If you’re wondering what’s up with The Leg: We’re hanging in there. LOTS of other stuff has happened that’ll show up here as I get time to write, but mostly? We’re hanging in there.
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.
Grass grows faster than my bones, apparently, because we’ve passed the four-month mark and there’s still not so much as a sprout at the fracture site. (Or at least, not one the radiologist can see. My surgeon THOUGHT he saw one a couple months back, but it turned out to be wishful thinking)
You play this waiting game when you break a major bone: It gets six months on its own to heal before it’s officially declared “nonunion,” allowing docs to try more adventurous solutions. (Whoever thought of “nonunion” had obviously never heard of the AFL-CIO).
Every month a paramedia bungees me into the back of a van and hauls me+chair+Mom to the hospital for x-rays and exam, awaiting one of three outcomes:
- It’s GROWING! Let’s make wheelchair exodus plans!
- Diddly squat. Come back next month.
- Uhm…well...the fragments are shifting around and we’ve officially failed. Bye, Elmo. Sorry.
So far, #2 has carried the day, but at last Monday’s visit I got tough: “Look, Doc,” I said bluntly, “This wait-and-see stuff is nice, but I’ve got a house to get back to, cats that need apologetic groveling, and an office at work with six inches of dust on the desk. Can we PLEASE set a date for normalcy here?”
“March 9,” he said simply.
“I just can’t take…Huh? Really?”
“If we haven’t seen growth by March 9, we’ll schedule your next surgery, ” he said.
Wait. “What kind of surgery?” I said suspiciously.
“Bone graft. We’ll dive into your abdomen, rip open your iliac crest, and suck out marrow like an anteater. We spit it back out out into a Cuisinart, toss in a little freeze-dried cadaver, dug-up dogbones, and demineralized fossils, add a couple of calcium pills and a little olive oil. We’ll pulse on high a few times, then pack the whole puree into that gaping hole you call a distal femur. And then we start the nonunion clock all over again.”
(OK, so that’s not EXACTLY what he said, but it captures the flavor.)
Short anatomy lesson (I looked it up): Your pelvic bones look like a big-eared child (or maybe the Ferengi Quark) with a spine sticking out of the top of his head. The ileum would be the top part of Quark’s ear, around to the back. It’s apparently rich in red blood cells and marrow, frequently used for harvesting stem cells and whatnot. I’m told it’s the site of choice for autologous bone grafts.
“It’ll be a little painful, because we’re cutting abdominal muscles, so if you’d rather, we’ll take material from the good leg.”
Uh-oh. A little painful? The last time my pain was 8 on a scale of 10, they called it “discomfort.” Do I really want to experience “a little painful?”
“Maybe that leg option…” I began cautiously.
“Of course, it’d be kinda hard to get around on that leg for awhile after surgery, so you want to think about that,” and he grinned, “Besides, the material that usually grows best with your kind of fracture comes from the iliac crest.”
Object of the game: Make bone grow. “I can take a little pain if it’ll get me out of this wheelchair,” I say with a gulp, “After that…the clock starts over?”
“All over. Rehab center, then we go back to monthly checks. But YOU,” he said decisively, “Are not going to need it, because now that you’re using the stimulator, your bone will GROW.”
He was talking about Beorn Bonegrower, a nifty little electromagnetic device that grabs my bare thigh every night for thirty minutes of…nothing. I’m told it’s sending pulses through the fracture site, encouraging my osteoblasts to get with the program and grow.
I can’t feel a thing, though; I just pop the device on, push the button until I hear a beep, and wait for it to give me a double-beep and shut down. The tech who showed me how to use it warned me that I could only push that button once in a 24-hour period, because after that it will ignore me until its 10PM reset.
“That’s to prevent people from just keeping it on all day long. You’d be surprised how anxious people can get when they use these things,” she said.
Surprised? Not really, no.
Beorns are said to be marvelously effective for growing “nonunions.” Supposedly it takes at least 30-40 sessions to see results; I’m on #24 tonight.
“On March 9,” he said, “You’ll come in here, and that bone will be GROWING, so we won’t need another surgery. But just in case, we’ll be ready.”
Hey Beorn! Yo, osteoblasts! Hear that? It’s your cue: Get busy.