Rob Stansfield

Philomorph with a sense of adventure and lots of curiosity

A Hole in One (Leg)

I apologize for a post “all about self”. (My kids developed this Pidgin English growing up in France. They did all sorts of things “all by self”). It seems a bit self-indulgent, but consider it a short story. A stump of a story so to speak.  It is of course a follow-up to “The Shortest BDR Ever”.

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I’m able to sleep again with my leg under the blankets instead of wrapping up in warm clothes for the night. I’m able to toss and turn again! That was also true two months ago but wait, listen, stuff happened. I must take showers again with my leg in a giant condom, the “SEAL TIGHT Cast & Bandage Protector, patents pending”. But I can also walk now, with a limp or with a cane or with both, and that’s real progress, so it’s time for an update.   

I broke my leg on May 28, 2017 riding in New Mexico with my friend Charlie, which was on Memorial Day weekend in the USA, and six months ago now.  And the same night, surgeon #1 in Alamogordo, NM put in a Titanium plate and fifteen screws in operation #1, some of which broke “because my bones are so hard” he said, intending a compliment.  And Penny mounted the rescue mission to get drugged-out Rob and bummed-out Charlie and the purpose-built bikes and the brand-new luggage back to Arizona.

Memorial Day is the unofficial start of summer, and Labor Day in early September the unofficial end, never mind the solstices, and as the summer sped by the tibia bone in my left leg failed to heal.  In fact, physical therapy that I started in August appeared to make the break worse. Even I could see that on the monthly X-Rays, so PT was fast abandoned.  I got really, really good at speeding around on a knee scooter, indoors and out. The first knee scooter I bought kept falling apart but my “all terrain” version with 12” wheels has been a hoot.

Surgeon #1 in Alamogordo recommended that I follow up with surgeon #2 in Tucson, which I did despite that fact that his office is almost an hour’s drive away so that gasoline (petrol) costs have nearly rivaled the potential health care costs.  Bones, he told me, will heal in about four months, on average. Or not. And after the requisite four months, the main break in my tibia did not, though other small fractures healed up fine. After confirming this with a CAT scan, surgeon #2 conferred with surgeon #3 and they jointly recommended removing the plate and screws and replacing them with a rod down the center of the bone, as soon as possible.  Surgeon #3 (call him “Rod”) is a rod specialist.  I think all he does is rods – and I thought my Ph.D was specialized.

This was – is – touted as the optimal solution, since the bone parts, concentric about the rod, will be able to move towards each other and with a little love fuse back together and re-establish their previous long-term relationship. But the docs will still check, after another four months, if this is actually what happens. And if not, there were murmurs of “bone growth stimulation” whatever that means.  But one step at a time, please.

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So on October 30 I had operation #2 as an outpatient, though under sedation, with surgeon #2 who re-opened the original longitudinal incision to take out the obsolete hardware. Apparently, for some of the broken screw heads buried in the bone, hollow circular screw bits were necessary to drill into the bone around the screws in order to get them out. For the next few weeks I was rather terrified to put any weight on the leg since there was nothing holding it together, and it was supposedly even more fragile because of that drilling!  Not to worry, that time was fine.

Operation #3 with surgeon #3 (“Rod”) was supposed to be two weeks later, but the surgical “wound” had not quite healed, so we waited another week. In retrospect, we should have waited longer.  The rod is inserted from the knee, under sedation again, with maintaining screws inserted on either side of the leg at top at bottom through small incisions.  It has got nothing to do with the original long incision further down the leg, under normal circumstances. Unfortunately however, the pressure caused by “reaming” (aaarrg!) the tibia and inserting the rod re-opened the original long incision in a couple of places, which obviously wasn’t supposed to happen. I think this irritated surgeon #3. Perhaps it spoiled a winning series, I don’t know.  I think I recall someone saying it “burst” open during the operation, but I may have imagined that.  It was a spoiler, in any case.

Thanksgiving is probably the biggest holiday in the USA, perhaps because it is secular as well as historic and national.  It’s always the fourth Thursday in November and families get together from all over to have a meal very similar to the Christmas dinners of my youth in England, except for differences like cranberry sauce with the turkey, sweet potatoes, corn bread, and pumpkin and pecan pies for dessert. Delicious! I had gone in on Monday November 20 expecting to stay overnight and ended up in hospital for three and half days, because of that wound opening up. They let me out at 1 pm on Thanksgiving Day, so I did get to have a family dinner with Penny, Alastair, Beth, Nick and the triplets, for which I was very thankful.

There was absolutely nothing to do, lying on that hospital bed.  I can’t remember the last time I did absolutely nothing for so long. It reminded me of childhood when time seemed slow and eternal and boredom was not unusual. I haven’t been bored in years, decades even!  Of course, they came to take blood every eight hours, day and night, and new people introduced themselves every shift change, all quite normal if you’re used to hospital stays I suppose. There was very little difference between day and night except for the presence or absence of light at the window. The blinds were never closed. There was a TV with 100 cable channels and I had a remote control so occasionally I would pass thirty to ninety minutes channel hopping and marveling at how there was absolutely nothing, really nothing, to occupy anyone with more than a single brain cell.  It amazes me that people pay for that.

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Surgeon #3 called in the wound care nurses on day 2 for their opinion. They didn’t think much of it and counseled an ordinary dressing.  Surgeon #3 thought otherwise, overruled them, and then must have ordered all kinds of stuff because deliveries to the room continued over the next 24 hours.  There was a very sweet and chatty nurse on duty who marveled with me at all the fancy equipment that was being delivered, and neither of us knew what it was for.  She held up a scalpel to show me, which told me she was not strong on empathy. On the morning of day 3 the doctor brought the wound care nurses with him again and told me to hold very still while he cut the wound to open it between the two leaks. Then they placed a “wound vacuum” contraption on it and said that the “wound vac” had revolutionized wound healing. Well, you learn something new every day.  Now I had a transparent tube from my leg to a vacuum device and I could watch blood and drainage move along there, move along if you please. Very nice. I still had to sleep on my back, but I was enjoying the opioids again.

When they discharged me they gave me a portable wound vac with a battery powered vacuum device in a holster (I had to plug it in overnight) and the transparent tube with you know what in it for the entire world to see.  So I didn’t go out much after I got home, you don’t want people to stare at your body fluids do you?  I also had a nurse come to the house to change the dressing, first under vacuum, now not, three times a week. There was likely a hematoma in my traumatized leg, contributing to the bleeding. The leg certainly looked beaten up. The wound vac worked a treat and we kept it on for about two weeks. Then it just looked like I had a hole in my leg. On one visit the nurse asked me to wiggle my foot while the dressing was off and we could see the fascia and muscle wriggling about inside.  “I’ve never seen that before!” she said.  Penny was home too and found it terribly fascinating. As a massage therapist Penny’s always been interested in anatomy and physiology and would love to dissect a cadaver one day. Until then she has me.

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The nurse still visits three times a week, and I change the dressing on other days.  I’m basically recovering from two things – the rod, and the wound. The first is going fine I think. I can bend my knee again, put weight on the leg and limp around, do some exercises to bring dormant muscles back, and I expect I could start to go for walks, if not for the second. The wound is a pain in the leg.  I’m officially on “home care” which means not going out to work or to volunteer.  Although I do sneak out to go shopping from time to time.  I no longer need painkillers.

I’m not complaining, I’ve been patient and optimistic I believe, and I’m certainly very grateful for all the care I have received, for our health insurance which is not a given in this country, and which ironically, I worked with a colleague to introduce in April to the nonprofit I worked for until August.  As it turned out, that was “just in time”.  And I’m very grateful to Penny for all her patience.

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