Continued from My Summer Interrupted, Part I
It had been a pleasant, relatively quiet Independence Day holiday for me. I had settled into my recliner for the evening, laptop in front of me, cool drink at my side. My intent had been to write a blog post about the two weekends I had spent riding to and from Rock Island, to see a couple of my son’s stage performances, and I was doing exactly that when someone in the neighborhood began setting off heavy mortar-type fireworks.
My wife ran to the sliding door to call our dog in. Leia, a high-spirited black Shepherd/Labrador mix, was afraid of fireworks and would not have been outside had we realized the neighborhood idiots were going to pull out the heavy artillery that early. Karen called several times and then stepped out onto the deck. She returned quickly, yelling out, “She’s not in the yard; she’s gone!”
Leia runs fast and jumps effortlessly. Once underway, she doesn’t really spring when she jumps; she merely raises her landing gear and soars over obstacles. At three years of age, she is still quite the puppy and she absolutely does not like fireworks. She had jumped our picket fence several times in the past, so as a precaution, we had installed some plastic “deer mesh” fencing several feet above our wooden fence. We would later find out that on this particular night, Leia had been so spooked, she flew right through the deer fence, leaving a large, gaping hole in one panel. But we hadn’t seen that yet and since my girl had never gone very far in the past, I went out after her without stopping to grab a leash.
Several minutes later, two of our neighbors were out combing the neighborhood in an effort to help me find my dog. Four or five blocks out, my neighbor Jim caught up with Leia along Joliet Road, a fairly busy street, and walked her toward me. Not having a leash, I took Leia by the collar and the three of us began walking toward home. We were with a block or two of arriving when my wife pulled up to the curb in her minivan. Recognizing the van at once, Leia veered toward Karen’s van and lunged with all her might, pulling me right off my feet.
What occurred next took all of a second or two. I pinwheeled toward the van for a couple or three yards before gravity took over. As Leia broke free of my grip and zipped around to the driver’s side of the van, where Karen had opened the door to let her in, both of my feet left the ground and went out behind me. An instant later I landed in bellyflop fashion, making full body contact with a concrete sidewalk. There is some speculation that I may have hit the side of Karen’s van with my left hand as I went down—she said it had sounded like something had hit the van hard and from her vantage point, she thought it might have been my head. I have no recollection of that. What I can recall are shock and pain. My torso had taken most of the impact on landing, or so I thought. The wind had been knocked out of me and I felt a wall of pain across my chest and stomach areas. My right elbow had taken a bit of a scrape and was bleeding. I felt no worse pain in my left arm than anywhere else. Yet.
“Do you need help getting up?” That was Jim, one of the nicest neighbors I’ve ever known. He had moved in to assist as needed and by that time, Karen was standing over me, too.
“I dunno, but let’s wait a minute before we find out.” I was still lying face-down on the sidewalk, trying to get my wind back and hoping the pain across my body would subside. My mind was not particularly clear. They stood by and let me wait a bit longer. Then I tried to get up.
The pain that fired through my left arm from shoulder to fingertips assured me that all was not right. I went loose again, lying prone on the concrete. “I can’t use my arm!”
Jim helped me to my feet and got me over to the van. I vaguely recall he and Karen saying something about the emergency room. After thanking Jim profusely, and our other neighbor, Tony, who’d been covering the area by bicycle, Karen drove to our house only long enough to put Leia in the house, and then drove me to the Edward Emergency Department of Plainfield, a component of Edward-Elmhurst Health and the only ER in town.
The 4th of July must be one of the worst days to need emergency care. It must rank right up there with New Year’s Eve and Christmas. I’m sure the people working those days see some very interesting cases. I’m also sure they’d rather be elsewhere. I know I did.
Before I go any further, let me state for the record that every staff member I saw at the Edward facility that night seemed friendly, courteous, and professional. Let me also add that most of our past experiences there have been positive ones. It was only in hindsight that I saw a dreadful comedy of errors unfold—and I was playing the unfortunate straight man in that comedy. Without going deep into every detail, here are the low points of what happened.
- When we arrived, I nearly passed out walking from the van to the doors. Karen went in to get help. They came out to talk to me but all I could tell them was that I couldn’t see, that everything was going black. They brought out a wheelchair and took me inside.
- After some preliminaries, they took me for x-rays. There were two techs in the room, both very nice. In order to take the x-rays, I had to stand in front of some sort of panel. I did the best I could but the room started going dark again. As soon as they were done, they let me sit down and once the images were verified, they wheeled me back to where I had been before.
- A doctor on staff came in and informed me that I had fractured my shoulder. They gave me some pain medicine, a sling and the phone number of an orthopaedic surgeon to call the next day, explaining that the specialist would determine whether or not surgery would be necessary. I asked about the pain med they’d given me, which hadn’t seemed to lessen the pain at all. The nurse suggested that I give it more time.
- They wheeled me outside and Karen brought the van around. I almost blacked out a third time but got myself into the van. The pain meds still hadn’t done much for me. We went home and as I walked in, rather than blacking out, I was hit by a wave of nausea. Fortunately, it passed after I settled into my recliner, where I spent the night.
As you read this, I want you to bear in mind that I had sustained a very painful injury, the extent of which had not yet been discovered or disclosed, and for which I had received no treatment other than x-rays, a sling, and a bottle of pills that weren’t anywhere near strong enough to take the edge off my pain. Anything that caused me to clench the muscles in that sector of my body set off a wave of pain strong enough to make me scream. I make no exaggeration here, I assure you.
- The following day, Karen phoned the orthopaedic surgeon’s office and was told he wouldn’t see me because this guy is a foot and ankle specialist. I think it was at this point that we began to seriously question the “care” I’d received the previous evening. Karen called the ER back and left a message.
- While this was transpiring, I contacted my new employer and explained the situation. I was supposed to be at work, but that was not possible due to the extent of my injuries, my inability to drive, and the narcotic-though-insufficient pain meds I was taking. I hadn’t been there long enough to earn paid time off or any benefits, for that matter. My only hope was to still have a job by the time this nightmare was over. My CEO was quick to allay my fears in that regard, which only increased my admiration for the man and for the organization he leads.
- Karen then proceded to spend a few hours calling my primary care physician (closed) and a host of other offices, none of whom could schedule me to be seen timely. This includes the DuPage Medical Group, to which the foot and ankle specialist belonged. After spending substantial time on the phone with DuPage and getting nowhere, Karen declared them “useless” and vowed never to use them again if she has a choice.
- I had taken to sharing my experience thus far on Facebook. I got lots of sympathy and a few well-meaning suggestions, but no outright help. That is until a friend of mine who works at Rush CopleyMedical Center in Aurora gave me the name of an orthopaedic group to call and the specific doctor for whom to ask. An insider recommendation!
- Upon receiving the recommendation, Karen called Rush Castle Orthopaedics and requested an appointment with one Arif Saleem, MD, a shoulder specialist. Although the doctor himself was out of town—hey, 4th of July holiday—his assistant was willing and able to see me that very afternoon. Karen scheduled an appointment, hung up the phone, and just breathed for a while.
- At some point, an Edward ER nurse called back insisting that the orthopaedic surgeon whose name they’d given me should still be willing to see me. Karen again relayed what she had been told. This was turning out to be anything but a fruitful conversation and I could feel my wife’s frustration building to a dangerous level, so I suggested she tell them we’d already found somebody else to see. She did so and that ended the conversation, but not my troubles.
- Later that afternoon, the Physician Assistant saw me. She was friendly, professional, and by all indications, highly competent. Just one problem, she couldn’t tell much from the x-rays that had been taken at the ER the night before—yet another red flag concerning the treatment I’d received there, if you’ll pardon the exaggeration. So she ordered another set, which showed not just a fracture, but a severe one, involving a shoulder that was likely broken into “a number of pieces.” She wrote an order for a CT scan, which would be necessary to determine the best course of action, but added that surgery seemed quite likely.
- At this point we obtained an appointment to see Dr. Saleem on Thursday, July 12, which would be eight days after my accident.
- We couldn’t get the CT scan done that day, July 5, because it was late and because some front desk worker claimed they would need approval from my insurance provider—and that she had three days to accomplish that feat.
- On Friday, July 6, the front desk called to inform us that no approval was necessary and we could schedule the CT scan. When Karen called back, the earliest appointment she could get at any location was on Sunday, July 8, four days after my injury had been sustained.
Four days had passed, so far. Again, any time I moved wrong or sneezed or the planets aligned a certain way, I involuntarily cried out in pain and then waited, sometimes for quite a while, for the pain to subside. This had become very disconcerting for my wife, my sisters, my friend Ann (herself a healthcare professional), and anybody else close enough to me to know what was really going down.
- On Sunday, July 8, I went to Rush Copley Medical Center and had my CT scan. Then I went home. Everyone was very helpful, friendly and professional, but not one person gave me any indication that going four days without actual treatment of my injuries was the least bit out of the ordinary.
- I repeatedly ran out of pain meds because prescriptions for opioids cannot be written for large quantities or to include refills. No skin off my banana except I was still experiencing substantial pain from my as-yet untreated injuries. I totally understood the need for strict controls but at that time I was not yet an addict in the making; I was just a guy who didn’t want to keep screaming in pain every time I upset the bag of jacks that was my left shoulder joint.
- On Thursday, July 12, I met Dr. Saleem and instantly liked the man. He didn’t sugarcoat anything. I had sustained a severe compound fracture and surgery was indicated without question. Once in, his first option would be to try and repair the fractured head of my humerus, the “ball” of my shoulder joint. This seemed unlikely but was still his first option. Barring that, he would replace the joint. By approving both options, I allowed him to address my injury one way or the other. I would enter the OR as an outpatient. If he could save the shoulder, I would go home that day. If a replacement had to be performed, I would become a guest of Rush Copley Medical Center for a couple of days. Surgery was scheduled for Tuesday, July 17.
This, in a nutshell, is how Edward-Elmhurst Health allowed a patient to “get away” and end up being treated by Rush Copley, a hospital that doesn’t even serve Plainfield. On one hand, I’m gravely disappointed in the way my case was handled by the ER, from the insufficient x-ray images to the inappropriate surgeon referral, all of which prolonged the amount of time that passed between the day I sustained my injury and the day it was fixed. On the other hand, their actions allowed me to connect with a well-regarded shoulder specialist, thanks to a personal recommendation from a friend. So maybe I was better off.
By the time Tuesday, July 17 came around, I was ready to have that painful broken shoulder fixed one way or the other. My hope, of course, was that Dr. Saleem would go in and find a shoulder that could be repaired instead of replaced. When they wheeled me out of recovery and into an elevator instead of back to the prep room where I had started, I knew that wasn’t the case. As the nurse wheeled my bed out of the elevator and onto an upper floor, I said my first full sentence following surgery: “I take it I’m an inpatient now.”
To which the nurse calmly replied, “Yes, you’re an inpatient.”
My heart sank at the realization.
To be continued…
I think interrupted is an understatement. It’s hard to believe that they couldn’t see that sort of damage.,! Shoulders are certainly painful – I know that from experience.
Glad you ended up with a good surgeon and hope you have a good outcome.
My God, Mike, I had no idea how bad it was. I’m glad you you found someone that could properly take care of you. Mind you, here in Ontario barring a life-threatening emergency, the length of time you waited for treatment is not uncommon. Waiting three months or more for an MRI is the norm. It also depends on the competence of your primary care provider. The initial x-ray which failed to show the hip arthritis was taken in January 2017. The hip replacement finally took place at the end of August 2018. In a single-payer system like we have, everyone gets the necessary treatment – when it’s their turn in line. Unless of course you are a well-connected politician or are willing to pay private fees (yes, there is private health care here in Ontario if you have $$$). A few year’s back I read an article in Reader’s Digest Canada about an investigative reporter in Montreal who decided to compare private vs public services available to people without a family doctor. Interestingly, both systems used the same facilities. Posing as a patient without a family doctor, it took him 30 days to get an appointment with a physician. Then he went to a private facility. He was seen promptly ($$$) and quite by accident and unplanned within a few days was diagnosed as needing by-pass surgery. He was released from hospital on the day of his public system first appointment. Ok, so it’s not always like that. You can get the care you need and wait for it, or you can pay for it and get it more quickly. I don’t know the answer. Sorry for rambling. Hope your recovery continues smoothly.
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