Dan and Hannah Hike with the Family Rawding on the San Ysidro Trail (2017) and Then… Part 6 of 6

Part 5 ended with the successful surgery to repair Hannah’s gashed upper and lower left leg.

While Hannah is in a hazy fog from the medication, Tony, our surgeon, returns to the operating room.  He mentions that he will implant a drain that will siphon off excess fluid from deep within her thigh while it is healing.  Then looking to me, he says, Would you like to empty it?

Under his guidance, I invert the plastic bulb and pour it into a plastic cup.  Then, he says to us, before you drain the plastic bulb, squeeze down the tube from near the leg to force the excess red liquid down to the bulb.  This will help prevent the bloody fluid in the tube from clotting.  Would you like to try it, he says to me?  Experiential learning at its finest.

I squeeze the red discharge down the tube, knowing that I will remember little back at the cottage if all he does is show me how to do it.  He wants Hannah to take it easy this Thursday, gentle walking Friday, and by Sunday she can do anything she feels up for.  Whoa.

There are no limits to what she can eat or drink.  We should change the bandages after 48 hours and empty the drain 2 to 3 times per day, measure the discharge, and note the color.  In time, the color should turn from red to yellow.

While Molly has arrived to take us back to the cottage, first Kasey, an Ed Tech, wants to give Hannah a lesson in using crutches.  Taking us to a quiet place in the hallway, he demonstrates lifting the injured leg back, stepping forward with the stronger leg, and moving the crutches one step forward.

After adjusting the crutches for Hannah’s height (they are ours to keep and she never uses them; we later donate them to the Montecito Fire Department), Hannah tries, wobbles and flops back into the wheelchair behind her.  She mentions that she sees two Kasey’s; at this point he gets that she needs to be wheeled out in a wheelchair to our waiting car.

At the cottage the evening after the trail gave way

Once back at the cottage with Owen and Max in bed, Molly, Tip, Hannah, and I talk about our day on the trail.  Famished, Hannah eats two big bowls of Trader Joe’s salads and the big half of a Los Arroyos chicken burrito.  She toasts her day with a glass of white wine.  Oh, that we all could celebrate so after such a day.

We all know how fortunate we are that Hannah is sitting with us six hours after the ground gave way beneath her feet.  That her leg is sutured and stapled, and not…  We just don’t go there.  To what end?  The subjunctive can be positive when it brings up good possibilities but not when it goes down Alice’s rabbit hole.

Aftermath

Within a day, Hannah and I are slow walking a half mile.  Two days after, we slow walk over a mile, three times a day.  Two weeks after we walk a mile at a normal pre-fall pace.

Three days after our hike to San Ysidro Falls

Three ibuprofen before bed for the first five nights are all the pain meds she takes.

Repeatedly we hear from the health care professionals, You are healing so well because you are in such good shape.

Tony our surgeon gives us his cell number and calls us at the cottage the day after Hannah’s surgery.

The drain comes out seven days later, the 25 staples are removed 13 days after.

After a month, she’s back on the pickleball courts at home in Maine!

 

So, we thank these angels in our lives:

Tip, for his rescue of Hannah off the cliffside.

Molly, for getting the EMTs in position once Hannah came off the mountain.

Zach and Dominique, American Medical Response EMTs, for diagnosing her wounds and safely delivering her to the ER at Santa Barbara Cottage Hospital.

The Ed Techs and Karen our RN at Santa Barbara Cottage Hospital who prepped and cared for her pre- and post-surgery.

Tony, our surgeon

Dr. Tony Anagnostou for his surgical skill, comforting bedside manner, follow-up calls, and accessibility.

Corky Thomson and Jane May of York Hospital who made Hannah’s appointment happen the very next morning back in York, after we landed in Boston from Los Angeles.

York Hospital’s Dr. Elizabeth Helmer and nurse Alicia for picking up the ball once we returned to Maine.

To conclude Hannah’s saga, Hannah and I reflect on the entire adventure.

Dan and Hannah Hike with the Family Rawding on the San Ysidro Trail (2017) and Then… Part 5 of 6

Part 4 ended with Hannah prepped for surgery in the ER at Santa Barbara Cottage Hospital.  Three hours before on the San Ysidro Trail in nearby Montecito, she fell 15’ into a 40’ ravine of jagged rocks when the trail gave way beneath her feet.  The two significant, deep left leg wounds are on the very same leg that she busted while water skiing five years ago.  Click here for the first of the three part series on Hannah fracturing her tibia while water skiing in 2012.

Tony our surgeon, another angel

In walks another angel on Hannah’s journey.  Dr. Anthony Anagnostou introduces himself as Tony, her surgeon.  As he looks around the wound, he is calm, professional, and encouraging.  After getting the details from Hannah of the accident, he says, This is a deep cut.  It must be thoroughly irrigated to reduce the risk of infection.  I will place needles of medication around the wound in your thigh.  The anesthesia will take about ten minutes to kick in.  This is a serious cut, but it is something I have seen before and it is routine.

With those words (it is routine), I feel elation and relief knowing that this isn’t his first rodeo and Hannah is going to be okay.

Tony irrigating the wound

Explaining that he will first repair the deepest tissues near her thigh bone, then sew the middle layer of tissue and finally the outer layer.  There will be staples to keep it all altogether until they are removed in 10 to 14 days.  Amazingly, no muscles have been ripped, no tendons torn nor bones broken.

Three two-quart bottles of saline cleanse the wounds.  Hannah and I both feel she has been most fortunate that her capri pants weren’t torn away by the slide over the sharp rocks when she fell.   In fact, the upper part of her capris never ripped.  How could they not tear at all when she had such a deep wound?  They kept more dirt and grit from infecting the wound.

One Ed Tech squirts the solution from the first bottle while another siphons out the bloody liquid, like dental hygienists do as they clean your teeth.

At this point, Tony comes in to irrigate the wound with the final two bottles.  Always looking to his expression for signs of good news, I see a dedicated professional going about his business.  Later, he is referred to as an Ivy Leaguer who wants to save the world; he’s going to Africa.  That is music to my ears that we have such a man.

Now that the medication has kicked in, Tony goes to work.  Karen and the Ed Techs all watch the deep tissue work, something I cannot see, or even want to see, sitting opposite where Tony is operating.

When he needs assistance, he is professionally polite, and appreciative of their support.  As he works calmly and intently, Tony pulls out his smart phone to take pictures of the wound and the stages of his care.  Later, he mentions that the wound on her thigh was so deep that he could put his hand in up to his wrist.  He says he will send the pictures of Hannah’s wound for us to see, if she wants.  (Two weeks later, Hannah sees them, but I am still not ready to look at them.)  Though Hannah will have scars from the surgery, Tony wants Hannah to know how fortunate she is with just scars.  Hannah knows!

Hannah, eyes closed, face turned my way, feels nothing.  She is on major painkillers that will keep her in a fog till she gets to bed tonight.  Only later do we count the 8 staples in her lower leg wound and the 17 staples to close the thigh wound.

Soon an orderly comes in and says that there is a need for examination room 4.  Tony turns matter of factly and responds that he’ll be done in five minutes.  That works for everyone and pleases me no end that he is almost done 40 minutes after he began.

Tony our surgeon and RN Karen wrap first her lower leg, then upper leg in gauze; they then put a compression bandage over each section.  She is good to go.  That said, when she looks at me, she says, You have three noses.

 

Cleveland Clinic’s attention to the patient

This six-minute video from the Cleveland Clinic captures the importance of encouraging words when doctors are dealing with patients.  Tony our surgeon could have starred in this video.

 

Dan and Hannah Hike with the Family Rawding on the San Ysidro Trail (2017) and Then… Part 4 of 6

(Part 3 ended with Hannah strapped onto the ambulance gurney on her way to the ER of Santa Barbara Cottage Hospital.)

With eight miles to go to the county’s trauma hospital, I sit up front with Dominique, an EMT for six months, while Hannah is in the back with Zach, the more experienced EMT.  And Zach does what good EMTs do, he lifts Hannah’s spirits by keeping up the conversation by providing information and asking her questions – all to keep her mind off the subjunctive – the what ifs, the might have beens.

While Dominque drives through Montecito and then on The 101 for the hospital, I notice there are no lights and sirens.  Wondering to her if that is a good sign, I see Dominique smile and nod that it is.

Once within ten minutes, Zach calls in our ETA to the hospital ER; it is not lost on me that it is a call I couldn’t have made if I were driving Hannah to the hospital myself.

ER entrance on the right

Arriving at Santa Barbara Cottage Hospital in the downtown of this city of 90,000, we have still another advantage since I didn’t drive Hannah to the ER – we bypass the waiting room as they whisk us through the dedicated ambulance entrance, directly into an operating room of the ER.  I hear that room 4 is ready, and within 60 seconds the Ed Techs are lifting Hannah off the gurney and onto the operating table.

RN Karen (far right) prepping Hannah for surgery as the Ed Techs look on

Karen, an RN, takes charge with assurance and warmth.  Soon, she puts a clip on Hannah’s finger to measure her oxygen level.  An IV is inserted for the pain medication.  A nasal cannula breathing tube is put in her nose to deliver supplemental oxygen.  Throughout this time as I sit next to the operating table, Hannah is alert and turns my way to remind me how fortunate she feels.

Throughout the 1.5 mile hike out of the woods after the trail gave way beneath her feet, Hannah has mentioned how lucky it was that it was she and not our grandsons or their mom and dad.  She tears up with that realization.  The subjunctive, when it goes down to the dark place of what ifs, what might have beens, can cloud judgment and focus on regrets rather than the beautiful present.  Karen and the Ed Techs can’t believe she is not in any pain since they now have all seen the wound that goes to the bone in her upper thigh.   This is the same leg that she fractured her tibia five years ago when water skiing.

Karen asks about medications, allergies, blood thinners or diabetes.  Hannah’s answers are none, none, no, and no.  Coincidentally, they describe Hannah as the patient-of-the-year, just as the EMTs had, because, despite the large wounds, her disposition remains sunny.

Dr. Richmond, head of the ER, examines Hannah’s wounds

Dr. Richmond, the head doc of the ER, comes in upbeat and talks to Hannah as he examines both the deep calf and the deeper thigh wounds.  Turns out he had been hiking on the very same San Ysidro Trail that we were this morning.  Looking for clues, I see no distress in his voice or worry lines on his face.  It seems Hannah’s upcoming surgery is not crisis surgery; and for that I am again grateful.

We don’t know who, but another angel is about to come upon the scene.

Phuc Tran on the TED stage

With my use of the term subjunctive, you would be correct if you had guessed that I had recently listened to a TED Radio Hour podcast on the subject.  Here is the thought- provoking Dark Side of the Subjunctive by Phuc Tran, a resident of Portland, Maine (15 minutes).