A cocktail of pain relief and emergency intervention

We got to the Bicheno medical centre shortly after 3:30pm - according to Google Maps.

I was helped onto an examination table / hospital bed thinggy and supplied with the requested equipment in case my feelings of nausea materialised to worse.  

The senior ambulance officer who had dropped in - for whatever reason - had, in a previous life, been a pharmacist and immediately took charge of the drugs side of things - starting with a maxolon injection to settle the nausea them followed by some pain relief.

So, there was him, the GP, the practice nurse and a medical student, with Pete hanging in the back ground until he was subsequently sent to the waiting room.  

Everything is a bit of a haze:  I really was in too much pain to deal with 'stuff''  No, I hadn't bee there before (despite owning a shack in the place for 29 years) so they needed some details.  Too hard.  My grateful thanks to Pete for filling in necessary information after I'd said 'tell them Pete' to my personal details etc.

I was sufficient compos mentis to remember my ingrained childhood instructions about shoes on beds and commented and the doctor suggested Pete could make himself useful by removing my wet and sandy boots and socks.

In order to insert a canula, she tried to push up my sleeve - it wasn't going to work and she asked if she could cut it - I told her to do what she had to so my t-shirt was slit up the left sleeve, then the right sleeve to access my shoulder, then the middle to enable access for various sticky dots which I think were attachment points for monitoring equipment.  Then removed.  

At that point they decided that soggy, sandy jeans were surplus to need (I am glad it had not been a cold day as such things can induce hypothermia as quick as you wish) and removed those.  The GP handed those to Pete, along with my cut shirt, advising that washing and repairs were in order, and sending him into the waiting room.  I didn't like the chance of the latter being vaguely possible, even by me!

The team in attendance did their best to lighten the situation, and I was sufficiently aware of that to tell them, in between my groans of pain, that in different circumstances I would appreciate their sense of humour.

They also did their best to make me a little comfortable with support under my damaged shoulder and, at my request, a basic wipe of my face to remove the saltiness that was starting to seep into my eyes.  The male trainee doctor made an attempt with the GP giving my face a good sponge wipe to remove the salt and sand a few minutes later.

The GP was going to attempt to reintroduce my arm to my shoulder socket, while the ambo administered ketamine.  Chosen, I think I was told, to ensure that I was somewhat conscious through he procedure.  I recall seeing the GP checking on herself the locations of the ball in the shoulder socket.

I was told I needed to calm down before the ketamine as it might have a strange effect.  I tried by controlling my breathing as gentle panting, and found out that 'strange effect' was the understatement of the century.

I certainly deadened the pain and for a while I was aware of their voices but then everything I could see dissolved into a mish-mash tessellation of rectangular shapes that were weaving in and out of each other  and I recall the thought that I was uncertain if I were alive.  It must have been shortly after that as he started to cut the dose that I recall saying 'I don't understand what is going on, it's all weird'.  

They started to explain to me about the dislocation - that wasn't what I was referring to, I was referring to what was going on in my head.

Gradually my vision returned and 4 concerned faces were leaning over me.

Anyway, while the GP had managed to get things back together, they popped apart again and a fracture was suspected necessitating an x-ray.

So plan A was to send me to St Helens which has XRay facilities.

An ambo from Scamander popped his head into the room to check what was happening and offered the thought that St Helens would  only send me to Launceston - via that particularly long and winding road over the Weldborough Pass and I be best sent directly to Launceston from Bicheno.  Further discussion about where I actually lived resolved that my destination should be Hobart.

It seemed to take forever to get me into the ambulance, trussed up like a Christmas turkey to stabilise my shoulder, with something they referred to, I think, as a kettle, and the light was starting to fade, but by 5:45pm I was in the ambulance and they were ready to go.  I was aware that I had none of my medical cards with me - so Pete had returned to his place and grabbed my laptop bag, which contained my purse with cards, so that was in the ambulance with me.

I was hooked up to multiple machines, including a saline drip for hydration and pain killers, and various monitoring equipment.  And oxygen, as it seems my blood oxygen levels were depleted.

Before me left, Pete took the precaution of advising our morning dive profile, as the road to Hobart ascends to more than 300m above sea level.  Perhaps another reason they put me on oxygen.

I was most grateful that there was a volunteer ambulance officer on duty as she drove while the senior paramedic monitored my condition and administered extra squirts of pain relief (low level ketamine and something else) when I groaned too loudly.

He was good company, and kept me filled in about the plans (changeover at Triabunna, as he was already past his shift finish time) and working out where they would take me - my request was Calvary.  It was arranged. He also kept up a running conversation about this that and the other, it did help to distract me somewhat. 

A phone call from Triabunna caused him to call the driver to stop.  Triabunna had a call out, so we had to return to Swansea to do a changeover - that seemed to take forever but Google maps tells me it was only about a 4km backtrack!

By now, I needed to pee and opted to use the facilities at Swansea rather that the bedpan, which neither of us seemed to like the thought of.

The female volunteer assisted me to the facilities and back - not that there was far to go by the time they wheeled the stretcher inside the very spacious facility.

Again what seemed like interminable delays before I was in the hands of the Swansea crew, and I was introduced to the senior ambo from there with the information that he could be grumpy if not home by midnight.

He was somewhat more taciturn and a bit less reactive about the extra squirts of pain relief, advising that in a couple of minutes we'd be on a straighter bit of road and I could have a bit extra then.  I would have preferred a magic wand with all the pain gone.

That road is bumpier than I had ever known - travelling it in the front of a car with good suspension is more comfortable than the back of an ambulance which was really never engineered for comfort in the back.

I resisted asking 'are we there yet' but did ask a couple of times - or maybe more - where we were.  Oh so slow!  But the driver (another vollie) was driving more slowly to reduce the discomfort for me.

The paramedic decided to change my pain relief and took me off the ketamine/whatever mix, and substituted morphine.  I was also allowed the tiniest ampule of water to wet my mouth which was feeling outrageously dry from the drugs.

Shortly before 10, we arrived at Calvary to be told they couldn't take me as it was too late and only one doctor remained on duty.

I was sufficiently with it to state that we were only left with one choice and I didn't like his chances of being home by midnight, sorry!

So off we went to be ramped at the Royal!

I was duly transferred from the ambulance stretcher to a hospital stretcher and wheeled into a corridor where I inquired again about using facilities, which it turned out were just behind my head.  I was helped off the stretcher, with the woman vollie attempted to shield my dignity (I was attired only in bra and knickers) with a sheet.  A passing security chap discretely averted his eyes.

Upon returning to the stretcher, I commented how gritty and nasty their floor was - turns out that was all from me, the paramedic had given the sheet a shake before I returned.  I knew I was very sandy, but didn't quite realise how much!

In due course I was moved to an emergency ward cubicle and a nurse advised I would be given pain relief - good, the stuff from the ambulance was wearing off.  She started with an ibuprofen tablet and some intravenous paracetamol, advising that oxycodone and something else were to come.  Needless to say, the effect of the first 2 were minimal.

It also hadn't helped that she said it was OK to drink water (I questioned that, knowing that if I was to have a general anaesthetic, water would be ill advised) but was assured drinking water was OK, so she left the cup of water on the table by my damaged shoulder.  Useful not!  I managed to attract the eye of a chap sitting with the patient opposite and asked for his assistance, which he willingly provided, moving the table and the cup to a more sensible place as the nurse returned.  I tried asking the nurse whether the contraption that was immobilising my shoulder was ambulance equipment that should be returned to them before they left, but after 2 attempts gave up.  The English language requirement for foreign nurse recruits really does need to be raised!

She asked if I was OK.  Resisting the temptation for profanity, I advised negative, I was in pain with a dislocation and suspected break.  Did I want another blanket.  No, I was in pain.  Apparently she meant was I warm enough - I reiterate my previous comment about English language skills.  After what seemed like hours I asked when I would be sent for x-ray - after the doctor has been.  When will the doctor come.  Soon.  Maybe.  Repeat all questions again after a while and she reappeared with oxycodone.  Still no sign of doctor (why I needed to see a doctor before x-ray was beyond my comprehension, the GP at Bicheno had decreed I neede an x-ray!)  Eventually a lovely x-ray technician came to collect me and very gently got all the x-rays needed, including, at my request since it was also extremely painful, my elbow.

Not long after I had been returned to my cubicle, the doctor did come to say there way not break. Whoo hoo, that is something at least.  My record (along with my bone) is not broken!  And I would be relocated to another section where part A and part B would be reinstated to their correct places.

He and his crew were great, and while I advised that if their choice of pain killer this time for the procedure was nitrous oxide I recalled having that at the dentist as a child, and knew the after effects - yes, he said, not uncommon!

Anyway, I was under its influence and everything was going smoothly then someone's version of Siri or Google decided to talk in response to someone's question - it might even have been mine, as my handbag and laptop were sitting nearby, but it was rather funny!

So, everything back in place, after effects appropriately dealt with, and the lovely x-ray technician wheeled his portable x-ray machine in to take some pictures to illustrate that all was back in place.  It was.  Great.  Much less pain but still a lot of discomfort.  It was 2:30am!  Rather a marathon.  

Having established that there was noone at home to look after me, I was choofed off at a ward for the remainder of the night.  I managed a couple of short stints of real sleep, but in between needed to attract the attention of the nurse to assist me out of bed - first lowering the rails and walking the few steps with me to the bathroom and managing the oversize heavy door.  I didn't want to call out, as there was someone else in a curtained off bed nearby, so had to wait until someone was nearby.

I did feel the need to request assistance with charging my flat phone battery - as I knew I was going to need someone to collect me in the morning, and the nurses obliged.  I also knew I was going to have to request someone to bring clothes for me - but when the doctor came to check on me, he advised they have supplies for such emergencies and I was provided with some clothing that at least covered my underwear!

The orderly had come around with a breakfast tray for which I expressed gratitude as I'd had nothing to eat since lunch the previous day, but there was nothing on it I could eat.  He left me the hot water and instant coffee sachet (international roast!) and went off to find a packet of cornflakes which I could eat!

I was given various instructions, including keeping the sling on for 2 weeks, a prescription for some big-boy pain killers and anti inflammatories, and discharged so went to meet my lift, Kris, at the main entrance.  After she deposited me at home, made me a decent coffee I thought I'd have a shower to wash off the sand, but decided sleep was a greater priority and went to bed.

When I woke, showering and dressing was tedious and time consuming but I got there after an hour!  It is going to be a long, slow recovery.  There is nerve damage because of the time between the dislocation and everything going back into place.  I am having to be careful about what I choose to dress myself in.  No t-shirts or jumpers!