Dealing with a broken arm: the Thailand edition - Personal -

Every so often, real life gets in the way of traveling/blogging. Last Tuesday night (19 August) was one of those times, and it happened after coming home from a quiz night, of all things…

To get some of the obvious questions out-of-the-way, yes, I am mostly fine. It’s been nearly a week since the accident as I type this (actually, using Siri on the Mac) and even though my arm is not 100%, it’s a lot better than it was. I still can’t type, so most of this post was “written” through dictation.

So what happened, Chris?

It happened around 11pm last Tuesday night. I jumped on my bicycle and was writing down the road home — a road I’ve ridden down 100 times…

The next thing I know, I’m over the handlebars and unable to move my right arm.

As far as I know, I didn’t hit anything, there were no vehicles around, and I was not drunk (a little buzzed after a couple of beers, but not drunk). Believe me, if I did hit something, someone would’ve come out complaining and yelling about it. There was nothing around to hit, really. Looking back, it must have been something on the road, a pothole, or something along those lines. When I went back a few days later I didn’t see anything…

A few minutes of shock and sitting down later, I realized I was surrounded by half a dozen locals who were willing to help, but didn’t quite know how to say it. You know that quick little mental check you do after an accident to see all of your extremities are still working…? Brain okay, left-hand okay, left leg, okay, right leg, okay, right arm…?

Yeah, not so much. The top half of my right arm was bent inward at a very unnatural angle — it was kind of like looking at a slow-motion replay of a football tackle gone horribly wrong. I later found out both bones in my arm were both broken — the radius and the ulna, for you trivia buffs that aren’t nurses — and were fractured, apparently pretty severely. Thankfully, the adrenaline had set in, and I wasn’t in a lot of pain… at least for the first five minutes. One of the Thai people that was nearby apparently had called his friend to bring a truck, and we drove the half a kilometer to the emergency admission of the local private hospital. This is all less than a kilometer from our house, mind you, so I called Laura and told her where we were going…

Thanks to Laura’s adept handling of paperwork and bureaucracy, I was seen quickly and taken care of, at least the basics. Since we don’t have local insurance, the doctor referred us to the local public hospital for the eventual surgery. From there, Laura had jumped in the ambulance with me, which we took over to the public hospital. This is now about 1am, Wednesday morning, and I’m bandaged and wrapped up and quasi-comfortable in a bed, I tried to sleep… Laura went home, promising to check in the next morning. Alas, this was shaping up to be a stay that would measure in days, not hours. Rolling over to get some sleep, however, was not possible.

Day 1 (Wednesday)

You don’t often think about how early 5am is — especially when you’re a night owl like I am. It seemed to come in with a whimper, though — The lights were already on, and some nurses seemed to think that a full on conversation loud enough to hear across the room was perfectly acceptable at 4am. There are plenty of jokes to make about hospital food, but let’s just say this is the first main reason to not stay in a hospital. At least any longer than necessary.

The second seems obvious — the hospital clothing. I get that hospital clothes should be easy to put on (or remove) and basically one size — and frankly I think the system they have at Thai hospitals is pretty decent. It’s a shirt that ties in the front and a sarong like piece that wraps around your waist and can be held in place with a couple of small rolls (or a couple of clothespins — bring a couple of those if you have to go to a Thai hospital.) Despite multiple nurses insisting on my removing my boxers, I balked — until you’re taking me to surgery, there’s no need to have my genitals exposed to the world. While I couldn’t quantify it for sure, anytime someone was sitting instead of laying down, the men needed to… adjust themselves to ensure they weren’t sticking out…

Laura arrived with the sort of things you need when staying at a hospital — electronic devices, chargers, books, and so on. You’d be amazed how much of a charge you can go through on an iPhone and a matter of hours… I also quickly became aware of why virtually every person had someone being serving as a handler — nurses are there to give medication, check blood pressure, and as little else as necessary, it seemed. Security, it seemed was nonexistent — assistants were allowed to stay in the ward overnight, some opting to lay a mat down the floor below the hospital bed (!!) With others thing to lay down in our room outside the ward. There was room or perhaps 100 people, but it basically looks like a refugee zone.

Nurses come by to do a blood pressure check every so often, and inevitably my IV needs some checking. Trying to do any kind of movement seems to jostle it, which includes playing with my iPad. What little bit of talking with the doctor came in the ward, with a surgery scheduled for Friday. Apparently, my case fairly takes a lower priority than an emergency or infected case. Quite amazingly, two bones were broken, yet the skin was completely intact and there was feeling in my hand, no other damage done…

Since one arm is basically out of commission and the other arm is tied up (quite literally — the IV makes it difficult to have much motion), there isn’t a whole lot I can do. I’ll settle for playing with the iPad, but it’s difficult to do much else. As a blogger, I hang my head a bit in retrospect — I have no notes, despite having a lot of things to note.

No surgery today, though — Friday is a possibility, the nurses say. I resigned myself to being around for a bit longer than expected.

I should note that the way this system seems to work seems to come out of sheer lunacy. On one level, you have plenty of paperwork and notetaking, yet every time I was asked my name, often my weight, allergies, where I’m from, and so on. I’ll give you the first one as a security measure to ensure you have the right person (even as I’m wearing a bracelet with my name on it) and maybe even the third one (because who wants to troll through 20 pages of documents?) It must come from curiosity — in the entire time I was in the ward, the only other foreigner I saw was my wife. Still, being talked about in the third person (hearing the word farang come out someone’s mouth every other sentence whenever they were what you don’t know was enough to get on my nerves within the first half an hour.)

Day 2 (Thursday)

Another 5am wakeup call? You have to seriously wonder how you’re supposed to get better when you’re deprived of two actual source of healing: lots of sleep and plenty of clean water. While they never explicitly stated it until the next day, apparently anesthesia requires an eight hour fast. Looking back, it seemed fairly clear who was expecting surgery based on who got meals since they were tagged by people’s names. There was a Western option available, which I accepted after trying their version of rice porridge. Western or Thai, I wouldn’t wish hospital food on my worst enemy.

Around noon, the nurse confirmed I would be having my surgery tonight around 8pm. Minutes later, a second nurse came by informing me my surgery would be “this morning or this afternoon”. Ahh, disorganization. That’s fine, I think to myself — if I don’t have to eat any more hospital food it would already be a pretty decent day. The nurses, with two different sets of paperwork, confer. My surgery will be at 8pm. No explanation was given for the discrepancy.

It’s about halfway through Thursday afternoon where I begin to wonder if this entire hospital has been taken over by eight-year-olds. The amount of giggling I’ve heard during this hospital stay is mind-boggling — and this is coming from grown adults with a fairly serious profession. I get there’s a need to keep up spirits or something, but it took a lot more patience than expected to deal with that… Bear in mind, of course, that this is the first time I’ve been admitted into the hospital as anything older than a baby. I’ve gone with Laura to her hospital visits as the caring husband and assistant, but I’ve never needed to go on my own — at least, until now.

Around 7:40pm, the party gets started — I had transferred to a bed headed for surgery, kissed my wife bye for a couple of hours, and got moved on. While no talk of anesthesia was ever done before hand, it seemed the appropriate time for them to ask mere minutes before heading into the surgery (in the recovery/waiting room)… Laura seemed to think general anesthesia would be necessary, but the doctors indicated an option of lidocaine, which would knock out just the arm and shoulder. Local is always cheaper than general, so lidocaine it is. From the waiting / recovery room, I got to stare up at the first world lights while waiting for the anesthesia to kick in…

The giggles, apparently, aren’t limited to nurses that looked young enough to be called teenagers. On several occasions, I had to stifle a stern word for even the duo that was operating on me. I was warned of “sensation but no pain” — and I wanted to believe it… instead, it felt like my arm hanging out playing at 30,000 feet — extreme cold, numbness, tingling, and so on. What made this quite possibly the most uncomfortable procedure of my life was general inability to move — my left arm had an IV in it and was strapped down, while my legs were strapped down as well.

Day 3 (Friday)

Another 5am morning — this one obviously feels like a ‘morning’ because they thought to turn down a little bit last ‘night’. It’s the night staff’s job, of course, to rouse their patients and insure they’re ready for the treatments, surgeries, or whatever else they have coming up today.

From the very first nurse that inquired, I had made it fairly clear that I wanted to leave the hospital today. Or as soon as possible. If you don’t assert yourself, you’ll feel a lot less in control of things. At first, response was “no, you should stay till tomorrow”, to which I asked “why?”. Since I had already had the surgery and didn’t need any follow-up treatments, they began to come around. I figured any rest and recovery could happen as easily at home as it would in the hospital. Upon hearing multiple nurses admit there’s no reason to stay any longer, they agreed to begin the checkout procedure, at which point I texted my wife to let her know. “Relieved” doesn’t quite begin to express it — between very little sleep, crappy food, and difficult movement at best, I do hope another visit to the hospital won’t be necessary for another 60 years or so…

In any case, I got patched up, the IV got removed, the bandage changed, and officially checked out around 2pm. We crossed the street, hopped in the songthaew, and made our way home. From there, it was time for a shower, a shave, and a nice long nap. I’ll be on a few different meds a few times a day for the next week or so and my arm won’t be 100% for a while, but I’m glad to be out of the hospital and comfortably at home.

If you find yourself in a Thai hospital, a couple of thoughts:

  • If you have a spouse / significant other, bring them. Drag them, ask them, cajole them, whatever you have to do. Between being more level-headed and less affected by medication, he or she will be more able to get whatever you need than you will.
  • Patience will win the day. Even at the best organize the hospital in the country, things seem to move far slower than usual.
  • Private hospitals will be cleaner, more efficiently run, have more English speakers and generally more expedient. You’ll be paying twice as much — or more — for the privilege, though.
  • Assert yourself! Many times a request or recommendation will be made, but not all of these are required. Taking your medications shouldn’t be questioned, but things that involve comfort probably should be considered optional, and tell such time as they become necessary…
  • Expect a… lower level of organization. In short, you may need to make the same request multiple times, or you may simply need to be more patient while your request is being processed. Don’t assume that just because someone wrote it down it’s actually happening.

Before I can fairly end this story, I should note that this is Thailand — a system where what happens inside the hospital matters very little once you’re outside the hospital. Case in point: the first taxi driver we saw attempted to charge us double the metered rate.

He received the middle finger — well, from my good arm. May recovery come soon.

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