Lessons Of A Fractured Hand

As is usual for me, this year I went back home for the Christmas holidays. It’s always a nice time, however I find that it always ends up being busier than expected. This year was no exception. I had the usual family gatherings, drinks with friends and other get-togethers. Plus, there was one additional sporty social event. My girlfriend and I, who are both runners, were invited to join the Tri-Annual Harry and Henny Fun Run. It was a simple event, start the day with a 5k, a 10k or a half-marathon and then enjoy a nice breakfast. Seemed simple enough and I didn’t put much thought into it. Christmas is busy, it’s always like that, so what’s the worst that could happen? All I was worried about was a bit of burn out at the end. Little did I know, I would be learning a lot of important lessons in the coming weeks.

The morning of the run was a chilly -10 degrees with a light dusting of snow coming down. A group of around 20 people turned out for the run. There was no particular demographic, just a bunch of running enthusiasts. Just a group of young and older runners shivering out in the snow. So as is normal when the race started, I put on my headphones and began to go at my own pace. I was feeling confident that the 10k would be easy and, for the most part it was. The light snow had covered the trail a little, there was also occasionally a small amount of ice. None of that worried me because I was well in the zone by this point. My running playlist was been perfect and with the clean air I felt exceptional. Just as I reached the 7k turn around point, while thoughts of a good finish were firmly in my mind, I put my foot down onto a bit of black ice without noticing. My feet slid out from under me. I panicked and threw my hands down to catch my fall. Hitting the ground hard in two places, I could feel the shock as I realized what happened. First my knee scraped across the cold ground, ripping my pants and my skin. Then down came my hand. It hit square on, it hurt and was stiff, but there was no sense that anything was really wrong. After that I did what came naturally, I got up and kept running. After all, it was just a small fall right?

By the end of the morning, I was pretty convinced that I had sprained my hand. I had sprained things before, so I knew it would swell, it would be sore and it wouldn’t move easily. I don’t know if I played it off too well or everyone else had the same idea. We just went about the day and I put my hand on ice. It had swelled up as expected but the pain started to get better. When it did hurt, I assumed it was normal and that I could just tough it out. After all it was just a bruise, it would get better. Looking back now its easy to see what I did wrong, but I didn’t have the experience that I have now. So I kept acting normally, I used my hand a little and iced it a lot. The swelling went down and I figured that I would get better quickly. Before I knew it my trip home was done, and I was on my way back home to Montreal.

Back In Montreal

At first, my time back in Montreal was very uneventful. As expected, I was very exhausted from all the rushing around at home. I cooked, I cleaned and I slept mostly. Did a bit of socializing and a bit of shopping. I really returned to life as normal. My father-in-law saw my hand, which was still swollen, and was concerned. He examined it and concluded that it was probably fine. After all, there was almost no pain anymore. Just to be safe I did go out and get a brace to support my wrist. I figured that it might help a little.

The real tipping point for me was when I got to work. My boss saw the brace that I was wearing and he advised me to get it checked out. My other co-workers as well, they all gave me a hard time. By the end of the day I was feeling much less confident about my hand. In addition to feeding my self-doubt, they also reminded me of a service that we have at the office. It is called EQCare and it is an online medical service. Rather than waiting forever in the emergency room, I could talk to someone that day through the service.

So that’s exactly what I did, by the end of the day I had talked to a doctor and gotten a referral to get an x-ray. By the next morning, I had my x-rays and was informed that yes, I had a small fracture. Normally I would just leave after that, but I felt compelled to see what my fracture was like. So I talked to the staff at the radiology clinic and asked for a copy of my images. In the end they agreed, and I left with both the knowledge of my fractured hand, and a CD containing the original x-ray images. Little did I know, but that CD would be one of the most useful tools I could have. I took it everywhere after this.

CHUM

In Montreal, just like most major cities, there are a lot of hospitals. The biggest one is known as the CHUM. It is an imposing set of all black buildings with clean white hallways that stretch off in all directions. It is the results of a project to merge multiple smaller hospitals and improve health care in the city. So when my doctor told me that I should “Go to emergency right now”, that is exactly where I went. After all big and new must mean that I would get the best care. I had suspected that I would have to get some treatment after managing to open my x-rays at the office. I clearly had a nice big spike of bone that had cracked off inside my palm, under the pinky. It was time to get me fixed up.

Now, I am not someone who finds waiting in the emergency room to be an unreasonable expectation. So I grabbed my seat around 4PM and did the usual triage upon entering. Honestly I was having a pretty good time all things considered. I had everything that I needed. It was a good opportunity to think about what had happened and what would happen. Honestly I was fairly nervous because by this point a week had passed and the bones had probably already fused. I didn’t know exactly what could be done but I waited patiently hoping for the best. The whole evening quickly descended into a blur. Some friends from nearby dropped off a care package and lots of people called me to see what was going on. In the end I spent 11 hours in that emergency room. I left with a cast, an appointment to see a plastic surgeon and a splitting headache.

After my trip to emergency my confidence was coming back. I knew that I had screwed up my hand but at least I had a plan. So I waited patiently for my appointment with the plastic surgeon. Quickly it became apparent that the surgeon would not have a lot of time for me that day. He was split between consultations and viewing patients in the surgery ward. So, when he finally got to me he was clearly not willing to spend any extra minutes that he didn’t have to with me. After taking a quick look at my x-ray he told me that if it was the first day then they should have done something. However, since it had been a week, he was not going to make sure that I end up with a perfect x-ray. So he recommended that we just leave it as is, because if he attempted surgery and it was already fused he wouldn’t do anything. This didn’t sit well with me, so I pushed him for more information. He told me the usual risks of surgery, and what could go wrong. He also told me that if we leave it, as he recommended, then I would probably develop a form of arthritic pain in that joint because the bones were not properly aligned. I pushed him to go for the surgery option and eventually he agreed. However, he left with the following remark: “You know it will be three weeks by then”. This made my stomach sink. I could feel that I would not have a good chance along this path. He clearly was not confident that anything could be done.

Sacre Coeur

Now, while this process was occurring, my girlfriend was working at another hospital across the city. It’s not as big a hospital as CHUM, but they do have a good history of dealing with trauma patients. So since my hand injury was the effect of sudden trauma from my fall, just maybe they could offer some more helpful guidance for me. So while I waited for my pre-operation at CHUM, my girlfriend ran into one of the plastic surgeons at Sacre Coeur. After discussing my situation, the surgeon suggested that I come in that afternoon, so she could see my hand. It was music to my ears. Maybe I would be able to get more help at this other hospital. I had finished my pre-operation at CHUM but still didn’t know when my surgery would be. Things were moving way too slow with the first surgeon.

Compared to the clean white walls of CHUM, Sacre Coeur looks like something from a different planet. There is a mix of old and new equipment moving up and down the halls. Everything that you see seems to be less organized but twice as useful. It’s the kind of place that makes you feel assured that everything works, even if nothing quite work on its own. So I made myself to the next waiting room in my now long list of waiting rooms. Surprisingly, it only took me about an hour of waiting to see the doctor. As it turns out, she was a hand specialist. She was quick to explain not only the extent of my injuries but also the physiology of my hand. She told me the same risks as the other doctor but also told me the expected recovery times if they occur. Then she explained how quickly those arthritic effects, that the other doctor mentioned, would take to set in. From her point of view it was not later in life but only a few years before it would become a problem. So finally she recommended that we operate because there were still things that could be done to fix it now. This was music to my ears because not only was there a clear plan, she was not afraid to explain it and put it into action. So I left that office knowing that within a few days I would have my surgery and that things could still be done.

Two days later I was back at Sacre Coeur. I was feeling pretty relaxed, all things considered. The only thing that made me feel a bit off was knowing that I was going to have local anesthetic for my procedure. It’s an uncomfortable feeling for me knowing that I will hear them working on my hand. My first stop was the anesthesiologist. For me this was the most interesting part of the surgery. She had to find the exact location of the nerve bundle within my arm. To do this, she used a needle that would emit an electric shock into my shoulder every second as she poked around. When she got close to the nerve, different parts of my arm would jump around. It reminded me of when I would accidentally touch the electric fencer as a kid. When she found the right spot she injected something that would fully numb and paralyze my arm for up to 24 hours. She also assured me that she would give me some cocktail during the surgery so that I don’t really know what is going on. This helped me feel a bit more relaxed for what was to come. After I was wheeled into the surgery room, the drugs started to kick in. My arm was going numb, and I was getting rather relaxed. My surgeon arrived along with her assistant. He was a plastic surgery resident with two years remaining. After the drugs really hit me, the surgery became a blur in my mind. I remember hearing a lot of drilling, I remember asking a few questions, and I remember feeling really high. Before I knew it things were over, and I was back in post-operation. I saw the surgeon one last time. She said that I had multiple small pieces that they had to re-fracture. It was not an easy surgery to perform but in the end it was a success.

Recovery

After surgery, I was completely exhausted. Not only did the procedure take a lot out of me physically, but the last two weeks were very difficult emotionally as well. There is thankfully no pain for me after surgery. I feel like things are going to heal well and I can’t wait to get back to my regular routine. It’s just a matter of resting and recovering. Everything that I do now is done only with my left hand. Including writing this blog post. They say that I should get the wires removed from my hand in about 6 weeks.

This whole process has given me a lot of things to think about. There are some important lessons that I learned along the way. Starting with day one of the accident, I should have gotten it checked out immediately. I’m not saying go to the hospital for every single injury, but I did not go because there was not a lot of pain. That was the wrong approach. What should have been done was look for things that didn’t work quite right. So if you have restriction of movement or a bit of a bump in an odd place, get it checked out just to be safe. The second lesson comes from something that I actually did right. When I got my x-ray, I had a feeling that a copy of my documents would be useful. Later on I used that copy at every step of my procedure. So having a copy of your medical information that you can look after is very important. It’s a situation where its better to have and not need rather than need and not have. In the end the biggest lesson for me was how to navigate the medical system. I assumed that the latest and greatest hospital would be enough to look after me. I was very mistaken. As of right now, if I had stayed with the first surgeon, I would still not have had my operation. Plus with his outlook on my situation, I would probably be no better off after he finished. I would say is that if you feel uncomfortable with the medical path you are on, don’t stop, but start a second search. Look for a specialist for your particular problem and get a second opinion. You are well within your right to do so and it can not do any damage to your situation. Make sure that you find the right person.

Finally, I would like to express my thanks to everyone who was able to help me along this journey. Starting with all the great men and women who work at EQCare, CHUM and, Sacre Coeur. You were all very helpful and supportive. This experience has given me an even greater respect for all of our healthcare workers. To my co-workers for looking out for me. For making sure that I end up alright when this is over. Thank you to my friends who helped me with care packages and support. You all helped make this easier to get through. Thank you to my mother and father for being there when I was feeling unsure and scared. They supported me and helped me work through all of this. Last but not least, I want to thank my girlfriend and her family. Without them I likely would not have switched hospitals and found a better doctor. I would not have learned all the valuable lessons that I did. I would not have felt so well-supported now that I am recovering. It is clear to me that I have the best people surrounding me in my life and this last three weeks really has shown it.

TLDR

19/01/2020