Nine months later

A couple of weeks ago I went to see my surgeon again for follow-up about my tibial plateau fracture (and the other, far less interesting fractures). This is always a saga. I am booked for two x-rays every time (top and side) and there is a lot of hand-waving and frustration when the x-ray technicians realize that I have too much hardware in my leg to capture in a single shot. Then the techs apologize about having to take four or six shots instead, because the radiation involved in the number of x-rays I’ve gotten over the last 12 months is not exactly trivial. On the up side, I can now put my kids to bed without a night light.

I’ve learned the hard way that I need to dress for the x-rays and the subsequent physical exam: wide leg pants or skirts only, with easily removable hosiery, because I’m going to have to go bare from ankle to thigh. Leg surgeons hate knee boots. But there is always something interesting to learn. This month I asked why the x-ray machine had a cup holder, because it’s not like the techs stand around next to it and would appreciate a place to put their coffee—they sprint out of the room as fast as possible. They told me it was to hold the cup of contrast dye that people who get live x-rays of esophageal function have to swallow. I was fascinated.

My first post-surgical x-rays back in April showed my tibia in pieces, which were held together with a bunch of screws and a metal plate. (My fibula looked like gravel as well, but it turns out that no one cares about the fibula. It’s not weight-bearing.) Later x-rays showed that the tibia was once again whole, but still had huge, ragged divots that made it look like something a dog had been chewing.  But this set of x-rays showed my tibia had completely healed, with smooth edges from knee to ankle. I couldn’t stop admiring it.

This was fantastic news, especially given that I was told that probably wouldn’t happen for a year. I have been healing fast. And it also meant that I could schedule my final surgery, when my surgeon will take all of that hardware out. We were all feeling so festive that we picked the next available date right then: June 3rd, 2014.

It's impossible to take a good picture of a knee. Anyway, my real knee is at the top, and the bulge below it is the plate. Would you believe that nine months ago this leg was covered with bright red scars?

It’s impossible to take a good picture of a knee. Anyway, my real knee is at the top, and the bulge below it is the plate. Would you believe that nine months ago this leg was covered with bright red scars?

Technically removing a plate like mine is optional, but in my case there is so much of it that leaving it in would be problematic. The plate is so obtrusive that I’ve started calling it my third knee, and the longer it stays in the worse it gets, because more bone grows over it. It prevents me from doing things like kneeling, because putting weight on that part of my leg feels a lot like being stabbed in the tibia, which is pretty much what is happening: the plate presses on the screws, which in turn press into the bone.  So giving the kids a bath is an issue. When people see me walking now, my gait looks normal, but there are quirks; I have trouble on stairs, especially at the end of the day, and as a result I have become that person who takes the elevator to travel just one floor. I can’t run to catch a shuttle bus, and sometimes I fall over unexpectedly. I could improve the situation by lifting weights more often (okay, ever) but only to a certain extent.

This has all been an interesting lesson about invisible disabilities, which I appreciate, because I used to be impatient about things like people taking the elevator to go one floor. I have been sensitized.

Anyway, one more surgery, and although I’m looking forward to the outcome, which is a near-complete recovery, it doesn’t come free. I’ll need to take another two months of disability, because once the screws come out, my tibia will be so riddled with holes that it will look like a piece of Swiss cheese. With the bone so fragile, a single fall could fracture it again. So although I’ll be partially weight-bearing after I get out, I’ll still need to go back on crutches, and I’ll also be almost completely housebound. With the fall risk preeminent, I’m also not allowed to ride anything but a stationary bike during those two months.

I’ve also realized that even a much-desired surgery looks a little scary when approached without the benefit of a serious narcotic haze. I went on a morphine drip as soon as the paramedics arrived after we were hit in April, and didn’t go off IV narcotics for even a minute until I was released two weeks later, after two surgeries and several days of inpatient rehab. I’m mostly looking forward to getting the plate out, but there are moments when I put my head between my knees and take deep breaths.

Overall, though, I mostly feel lucky. It was a serious injury, and I’m going to walk away from it (literally) almost unscathed.

My colleagues sometimes joke that they expect me to commute by tank now, instead of by bicycle. The irony is that I wasn’t injured commuting. I was hit on a Sunday in Golden Gate Park, and I still sometimes have uncomfortable flashbacks while riding in the park on weekends. But weekday commuting doesn’t feel dangerous. There is no objectivity in fear.

My daughter has no patience with knee photos, and insisted that we take a picture together instead. She has a point.

My daughter has no patience with knee photos, and insisted that we take a picture together instead. She has a point.

Looking back, what happens seems both crippling and distant. If I’d been told in early 2013 I would be hit and spend months on disability, with a full recovery not expected until 2015, it would have seemed impossible to survive. But time rolls on and even now life is pretty close to the old normal, and I can afford to rearrange life a little over the next few months to make it completely normal. We still commute by bicycle and walk around the neighborhood. I wouldn’t wish an experience like this on anyone, but having been hit once, I understand why people shrug off injuries and keep riding. I’ve had lots of occasions to compare travel by car and travel by bike in the last year, and riding is still easier most of the time. Even when I was still using a cane, riding a bike where I needed to go meant that I could minimize painful walking. Now that I’m walking unassisted again, why not keep it up? I think that streets should be much safer, but even if they’re not I’m not ready to give up riding.

2 Comments

Filed under injury

2 responses to “Nine months later

  1. Wow, your detail is really interesting, maybe not for everyone. I am glad you are healing and able to ride. It is amazing how mobile you have been despite having so much damage.

  2. Virtual high five for posting a knee picture! You didn’t get around to using the Brompton as a stationary bike last time around, right? Maybe you’ll do so this time. I’d like to hear how it works in that role.

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