Feb 23, 2014

Fractured Bones and a Doctor with an Attitude

I broke my big toe on a cutting board that had fallen from a pile of stuff. Please. Don't ask. Imagine whatever you'd like. 

That was in October 2013 and I quit going to the gym, and naturally, what I had gained gym-wise was depleting rapidly. In November, I went to rehab in Pittsburgh, where I was visiting my son, and the therapist phoned the rehab doctor, known as a physiatrist (I always love to say physiatrist because people always think, as a result of my  stroke,  I'm mispronouncing psychiatrist and they think I'm going to a shrink--sorry to disappoint), who said that 2 or 3 weeks in the rehab in-patient facility (rehab 4 to 5 hours every day of the week) might prove to be not such a bad thing. 

He was serious, and he said to come back Monday for a solution. I mean, I couldn't just check in to a hospital for rehab without his help, but ironically, something happened to make it so.

In December, still visiting Pittsburgh,
my cousin came to visit for a week. Do you know what the Ancients said about visits? Visits are like bad fish. Stay for more than 3 days and they'll both end up stinking. I don't know about that analogy, but her stay was hectic, with her 10 steps ahead wherever we went. I tried to pretend I could keep up with her--it made me feel normal--but it was pointless. She was always in a hurry, like she was having a race with her bucket list.

She left when the week was up, and I was invited to my son's house to chill out and have chicken soup with
non-gluten matzah balls. You'd think non-gluten matzoh balls would be a set up for a joke, but it's not.
Nothing is funny here, both before the non-gluten matzah balls or after. By the way, I couldn't tell the difference between non-gluten and gluten. All matzah balls taste the same. The thing that matters is the weight of the matzah balls. My ex-mother-in-law's matzah balls were like tiny bits of mortar, hard and dangerous if they were airborne, but I digress.

I traveled up my son's path with him right behind me. And then I caught my foot on the lip of the step and
I fell backward. Fortunately, my son was there to catch me, but not before I skinned my knee and my elbow, and telling my son, once again, that I was incapable of grace. I went into his house, had the soup, and went back to my apartment. 

Here's where the strange part comes in. In summary, I went into his house and an hour and a half later, walked back to the parked car that was across the street. I walked up the outside 4 steps to my apartment, up 4 steps again inside to get to the elevator, and down a long hallway--maybe a hundred feet--to enter the apartment. I went to the bathroom, brushed my teeth, and went to bed. I got up in the morning (here's it is--the mind-boggling part), went to the bathroom, and as I stood up, my stroke-affected leg collapsed like it was made of straw. Fortunately, I didn't hit my head as I careened into the bathtub.

So there I was, on the bathroom floor, but luckily, I had Life Alert. You know, "I've fallen and I can't get up" commercials? So I pressed the Life Alert button and shortly, two paramedics were standing in my bathroom doorway. The maintenance man let them in.

One paramedic said, as he helped me to my feet, "Your choice. You can go to the hospital or not. You're not hurt, as far as I can tell. But you never know."


I thought about it. My foot just collapsed. Was I tired from the hectic-cousin visit? Or maybe there was something else wrong. Or maybe it was the combination of both. If I was a betting gal, I'd go with the latter. And I didn't have an option.

So I took a ride in the ambulance and went to the closest hospital. They kept me overnight, what they called "observation mode." When they took an x-ray of my ankle and upwards, the orthopedic surgeon said that nothing was broken, but my foot ballooned to thrice its size, bright red, and swollen, and when the doctor pushed it, his fingerprint impressions remained.

"Maybe I broke my toe again. I mean, there has to be some reason that I walked on it yesterday and this morning, my foot collapsed," I intentionally whined.

The doctor said, "We'll x-ray you toes," in a snarly fashion, like he didn't like me telling him his business. 

"Too bad," I said to myself. Most doctors in the universe are like that, at least in my experience.

The x-ray happened a short while later, but at this point, I couldn't even put any pressure on my foot. The doctor came in with the results in a half hour.

"You fractured the second and third metatarsals." He looked down at the floor. He couldn't get over the fact that I was right. "We're going to transfer you to a different hospital that has more physical therapists than here," the snooty doctor said, who still had an attitude. He was sneering, or maybe that was my imagination.

So I went to a different hospital and just as the physiatrist said, I got rehab 7 days for around 30 hours a week. I stayed there for 3 weeks and then it was time to go back to the apartment. Even though I enjoyed the therapy, I had enough.

My fractures healed to the day the doctor predicted, 4 weeks later. And I was happy that I had instructed the doctor to do what made sense. Sometimes doctors and other health professionals don't listen to the patient, as it was in my case. Hell. I wrote a book about that very thing.

Not to miss an opportunity:
My book, "The Tales of a Stroke Patient," is available online everywhere, like: 

from the publisher, http://bookstore.xlibris.com/Products/SKU-0115053049/The-Tales-of-a-Stroke-Patient.aspx,
or from Amazon,  http://www.amazon.com/The-Tales-Stroke-Patient-ebook/dp/B009J9QC64/ref=sr_1_1?ie=UTF8&qid=1373898600&sr=8-1&keywords=tales+stroke+patient  
or from Barnes & Noble, http://www.barnesandnoble.com/w/the-tales-of-a-stroke-patient-joyce-hoffman/1113052852?ean=9781479712496.

Feb 8, 2014

My Personal Evolution, aka As It Turns Out, She Was Not "All That"

Lists are a way to keep track of the things you should--or should not--be doing or have done. When you're done with the list, presumably you're finished with all the things appearing on the list. But are you really? The lists are usually in 5s or 10s, convenient, familiar numbers to use. Take a look at some samples:

5 Foods That You Should Never Eat (I still eat 3 out of 5)
5 Stages of Grief for Chiefs Fans (They were doing so great for a while)
5 Stages of the Sleep Process (If you think of the 5 stages, you won't go to sleep)
5 Stocks With Big Insider Buying (Wall Street sucks)
5 Books to Help You Reach Your Goals for 2014 (Reach your goals? Really?)   
5 Signs You May Have Pre-diabetes (Or maybe the actual diabetes)
5 Best Films Oscars Nominations (They usually come in 5s)
The Top 10 Lists of David Letterman (Er, that is, David Letterman's writers)
Best 10 Movies of Matthew McConaughey (It's the dimples...anything he's in, I like)
5 Years After, 10 Things to Remember (I could think of a lot of things if this article was called, "10 Years After, 5 Things to Remember")

Lists are completely and purposely definitive. But are there only 5 or 10? How about if there's so much more? Take Elizabeth Kubler-Ross, for example. She was the author of the 1969 legendary bestseller, On Death and Dying, and a psychiatrist, who died in 2004. I wonder if she took her own advice about death and followed all the stages of grief: denial, anger, bargaining, depression, and acceptance. In one article, she said that she was ready for death after suffering multiple strokes. But was she really? Known as the Kubler-Ross model, did she skip the first 4 stages and go directly to acceptance? I have my doubts.

Yale University conducted a study of bereaved individuals between 2000 and 2003, based on the Kubler-Ross model, and concluded from their findings that half were consistent with the five-stage theory and others were conflicting with the model. P.K. Maciejewski said in 2007, in the Journal of the American Medical Association (JAMA), several letters were also written and published in JAMA, criticizing this finding and belittling "the stage" concept because, for one thing, the Kubler-Ross model didn't evaluate the support--friends and family--aspect.

More recently, Megan Devine, the author of "Everything is Not Okay," and a contributor to the Huffington Post, wrote "The 5 Stages of Grief and Other Lies That Don't Help Anyone" in December 2013. In the article, Devine says of Kubler-Ross model, "The griever is expected to move through a series of clearly delineated stages, eventually arriving at 'acceptance,' at which time their 'grief work' is complete...and if you don't progress correctly, you are failing at grief. You must move through these stages completely, or you will never heal.This is a lie."

Devine goes on to say, "[Even] Elisabeth Kubler-Ross wrote that she regretted writing the stages the way that she did [in retrospect], that people mistook them as being both linear and universal. Based on what she observed while working with patients given terminal diagnoses, [Dr.] Ross identified five common experiences, not five required experiences."

Ruth Konigsberg, the author of "The Truth About Grief: The Myth of its Five Stages," confirms Devine in saying, "The Kubler-Ross theory has never been validated by one single study. But it certainly seems time to move beyond our current habit of using untested theories to create unnecessarily lengthy and agonizing models for loss, ones that I believe have created more fear of and anxiety about the experience.” 

Konigsberg also says how the Kubler-Ross five stages mistakenly "show a hopeless road, making people think that they must grieve for the rest of their lives." Konigsberg stated that “loss is forever, but acute grief is not, a distinction that frequently gets blurred.”

You're reading about death, but actually this advice from Devine and Konigsberg, in my opinion, applies to anyone or anything you're mourning, i.e. death of a marriage, of a job, of a pet, of an illness. I don't know what's going on in the head of another, so I'll only talk from my perspective. There is no cookie cutter pattern for me, and most likely others, as it relates to stroke. Each stroke survivor grieving the loss of impaired body function, just as snowflakes (presumably), is different.

We are constantly evolving, from one day to the next. Grief has its own timeline, custom to fit you. The stages don't go in order either. I still, five years later, have not accepted my condition for any significant length of time. The shortest stage for me was bargaining because I already had the stroke. Bargaining in duration was not an option. The longest stage for me was anger.

I have a theory. The better your life is right before the stroke, the more you will resist positivity after the stroke. Distractions, like going to the movies or going out to dinner help, but they are only temporary. When I get into bed after the chilly, bleak day is done, I don't like how my affected foot is just lying there outside the cover, or I have to pee two hours later and just can't "run" to the  bathroom. Stuff like that.

And I have more stages than the five in the Kubler-Ross model:

I got "guilt," a 6th stage, when after I had a stroke at 4am. My manager was left in a lurch without me. Not so much anymore, but traces of it surface now and again.

I got "ambivalence," a 7th stage, because I didn't know where I was, emotionally speaking. Sometimes, for about a year when I first had my stroke, anger would be followed by depression going back to anger in rapid succession, and sometimes, both anger and depression would come simultaneously. Or I'd lay there in limbo, trying to decide on my emotion.

And finally, I got "frustration," an 8th stage, even now, when the people looking at me and on the phone don't understand me. Sometimes, the ones in person put their heads at an angle and squinch up their faces in anticipation of not understanding me. The people on the phone probably do the same as well. I'm intelligible, but when I get tired, I have to be careful that I'm not slurring my words. Like I said, I'm evolving.

You don't have to buy my book to know that nobody, except the evil doers of horrendous deeds, like Hitler and Osama bin Laden, deserves a stroke. Nobody.