wheelchair-delivered

Happy crashiversary, Elmo!

Two months ago, the bottom of my left femur seceded from my leg. If I’ve learned anything from this, it’s that patience really is a virtue.

Trouble is, I’m not that virtuous.

“I saw this and it’s exactly YOU!” a coworker once beamed, handing me a refrigerator magnet. It said, “I want it all, I want it now, and I want it delivered.”

On Friday night, Sept. 16, 2016, I fractured my left femur just above Elmo, my replacement knee. I lived in a wheelchair, facing hip-high amputation of my left leg, for about two years while I fought health care bureaucracy, cost-conscious HMOs, and myself to figure out a way to walk again. (Spoiler alert: Elmo won!)

I documented my adventures in remobilization in this blog. They’re awfully self-indulgent, occasionally icky, and probably only of interest to me, but on the off-chance that they help someone else with a catastrophic injury, I’m keeping them together here. If you don’t want to read them, that’s OK; I still love you. If you do, you might want to start from the beginning, on the archive page that lists all posts.

Yup. That would be me. And watching paint dry is a rollercoaster ride compared to watching my bone grow, so there’s plenty of opportunity to be patient. Just as patiently, my medical team explains that growing bone

just.

takes.

time.

“That was a really bad fracture, Cynthia. Count on 6-8 weeks non-weight-bearing,” said my (now-beloved) orthopedic surgeon, AKA The Doc, as he started rebuilding the jigsaw puzzle that was once my thighbone.

Non-weight-bearing: The Leg can’t so much as touch toe to ground, so I hop like a 1-legged bunny or sit in a wheelchair for 42 days. I can do that. I think. 

Post-op, The Doc ups the ante. “That was a really bad fracture, Cynthia, even worse than it looked on x-ray. It’ll be AT LEAST eight weeks of non-weight-bearing.”

Deep breath: OK, wheelchair for 56+ days. Piece of cake. Well, not cake exactly, maybe more like a Prinsesstårta that I’m forced to make with only a lightbulb, spoon, and a Pringles can. But OK. I can do that.

Next visit, it happens again. “That was a really bad fracture, Cynthia. I’m scheduling monthly visits for you, because that was a really bad fracture.”

You already said that already. Wait…WHADDAYA MEAN, MONTHLY VISITS? You said 8 weeks. We’re on week 6. I counted. A lot.

“I said AT LEAST eight weeks,” he corrected, “It takes time to see any change in the bone, so a monthly check-in is best.” So we measure in months, not weeks.

Every month for the next three months, I’ll be webbed into a wheelchair transport like a giant fly, and we’ll go down to see The Doc and all the nice x-ray techs.

“AT LEAST the next two to three months,” he reminded me.

Do you guys even HAVE a wheelchair exit strategy? Sorry. Unworthy thought.

Of course they do. It’s called “Be Patient, Cynthia.” BPC. BPC.

The Doc reviews October’s x-rays, tells me everything’s still where it ought to be, which is really good. It indicates that healing may have started in that bone. BPC.

This is what I like about The Doc: When he’s in the room, he’s with you. He doesn’t check his phone or look at his watch, he pays attention. He doesn’t talk down, he doesn’t dismiss, or pull punches. Wish more doctors were like that.

“Even once you’re weightbearing, the visits continue,” he says, in this Charlie Brown kinda way, “As long as the bone is still healing. That was a really bad fracture, Cynthia.”

You keep saying that. OK. I just did 56 days in a wheelchair. I can do another 56 or 84…? 

In a way, this is a GOOD thing: It means that Elmo is still with us. I could get out of this wheelchair a lot faster if we went to Plan B. No BPC required. However…

Plan B: NOT saving Elmo

There’s this 3000-pound gorilla in the room that I really haven’t quizzed the medicos about: What happens if my bone stays broken? (technically, this is called “nonunion”) There’s a hole in my femur about the size of a hazelnut where they tell me the bone was too crumbled to do more than hoover it out.

What happens if my body doesn’t replace that missing chunk with new bone?

“So, how can you tell that Plan A isn’t working and we can’t save Elmo? I mean, outside of really obvious stuff like infection or my leg falls off or explodes or something?”

He smiles at that. “We check the x-rays for any sign that the bone fragments have started moving. If they have, they’ve broken free. If we see shifting on the x-ray, we wait a bit and x-ray again. If we see even more movement, then we assume it’s not going to heal.”

“And then I lose Elmo?”

“Yes, at that point our only option is a distal femoral implant,” he said, “We take out more of your femur, above the damaged area, replace it with an artificial femur and knee…”

“…which doesn’t work as well as Elmo, right?”

“Right, and it doesn’t last as long. It’s also less comfortable.”

“Less comfortable” = doctorspeak for “ouch.”

“What are the chances, when the implant wears out, that it can be replaced?”

“Hard to say. We try not to take any more of the femur than necessary to place the implant. If there’s enough femur left, we can try a second implant. Usually,” he said, looking serious, “There isn’t enough left.”

“So you fuse it all together and I get this really, really short leg that doesn’t bend?”

“Well, no. If you think about it,” he said reasonably, “There’s really nothing much left, bone-wise, in most of your leg. So the only real option is amputation.”

Suddenly this becomes very real, this $6 Million Dollar Woman stuff. Although, taking inflation into account, it would really be $33,391,764.71 in today’s money. 

Me as The $33.4 Million Dollar Woman. Ulp.

“So I lose my lower leg…” I say slowly…

“Not exactly. You see, there’s no bone at all until about mid-thigh, so that’s where we would…”

“Oh yeah, of course,” I manage, “Silly me.”

Suddenly, patience isn’t all that difficult to find. Be patient, Cynthia. BPC. BPC.

We talk about the fact that, even when I’m healed and walking again, my femur will be at high risk for rebreaking if I fall, for anywhere from three to nine years. Falling down has become strictly verboten and my home needs to be made fall-resistant.

Lots of problems there, which is why I’m currently living at Mom’s. My driveway has something like a 35-degree slope. “You don’t even get OUT OF THE CAR on that driveway,” said the occupational therapist, “Drive into the garage and get out there, where it’s level.”

It’s also like Stairmaster Central in there. Four levels, minimal rails, and the bathrooms are all at the top. Since right at the moment even climbing one step requires the kind of logistics needed to put on a Lady Gaga concert tour… nope. Not until I can walk and climb and all that. Even then…

“New stair rails,” says the OT, shaking her head at the follies of able-bodied architects, “And get rid of that sunken tub in your bathroom.”

Thought about selling the place, but stubbornness kicked in just as I was calling the realtor. The only way to ever make the house ADA-friendly would be to tear it down and start over, but with a few good contractors I can make it a lot safer. Better stair rails, redo the master bathroom and maybe add one downstairs, ream out the studio and turn half of it back into a garage…

I’m healthy, I’m strong, and I’m getting estimates for construction. I’m working 9-5 on weekdays, making arty stuff on weekends. Working out with weights to the point that my arms can just about heft a Buick. I’m keeping busy.

BPC. BPC. BPC.

*I left The Fortress in early October, and found I couldn’t go home because of the aforesaid inaccessible house. More sensible than her daughter, Mom picked out a house with living accommodations (and bathrooms) on the main floor. Just FYI, wonderful wonderful friends are taking care of Lola and Nikki and the house until I can get some catsitting tenants moved in there.