Sunday, February 13, 2011

Sunday the Thirteenth

Usually, the "thirteenth" of anything is supposed to be bad luck, but I'm feeling pretty optimistic today. It's been a very slow morning. (And why not? my foot is best kept up in the air, higher than my heart, so there's not much to do besides read. Thank God for Jane Austen.)

I've been posting little updates on the foot situation on the Op Op Facebook page, so those of you who have "friended" the Op Op on Facebook already know what's been going on. But here's the summary.

Monday morning (Feb. 7th) I slipped on the ice on our sidewalk and broke my left fibula (the bone just above my ankle, on the outside of my leg). In the ER, they kept asking me "how I fell," and for the life of me, I couldn't tell them. However, upon reflection, I think I have it figured out, working backward from my first clear memory after falling (it happened so fast, and my immediate reaction was to roll over onto my other side).

It was just a small patch of ice--only a few feet wide. My feet slid sideways toward the right, and my left foot must have gripped the good concrete as soon as it ran out of ice to slide on, so that my left foot got turned too much toward the left, with my weight coming down on it.

After I landed (and yes, I heard a "crunch" in my ankle concurrent with the onset of pain), I rolled over onto my right side and stuck my hurt left leg into the air. The foot was bent too far to the left (though I wasn't consciously bending it). (Gross.) I reached down and moved it back into position (another "crunch"). (A few days later, the orthopedic surgeon told me I'd done a pretty good job of setting it.) (I wasn't quite aware that that's what I was doing. Now, I'm kinda proud of myself.)

Here comes the advertisement for cell phones: Mine was in my back pocket. I called Sue, who was just inside the house, and she came out, helped me into my car, near where I fell, and drove us to the Emergency Room.

Pain medication; X-rays; diagnosis (fractured fibula); splinting; an orthopedic surgeon recommended.

The ER doc said he didn't think it very likely that I'd need surgery; it seemed in good position; he guessed only 4-6 weeks in a cast.

So it was a surprise on Wednesday when the orthopedic surgeon told me he strongly recommended surgery--a cast, he said, wouldn't be able to hold it stationary enough for it to heal properly.

And so it was all set up right away; surgery on Thursday morning, preoperative interview and testing at the hospital that very afternoon.

Boom, boom, boom.

Thursday, naturally, was mostly a blur. For all the amazing things that surgeons can do to help us to heal better, perhaps the most remarkable miracles are performed by the anaesthesiologists and narcotic pain medicines, that they can drill on bones and you be up and about within a few hours, without screaming.

Like the last time I had orthopedic surgery, I had a nerve block, but this time, it absolutely worked. (I won't go into the fascinating/gruesome details, which reminded me of the eighteenth-century neuro-electrical experiments that inspired Mary Shelley to write her novel Frankenstein.) It made my lower leg and foot completely numb--indeed, paralyzed--for over twenty-four hours. No pain medicine needed all that time. It was noon the next day when I discovered I could move my toes a little, and three when I started to feel the incision. Pretty awesome, huh?

I won't put a link into my blog, but if you Google on "Youtube fibula fracture," you can find an animated video that shows, I think, pretty much what they did to me; it's basically a contoured mending plate with two or three screws into the sound bone on either side of the fracture.

[Addendum: I didn't know it until some weeks after I wrote this post that he also put a longer screw through the bottom of my fibula and into the tibia, in order to hold in place the ligament that goes between then, which had torn when I broke the fibula.]

After the surgery, the doctor told Sue it went very well and that I have good strong bones. I was amazed to read the postsurgery instruction sheet where the doctor had checked "weight bearing as tolerated"--wow!

[Addendum: That was a total mistake on someone's part; I wasn't supposed to be weight-bearing at that point at all! Good thing I didn't put any weight on it until I'd double-checked about this point!]

You have to understand: I don't have much experience with broken bones, casts, and what-not, and my one experience with it was nightmarish. No one in my immediately family ever had fractures; my brother and I both made it through childhood and adolescence without any broken bones. I never saw what was involved in keeping the cast dry, bathing, getting around, learning how to use crutches, and so on.

So in October 2007, when I broke my foot, my had no hint of what was involved, what to expect, how to do things. It was rude.

And what made it even ruder was the nature of that infirmity--the Jones fracture is notorious for slow healing, and my hopes and expectations for regaining use of my foot were constantly jerked out of my grasp: "No, it's not healed yet; let's see you in another month." So I got pretty dang good at using crutches.

We had to modify our house. We moved furniture. We outfitted the clawfoot tub, using plastic hose and packing tape, for use as a handicap "shower." I learned how to go up and down steps without falling and eventually did it with confidence. I learned that, given a wide, clear, dry sidewalk, my crutching could easily outpace the non-crutching friends I was walking with. I developed respectible callouses on the heels of both palms.

So now, all that stuff is coming back to me. Having been "through this" before, it's not nearly so traumatic. Even when I was lying on the sidewalk, thinking, "oh, shit, my ankle or something's broken," my disbelief was mixed with a sense of resignation instead of a wild, frantic fear of the unknown.

The "been there, done that" aspect has helped tremendously.

The hardest part, all along, has been my fear of what "my" insurance company won't do for me, or will do to me, in response to these claims. They don't like it when you have claims. Now that I've had a big claim, it's certain that I will have to shop for a new insurance company when this one's year is up. (If you don't think there's anything wrong with the health insurance industry, I can say with confidence that you are not having to purchase your policy as an individual.) Indeed, I was crying in the ER, and the nurses assumed it was because of the pain--but instead I was thinking of my deductible. And there's no pill for that. (If there was, my insurance wouldn't cover it, and I probably couldn't afford it.)

One thing that's occurred to me several times in the past few days is that I'm truly grateful that "crutching" is a skill I have already learned. Much of the trauma of my previous fracture was caused by the handicap to my lifestyle. And so I keep thinking, "It would be a terrific idea for everyone to voluntarily spend a week or so on crutches--while they're able-bodied." Yeah: learn how to crutch forward and backward, left and right (like I've had to do on narrowly shoveled sidewalks), up and down stairs. How long can you stand on one foot at a time? Long enough to brush your teeth?

Indeed, it could be something they teach in P.E. classes--an incredibly useful skill. Not that you'd necessarily need it during your life, but hey, if you ever do, you'll be grateful you know how to get around without falling. Much better to learn it when you're feeling good, than to have to learn it when you're in pain or are loopy with pain medications. It would be more useful than knowing how to do a cartwheel, which they tried like crazy to teach me how to do.

So, here's the outlook: At the end of this month (two weeks after the surgery), I'll see the surgeon again. He'll remove the stitches and put me in a cast (I think--or maybe a walking cast?), and then I'll have another four weeks on crutches.

Thus, I'm looking forward to the end of March, when life might get close to normal again.

Sorry this has been a rambly diatribe; it's a sunny day, the first truly "warmish" day we've had for months, and I think I'm going to go to sit outside for a while.

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