That's gonna leave a mark

I guess it’s good to get the worst out of the way right up front, then things can only get better, right? My biggest apprehension about moving to Cokeville has always been the lack of medical facilities. (What? You didn't know we moved? Click here and get in the know.) There is a little clinic in town with a nurse practitioner that is open only on Mondays and Thursdays. It's fine for minor things, like a sinus infection, but certainly no trauma care. There’s 3 small hospitals within an hour’s drive, but they’re all pretty mediocre and everyone has a horror story to tell you from any one of those hospitals. To get decent medical care, you have to drive to Logan (1 ½ hours) or Salt Lake (2 ½ hours). For everyone in Cokeville, this is a part of life and something you just live with, but for a city girl like me, who’s never really lived far from a hospital, this is terrifying. My biggest fear was that someone in our family would have an accident or a medical emergency and the good hospitals are too far away.

Turns out Dan is the one who got to put my concerns to the test.

Winter is approaching and our little house is set up with propane heat. 5 years ago it was a pretty economical fuel source, but this winter they’re predicting that it will top $4.00/gallon. The propane tank holds 500 gallons and needs to be filled about every 6-8 weeks. I’ll let you do the math, but it falls squarely into the "holy crap" category. So we decided to buy a wood burning stove since the house is already outfitted with a chimney and pipe; that’s how they heated the house in the old days.

Everyone in town has been up the canyon cutting down trees for their wood burning stoves. It’s truly "Little House on the Prairie"ish, except with chainsaws instead of axes. It’s generally a good community effort with plenty of sweat and male bonding. Dan missed the first trip of cutting wood, as he was driving home from working in Salt Lake. He arrived in the late morning on Thursday (Sept. 4th) and helped Brian and his brother Kevin unload wood.

Brian is such a show-off! That's Becca next to Dan.

Amelia's favorite outfit is a princess nightgown handed down from her cousin Faith. I've stopped dressing her in it at night because it's too cold, but whenever she finds it in her drawer she insists on wearing her "Rella Dress." It's quite the little get-up.

She was not pleased that we wouldn't let her climb on the wood pile.

Later in the afternoon, the crew headed up the canyon to cut more wood. I was organizing and mopping the kitchen and I get a call from Becca at 4:55pm. She says they’ve "hit a little snag". THE understatement of the year! She tells me that Dan has cut his leg with the chainsaw and all I could say was "Oh, shit." (‘Scuse my french, but I’m pretty sure I’ll get a pass on that one.)

Here’s what happened, as best as Dan can recollect. He and Brian had cut down a tree and they were working at opposite ends, with Brian cutting the trunk into smaller sections and Dan trimming off all the limbs. The tree trunk was about waist high and Dan was cutting the limbs horizontally. Some of the limbs were kind of snarled so he had to cut into them at an angle from each side instead of just slicing it straight across. As he was cutting into a limb, the chainsaw caught on the trunk and ricocheted straight back towards his leg. It went straight into his left quadricep, about 3 or 4 inches above his knee.

He had no idea how deep it was, if he’d hit an artery or bone. Dan got Brian’s attention and as soon as Brian looked at the wound, he went running for the truck. Dan had the presence of mind to whip his belt right off and use it as a tourniquet. He pulled it as hard as he could for about a minute straight, until he could feel his pulse stopping, then he loosened it a tiny bit at a time. When blood didn’t spurt out at him, he knew he was going to live, and he said that made all the difference in the world.

Becca was at the truck and she and Brian loaded Dan in and sped down the canyon. They stopped at the first ranch house they came to and called ahead to the ambulance (Cokeville has about 30 volunteer EMT’s) so that by the time they got to the mouth of the canyon 30 minutes later, the ambulance was there to meet them. They took Dan to Kemmerer, about 50 minutes away. Of course, they were replacing all the bridges between here and there, so the road was super bumpy and for some reason, the EMT’s had only given Dan a small sniff of morphine for the pain, just 10 minutes shy of the hospital. Get that man some drugs!!!

Fortunately, as soon as the doc in Kemmerer got a good look at the wound, he knew it was way out of his league. He had actually called ahead to alert the life flight team in Salt Lake, so they were ready to take off when he called after looking at Dan. I was a little tickled when I got to the hospital in Kemmerer and this fellow in a flannel shirt, oilskin vest, John Deere cap, and scruffy hair started giving me the medical report. (I think he had been out hunting when he got the call.) You know you’re in Wyoming when your doctor looks like this:

Dan was already bandaged up, but, bless their hearts, the EMT’s had taken pictures and one of the medical staff had a little digital printer. I got to see how deep the wound really was. I’ll save the gory pictures until the end of this post and give you plenty of warning when they’re coming, as I know some of you got squirrely even with Lily’s pulled tooth pictures. The medical staff, both from Cokeville and Kemmerer, rarely get to see serious injuries like that, so several asked to take pictures and Dan said it seemed like everyone in the hospital came by to take a look. They asked his permission to take pictures and he told them, "as long as you promise to give my wife a copy for her blog." Good man, good man.

Dan severed about 3/4 of his left quadriceps muscle, across the front and partially around the outside. Fortunately, most of the blood supply in your thigh is on the back side, so he really didn’t bleed too bad, and the wound stopped just barely shy of his femur. A miracle. I am just amazed that something as powerful as a chainsaw could go into Dan’s leg and somehow he had the strength and the reaction time to pull the sucker out before it cut his whole leg off. Adreneline is an amazing thing.

After I arrived in the Kemmerer ER, the AirMed flight crew from Salt Lake showed up within about 30 minutes.

They loaded Dan into an ambulance and transported him to the small airport where a fixed wing plane awaited.

Fortunately, I was able to go with Dan on the flight. I was relieved to be with him, but in my sick twisted way, I was also glad I could go along and get lots of pictures. (When my brother David fell into a lake in Maryland and fractured his tibia and fibula, was I trying to help him out of the water? No, I was snapping pictures while we waited for the trained professionals to arrive. I think that type of behavior may require some sort of psychological evaluation.)

And even more twisted, I was pleased to see a beautiful sunset on the horizon. Hey, if you’ve got to life flight your husband because he almost cut his leg off, at least you can get some pretty pictures.

Dan was pretty doped up on morphine and several other things they gave him in Kemmerer. He slept most of the flight while I snapped lots of pictures. When we landed, one of the AirMed guys commented that I was really documenting this event well. I explained that I was a professional photographer and obnoxious in addition, and he nodded and smiled at me with an "Oh, I see" look on his face.

When we walked into the University of Utah ER, I felt this overwhelming sense of relief. I knew there were excellent physicians there and that Dan was at the best possible place for his care. There were all kinds of doctors and medical personnel milling around and I said to myself, "that is a beautiful sight." After a couple more hours of poking and prodding and evaluation from several doctors, they took Dan up for surgery (7 hours after the injury occurred). The trouble with a chainsaw injury is that it not only cuts you, but it removes tissue in the process. So there was not a nice clean-cut wound to just stitch up nice and neat. They had to flush out the wound, remove debris and some tissue, and stretch the muscle to reattach it. Going into the surgery, the surgeon told me that typically these types of wounds don’t hold sutures well and they tend to form a lot of scar tissue which shortens the muscle and decreases its function in the future. With Dan being an avid bicyclist, this was a big concern for him. So when the surgeon reported to me after the surgery and told me that they had been able to get three layers of stitches in, that was great news.

Dan got out of surgery at about 1:30am and they admitted him upstairs to recover. After seeing the orthopedic surgical resident on call and the physical therapist in the morning, they released him at 2:30pm. It’s freakin’ amazing that you can cut yourself with a chainsaw at 4:30 in the afternoon and be headed home less than 24 hours later. My Mom drove us to Evanston where Brian met us and drove us the rest of the way home to Cokeville.

Dan’s recovery is going OK. As you can imagine, it’s pretty painful. His wound is bandaged at the surgical site and he has an ace bandage wrapped around his whole leg with a knee immobilizer on the outside. At discharge he was instructed (not by his surgeon, but some resident) not to remove any of the bandages or the knee immobilizer until we go for his two week follow-up visit. Because the wound was so dirty and tricky to sew up, it’s more prone to infection and it’s more likely that the sutures will come loose with movement. But Dan called the surgeon this morning and she said he could take off the ace bandage, keep the knee immobilizer on during the day and remove it during the night. He shouldn't soak the wound but it's OK if it gets a little wet, so I think we'll try wrapping it up in plastic so he can have a shower. (Reminds me of all those times my mom wrapped a trash bag around my brother Don's arm or leg so he could take a shower. How many casts did you have growing up, Don?)

While Dan is in a lot of pain and starting to get weary of how stoned he feels all the time, his spirits are amazingly high. We were talking last night and he said maybe in a couple of weeks he’ll get all depressed about how the injury will affect his ability to cycle or that he might have a little hitch in his get-a-long for the rest of his life, but for now, he was feeling pretty relieved and thankful for how things turned out. He said it’s amazing how much your perspective changes when you have faced the reality of dying. For the first 3 minutes after he got hurt, he sat there thinking, "I may die, right here in this forest" and when he realized that the worst that could happen was that he’d be permanently disabled, he was pretty happy to take that alternative. He said the reality of dying was so much more potent than the reality of being disabled, that it wasn’t even a comparison. So for now, his attitude is "hey, it’s just pain" and he’s looking forward to a good recovery. And he said that for all the crazy and dangerous things he's done in his life, it's amazing that he made it this long without paying the price.

Dan went for a few short walks yesterday (he can bear weight as tolerated) and is weaning down on the pain meds because they give him bad headaches and he's tired of being zoned out.

Dan was talking to his friend Elden yesterday and he asked how I was doing. Dan said, "well, about 7:30 at night she starts crying and by 10:30 at night she's completely hysterical." I laughed because it was about accurate, at least for the first 2 nights at home. I remained pretty calm through the whole ordeal until the night we got home and it all just hit me. I bawled like a baby. Not only did the gravity of the situation finally sink in, I was tired, and anyone who knows me well knows that I turn into a basket case when I’m tired. I was worried about the wound getting infected, worried about all the pain Dan was in, trying to balance meeting the girls' needs and taking care of Dan, exhausted from being pregnant and getting up several times a night, and feeling selfish for even bawling. I mean, I wasn't the one who'd almost cut my leg off! Dan and I had a good talk about it and he came to the rescue by calling the Relief Society and asking if a few of the women in the ward could watch the girls in the afternoon for a couple of days. That has made a big difference because I can get a nap and still get things done around the house. There's still lots of unpacking to do.

On Saturday morning Dan said, "Guess what I was supposed to do this morning? Today is the charity wood cutting day." One Saturday every fall all the menfolk (and some womenfolk) head up the canyon to cut wood for those in the community who can't get their own. I told Dan, "I guess we'll be on the receiving end of that this year." You gotta love Cokeville!

OK, are you ready to see the gruesome pictures?









Cami, stop looking and keep scrolling.










For all the interested nursey types or other weirdos that like to look at stuff like this, here it comes:










Pretty gnarly, huh? The pictures don't really do it justice because most of what you see is congealed blood and you can't really see how deep the wound is. Later, at the U of U ER after the bleeding had stopped, you could really see how mangled things were. I can't believe I didn't get a picture. What a slacker.
I will now insert some cute pictures of Amelia to act as a buffer between the gross pictures and the link for the comments section. She loves to go out to the corral and say hi to the horses and yesterday there was a special treat: 3 new colts that had just come from a horse sale.

As a last word, I think Mom said it best. "A cord of wood is pretty cheap in Cokeville - unless you add the hospital bill."