September 2006
Tuesday September 6, 2006
The Orthopedist 4
or Cast Off
After eight weeks in a cast, I had had about enough. Over the weekend, my crutch slipped in a damp spot on the deck, and I crashed into the side of the house. I wondered if, at this point, the cast and crutches had become a liability rather than a solution. I spoke to a friend who is a medical doctor and just happened to have broken her ankle about ten years ago. Of course, she lives in another state and could not evaluate my x-ray, but the first words out of her mouth were “it’s time for that cast to come off”. Every break is different, and my foot was dislocated requiring the orthopedist to pop it back into place. However, my friend had worn a walking cast for about half of her eight-week disability. She basically got up and walked away when her doctor removed the cast from her leg because she had already been walking on it and rebuilding her strength. I hoped to regain mobility in my ankle as quickly as I recovered flexibility in my knee, which was only a couple of days. My knee was not injured, but my ankle should be healed after eight weeks of isolation.
My husband took me to the orthopedist Tuesday night after work. He immediately cut off the cast and asked if I wanted to keep it as a souvenir. My first response was to throw the thing into the garbage. Good riddance! Then I decided to save it for photographs, which I will add to my photo gallery when I get around to it within the next couple of weeks. It stayed in the back of my husband’s car for the rest of the week. Once the cast was off, I crutch-walked to the x-ray room and boosted myself onto the familiar table. A lead apron over my belly prepared me for the procedure. My x-rays were excellent; beautiful, in fact, if you are into that kind of thing. I smiled and laughed in absolute euphoria. I moved my toes then flexed my ankle. It moved readily. No pain but some stiffness. I was ready for action.
The doctor pulled a small brace out of a box and strapped it around my foot. It will keep me from twisting my ankle laterally and re-injuring the tender joint. I could accept that. Then he told me I had to wear the brace for four more weeks. And I will need physical therapy. I just about had a fit. Why is this taking so long? I still don’t know. I have not gotten a satisfying answer. He bases his diagnoses and recommendations on experience, which makes sense, but why is my injury (that did not require surgery) so much more severe than all of the other people I know who have broken their ankles? People have actually introduced themselves to me in the grocery store and shared their stories upon seeing my cast and crutches.
Doc demonstrated how to walk with both crutches for support. Placing the crutches and injured foot on the floor at the same time would reduce the load on my wounded joint. As I become stronger, I can lose one crutch. Eventually, I will not need the crutches at all. As I watched his movements, I decided I could copy them, got up off the table, and reclaimed my ambulatory aids. I could indeed move slowly and carefully with two crutches. Then he told me he wanted to see me in four weeks. Four weeks? I’m going to be walking in a couple of days. What’s with this “four weeks” crap? He conceded three weeks. I tried to bargain for two. The orthopedist said he liked my spirit but did not want to see me before three weeks unless I was having a problem. I do not know what possessed me, but I told him I would walk on Monday. He countered with I might very likely still be on crutches in three weeks. My eyes narrowed. I will walk by Monday. Over the weekend, I will learn to walk again. Even though this guy is an orthopedist and sports medicine doctor, he has probably never seen anyone so cocky and ridiculous in his career. There is no one more determine than an injured athlete. And he has never met me before.
Read about my other trips to the orthopedist: 1 2 3.
September 7-9, 2006
Agony and Ecstasy
Did I mention that I started a new job this fall? I work in public education and had been home all summer. I decided to move to a higher paying school district and secured a position last spring. At least my husband and I took a cruise and enjoyed a couple of weeks of freedom before his hip replacement and my ankle break. I kept my chin up all summer. I even flew to visit my father. Of course, I did not have to do anything. This does not mean being in a cast all summer was easy or wonderful. It was miserable to be alone in the house, freshly injured, while my husband was in the hospital and rehabilitation. Circumstances forced me farther out of helplessness faster than most people have to accept after such a trauma.
So I went to a new job in a cast and on crutches. The first few days were just orientation, no students to complicate matters. I felt awkward and uncomfortable. New jobs are tough under the best conditions. This made it that much harder. Fortunately, the cast came off the evening before the kids came back to school. However, I had no time to experiment with my newly liberated and supposedly healed joint before (figuratively) jumping in. I still could not drive a car, and my husband had to take me to work, which discombobulated his whole schedule. Most people were very kind and supportive. The kids were eager to help me. They wanted to hear about how I had gotten hurt. One introduced herself as a fellow ice skater. I love to teach and cannot imagine myself ever returning to another profession.
Of course, there are nice sympathetic people and then there are jerks. I do not want to go into too many unpleasant details, but it is obvious certain individuals will not cut me any slack. One person actually hurt my feelings so badly, I wanted to look into going out on disability until I am more mobile. I am doing my best under some pretty rotten circumstances; cut me a break, please. I have decided to avoid this person, who unfortunately is my direct supervisor. A coworker told me this is my supervisor’s management style, so I should not take it personally. That made me feel better, but I was still unhappy that I have to wade through this kind of nonsense.
When my husband came to take me home, my leg had swollen to grotesque proportions. I was very uncomfortable and my ankle tender with pain. I never really experienced pain during this injury, so this was a rude awakening. I sincerely believed I would be up and about within a few days. When the doctor told me I could be on crutches for three more weeks, I was horrified and chose to defy him, as though I could use will power alone to make myself walk. I wanted to cry when I got home, but instead rinsed my leg with very cold water and called my father to bitch aerobically.
On Thursday, I shoved my braced foot into my sneaker and went to work. My husband dropped me off and a new friend drove me home. I avoided my supervisor and had a better day. We went out to dinner that evening with friends. I refused the handicapped ramp and used my crutches to get up the stairs into the restaurant. I insisted upon getting up with one crutch and serving myself at the salad bar. I started the day on two crutches and switched to one by lunchtime. At dinner, I could walk with one crutch and carry a plate for the first time in months. I felt liberated. Actually, I was so secure, I lifted the single crutch and carried it back to the table.
I walked on Thursday.
I drove myself to work on Friday.
I did not wait for Monday.
Sunday September 10, 2006
Walking
The swelling in my calf was very disturbing during the week. I had been wearing sneakers to work over my brace. By the end of the day, my leg looked like it could explode. The leg did not hurt, but it made getting around more difficult. I definitely needed some type of slip-on shoe that would fit more easily over my injured ankle. My husband and I went shopping on Sunday morning and I bought a pair of beach sandals, the type with Velcro straps that wrap over the top of the foot and around the ankle. They have textured soles designed for walking on wet rocks. My braced foot slipped easily into the shoe and the straps adjusted comfortably. I walked around the shoe store on one crutch. Just wearing a different shoe made me feel so much better, I set my crutch down and walked unassisted back and forth next to the displays.
At home, I walked easily around the kitchen and dining room exclaining in utter astonishment “I can walk! I can walk!” as though a faith-healer had slipped me a c-note. Of course, I am not walking perfectly and have a pronounced limp, but I will gladly accept this improvement. My husband decided the sneaker had been part of my problem, as it was probably too tight and aggravated my condition. The rejected footwear has been in the closet ever since.
I never truly realized how wonderful it is to be able to walk. Walking is freedom. I can go places without help from anyone. I can do things for myself. I can move about in the world. Someone who can walk can do other fantastic things too like run, dance, and skate. It is such a blessing to be able to walk! If you are reading this and you are able-bodied; get out of your chair, off your lazy ass, stand up, and walk. Think about what it would be like not to be able to do that. I am grateful that my disability is only temporary, but it has opened my eyes to another life, one of limited mobility. So many people live their lives with permanent disabilities. I can only begin to understand the challenges faced by these individuals. I know my body will heal, and I will be do all of the things I used to do before that unfortunate fall. It makes me want to celebrate my body, take better care of it, and push my athletic limits. I am making progress.
Mid-September 2006
Physical Therapy
My first and second visit to physical therapy were deceptively pleasant. They resembled a luxurious health spa experience I could never afford. Except for the device that sent an electric current flowing though my leg and forced the atrophied muscles to pulsate and pump the fluid out of my swollen limb, it was like a trip to paradise. Actually, the electric thing wasn’t too bad either. The therapist turned off the lights in my room and played Bruce Springsteen. I relaxed completely. Then he showed me some exercises and massaged my foot and calf. He stretched my ankle and examined my flexibility deficiency, otherwise known as the reason why I limp. I can almost point my toes like a ballerina (or a skater), but I cannot pull my toes back in a runner’s calf stretch. I have lost about eighteen degrees of flexibility in this direction. I regained four of those degrees in the first session. The therapist said he would have to watch me so I don’t overdo it. I show all of the signs of an over-enthusiastic, dangerously motivated patient.
He warned me that I would not regain a full range of motion over the weekend, and I should not try. Otherwise my muscles will spasm and I will lose ground by causing a different type of injury. I listened, but knew I could push myself harder than recommended. I do the exercises almost continuously when I am home and have created some of my own to enhance my recover program.
I did not use crutches for much more than a week after the cast came off. I defied the laws of human physiology and the gods of orthopedic medicine by making more progress than my doctor dreamed possible. While I walked slowly at first, I walked under my own power, putting all of my weight on my damaged foot. The power of determination must be the greatest force in the universe, at least in the universe that revolves around me.
Later trips to therapy became more difficult. I had reached a point of frustration where I could feel no pain. I am a student of the no longer fashionable school of “no pain; no gain”. I could not pull my ankle back to the point of pain. Discomfort equals progress. I complained to the therapist that I could not feel any pain. He told me to be careful what I wished for and proceeded to stretch my affected ankle in a wickedly agonizing variety of movements. He took breaks allowing me to regroup and suck up the pain that would make me a skater again. Stupid me, I had gone to a Saturday morning appointment without eating breakfast, and my blood sugar crashed right there on the torture table. I found a granola bar in my purse and relaxed while an assistant wrapped an ice pack around my newly loosened joint. Enduring pain on an empty stomach is especially challenging. I have lost much of my appetite due to lack of activity. However, I will not make that mistake again. I will force something nutritious down my gullet before every future session.
My coworkers comment on my improved ability to walk. I am walking pretty well and feeling excellent. I have settled into my new job and am happy there. As I feel better physically, I discover resources within myself to apply to my career situation. Those resources were buried beneath the overwhelming burden on my body as it learned to walk again. Now I am walking with a barely noticeable limp. I am not ready to run, but I feel ready to skate.
Friday September 29, 2006
The Orthopedist 5
Three weeks had past since my cast came off. I returned to the orthopedist for x-rays and a progress report. I hoped not to have to wear a brace anymore, to receive a clean bill of health, and his blessing to do whatever the hell I want with my newly healed body. Although I limp slightly, it does not bother me, and I want to get on with life, assuming the limp will gradually fade and eventually disappear completely. I got none of the above. The doctor wants me to wear that brace for another six weeks! Evidence of a fracture can still be seen on my fibula, the joints swells, and has not regained a full range of motion. None of this overly concerns me. It will go away with time. It is the persistent phlegm that causes one to cough long after the misery of sickness has sent one back to work.
Of course, Doc thinks skating is “risky”. I hope it did not take him four years of medical school and who-knows-how-many years of residency to come to that brilliant conclusion. Skating got me into this mess in the first place. Everything is risky. Driving down the freeway in rush hour traffic is risky, but that doesn’t mean I don’t have to work for a living. He said I should wait eight to ten weeks before skating. I will not do that. He is probably giving me the advice that is best for me and for him. He certainly made a note of this recommendation and my desire to get back on the ice. If I should fall and re-injure my ankle, he will have a written record of his medical opinion to protect his ass from lawsuits. If I were an up-and-coming star athlete, the orthopedist and a team of therapists and trainers would be redoubling their efforts to get me back into the game. However, I am a middle-aged recreationalist. So he tells me to play it safe and writes “8 to10 weeks” down on my chart.
We adult athletes travel a strange path. When we are injured, getting us back into the game is not a priority for anyone but ourselves. In fact, our eagerness may be perceived as foolish by friends and physicians. We do not have an important competitive season in our futures, so why not stay off the ice indefinitely, until no one can tell we were ever hurt in the first place? Because that is not living. When I was first injured, I had no guarantee that I could ever skate again. I did not know the extent of the damage while I shivered on a gurney in the emergency room. Maybe I will limp for the rest of my life. Maybe my ankle will be stiff and achy in the morning forever. I don’t know. Actually, I care a lot less about those possibilities now that I thought I might when this odyssey began. After using crutches and wearing a cast for months, as soon as I could walk, I felt healed, whether the actual “healing” would be considered complete or not. I can honestly be satisfied with how I walk right now. This does not mean I will discontinue my exercises and efforts for complete recovery, but I have been disabled, and now I am not. Even if I were never able to skate again, it would not be a complete disaster, because I can walk. My level of appreciation for simple things is off the proverbial scale in a way it never could have been without having this experience.
I never allowed myself to think of things like not being “good as new” or not “coming back stronger than ever” and all of those clichés real athletes say during television interviews. I always assumed I would. There could be no other option. Some sort of internal self-preservation mechanism takes over during times of physical distress and keeps a person grounded. I was completely focused and completely positive. Now I realize skating or not skating is not the most important thing in the world. Yes, I love to skate, but I love to walk even more. I have yet to step on the ice again, but when I do, no matter what happens or what I achieve in the future, it will be sweeter than anything I have ever imagined.
Read about my other trips to the orthopedist: 1 2 3 4.
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