving.
*The neurologist returned at 4:00 AM to tell me the CT didn't show anything but the most likely cause was, as we had discussed earlier, a bleed or blood clot compressing my femoral and/or common peroneal nerves in the groin area based on the distribution of numbness and weakness. He recommended a neurology follow-up for MRI and EMG studies. I thanked him. He was so good.
*I was discharged around 4:30 AM, exhausted and in pain, 12 hours and 15 minutes after I had arrived.

When I left the ER, thankfully my symptoms had pretty much resolved. I could dorsiflex my right ankle and the numbness from my buttocks to my toes was almost gone. I waited 30 minutes for a cab prior to the 10 minute drive home. I got home at 5:20 AM.

Interestingly, during that 10 minute drive my right leg symptoms began to return. Sitting, it appeared, was not a doable position. The explanation of something compressing the nerves in my groin made even more sense in light of this new evidence.

Things have gradually been improving. This is the first day I've been able to sit here at my computer without my leg getting numb. Mayo has not called yet to set up the neurology follow-up (shocking!), but I'm hopeful I won't need the appointment after all. My groin area still feels full. My leg still feels different if I sit for a long period (like right now), but overall I'm doing well. I know things could have turned out much, much worse. I'm so grateful they didn't.

1 comment:

Katy said...

Wow! I'm so glad that the symptoms started going away. The ER experience sounds terrible, and you are a medical professional. You know more than most about how to advocate for yourself. Terrible, terrible service. I'm so glad that it was not a stroke and does seem to be resolving.

I'm wishing you a speedy recovery!