The hubs developed a leak of spinal fluid at his surgical site. We took him back to see his Neurosurgeon and he was booked straight in for surgery. He was due to be back on the boat in 10 days time and the idea of going back under the knife got to him. When he was coming out of anesthesia, he couldn't use his legs. Naturally, I freaked out. I kept my composure for him, the PA kept checking and rechecking his legs. He wasn't even completely conscious yet. I had to explain to him, in his haze, that he was going back under because his legs weren't working. He didn't see me cry and he didn't hear my voice crack. They hit him some O2, some more versed and then wheeled him away. My hands were shaking and I nearly hyperventilated in the waiting room. I was still ok. I had to be because I had to make the hardest phone call of my life so far.
It was nearly 11PM in England, I had just called his Mum to tell her he was okay not even and hour before. I knew she had gone to bed with a clear head, knowing he was alright. Unfortunately, his Dad answered. That man hates me and I knew I'd woken him up. I asked, as clearly and calmly as I could to speak to his wife. I told her that the recovery team had come to get me and that her son had failed his neuro exams. I had to explain that he couldn't use his legs. I was mechanical and I relied on my training as a nurse to stay detached and deliver the news to a patient's family, but then she asked me how I was doing and I broke. I told her that I knew I couldn't care for him here and that I needed to think about long term plans. She's the only one in my husband's family that accepts that it wasn't my choice to leave England, but his. I told her I would keep her informed and that I needed to wait for the surgeon to come back out.
While I waited for the surgeon, I began looking at the cost of moving. I began looking at options. I began the dreary task of living in the worst case scenario. Then I learned something. I learned that while I'm here, looking to go back and restart nursing school and spend 4 years restudying to do something I'm only mildly interested in, I could spend 5 years studying to be a doctor in England. My first passion. Science. Medicine. I made my mind up. We WERE moving to England. I married my husband when I was 19, and I quit college for it because he was "non-taxable" due to his status working for the US Military. I followed him everywhere for nearly 10 years and because of that, all the financial stress falls on his shoulders. So I decided that if he comes out of this surgery with his legs working or not, we were going back to England. We were doing it right and I was going to medical school.
The surgeon came out and told me there was no obstruction, no pressure, no swelling, no damage to the nerves and that the nerve conduction tests went perfectly. He then asked me if it could be psychological. I said, "No, he's been calm, I don't see how it could have happened with him so sedated." But the Doctor said it does happen. I was so flustered and so focused on calling his mother and seeing him that I didn't think. In recovery, he was still failing his exams. High and barely conscious... he was still unable to respond to painful stimulus, he was unable to move his legs. I asked the nurses how his pedal pulses were, checked them myself. Checked capillary refill. Performs my own neural exams. I needed to make it real in my mind. The nurse stood beside me quietly and nodded as I pinched his nail bed, dug my nails into the soles of his feet, asked him to push and pull against my hands. The surgeon had come back to check on him again and watched me. I looked at them both and said, "He still has feeling though. I don't understand. It's like his brain has just turned his legs off." They both sort of shrug-nodded. The nurse must have thought I was going to cry or something and she shooed me out while they moved him from recovery to his room.
I called him Mum and explained that he passed the nerve conduction tests. The nerves were perfect. The paralysis was completely unexplainable. That we were going to have to sit it out and see how he is when he's more awake and able to understand things. I told her I would keep her posted and naturally we were both scared. I told her that I didn't care what he said, I was going to put my foot down about moving back to the UK. In the room, he was more with it. He asked if his Mum knew and I told him that she had been kept in the loop. He was confused, but not quite scared. That's when it really clicked. He such an outwardly stressed guy. He'd only had one episode of it before, but it was pretty severe. I went out to the Nurse's station and luckily his surgeon was there, wrapping up paperwork.
"Conversion Disorder," I blurted out, and they looked at me confused.
"He has conversion disorder, he was only 0.5mg of lorazepam until a few months ago. He's only ever had one flair up before, it was a severe case of dysuria. It was so bad that they did a ureteroscopy on him to try and find the cause."
"I'd say this is his second episode then," the surgeon said.
Exactly! This isn't just idiopathic paralysis!"
"Hysterical Paralysis," his neurosurgeon and I both said together.
"My brother has very mild conversion disorder, but hysterical blindness, deafness and such are so rare," the Doctor said.
"I know, do you think we can try putting him back on the Ativan and see if that helps? He must have been worried about losing his job, his FMLA leave is up in a week, but he wasn't outwardly stressing about it. He must have already begun the episode, turning the mental stress to physical and the CSF repair just triggered it."
"Yes, I think that's a good idea. We'll get an MRI tomorrow to be safe, and try and get him into a Rehab place to get him moving again, if they'll take him. If not, we will discharge him."
"Push him out of the nest? Force him into reality again?"
"Yes, yes. If you're comfortable with that."
"I am. What choice do we have?"
I talked to him, made sure he got something to eat. Made endless cups of tea and when he was together enough, I approached the subject of moving to the UK. We had been saving up for a house, but, it wasn't logical to keep putting off my education and relying on just one earner. He's been to work in the Middle East, Africa, Mexico, all over Europe and I've quietly sat on the back burner. With him being in his early 30's and already having had back surgery as well, he needed to think of a career change, he needed to look at going back to University. It only took logic. If he couldn't get his legs back, we didn't have a choice. If he did get them working again, well, it was only until the next catastrophe. Plus, having made the decision that losing his offshore job didn't matter, it relieved the stress that caused the Conversion Episode in the first place.
I'm an autodidact. I had an abusive upbringing and I lived relatively close to a library. I also had a wonderful school librarian who would get me medical journals when I was very young. I would sneak off to the library when I was not much older than my son is now. Maybe 6 or 7 years old. I would read anything science I could get my hands on. I went through an AIDS phase, a Cancer phase, a Psychology phase. Books were my safe haven, they still are and I have ALWAYS had a passion for learning. I taught myself Basic and Visual Basic when I was 8 or 9, HTML was soon to follow. I also taught myself French at around 8 or 9, starting with an Atari program, then with help from the Library's endless supply of knowledge. I began hacking and cracking small things before I even knew what it was, computers were great, but medical science was always my favorite. The Librarians, at first, didn't think I could ever understand what I was reading, but left me alone. Then I just became part of the furniture. I used my knowledge of Ohio laws to terminate my Mom's custody as soon as I turned 12, and moved in with my Dad. Books were my power, but I never had the means to properly get into or through school.
I had a 4.0 when I was in nursing school. It was easy as breathing for me. Clinicals were heartwrenching, but I'm and empathetic person, so they came naturally as well. What didn't come natural was the constant fighting amongst the students. It was like a constant episode of Survivor, as if there were only a few spots to graduate with. The instructors started and encouraged the infighting. I was in a class full of "mean girls" several of which came smelling of booze and some would deliberately hurt the non-verbal patients. If anyone complained about this, they would find themselves locked out of the clinical site and would be counted absent. Two absences and you were excused from the program. I know this from experience. My Dad was diagnosed with late stage 3 melanoma before I applied to Nursing school. I was told the program was flexible and they understood I was caring for an ailing Father. Clinicals missed for that reason would be able to be made up. I missed one Clinical because he ripped his surgical drain out, I missed the next for turning a student in for breaking my patients finger to hear her cry and getting locked out. I got back in literally 1 minute past cut off and was sent packing. The dean told me I didn't belong in Nursing School because my "priorities were fucked up."
Anyway, getting back to my husband. They kept retesting his reflexes and his range of motion. The whole day ticked by. His feet were under the blanket and he only saw them when they were tested. A thought was brewing in my head, I couldn't figure out what, but it was there. We worked out a plan for moving. A fast plan, in case he couldn't walk again and a slow plan, in case he does. The nurses kept coming in to encourage him. They told us we were amazing because he was up and walking right after his initial surgery. They told us how amazing we are together, how well we work as a couple. They just wanted him up and moving. It's a small surgical center, with a very small patient to nurse ratio, so they really do get very attached to you there. They were all concerned, you could see their brows furrowed as they checked and rechecked his legs. They spoke only to me about his condition and we were selective about the narrative we wove for him. His Therapist called and said he didn't think he could help him anymore. He only knew of one Psychiatrist with any experience with Conversion Disorder and he would call her, but he told me to bear in mind that Hysterical Paralysis is extremely, extremely rare. This was going to be trial and error for all of us. Part of me (the nerd part) was a little excited. The wife part of me was scared.
The next day, we had another problem. He's extremely claustrophobic and it was a closed MRI. So more sedatives. I went down with them. Still in my pajamas, sports bra, luckily. They began to put him in the machine and he began to panic. So I threw my glasses at the poor nurse and went in. I held his hand, then his head, then his leg. He trooped through it, I told him to close his eyes and he did okay. When they wheeled him back to his room, the bubbles in the back of my brain had finally formed into a cohesive idea. His feet were covered up. He could feel his legs but he wasn't connecting with them. "Stranger Danger," I explained to him when I unhooked and removed the airsocks, uncovered his feet and forced him to look at them.
I made him go through range of motion. I propped his legs up so his heels were off the bed and I forced him to look at how little his feet were actually moving. He was shocked and said he felt like they were moving more than that. Every circuit in the RoM's I forced him to push it harder, farther, hold it longer. Every time he tried to look away I made him watch his feet. I tried so hard to get him mad. He used to have such a quick temper, but he just wasn't getting mad. I needed him to feel something, anything. Push it! Pull up! You're NOT TRYING! Try harder! Stop babying yourself. This is fucking serious. We're getting discharged today. PUSH! Point your toes, Circles, circles! WATCH YOUR FEET! GET MAD!
The nurses were behind the privacy curtain that hung at the door of our suite. They peeked in, quietly and when the Hubs laid back, trying to give up, I looked and one and they nodded at me. He was moving more and more with every repetition. One dragged the PA in while I was yelling at him. He didn't notice the audience. I didn't let him look away from his feet. I told him I wasn't letting him see our son until he gave it everything he had. After a while, he decided to try and stand. When that proved to be a success, he decided to pee standing up. I stole a conversation with a nurse. I had to explain that I needed him to reestablish the connection with his legs and feet. I needed him to restore his "foot-eye" coordination and I wanted him to see how little he was actually moving his legs. Everyone kept his legs covered and I explained that I thought it was allowing him to distance himself even more from them, mentally. After a rest from his victory over the urinal, he sat in the recliner. He said his legs felt weak and rubbery, but he wanted to try a walk after a rest.
When he was ready, I held his arm and his hand. I allowed him to rest his hand on the hand rails, but not to use them. He went up the hall and back, made himself a cup of tea at the Keurig and sat back in the recliner. The nurses all cheered for him, just like when he did his victory lap after his discectomy. He announced he was ready to go home, he wanted to see our boy. I told him it wasn't happening until he did a whole lap around the floor without me supporting him and without the hand rails. I told him his leg were still strong, he'd only been laid up a day, and he had no logical excuse in the world to not use them. He reluctantly agreed. So after his cup of tea, we set off again. I held his hand loosely, and he did the whole lap.
So here I am, preparing for the UKCAT, the BMAT, picking out which Medical Schools in the UK to apply for and he's sitting across from me on Facebook. We both feel at peace with the decision. Would you care to guess the specialty I've chosen to pursue? Neuropsychiatry. .I really feel like if there's a switch in our brains powerful enough to paralyze us, imagine what it could do when used to heal us?
I'm aiming for Brighton and Sussex Medical School, my husband was born there and his parents live in Hastings. I'll apply for some schools in London as well, but, I am so in love with Brighton. It's such an amazing city. The only thing I have to overcome is that a long time ago, when I was in High School and suffering at the hands of some depraved individuals, my GPA suffered. I don't have the 3.5 they want, but, as a mature applicant with a background in the medical field, I'm hoping my UKCAT, life experience and passion makes up for it. I'm only 28, but sometimes, I feel like I've lived 100 lives.
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