City Girl Pt. 04

"If it's helpful," He said, "I just got a 'pins and needles' feeling in my upper arm and shoulder."

"I see." The doctor said as he sat back in his chair and started writing on his clipboard. "When you move your arm, do you feel any tightness?" He asked.

Chase moved his arm around a little bit. "Yes, in my shoulder." He replied.

"Ok." The doctor said. "I think you're developing compartment syndrome in your shoulder." He explained. "We're not going to be able to perform the surgery required to remedy that here, so we'll have to send you to another hospital. In the meantime they're probably going to want an MRI of the affected area, which we'll do while you're here. I'll go give my diagnosis and we'll get the ball rolling ok?"

"Ok." Chase said, the doctor then got up and left the room. Chase thought the he'd heard the term "compartment syndrome" in a safety briefing at work. The briefing was about hydraulic safety, which didn't particularly apply to him, but he did remember hearing about a case study. The study was about a guy who had been working on a leaking hydraulic system and got some fluid injected into his hand. The guy described the feeling as "like something bit [him]."

"That couldn't have been what I felt was it?" He thought to himself. He hadn't been working on the hydraulic system in the first place, but then again he had landed on a hydraulic hose that was clearly in need of replacement.

"Are you ok?" He heard Sarah ask. He looked to find that she had stood up and was approaching him.

"Yeah I'm just thinking." He answered. There couldn't have been any pressure in that hose could there? The only weight on it was the feederhouse. Then he remembered that there was probably an accumulator for the header float function. Then it clicked, he never did relieve pressure in that hose and the accumulator was probably still fully charged whenever he landed on the hose. When he landed on it, he could have opened up a pinhole leak and gotten over 2000psi of oil pressure shot into his arm. That would explain where the oil around the hole in his jacket had come from.

As the realization of just how serious the situation set in, he let out a heavy sigh. "This is way worse than I thought." He mumbled to himself.

"What do you mean?" Sarah asked.

"'Worse' as in 'I could lose my arm or even my life to this.'" He explained.

Sarah responded by gently putting her hand on his uninjured shoulder.

"Thanks." Was all he could manage to say in response. She gently squeezed his shoulder in response. Just then a nurse walked into the room and Sarah quickly retracted her hand and went back to where she was sitting.

"Ok are you ready for your MRI?" The nurse asked.

"Yeah," Chase answered, "But first, two things. One, I just realized that I probably got hydraulic oil injected under my skin and two, I work in an environment where I might have gotten metal pieces in my eye."

"Oh ok." The nurse said, "I'll be right back, we're probably going to have to get an x-ray before the MRI then."

"Ok." Chase said.

"In the meantime, can you come with me so you can change?" The nurse asked.

"Sure thing." Chase replied, he stood up and picked up his jacket. He then followed the nurse out of the room.

After he'd changed, he was taken to a different room and was given an x-ray. He was then taken to a waiting room for his results. He was surprised when he walked in a saw Sarah sitting there waiting for him. Although he wasn't sure what he'd expected her to do. He sat down next to her. "You didn't have to stick around you know." He told her.

She just looked at him. "I'm not going to make you go through this all by yourself."

"I can handle it," He assured her, "You don't need to spend all day here."

"Yeah well I don't have anything better to do so I'm going to stick around." She replied.

Chase sighed. "Can you at least go home after they get done with me here? They'll take everything from there."

He could tell by looking at her that she was about to protest but she relented. "Ok. Just get ahold of me when you can so I know you're ok?"

"If it makes you feel better, I will." Chase conceded.

"It would..." She replied.

A few moments later, the nurse walked back in. "Ok we didn't find anything. Let's go get that MRI done."

"Alright." Chase said as he got up and headed for the door. As he walked out the door he looked back at Sarah and gave her an appreciative nod and a slight smile. The nurse led him down the hallway to the MRI machine and walked him through what was about to happen. After her explanation, he laid down on the table for the machine. He was given a set of headphones so that he could listen to music during the MRI. The nurse then placed a cage of sorts around his upper torso and shoulder, explaining that it was needed for the machine to work properly. After all was said and done, he was slid into the center of the machine and left to attempt to listen to music through the noise created in the headphones by the MRI machine itself.

Within about fifteen minutes, the MRI was done. At which point he was told that the ambulance had arrived to take him to the other hospital where he was going to undergo surgery. As he got into the back of the ambulance, one of the paramedics informed him that everything he'd had on him when he'd came in was in a bag sitting in the ambulance. The paramedic then instructed him to lay down on a bed.

"Are you comfortable?" The paramedic asked as he laid down.

"Umm..." Chase said, "Can you sit me up please? I'd like to be able to look at something other than the ceiling."

"Sure can." The paramedic replied. He then raised the head end of the bed up so that Chase was reclined, but not laying on his back.

"Thank you." He said.

"No problem." The paramedic responded. "Can you give me your left hand so we can keep an eye on your vitals?"

Chase didn't respond but held out his hand. The paramedic then put a clip over one of his fingers. He then returned his hand to his side.

"So, what were you doing before you hurt yourself?" The paramedic asked him.

"Well I was looking at my combine to find out what all needs fixed." Chase told him. "Then, I fell and landed on a hydraulic hose and accidentally gave myself a shot of hydraulic oil."

"I see." The paramedic responded. "So you're a farmer I take it?"

"Sort of." Chase replied. "I haven't got much of a farm yet, I'm still trying to fix up a bunch of equipment before spring."

"Ahh. So did you just buy a farm recently?"

"Yes sir."

"Good for you. What are you trying to raise?"

"Beef."

"Nice. Good luck to you."

"Thanks."

The paramedic then turned and got a bag of what Chase assumed was a saline solution.

"We're going to get you started on an IV while you're here, that way when we make it to the hospital, the anesthesiologist can just get you put under and we can get that surgery done ASAP." He explained as he worked with the bag and affixed a needle to the end of it.

"Ok." Chase said.

"Are you ready?" The paramedic asked.

"Go for it." Chase said. The paramedic then stuck the needle into his arm and put some tape over it to hold it in place.

"I've got to hand it to you," He said, "Your veins are pretty easy to find."

"I'm sure they are." Chase replied, laughing a little.

The paramedic echoed the slight laugh. "Ok sir," he said, "If you don't mind, I can fill you in on what exactly is going on and what to expect once we get to the hospital."

"Ok." Chase replied.

"When you got that oil under your skin, it made its way into a muscle compartment. Once that happens, the oil will start to kill tissue and the affected compartment starts to sell up which can end up restricting blood flow to other parts of the body."

"So that's why my arm swelled up?"

"Yes. They took an MRI to get an idea of where the damage so that the surgeon knows where he needs to get to. Those results should be at the hospital we're going to already and the radiologist is probably walking the surgeon through them."

"That was fast." Chase thought out loud. "Not that that's a bad thing."

"Definitely." The paramedic agreed. "Compartment syndrome can lead to the need for amputation of the limb, or even fatality, if left untreated for to long."

"I remember that from a safety briefing at work." Chase replied.

"Yeah, these injuries are rare, but they can and do happen. Usually by accident, like in your case." The paramedic explained. "Now, when we get to the hospital, we're going to find the anesthesiologist and, once the surgeon is ready, he'll put you under. Then, when you wake up, you'll probably be in an immobilizer. As far as exactly what to expect after that, it depends a lot on the surgery."

"Ok." Chase said, "Thank you."

"No problem sir. We'll be at the hospital before too long."

"Ok." Chase said. The paramedic continued to make small talk for most of the ride and before he knew it, they'd arrived at the hospital and met with the anesthesiologist.

"Ok, the anesthesia should kick in in about thirty seconds." He said as he injected something into his IV tube.

"Ok." Chase thought to himself. He started counting backwards from thirty in his head as he was rolled into the operating room. At around five he stopped counting and went under.

When he came to, Chase heard the gentle hum of a fan. He could feel his right arm strapped against his chest. He shifted slightly and the bed he was on creaked underneath him.

"Are you awake sir?" A female voice whispered.

He groaned in response. "Barely." He muttered. As he moved slightly, he felt as though the whole world was spinning. He groaned again at the disorientation, and passed out.

Eventually, he came to again, hearing the same humming he had heard last time. This time he could tell that he was lying on his back. He opened his eyes, and looked around. The room was dark, save for the light coming in the door from the hallway. The white floor, walls, and ceiling scattered the light just enough to be able to see in the darkness.

"Hello..." the voice came again.

"Hmm?" He responded.

"How are you feeling?" it asked.

He suddenly became aware of the pain in his arm and shoulder. "Sore." He replied. "But other than that I'm just tired."

"Ok are you ready to go to your room?" The voice asked.

"Mhmm." Chase responded.

"Ok, the lights in the hallway might hurt a little bit at first." The voice cautioned.

"Ok." Chase responded. He kept his eyes open just long enough to see the nurse walk over to his bed. Then, he closed his eyes as he felt her start pushing him through the dark room to the hallway. The brightness of the hallway made his eyes hurt for a couple seconds before the pain subsided and he opened his eyes. As he was moved through the hallways, his proprioception gradually got better and he continued to gradually feel more comfortable.

Once he was wheeled into his hospital room, the nurse again asked him if he was comfortable. He nodded.

"Ok. If you're feeling up to it, your grandparents are here if you want to talk to them." The nurse told him.

"Ok. You can send them in." He said.

"Ok give me a minute." The nurse said before leaving the room. In a minute or so, she returned with his grandparents.

"Hey, there he is." His grandpa commented as he walked into the room. "How are you feeling?"

"Tired." Chase responded.

"I'll say." His grandpa replied. "I was getting worried that you weren't gonna wake up until we had to leave so I could go milk."

Chase chuckled in response. "Oh I'd have understood even if you did." He said.

"Boy what are we gonna do with you?" His grandma piped up. "We left you out on your own for one month and then you go and hurt yourself?"

Chase and his grandpa laughed. "Yeah," his grandpa added, "Maybe you should get a girlfriend out there to make you take care of yourself."

"Shush." Chase said laughing. He knew his grandpa was joking, but like most times when he was joking, the man did have a bit of a point. Chase knew that he wasn't exactly taking as good of care of himself as he probably should have been. He was still keeping up on his hygiene and the like, but he had been burning the candle at both ends any time he could. He wanted to make sure that he got everything ready before spring. Now, he'd gone and hurt himself, which really put the pressure on.

"How long before you're allowed to use your arm again?" His grandpa asked.

Chase was about to say he didn't know when the nurse answered for him. "He's going to stay in that immobilizer for a couple days so he doesn't rip his stitches out. After that, he can start moving it but it's going to stay in a sling for six weeks."

Chase looked at his grandpa. "Well there you go." He said.

"Well that's not too awful bad." His grandpa replied. "I'm sure those six weeks would be helpful though."

"Definitely." Chase agreed. "I just found out today that my combine needs the separator rebuilt."

"Ouch!" His grandpa said. "Does it have that many hours on it?"

"No, but it's had a bunch of rocks run through it." Chase explained. "FUBAR'ed everything past the feederhouse."

"Ouch." His grandpa repeated. "That's gonna eat up some time."

Chase nodded in agreement.

"Now don't you worry about that right now." His grandma chimed in again. "Right now you need to worry about getting better so you don't make anything worse."

"Yeah your grandma's right there Chase." His grandpa agreed. "You need to worry about your recovery first before anything else."

"I guess..." Chase lamented. He hated not being able to do anything, but he also knew that if he pushed the envelope too much, he'd make things worse in the long run.

"Ok good." His grandpa said. "We'll be back tomorrow evening to take you back home."

"Tomorrow?" Chase thought out loud.

"The surgeon wanted us to keep you here for tonight to make sure nothing weird happens." The nurse explained.

"Oh." Chase responded.

"Yeah." His grandpa said. "Tomorrow, you'll be able to call your boss and let him know what happened."

"Oh yeah." Chase thought out loud. "I forgot about that."

"Yeah. But don't worry about that right now." His grandpa said. "We'll deal with that tomorrow."

"Ok." Chase replied.

"Alright." His grandpa began, turning to his grandma. "We'd better get going, its four o'clock and by the time we get home, it'll be about time to milk."

"You'd better get going then." Chase said. "I'll see you tomorrow."

"Yeah, we'll see you tomorrow Chase." His grandpa told him. They then left the room.

The nurse stayed behind and checked his vitals. For the rest of the day, he stayed in the hospital room and watched TV until he fell asleep.