On October 16, 2022 my brother fell 8 feet off his back deck into the outside concrete basement stairwell. It was dusk and it was 38 degrees and the only witness was Sheldon—the neighbor’s dog. Sheldon barked furiously but his owner thought the coyotes were after him and promptly brought him inside.
My 77-year-old brother laid out there at the bottom of the stairwell all night.
When Sheldon came out the next morning, he once again started barking and staring over toward my brother’s house. Sheldon’s owner came out to look and saw both rails off the deck, the glider overturned, flower pots broken on the ground, and keys strewn in the driveway, but no brother. She finally called his name and heard him moaning. Upon closer inspection, she saw my brother face down surrounded by blood at the bottom of the stairwell. She called the paramedics and they life-flighted him from Harding Stadium in Steubenville, OH to a trauma hospital in Pittsburgh PA.
I later told him he had the right idea arriving by helicopter. The streets surrounding the hospital were all under construction– you had to pay to park in a parking garage, take an elevator to one entrance and walk to another elevator, then walk what seemed like a mile through a glass enclosed walkway and take yet another elevator to ICU where you had to call to gain access. It wasn’t a trip for the faint of heart and or short of breath.
As my husband and I began the 4 hour road trip to Pittsburgh, one of the ER doctors finally called to give me the details of my brother’s condition. The connection was terrible and I couldn’t hear anything he was saying. I asked him to please call me back because at that point I knew nothing about his injuries or condition. He never did. At that point I learned the first of many lessons along this long and thankless journey of patient advocate. No matter what—take the call. Run naked to your hot spot if you have to. Take the call. Because they never call you twice and rarely even call you back.
In the days that followed, it didn’t matter that I am a registered nurse with over 40 years’ experience. It didn’t matter that I was a certified Medical Legal Consultant. It didn’t matter that I worked for an Orthopedic surgeon or taught nursing skills at a Community College. It didn’t matter that I know my brother better than any other human being, and almost as well as his Creator. It didn’t matter that the year prior to this fall I was with him through his wife’s death, our brother’s death, and two cancer surgeries.
None of that mattered. I was simply, “The Sister”. Cue the ominous music or theme song from Jaws. Let me tell you why I was such a threat. I was there every day in the beginning. What I saw with my own eyes didn’t always match the narrative or the morning rounds. I didn’t hesitate to question their narrative. The Sister wants what is best for him. And that is to get him out of that hospital and back to his life. The least drugs and the best care. Always.
My brother had two skull fractures, a couple of brain bleeds, a fractured neck at C5-7, swelling on the brain and was on a ventilator. They said he may have nerve damage and some hearing loss on his right side since one fracture was so close to his right eye. He mostly slept that first day, but honestly didn’t look as bad as I thought he would. That was Sunday—less than 24 hours after his fall.
24 hours later, on Monday, he had surgery to repair the damage to his neck, a C5-C7ACDF. He was in surgery most of the day and under anesthesia for 5 hours. He came back up to ICU around 9 pm. He did well. He always does well.
Day 2 they removed his cervical collar and inserted a nasogastric tube for feeding. We were told the skull fractures were stable and no further surgery was needed. His vital signs were good and his oxygen was 99%. His head was so swollen he could have been Shrek’s stunt double though. But he was coming out of it.
Day 3 he was taken off the ventilator. He had a lot of secretions and needed to be suctioned frequently. He was pretty sleepy most of the day, but he told me, “I want out of here.” By the end of the week, he was agitated and trying to pull out all of his tubes. He was restrained. Speech therapy came and gave him ice chips and he could chew and swallow without choking. They continued to monitor him for seizure activity but he had none. Physical therapy sat him on the side of the bed and he was able to hold himself up for a minute but it looked like he was in a lot of pain.
Every morning the team would do rounds and they invited and encouraged the family to be involved. I was welcomed by most doctors except for one who told me to keep quiet so they could finish rounds and then I could ask questions.
This was the only time you could actually see the doctor during the day. We were there every morning to hear the various residents report on my brother’s condition. Sometimes it didn’t match what I was seeing. I didn’t hesitate to state what I saw. You can’t unsee things. The Sister becomes a problem when reports don’t match reality. I asked the night shift before I left every day if I could call and check on him in the middle of the night. They said of course. So when I called and they told me my brother was up singing oldies and taking requests (Dean Martin anyone?) and they loved him—it didn’t match the story that the sleeping pill Ambien was working. So when you figure they are asking my brother at every shift change where he is and who is President, giving him a drug that can cause confusion and suicidal thoughts especially in the elderly– isn’t helping him regain mental clarity. But one doctor would discontinue it (The Sister says it isn’t working (backed up by nightshift staff), and another would reorder it. At times it seemed like a power struggle; at times it seemed like they didn’t appreciate me questioning their authority. The nurses were awesome.
Additionally, I tried to explain over and over to each and every nurse that my brother was extremely healthy and active before this fall. At 77, he was still working full time, had cared for his wife with dementia for years at home, worked outside from sun-up to sundown on his lawn, in his garden and flowerbeds. He helped all the neighbors and knew everybody in town. He had two cancer surgeries and never took a pain pill. He was/is the only one in my family who didn’t take the vaxx and trusted me to tell him the truth about how to stay safe. I truly believe his healthy lifestyle is what saved him. How many 77-year-olds could survive a fall and a night in the cold? And that’s why I continue to believe God has a plan for him.
However, first we had to go through Rehab. That’s coming soon in part 2 from “The Sister”
Resources
https://www.spine-health.com/treatment/spinal-fusion/acdf-anterior-cervical-discectomy-and-fusion
https://www.drugs.com/pro/ambien.html#s-43685-7
