My “prescription” is a 29 day plan with daily modifications to each of the six struts on my Taylor Spatial Frame, trackable with an iPhone app that sends me reminders throughout the day and allows my surgeon to monitor my progress. Yesterday was day 15 of 29, which means I’m over halfway to a flat foot.
I won’t lie- it’s getting harder now. In the beginning, only two or three of the struts would change in a day, and in only 1 mm increments. Now that the ankle is fully separated, the upward rotation has begun and the strut changes are more difficult. Each of the struts move every day now, and most in 2 or 3 mm increments. The dials are more difficult to turn and the pain is reminiscent of a vice slowly crushing my bones.
This pain kicked in to high gear at my last appointment, just three days ago. Two of the struts on the backside of the frame, the side which is expanding, were too small to expand further and had to be changed out. As the entire frame is a complex engineered matrix of tension and compression members, one cannot be removed without imminent collapse of the remaining struts unless first placing some sort of support to hold the frame in place. In the past, the doctor would thread long bolts through the metal rings around my foot and leg to hold them stable, but my doctor brought out a new device invented by one of her colleagues during her fellowship. She called it “the Claw”. Small clamps bit down on the frame rings and she tightened the device to stabilize the frame. She started with strut number 5, and I leaned on my side and chatted with her as she worked, reading from a list of questions I’d been compiling for her. We addressed odd items such as whether or not such a thing as a bleach bath was advisable or if this was some crazy alternative treatment akin to putting a knife under one’s bed to cut the pain. (Knives under beds don’t work, just FYI. I highly recommend narcotics instead.) She was fine with a short bleach bath to disinfect the pins and we moved on to the efficacy of muscle massagers as she finished up strut 5 and began to work on strut 4.
I was facing the wall when I felt the frame begin to collapse, and with it my ankle. Patrick claims it was nearly imperceptible, but as strut 4 was pulled from the rings, I felt a crushing pain that stole my breath and forced a wash of tears through my tightly closed lids. I stared at the wall in silence. The doctor was becoming frustrated as the new strut was refusing to fit into place no matter how much movement in the frame she elicited. She left the room to find a different strut and I rolled to my stomach, buried my face in the pillow, and sobbed. Patrick hurriedly offered me more pain meds from the ready stash he had prepared before we left the house, but I couldn’t bring myself to move enough to reach out and take them. “I can’t
move,” I gritted through clenched teeth, and the doctor rushed back in with the new strut. I was kicking myself for not having the presence of mind to take more pain medication before coming in, but I really wanted to have a sober conversation with her this time.
She struggled through another long period of tugging and yanking on a frame that took turns stretching and crushing my freshly healing ankle bone. “I hope I don’t offend you if I drop an F-bomb,” she finally said, and our laughter helped to ease both the tension in the room and the pain in my leg just enough to allow her to get the strut in place. A few minutes more and the horrible claw device was gone. I could sit up, but the throbbing and visible swelling in the tortured limb was just beginning.
Just prior to this exercise, I had discussed my desire to reduce my pain meds to something weaker and hopefully less addictive. I take Tramadol during the day which is an effective pain medication that doesn’t interfere with cognitive abilities and has a very low risk for addiction, but at night I need something stronger for sleep. She agreed to prescribe hydrocodone to replace the heavy dilaudid I had been taking, but as Patrick wheeled me toward the pharmacy after our appointment, I began to doubt my wisdom in the timing of this change. I was reducing my ability to battle pain at the same time I was increasing a number of activities which would increase it: larger daily strut movements, at least two more strut changes like this one to come in the next two weeks, and the next day- Wednesday- I would physically return to work which meant an hour or so of driving in traffic each way and a few hours on crutches.
Patrick assured me it would be fine and we would just call the office if it wasn’t. Patrick is very different from me in the way he handles problems. I worry about every potential situation before it can happen so that I have the answer to each problem already solved and at the ready. He does not worry and instead points out the futility in such an endeavor to actually change what’s going to happen, promising to cross each bridge when he gets there. There are merits to both methods, but I am noticing that Patrick has far fewer wrinkles and gray hair than I do.
I took a hydrocodone on the drive home from the doctor’s office. An hour later I demanded something else as my head was fuzzy, but the pain was just as sharp and bone-jarring as if I’d taken nothing. That night was the hardest one since I’d left the hospital and Patrick jumped up multiple times to fetch me more pain meds when the schedule would allow. My Achilles tendon was on fire, my foot looked like a muppet appendage, and every muscle in my foot and leg took turns spasming and jerking on the offended ankle.
By morning, the pain and swelling had calmed down enough that I felt confident I would be able to drive to work for my first day back without passing out from the pain. I am obviously not allowed to drive while taking pain medication (laws and what-not), so I spent the morning working from home and elevating my foot until the very last possible moment. To be to work by noon, I have to leave the house at 10:30, which meant I had to call in to two of my meetings on the road to attend over the phone while driving with a swollen leg using my left foot. Patrick was terrified I was going to kill myself or someone else, so I just told him not to worry and we’d cross that bridge when we got there. He tucked me into the driver’s seat and gave me a very serious lecture in his most serious voice and then kissed me like we’d never see each other again.
The left foot accelerator pedal we had installed took some getting used to. I did mistake it for the brake more than once on the drive, but I drove slowly, put both hands on the wheel like a student driver, and forced myself not to let my mind wander. I survived. I pissed off a motorcyclist as I very slowly weaved my way up Germantown Road, clenching my teeth around every sharp turn, but aside from an angry shaken fist as he finally passed me at the top of the hill, I arrived at work unscathed and having caused no bodily harm or property damage along my trek.
It was a relief to be back at work and into the swing of things again. I was coaxed into showing my foot to the attendees in my first meeting of the day, but after that everyone else just commented on my lovely foot covering and said it was nice to see my face again. Hard to believe since my face hasn’t seen the sun in weeks, but nice to hear anyway. Shortly after my second meeting of the day, I was gifted with a key to my very own golf cart, mine for as long as I am on crutches and unable to board the shuttle that runs between campus buildings. I took my work buddy, Jarrod, for a spin around campus as he showed me the ropes of how to get around behind the buildings, where to park, and for God’s sake to follow actual traffic laws and not roll through the stop signs Marie!
By the end of the day, I was exhausted from all the crutching and my leg was begging me to lay down. I informed my leg we still had an hour and a half commute home and it began to shout in the form of angry muscle spasms that jerked on the frame and squeezed my ankle. This poor ankle. It’s been through so much. When this is all over, I’m going to treat it to a few days lounging in the sun on a beach. No walking, no frame, nobody trying to make it change when it doesn’t want to. Just some margaritas and the sound of mother’s screaming at their children in the distance. Heaven.
I called my doctor the next day. I informed the office I would be at work until 5 and would then swing by to pick up a prescription for something better than what I had just received if they would be so kind as to write a different prescription. The nurse was sympathetic and assured me she would see what she could do. At 4:59, they called me back to say they had made it happen and my new prescription would be waiting for me at the nearest pharmacy. After another day of driving and crutching after another night of agony and limited sleep, it took all my mental coaching abilities to convince myself to extend my commute with a detour to the pharmacy. I knew, however, that if I didn’t do it now, I would run out of what remained of the dilaudid in a day and I would spend the weekend in abject misery.
I parked as close to the pharmacy as I could, but once I made it up the pharmacist’s window, I was informed they were out of the medication. Not to worry though! All I had to do was take this hard copy signed prescription down the block to the neighboring building where there was a smaller pharmacy that had it in stock. I crutched a block in the heat, clinging to the prescription with two fingers and begging my arms to go faster. I waited nearly an hour for this next pharmacy to fill the prescription, and then crutched back holding the bag of medication with my curled fingertips. I stopped twice to catch my breath and willed the car to roll closer to no avail. By now every muscle in my lower leg and thigh were cramping up, but I made it to the car, threw my crutches in the backseat while I balanced on one leg, and collapsed on the driver’s seat.
I texted Patrick to let me him know I was on my way so he could start worrying and I relayed my little sob story to him. He responded with adequate sympathy and I felt foolish. “No, I”m okay, nobody tried to shoot at me or eat me. I’ve got to stop complaining so much.”
His instant reply? “Nah, it’s you.”
Find somebody who gets you; it’s so much better than trying to change.