Orthotics and Prosthetics

Try saying that three times really fast.  In fact, try saying it once.

The place I am presently chained to…Tallahassee Orthopedic Clinic…is larger than some hospitals, and has several departments.  MRI, Surgery, Physical Therapy, and of course, O and P.

I am for sure getting better.  I can tell by the number of devices I need in order to walk.  I went from this:

To this:

To this:

The second photo is a pneumatic boot.  Your next step after a cast. Its advantage is, you can (theoretically) take it on and off, which you can’t do with a cast.  I’m joking about theoretically.  It just isn’t easy.  When you put it on, you have all these straps, miles of Velcro which sticks to itself.  Which strap goes where?  Once you get it on, there is a little port where you inject air to stiffen the rigid sidc supports.  Or as one of my friends said, it’s a medieval instrument of torture.  And the longer you wear it, the worse it gets.  It’s heavy.  I started to feel like Frankenstein’s assistant Igor, dragging his leg around.

Two days ago, I graduated to the third photo:  an ankle brace.  Specifically a Gameday ankle brace.  I had to laugh when I looked them up.  They claim it’s very easy to wear and adjust.  Really?  It has a sort of mesh on top, and a lace-up tie that you have to do first.  Step One. Then there are two side straps that you have to weave under your foot in a figure 8 pattern and then secure to the top.  And finally, a third strap which goes around the top to secure the laces and the other two straps.  And I thought the boot was complicated?

The boot was serious Velcro,  and when I say Velcro, I mean nuclear Velcro.  Not only did it stick to everything, it attracted stuff like it was magnetized. I wore it day and night. It was black.  I have a totally white cat, and a red and white dog.  I had ditched one of the straps, and another was missing its little plastic thingy that you were supposed to feed the strap through I was embarassed when I saw the O and P guy.  He said, it’s okay.  It just means you were using it.

Kind of a nice thing to say.  Especially since he was trying to get a break to eat his lunch when I walked in.

Nice is not a word I would normally use about TOC.  It has a reputation for being like a factory, and the more I’m there, the more I understand that.  I have mostly seen a Physican’s Assistant that I love, but he is supervised by a physician I think is an idiot. This physician refused to renew my prescription for pain medication.  The PA said, Dr. Borom says he will not prescribe pain medication for more than a month after a fracture.

Seriously?  There is a time limit?  Every other thing I’ve had a problem with, they asked you to characterize your pain on a scale of 1 to 10 and treated you accordingly.

But the main thing is….I’m better.  I can still remember now how awful and desperate and frightening it was in the beginning.

 

 

 

 

Fakename Sees the Orthopedist

I went as soon as I could, on Wednesday January 2nd.  The first thing that happened was that I and the receptionist almost had to rumble.  To be specific, I was ready to come out of the wheelchair and go to the mat with this witch.  Plexiglas screen or not.  The issue was whether or not I had sufficient proof of insurance.  I said she could call to verify it, and she said she didn’t have time to call, but I could do it if I wanted to.  I said, “I won’t be calling, because I don’t think I should have to.”  She said, if it isn’t verified, I’ll have to put you in the computer as uninsured.  I said, “I don’t care how you put me in your computer.  It makes no difference to me.”   I was pretty sure that when the time came, SOMEBODY would verify that I had insurance.  Like when it was time to send out the bill.  I was, in a word, furious. This was not the way to start a new relationship.  The receptionists at my veterinary hospital are head and shoulders above this woman.

I grumbled all the way back to where my sister and I parked, and I said, “I am not accustomed to this kind of treatment”.  My sister said something along the lines of “What?  You expect them to behave like serfs?”  I was stung to the core.  NO!  I’m just accustomed to people being helpful.  Which one of us here has the broken leg?  I’ve been told no before.  Like no, I know it would be more comfortable for you to lie this way on the treatment table, but you can’t.  We need you to lie this other way.  Sorry.  I never had anyone tell me they didn’t have time.  If she doesn’t have time, she either needs help, or she needs a different job.

Very shortly I was called into the treatment room, which is a huge open area where many patients are in various stages of cast application or removal.  Fakesister said, “Oh my.  It’s an assembly line.”  Gulp.  I had heard this about Tallahassee Orthopedic Clinic before, that it was an assembly line.  Impersonal.

But it turned out, it was merely efficient, and not at all impersonal. I saw a physician’s assistant and dutifully handed over my X-rays from the Apalachicola ER.  I had to have one more X-ray–a gravity X-ray.  You hang your foot over the end of a cushion.  If it droops more than it should, it means one of the ligaments is damaged too.  I was fine.

Now let me count the ways I was lucky.  The fibula fractured right between two ligaments which hold the bone together.  No matter what I did, I could not make the bone break “worse”.  I did not also break the tibia, which often happens when the break is that far down toward the ankle where the tibia and fibula are connected.  Not breaking the tibia is a major perk.  It’s the weight-bearing bone for your entire leg.

Small anatomy lesson here…and thanks to Fakesister for it.  You know your ankle has two “bumps” on either side?  The one on the inside of your ankle is the end of the tibia.  The one on the outside is the end of the fibula.

But thanks to my good fortune, I got a walking cast right away.  The PA said I could put as much weight on it as I could stand, which would not be much for the next several days.

I got to pick the color of my cast, so I picked the only shade of white they had, which also glows in the dark.  I almost lost my nerve when this resulted in grins from nearby patients and virtual smirks from the technicians.  Fakesister said to the techs, “I’ll bet you’re used to this choice from 11-year old boys, right?”  But she also said she loved it, so I pressed on.

Later that evening, Fakesister tried to take a picture of it with her iPad Mini, but it doesn’t give off enough light to take a picture of it in the dark.  She describes it as a “ghostly greenish glow”.  It’s pretty cool 🙂  I’m glad I stuck with it.

The guy who put the cast on said I might scare my pets with it.  Now that I’m back home with my cat (the dog is at the vet’s), she hasn’t been alarmed by the cast at all.  But she is ultra-scared of the walker.  As far as she’s concerned, it’s a WMD.

The ER In Apalachicola

The ER is at Weems Memorial Hospital.  Chief Jay of the St.George Island Volunteer Fire Department advised me not to go there.  It’s possible he had some prior bad experience.  But I guess it depends on your expectations.  I was not expecting it to be the Mayo Clinic.  I needed only two things:  X-rays and a prescription for pain.  I got both, so I considered it a success.

The X-rays were no fun.  They kept wanting me to turn my ankle in directions it didn’t want to go.  There was another woman in there with me, who had a back fracture.  She kept screaming things like “Please, God, help me.”  They had done a portable X-ray and would not let her lie back down until they checked to see if the X-rays were okay.  If that had been me, I would have laid back down anyway and pardon my language, but fuck what they told me to do.  I thought the X-ray tech was extraordinarily insensitive.

Needless to say, I wasn’t feeling that great myself, but I had resisted crying except for one almost-crying episode.  But this situation had me in tears.  I wanted out of there, so I did not have to hear her screams any more.  This sounds selfish, but I couldn’t help her.  If I could have, I would have done anything in my power, screams or not.

You could hear her screaming all the way out into the waiting room, and my friends Brenda and Pat thought it was me.  They should have known better.  For one thing, I would not have been calling on God.

When we first pulled up to the ER entrance, I got what I now consider the greatest invention of mankind–the wheelchair.  I could have kissed its foot rests.

It turns out that wheeled chairs have been depicted in both Greek and Chinese art since the 6th century BCE.  But the first modern, lightweight, collapsible wheelchair was invented in 1932 by Harry Jennings, an engineer who built it for his friend Herbert Everest.  Everest had sustained a back fracture in a mining accident.  I could kiss them too.

After being wheeled back to my exam room from X-ray, the doctor came in and said, “I have some bad news and some good news.  The bad news is, you fractured your fibula, but…” I said, “Wait!  Are you saying I broke my LEG? By falling down one step?”  He said, “Well, yes.  But the good news is, it isn’t fractured all the way through.”  I guessed that must be good news, if he said so.  He told me to go ASAP to an orthopedist–they didn’t have one there.  And he gave me a prescription for Lortab–a hydrocodone/acetominophen combination that goes by many brand names, such as Vicodin, which Dr. House was addicted to on the TV show “House”.

It took 45 minutes for the only open pharmacy in Apalachicola to fill it, during which time we took a little scenic tour around the town.  It truly is a quaint and beautiful little fishing village with a lot of history.  Its name, translated from the Native American, means something like “people from the other side (of the river)”.  In this case, the Apalachicola River.  Subject of major lawsuits and countersuits by the states of Georgia, Alabama, and Florida.  The issue, in a nutshell, is Georgia hoarding all the water it can get into Lake Lanier, to support the population of Atlanta.  Meanwhile, the Apalachicola River needs a certain amount of fresh water to pour into the Gulf at Apalachicola Bay, to support the briny environment oysters need to live.  They can’t live in fresh water, but they can’t live in sea water either–it has to be a combination.

I can tell you that the beauty and history of Apalachicola are best appreciated when your ankle isn’t screaming.  But it was a good distraction.  I opened the bottle with trembling hands and promptly swallowed half a tab.  The ride back across the three bridges to get back to the island was therefore somewhat more bearable.

Next episode:  Fakename visits the orthopedist.

 

Cancer In Real Life

Out of respect for my friend, whom we’ll call “Jane”, I’ve refrained from discussing this issue up until now, but I have to beg forgiveness because I can’t deal with it any more without unburdening myself.  I’m ashamed of myself for being so weak. 

Jane was diagnosed with breast cancer in 1998, and went all out with every known treatment.  She had a mastectomy.  She went through radiation and chemo, and then took hormone therapy (Tamoxifen) for five years, until 2003.   She doesn’t remember what stage the tumor was, which defines what kind and how much treatment you get, and in the end it doesn’t matter.  Many women choose to take the route of the most aggressive treatment possible, even if it isn’t necessary, because of what I’ve previously called the “spider in the hair” phenomenon.  Get it off me.  Ick. 

Fast forward to 2006.  Jane was by my side when I woke up from surgery and was told by the surgeon that the suspicious area in my breast was indeed cancer.  Thank God for Jane.  She directed me to this surgeon in the first place.  Told me what medical oncologist to see and what radiation oncologist to ask for.  Prepared me for what to expect.  Jokingly, I used to call her my Spirit Guide, partly because she’s a very New Age kind of person.

Oddly, at the very same time this happened to me and I was quite preoccupied with Me, Jane got an upper respiratory illness…a cold or the flu or something, and they sent her for a chest X-ray, which as she later said “lit up like a Christmas tree”.  There were abnormal spots on the bones of her ribs.  She made an appointment with the medical oncologist to discuss it, but as I recall, it was before that appointment that she developed excruciating pain in her face, along with paralysis, and had to go to the ER.  She managed to get herself there, but I took her to have the MRI she had the next day or so, turnabout being fair play. 

The result:  Her breast cancer had metastasized to the bone.  Not to be brutal, but when that happens, it will kill you unless something else kills you first.  Since then, she’s had several bouts with chemo, traveled to Boston for a second opinion about her treatment, continued to work, and maintained  a positive attitude that verges on sainthood.

But late last year, she fell and broke her hip.  She had surgery and was doing well, and was back at home.  On Friday, I learned that Thursday of last week, she fell again at home.  This time she broke her leg, a spiral fracture of the femur, she tells me.  She had another surgery, and is now in a rehab hospital for an unknown length of time.  And her life as she knew it is toast.  She’s been fortunate to work for a government agency, with excellent benefits and a program where other people can “donate” their unused sick and annual leave to her, but by the end of this month, she will run out.  So she’s applying for disability, something she had hoped to avoid. 

You may think that I’m only thinking of myself–that I fear something similar will happen to me, since cancer metastasis is unpredictable.  That watching this happen to her scares me.  You would be totally wrong.  I have a very advanced case of denial.  It was hard enough for me to believe I had cancer in the first place.  I’m even better at denying I will ever be in Jane’s shoes.  But it’s more than that.  I know it could happen, but I don’t choose to live that way.  You could wake up every morning being afraid to go out of the house because you could be hit by a bus.  Or not.  I choose “or not”. 

So the real problem is that there is no manual for dealing with a friend dying.  She says she likes my demeanor.  I don’t hover and baby her.  If she feels bad, I’m likely to cover her with a blanket and say nothing.   I know that’s important.  Like me, she’s terribly independent.  I hope that continues to work.  But it takes an emotional toll on me to maintain that neutral attitude, when what I want to do is break down in tears and say, “Don’t go”.  But no matter what, I will find a way to keep doing it.  I’ll have to find someone else to comfort me.  It isn’t her job.  She’s busy enough.