The Day After
When I was young two films stand out in my mind as having changed me. The first one was “Nightmare on Elm Street.” I learned at a young age that I do not enjoy horror flicks. I may have glanced at some since that movie, but I have never sat down to watch another horror movie after Nightmare. The movie achieved its intended purpose and I had difficulty sleeping for several nights after watching it. This was roughly 1985 so I was right around 9 or 10 years of age. I don’t know if they had PG-13 or R rating back then but regardless I probably was too young to be watching it anyhow. Such is life.
The first movie that had drastic consequences upon the psyche of my inner child was “The Day After.” This was a made for TV type movie and broadcasted onto ABC, so one would think it would be mostly safe for viewing by children since it was broadcasted upon a family network. Remember, this movie was first released in 1983. The land of television was drastically different then than it is now. This was quite the edgy movie back in its day. For those unfamiliar with the flick I’m discussing, in a nutshell the movie briefly touches on a nuclear war between the good ole USA and mother Russia, but focuses more upon the aftermath, or rather The Day After and uses some rather graphic detail to depict its story. At 8 years old, yeah… I didn’t need to see that. I haven’t watched the movie since, but to be honest, there is a fair chance it would disrupt my karma now just as much as it did back some 27 years ago. Of course at the age of 8 I hadn’t a clue something like a nuclear war was even possible. I’m enjoying my first year of baseball and football, I’m trying to see how far I can jump my dirt bike, and I’m trying to not slip and fall on or dribble the basketball into the oil stains in my parents driveway as I play Horse against Jimmy Bernat. The power to end all of mankind with the push of a button? Yeah, that hadn’t really entered my adolescent mind just yet.
Fast forward to modern day and I realize Freddy doesn’t really exist. But North Korea does, and I probably read too much news about North Korea for my own good. They concern me.
But I digress…
So what has the days after my most forgetful accident given me? I’m about 6-1/2 weeks post accident and it is still affecting me considerably. For starters I haven’t even ridden my bike yet. Not because I’m scared to do so, but because I’m simply physically unable to yet. I really don’t know when I’ll be able to make my first commute to work. Pain medications are down to 1 or 2 pills per week, but I live with considerable soreness. On those one or two occasions when I, in my own opinion, broke down and took a pill, my mind simply quit on me. It had enough. It said to me, “I’m done. I’ve had enough. Just take the pill.” And so I did. It’s odd but I feel like I’m failing myself when the pain overtakes my own mind’s ability to tune it out.
I’ve been back to work fully for a couple weeks. Working for the University hasn’t been difficult beyond just getting there. In the morning is my worst time for pain as I am a rough sleeper and I’m betting that I toss and turn on my injuries but sleep through it. So getting the day started comes with great sacrifice. For the most part my arm just hangs there as I type. It gets sore, but frequent pauses in the typing allow me to rest it often. Once I’m at the bar working, however, is where my limitations clearly show. Reaching across the bar with a glass of beer isn’t quite possible yet, or at least not without medication. I get down to my knees if I need beer from the lower shelves because my ribs won’t let me bend over. If it is over my head it either gets done with one hand or doesn’t get done by me.
Those are just a couple examples of my disability thus far; a plethora more exist but I won’t bore you with them. The more pressing concern is the long term outlook and how it will impact how I want to live my life. It is no secret that SCUBA plays a large role in my life in a recreational sense. Additionally, I had aspirations of making SCUBA a part of my professional life as well. Whatever plans I had working to make my asperations into realizations were put on hold once I had a broken rib tear and rupture my lung. For an individual that breathes canned air from depths below sea level, the term “career-ending” would not be misplaced.
Here is the medical diagnosis taken from “Diving Medicine” by Alfred Bove (with notes added by me). In it he states the following regarding my injury:
“ Traumatic pneumothoraces caused by isolated injury to the chest wall should not pose any risk to the diver (so far so good, right?); however (uh-oh, I hate “howevers” in medical journals), most traumatic pneumothoraces are associated with underlying lung injury as well (mine was obviously – the 5 broken ribs). If the injury was severe enough to lead to radiographic changes (mine was – broken ribs and partially collapsed lung), it could have led to areas of air trapping (it did, about 20%, which has been slowly absorbed by the body and my lung is once again theoretically inflated to 100%). As a result, many authorities think that such persons should be advised not to dive (oh shit), although extensive diagnostic and hyperbaric chamber testing might define those at greatest risk.”
Let’s cut to the chase. It basically says the following: You should be able to dive again, but many authorities say you shouldn’t.
Hrmmm, OK…. OK? Talk about sitting on the fence with a medical diagnosis, eh?
In a nutshell what this means is in order to dive again with insurance I will need to subject myself to various medical tests, including a Spiral CT Scan to get a detailed image of the scar tissue (or even if it healed – some lung lascerations never heal) and hyperbaric chamber tests to see if my lung will collapse again at depth. Insurance is of paramount importance. Having a medical emergency in a third-world island nation is ridiculouslycostly. We are talking about 10′s of thousands of dollars in just the air plane ride to Miami for proper medical care. This is just for recreational diving… to be a professional dive instructor one must carry insurance without question. I simply cannot work in the SCUBA industry without insurance. Now is anyone going ot stop me from diving recreationally? No. I can show up at any dive facility, present my C-card, lie on their medical waivers, and off I go into the depths. Going this route, however, is not only foolish in a financial and insurance consideration, but it might just be life-threatening as well. Allow me to explain the scenario…
I’m at depth and my lung begins to leak air through my scar tissue or open wound that never healed. The air gets trapped between my lung and my chest cavity (inner rib cage lining). As I begin to surface a situation referred to as “reverse block” occurs. Quickly speaking, air at the surface becomes compressed (squeezed) as you dive deeper and when you surface it expands back to its original size at the surface. If this air gets trapped as you surface reverse block occurs and the air continues to expand but not escape. The resulting situation can be downright painful on the good spectrum, or life threatening on the opposite end of the spectrum. Reverse blocks are most common in the nose or ear canals when swollen sinus’ block the path of escaping gas. Now, following the same principle, my situation could be considerably worse. See, any gas that I trap will not be fully expanded to its original size at the surface because I did not trap the air at the surface. I trapped the air at depth and thus as I surface the air expands to more than its original size and thus the only way to return it to original size would be to drop back down to depth. Not good.
So what would happen to me if this scenario actually happened? First, the pain would be nearly unbearable. Basically it would feel like my chest was trying to explode because, well, it would be. This would in turn crush my lung and make breathing exceptionally painful and difficult. My brain would react to the failed lung and kick my other lung into overdrive, essentially causing me to go into shock and hyper ventilate. Remember breathing is painful? Hyperventilating doesn’t sound fun. Now with my one lung collapsed my inner chest cavity would be unbalanced. This in turn would cause a pull on my other lung trying to fill the void of the collapsed lung. Besides the obvious pull and stretching of the good, now over-worked lung, it creates a pull on my entire esophagus area, literally pulling my throat to the side making it feel as if I’m being choked. Naturally this further complicates the hyper-ventilation and shock. If this scenario were to take place in the vast majority of the USA a prompt call to 911 and I should be OK. This scenario happening on a remote exotic island location… not so much. It will literally be a race for life to find adequate medical care (remember that part about insurance?).
Best case scenario? In 6 months I subject myself to a Spiral CT Scan and a sealed lung is found to have minimal if any scarring and a subsequent series of hyperbaric chamber rides shows no leakage of air resulting in medical clearance and insurance.
I know what I’m hoping for.
