Stephanie — Memphis, TN
I had never traveled internationally before so when my new job as an International Project Manager required that I spend two months working in Europe I was very excited. I was eager to learn about the various business cultures and to spend some time enjoying the sites.
Somewhat dismayed, however, I found that working for a start up did not allow much time for 'tourist' activities. With only a week left in my stay, I was anxious to see some of the attractions for which Europe is famous.
After soliciting the HR director of my company to join me, we headed out to spend my last Sunday in Belgium exploring the city of Brugge.
After hours of strolling, shopping and listening to Christmas music in this wonderfully relaxing, historic city I found myself somewhat nostalgic and relaxed. So you can imagine my fear and shock when our rental car became airborne minutes after leaving Brugge; an out-of-control motorist had struck us from behind! Likewise you can imagine our excitement when we found ourselves alive, and seemingly unhurt, when our car came to a final landing on the opposite side of a ravine.
I noticed the pain gradually. I first realized it was uncomfortable, to lean back in my seat; within minutes the 'uncomfortable' became 'painful'. Fortunately, my companion was able to console me, not to mention convince me to remain still, until the paramedics arrived.
Though it took some time for the paramedics to accept that I did not speak one of Belgium's three official languages—Thank God for Mark, for Mark was the only one of 9 paramedics who spoke English! Mark took control of communications, and kept me informed of what would be happening.
After cutting off my shirt and starting an infusion (which is otherwise known as an IV in the US), the paramedics began to cut the top off the car to remove me. After putting me on a board, they carried me over the makeshift bridge that they had constructed across the ravine.
Somewhat in a state of shock, I was placed in the ambulance where I was greeted by not one, but two doctors. They explained that each ambulance comes with a fully equipped emergency room, which includes doctors. Wow, now that was new!
After arriving at the hospital, I began to fully acknowledge the cultural differences that I was hoping to experience. I was taken for x-rays. It was there that I was informed that they must remove my umbrella. What? I am wearing an UMBRELLA? "Of course, you must remove your umbrella," they said, as they tugged on my bra. Finally I understood; "that is not an umbrella, but underwear!" I explained, and we all had a much-needed laugh.
The language barrier continued to be a challenge over the next hour, as I attempted to answer their questions and they tried to explain what was to happen to me. I found some communication easier that others, however. For example, after an hour or so of questions, x-rays, CT scans and MRIs, I found myself feeling much better and wondering when I would be released. In the meantime, with the use of hand motions, I explained that I needed to visit the restroom. I was excited to see the nurse's look of recognition, as she nodded her head in the positive. After only a moment she returned, and my heart sank. No matter what language you are speaking, no matter what country you are in—a catheter is a catheter!
Panic set in. "I can't go to the bathroom!" "I can't go home!" "I am a million miles from home!" "What is wrong with me!" "You don't even understand what I am saying—you think I am wearing an umbrella!"
Fortunately, several of my coworkers had arrived, and they patiently explained to me (thankfully in English) that I had received a compression fracture of my L1 vertebrae. I soon learned that compression fractures are the most common type of fracture found in the thoracolumbar spine, occurring in 9 out of 10,000 people. They happen as a result of force pushing together the anterior (towards the front of the body) part of the vertebrae.
Again with the help of my Belgian coworkers, my doctors explained my options. I could receive surgery in Belgium; I could be put in a brace and flown back to the United States for surgery; or I could be placed in a brace for four to six months and reevaluate the need for surgery at that time.
The surgery, they explained, would involve an incision in my back in order to fuse two segments of bones together. Small pieces of bone are placed between the segments to promote growth. These pieces are called bone grafts. Bone grafts may be taken (harvested) from the patient (autograft) or obtained from a bone bank, from bone taken from a cadaver which is specially treated and sterilized (allograft).
Either solution would have to wait until the internal bleeding subsided. Since I had time to consider my decision, I settled into the small hospital room to await the arrival of my parents and to observe the simple but apparent, and sometimes humorous, differences between the US and Belgian healthcare systems. The first difference was that the concept of a 'private room' seemed unusual. Two to three patients shared the rooms. Televisions were rented for a daily fee, and the first patient per room to rent the television received the remote.
I spent 2 very interesting days with two elderly ladies with broken hips; one who seemed to enjoy Flemish game shows, and one who seemed to enjoy cigarettes - yes, they allowed smoking in the hospital rooms! I will forever be in debt to my magnificent coworkers who somehow managed to arrange for a private room!
After the arrival of my parents, and after conferring with our family doctor, I made the decision to have the surgery in Belgium, opting to use a cadaver bone.
Each day the staff would evaluate my status in preparation for surgery. I was to wait 8 days before having surgery. During the wait, my parents and I enjoyed 5 fun-filled days watching Sabrina, the Teenaged Witch, Suddenly Susan and the X-Files in Flemish (or maybe it was Dutch)—Thank God for CNN!
Finally, the day of surgery arrived. I will admit I was nervous, but I was downright SHOCKED when I was moved from my bed to a stretcher and placed in a trailer bed that was being pulled by a tractor! Maybe, I had made a serious mistake! My mother was mortified! Quickly, the staff attempted to explain that the hospital was under construction, and I was being moved to an older wing that contained the OR. Somewhat reluctantly, I acquiesced as I was pulled through the seemingly endless underground corridor.
After arriving at the OR, I remember..well..nothing. I remember waking up in recovery, I remember counting down each minute, every fifteen minutes, till I could hit the button again for a much-needed morphine release! (For the record, I believe those machines are off by at least one minute). Finally, I—along with my morphine machine—was moved back to my room and my awaiting parents. My doctor came to speak with us. Although he informed us that the surgery went 'really well,' it would be a while before I was fully recovered. He anticipated that I would be released in 4 to 5 days.
It must have been about then that my sweet, patient mother turned into a motivation monster! I believe she listened to the morphine bell ring twice (30 minutes, if you assume that the machine is timed correctly), before saying, "Ok, I think you should try getting up!" She must be crazy, I couldn't possibly move—I just had back surgery, for Pete's sake! Throughout the day her encouragement turned to exhaustion, and I admit that I was happy to see her retire for the night.
But as I lay there alone, I began to wonder if I could move. Maybe, I could just sit up? Slowly, very slowly, with a straight back, I pushed myself up to a sitting position! Though, I will not pretend that it was not painful, it actually felt good after lying in bed for 10 days straight! I lowered myself back down and savored my accomplishment. It was not long, however, before I wondered if I could do it again. I did! and this time it was easier and faster, and I sat up even longer—Yippee!
When my parents arrived the next morning, they found me standing beside my bed! When the doctor came to visit he seemed surprised. For all of my efforts, he removed the morphine drip and the catheter. While I was nervous to see my morphine go, I was not exactly disappointed to say adios to the catheter. That day, though slowly, I walked around the room and for the first time in 10 days, my mother washed my hair!
The following day, with a Valium in my pocket, we all boarded the plane for our 11-hour flight home. Without ever taking the Valium, I arrived home on December 23rd, just in time for Christmas!
It has now been 9 months since my surgery, and I have been completely released from medical care. There is no remaining pain, and the 7-inch scar that I had feared would always tattoo my back is almost invisible. I am extremely appreciative to my talented doctors for the care and treatment that I received, which has resulted in a quick, uneventful recovery. Additionally, I am thankful to both the Belgian hospital staff and paramedics for both the hospitality and the patience that they afforded me. Lastly to my parents and coworkers, for their understanding, motivation, humor and never-ending concern. I imagine that the tone of this story would be vastly different if it were not for all of these people.
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After reading this please keep in mind that all treatment and outcome results are specific to the individual patient. Results may vary. Complications, such as infection, blood loss, or nerve damage are some of the potential adverse risks of spinal surgery. Please consult your physician for a complete list of indications, warnings, precautions, adverse events, clinical results, and other important medical information.
