Thursday, November 24, 2016

What I’m thankful for today - recovering from a broken fibula

 One of my favorite episodes of the four decade old TV show M.A.S.H. was titled Out of Sight, Out of Mind. In it surgeon Hawkeye Pierce (played by Alan Alda) lost his sight but then got it back. He got to temporarily experience the world in a completely different way. So have I.  It’s a topic for speeches about keeping a positive attitude. But it has reminded me of that bumper sticker that says Oh No! Not another learning experience!

On a late afternoon early in the fourth week of July I broke my fibula. That’s the smaller of the two lower leg bones, behind the tibia (as shown above). My wife and I had taken the Wallowa Lake Tramway to the top of Oregon’s Mount Howard (8,256 foot) and hiked around on a loop trail. About 100 yards from getting back to the station, while going downhill, I slipped on some loose gravel and fell. My right ankle was dislocated, but thankfully I immediately popped it right back into place. The tramway staff put me into a trailer behind a four-wheeled all-terrain vehicle, drove me back to the station, gave me some Advil, and helped me into the back seat of my Honda Fit.

My wife drove to the emergency room of the hospital in Enterprise, Oregon. They x-rayed my leg, told me my right fibula was broken, put me in a cast, and gave me a set of crutches and an ice bag for the swelling. By the time we got to La Grande, Oregon and I-84 it was too late to head back to Boise so we stayed in a motel. The next morning she drove back to Boise with me sitting sideways on the rear seat.

While waiting for orthopedic surgery I wound up getting three blisters growing under my cast. Fracture blisters are an uncommon complication. We found out when one burst, so we went to my nearby urgent care clinic. They removed the cast, took photos, and called my surgeon. He said that fortunately the blisters wouldn’t interfere with either of his incisions, so just dress them and put on another cast. They’d  take care of the blisters during the surgery.

On the afternoon of August 2nd I had orthopedic surgery at Saint Alphonsus hospital in Nampa. The surgeon installed a metal plate with a dozen screws to hold my bone together, a “rope” to pull my ligaments back into alignment, and put me in another fiberglas cast. They gave me a prescription for painkillers, but I needed them for less than two days. 

Then there were twelve weeks of couch potato time without me being able to put any weight on my right leg. I rolled around the house using office chairs both on the ground floor and second floor. Since I’m retired I watched a lot of TV, listened to the radio, and used a laptop computer to read and blog.

To go up and down stairs I sat facing downhill and used both arms and my left leg to lift my torso and right leg. In the kitchen I could still reach the stove, refrigerator, sink, and dishwasher. But only the front of the over-the-stove microwave oven was reachable from my sitting position. The back of the microwave and top cabinet shelves were more difficult - I had to stand on my left leg while bracing myself on the stove or counter with one hand. Then I could use the other hand to reach for things.

We also adapted by fitting our shower stall with a Moen shower chair and hand shower on a seven-foot hose. For showers my cast went into a clear plastic protector like a Christmas stocking with an elastic top. We had the low, round toilet replaced with a taller, elongated ADA-compliant one. I can roll the side of my office chair up to the toilet and easily transfer to the seat.

For going outside we got an inexpensive Blue Streak wheelchair from Drive Medical (at Amazon) with an 18-inch wide seat. We can get around with me in the right front seat of my wife’s minivan and the wheelchair in the back. Shopping at the WINCO supermarket or COSTCO store looks much different (and less friendly) from a wheelchair than it does standing up. The two-inch high threshold at the entrance to Golden Star, our favorite Chinese restaurant, now was an obstacle I had to go over backwards. That wheelchair was chosen based on it being narrow enough to go through our bathroom doors. But it was too clumsy to use for getting on the toilet since the front wheels get in the way.

After six weeks they removed the cast, x-rayed my leg again, and switched me to a knee-high Aircast XP Walker Extra Pneumatic brace (as shown above) that is worn over a 22-inch long tube sock. It has air chambers on the front, rear, and sides that can be individually inflated (arrows) or deflated using a squeeze bulb. The Aircast could be removed for taking showers, so I was much more comfortable than I was with the nonremovable fiberglas cast. But it still is very warm, and has to be removed twice a day because sweat winds up on the rubber under my foot. Also, the Aircast only came with two socks, so we ordered another six at Amazon. 

Twelve weeks after surgery  (at the end of October) I was done with the Aircast, and could put weight on my right leg again. But my right foot had swollen from a size 11 narrow shoe size to a size 13 medium. I know that because we got a used pair of athletic shoes at the Idaho Youth Ranch store. Elevating my leg and applying an ice pack didn’t seem to help reduce the swelling. Over a weekend it wouldn’t go down. Monday I went to my local urgent care clinic. The doctor said it might be an infection or perhaps a blood clot. To rule out a potentially serious clot, she sent me for an ultrasound scan of my leg at Saint Alphonsus Hospital in Boise. So my wife and I waited in the emergency room for most of the afternoon. Thankfully it wasn’t a clot, so I didn’t need to take blood thinning medications. The next day I had a follow-up appointment with the physician’s assistant to the surgeon. He gave me an antibiotic to take care of any infection. He also prescribed compression stockings. When I went to Norco to get them, they said my foot was swollen to where a sock that would be useful for my ankle would not fit. So, for now I’m instead using six-inch and three-inch wide elastic bandages to apply compression.  

Currently I am getting physical therapy, doing exercises, and learning to walk again starting with crutches. My leg muscles are in sad shape from disuse. I can stand, but not walk without crutches or another support. We have a stationary exercise bike facing the TV in the living room that will help with my calf muscles.  But last Wednesday I managed to walk up the stairs using the handrail for support. So, I can see an end to my immobility and am in reasonably good spirits. Medicare and my supplemental insurance has covered the vast majority of my expenses.

It is likely I can recover completely, so the only leftover from this adventure will probably be getting hand searched every time I fly. That plate will set off metal detectors at the airport. I am planning on carrying images of my X-rays in my cell phone to show to TSA, and also perhaps a couple of 8-1/2 x 11” hard copies laminated on a page. 

Images of a leg and a wheelchair came from Wikimedia Commons.

December Holiday Update

My present for the holidays is that I actually can walk around the house for short periods without a cane or crutches. My gait is pretty lousy - not much better than a zombie at 1:20 in this clip from the movie Night of the Living Dead.

At Harbor Freight for $60 I got a four-wheeled walker with 7” wheels, a seat, and a basket. It works well for getting around outside. (The list price is $70 but there always is a coupon for 20% off on one item). 

I tried again at Norco and got a pair of  $75 prescription-grade compression stockings - sized by them based on my normal left foot. They turned out to be uncomfortably tight, and I couldn’t stand wearing them for more than an hour or so. But in the AAA travel catalog I saw Sockwell+ non-prescription socks. I got three pairs of their over-the calf Circulators for $25 each from their web site, and can wear one on my right leg for up to about five hours.  

I moved the Moen hand shower and shower chair from the master bathroom to the bathtub in the hall bathroom. Now I can get in and out of the tub and take a sit-down shower all by myself. I also can remove the chair and take a tub bath. 

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