Chapter 93: First Painful Steps

Owen was settled into a room and provided with lunch as soon as he arrived at the hospital in San Antonio. Being on the ground was a relief after so many hours in the air but being without Amelia was distressing. Not able to reach his pack or anything that might help him pass the time, Owen came to the penetrating awareness that he could not fetch anything for himself. At this point, he was completely dependent on others. He stared at the ceiling, trying to process how he would allow others to care for his every need when he arrived at home. Being the helper came far more comfortably and naturally to Owen than being the helpee.

As he lay there, Owen didn't feel any one emotion too intensely. Instead, he felt a conglomeration of emotions that swirled in and out of his awareness taking turns one after another: gratitude, anger, heart ache, relief, sadness, worry, love, disappointment, and anticipation. His head felt full of feelings, as if it was about to burst. Rather than resting the emotions in his heart and simply feeling his way through them, he was stuck in his head attempting to analyze them. Processing the last five days would be part of his task while in San Antonio. He knew that he would not be allowed to go home until a doctor determined that his psychological state was sound, all things considered. Therapy, given his history of PTSD, would be a certain necessity in the coming months.

A time when the world moves so slowly

At 2pm, someone knocked on Owen's door quickly and proceeded to walk in, "Major Hunt? I'm Josh, your Physical Therapist."

Owen held out his hand, "Nice to meet you. You can call me Owen."

"Ok, Owen, I have a few questions for you before we begin our work together," Josh said. "I understand you have a gunshot wound in your abdomen that did not require surgery, a bruised femur, extensive bruising on your right side, and a broken patella, is that correct?"

"Yes," Owen answered with boredom, having been asked the question numerous times over the last five days.

"Are you a career soldier?" Josh asked as he looked at his tablet where he was recording Owen's responses.

"No. I've been overseas numerous times since 2001. I'm a trauma surgeon and the head of an ER in my civilian life," Owen explained.

"Wow. What a fascinating career. You'll have to share some of your stories with me while we're working together," Josh commented. "Back to the questions: Tell me about your family."

"My wife, Amelia, is a neurosurgeon at the same hospital where I work. We've been married two years come April and it had been a hell of a two years. During that time, she gave birth to preemie twins and we adopted my cousin's three children when she died unexpectedly. Mia's expecting our 6th in early July," Owen detailed. "It's ok to be overwhelmed by all that…Lord knows we are," he added with a chuckle.

Josh smiled, "Actually, I'm the 2nd of 6 kids. I understand the realities of big families. Where do you all live?"

"Seattle, Washington," Owen answered. "We have a house on Lake Washington barely guarded by two golden retrievers."

Chuckling, Josh continued, "Have you ever had physical therapy before?"

"No, but I'm fairly familiar with it from a medical and surgical point of view," Owen shrugged.

"Well, Owen, I'm going to become your best friend and your worst enemy. The exercises I'll have you do will hurt and will push you but doing them will get you one step closer to home. Is your family down here with you or at home?" Josh inquired.

"They're home. My hope is that I'll only be here 2-3 days and then sent home to continue there," Owen shared cautiously, afraid that Josh had other plans in store.

Josh nodded slowly and seriously, "It's possible, but won't be easy. I'll help you reach that goal, but you're going to have to work your ass off. So, let's get started. We're booked for the next 90 minutes. You ready to try standing?"

"Here? Right now?" Owen asked with surprise.

"Yep. We'll graduate to the PT room in a bit. Right now, let's get a sense of that left leg and its strength," Josh said as he pulled a walker up to the side of the bed and lowered the bed's height. He explained to Owen how to get out of bed most easily and where to grab the walker. After the instructions, he reminded him, "Remember to use your arms and your left leg. No weight bearing on that right leg today.

Slowly, Owen sat up at the edge of the bed and paused as he'd been instructed to do. The two chit-chatted as Owen's body accustomed itself to an upright position. Josh told Owen to take his time and to let him know when he was ready to slide that left leg onto the ground. Owen elaborated on the details of his family as they waited, sharing Gwen's journey with spina bifida and showing Josh a picture of her with her walker.

"She's gotten so big since I left," Owen commented mournfully as he and Josh looked at the picture.

"If Gwen can stand without feeling in one leg, you can stand with one leg out of commission. Let's go for it, Owen," Josh urged.

Taking in a deep breath, Owen set his phone down on the bed and reached out for the walker with his right arm as he slid his left leg to the floor. He hadn't anticipated the discomfort on his right side and arm, but he powered through it. With Josh's encouragement, Owen used his three functional limbs to stand.

Through clenched teeth and a fake smile, Owen asked, "Now what?"

"Now you'll stand there for about 10 more seconds and we'll practice sitting back down," Josh instructed as he described the process.

After Owen sat, Josh looked at him quizzically, "Tell me what hurt and what was most difficult as you went to stand or as you stood."

"Standing up, I felt a little uneasy about trusting my left leg to bear my weight. On the right side, my torso clenched up. It's bruised from shoulder to hip," Owen shared.

Josh nodded as he noted Owen's comments into the tablet, then asked, "Tell me about sitting down. What hurt and what was a challenge?"

"Bending down at the hip seems to pull at both my leg and torso. Everything else felt a sense of relief," Owen grinned.

"Good," Josh nodded, "Let's do it again." After 15 rounds, Owen had sweat beading down his face. He didn't mind because it helped hide the involuntary tears that came from the pain of his efforts. Josh gave Owen a ten-minute break and let him know that they'd be heading to the therapy room shortly. "But first, you'll be the one to get yourself into and out of your wheelchair. Don't worry, we'll practice a few rounds of that too," Josh grinned and patted Owen on the shoulder before stepping away.

Owen, exhausted from the recent efforts, thought to himself with thick sarcasm, oh good. I'm so damn glad we'll do it multiple times. I was worried, Josh. He drank half a bottle of water and wiped down his face with a towel Josh had given him but remained sitting upright.

At the end of the break, Josh came back in the room with a wide smile and inquired, "Worst enemy about now?"

"Not quite," Owen grinned. Josh explained the step by step process of getting into and out of the wheelchair. It was far more complex than Owen had imagined and then standing up with the walker had been. After the 10th round, Josh offered to push Owen to the therapy room where they'd work on some range of motion assessments.

As Josh and Owen continued the therapy, Josh gave Owen an overview of what they'd try together later in the evening. Owen would have PT three times a day and OT twice a day. The OT would help him learn how to cope with his temporary disability while the PT would work to eliminate the disability. Josh shared that Owen had been put on Ann's caseload. According to Josh, Ann was the best OT in the hospital. After the PT, Josh assisted Owen in getting settled back in his room and Owen had no problem falling asleep and taking a two-hour nap.

When 5:30pm rolled around, Ann came into the room just as Owen was waking up.

"Hi, Major Hunt. I'm Ann, your Occupational Therapist. Looks like Josh has already gone a round with you, hmm?" observed the young attractive OT with long blonde hair and beautiful green eyes.

Owen extended his hand, "Ann, call me Owen."

"I'd like to use up about 30 minutes of your day today. Tomorrow, we can get started in earnest. How's that sound?" Ann asked.

"Sublime," Owen chuckled, relieved she wasn't going to make him work that day. "Tomorrow sounds perfect."

Ann asked nearly the same standard questions as Josh, but added in questions about Owen's house, focusing especially on the flooring and layout. She was glad to hear that Owen would have medical assistance at home but encouraged him not to become too reliant on their assistance. She also discouraged round the clock care after the first week. By then, he'd be steady enough that his fall risk would be minimal. The goal, she reminded him, was to become self-sufficient as much as possible as soon as possible. When Owen first arrived at home, he'd need to live downstairs. Ann promised to help him figure out how he could make that happen.

Owen was thrilled to see a text from Amelia at 6, just after Ann left his room. Amelia wrote, On the ground. How are you?

In pain. Started PT today. 10 rounds of get in and out of a wheelchair, 15 rounds of stand up and sit back down, plus all kinds of range of motion exercises. Encourage me… the pain is horrific. Owen admitted.

Oh, O. So sorry. I have complete faith in you – you are a determined man. Can't they give you something for it? I like to prescribe mild pain meds for my patients a half an hour before OT/PT and the heavy stuff after. Amelia suggested.

Haven't met a doc yet, just my torturer. Owen responded.

You know what to do – hit the call button. Your pain is as valid as anyone else's needs. Amelia prodded.

Owen ended the conversation, typing, Gotta go. Hurting.

He pushed the call button and a nurse came in a few minutes later.

"Hi, Major. I'm Jean, your nurse tonight. You pushed the call button?" Jean asked with a chipper and efficient manner.

"I'm wondering when I can have something stronger than ibuprofen. I'm really hurting," Owen explained.

Jean looked at her tablet to pull up Owen's chart. "I can give you a Vicodin now. It looks like the bulk of your pain meds were ordered to be administered after your last PT session tonight," Jean shared.

"The Vicodin would be a help, Jean. Thanks. Who do I speak to about rearranging the dosing regimen?" Owen asked.

"I'm sure the doctor reviewed your entire file before setting up the schedule," Jean assured with a smile.

Owen interjected, "Jean, I'm a trauma surgeon. I'd like to speak with whomever ordered and scheduled my meds, please."

Jean smirked, "I'll see what I can do, Major. And I'll be right back with the Vicodin."

When Josh returned at 6:15pm with a broad smile and enthusiastic tone, he gave Owen the choice of repeating the earlier therapy or moving on to trying to walk. Owen mentioned that he'd just taken a Vicodin but was ready to tackle the session. After Owen showed Josh he could still get out of bed, stand up, and get into and out of a wheelchair, Josh announced that the next task was to try walking. Owen placed himself into the wheelchair and Josh pushed him down to the therapy room. Josh parked the wheelchair at the end of a set of even bars and told Owen to stand up like he'd done back in his room. The even bars provided stability and support while an assistant stood behind Owen and Josh walked backwards in front of him. Slowly and with intentionality, Owen stepped one foot after the other. On the right steps, his arms bore the brunt of his weight. Each step took effort and focus. Owen gritted his teeth as he stepped and yelled out in pain a few times. Choice words peppered his exclamations.

When Owen was beginning to wear out before Josh wanted to stop, Josh reminded Owen of the benefits of being able to walk a few steps. Not only would the catheter be removed, but he'd also be much closer to returning home. Both points helped Owen rally until the end of the appointment.

Back in his bed at 7:45pm, Owen nibbled at his dinner before sliding the tray away and closing his eyes. He pushed the call button because he was in desperate need of pain relief. Jean's voice came through the speaker, "Yes, Major?"

"I'd like my pain meds, please, Jean," Owen winced with a hint of a growl.

Jean responded, "I'll be down there as soon as possible, Major. We had a code and I'm now covering my own patients and two other nurses' patients. I'm sorry."

Owen flung his head back on his pillow and growled to himself. He made a fist and hit it into the bed several times as he gritted his teeth. His phone lit up with a FaceTime request from the family. He denied the call and groaned.

After he denied the call, Amelia texted, Just FaceTimed, no answer. You ok?

He responded; I know. I'm sorry. Pain is tearfully excruciating. I'm overdue for my meds but nurses are swamped. Can't let kids see me like this.

Amelia wrote back, Text me if we can connect later? I told the kids you were getting bloodwork done. There's always tomorrow if you aren't up to talking tonight. They love the photo books btw.

Good. Gotta stop. Really hurting. Wish you were here to storm the halls and get my meds. Xxoo, Owen concluded.

He pushed the call button again, not caring if he was the squeaky wheel. Jean's voice came through the speaker about 5 minutes later, "Yes, Major?"

"Meds. Now. Please," he grumbled with gritted teeth.

"Doing my best, Major. Someone will be down with them shortly," Jean responded.

Ten minutes later, just as Owen was about to hit the call button again, a nurses' assistant came in. "Good evening, Major Hunt. I have an array of medications for you. Would you like me to explain each one?"

"Please," Owen grumbled with closed, squinted eyes.

"I have a Fentanyl injection for your pain, another injection through your PICC line - an antibiotic called Cefazolin, oral Demerol also for pain, and oral Ibuprofen to reduce swelling," the assistant explained.

Owen opened his eyes. The assistant handed him some water and a small cup holding the pills. When she started to prepare to inject the other meds, Owen stopped her, "Wait."

"Yes, Major?" the assistant asked.

"The Fentanyl will sting if it isn't pushed. Can you follow it with saline please?" Owen requested.

"I'm afraid I can only administer what the nurse gave me," the assistant grimaced.

Owen took a giant, frustrated breath and stated firmly, "We're talking saline here. Saline."

"I'm sorry, Major. I have to follow orders exactly as given," the assistant apologized.

"Let's work this out," Owen snarled. Out of frustration, Owen pushed the call button and waited for a response.

Three minutes later, Jean answered, "Hi, Major. A nursing assistant should be in shortly."

"Jean, she's here but cannot push the Fentanyl without your oversight," Owen complained.

"Why do you need it pushed?" Jean asked firmly.

Owen sighed, "Because it stings if it isn't followed by saline. I'm in enough discomfort as it is."

Jean huffed in frustration, "I'll be right there." She walked in and thanked the assistant for all that she'd already done, telling her she'd done a great job. Then she turned to Owen and looked at him with a grim expression as she injected the Fentanyl and saline. Warning him, she offered, "Doctor or not, Major, there's no excuse for snapping at my staff."

"I'm sorry," Owen apologized as he hung his head. "Pain does crazy things to asses like me."

Smiling and trying not to laugh, Jean simply mumbled, "Mmm Hmm."

"Any chance I can get a PCA so I can dose myself? It'd make it a hell of a lot easier on all of us," Owen begged.

Jean folded her arms and shook her head, "I doubt it. You don't need continuous dosage, Major. We're trying to make you less dependent on the pain meds over time rather than more reliant. But, if you want to try, you can ask the doctor when she comes in tomorrow morning if you want."

Owen grimaced, guessing the request wouldn't be worth his breath