Today I had to – literally – crawl from my wife’s car to my house. Because I couldn’t walk. Life is what happens while you were making other plans.
About six months ago I sprained my right ankle in kung fu class. It gave me occasional pain, mostly in cold weather, but I thought it was healing and I could just let it heal. Until about two months ago when I was out with friends on a chilly evening and my ankle folded up under me, just lost the power to support me entirely.
I escaped serious injury from the concrete pavement because I am really good at falling down without hurting myself. This is a skill you learn in early childhood when spastic palsy compromises the motor control in a leg. But it meant I had a prompt need to find out what was going on in there.
A couple of visits to doctors and an MRI scan later we determined that I had developed one of the more unfortunate possible sequelae of a sprain, a thing called an osteochondral lesion. This is what happens when an area of bone in the load-bearing area of the joint erodes away, so the cartilage above it is no longer supported. If the unsupported cartilage is then damaged, the long-term result can be crippling arthritis of the joint.
In my case, it seemed I had gotten lucky. The cartilage seemed undamaged in the MRI images. The indicated procedure is to go in with an arthroscopic probe and squirt synthetic bone into the lesion. Once it hardens it can support the cartilage so it doesn’t take additional damage.
I waited nearly a month for the surgery. Two weeks ago, while still waiting, my ankle folded under me as I was cooking breakfast. This time I wasn’t so lucky. I tucked in the right way to avoid injury from the floor, but the back of my head hit an errant chair leg, producing a laceration that bled copiously on the kitchen linoleum.
I picked myself up, applied pressure with a towel, called my wife, and informed her that when her errand was done she’d need to take me to the ER. A short but extremely expensive visit later I returned with three staples in my head and an MRI scan reassuring everyone that I probably hadn’t taken any permanent damage.
I think the medical staff got that before the MRI, because my main coping mechanism for hospital stress is wry humor aimed to make the people attending me laugh. I do it because this helps me feel in control of my situation, but in this particular case it conveyed something else that was useful. Comic wryness is, after all, pretty much impossible to maintain when you’re concussed or shocky.
Home again home again. It’s nice that even at 61 I’m a physically tough person with a high pain threshold and a thick skull who is actually rather difficult to injure – my school name over at the kung fu kwoon is “The Mighty Oak”. And I like that I can be self-reliant and stoic under stress. But thank you, I’d prefer not to have this confirmed by repeated injuries…
I had that surgery about eighteen hours ago. And ended up crawling from my car because none of the medical people talked about or planned for my post-operative problems until after I was out of anesthesia. Pain management was as far as they got.
It was not made clear to me in advance that I wouldn’t be able to put any weight on the joint for a minimum of two weeks, at risk of compounding my troubles. A nurse handed me a pair of crutches as an afterthought, but everyone’s specialties we so siloed that it didn’t occur to anyone to ask if I knew how to use them, let alone whether the impaired motor control in my uninjured leg might disqualify me.
So now it’s oh-dark-thirty the next morning, I’m writing this because the anesthesia and the four hours or so of shut-eye after I got home have left me all slept out for the moment, and I’ve learned from experience that quietly coding or writing until I’m tired enough to sleep again is better for me than tossing and turning.
I was scheduled to give the main keynote at South East Linux Fest on the 14th (this was well before I even knew I was going to need surgery, let alone how close to the event it would be). I’d have to do it from a wheelchair, now. I don’t have a wheelchair yet; we’re hoping to get one tomorrow. It may not be practical at all depending on my medical state, and I can’t even get my post-op check until after SELF. It’s hard to predict whether I’ll be able, and in a mere ten days I don’t think the odds are very good.
Part of the reason this is a public blog post is as my subjunctive apology to everyone who was expecting to see me at SELF, in the all-too-likely event that I can’t be there. Right after I post this I’m going to put a link to it on SELF’s IRC channel and recommend to the organizers that they find someone else to keynote.
I’m not entirely sure a wheelchair will fit in the corridor and through the doors of my house. Until I can verify that, I move by knee-walking or crawling. Besides forcing one to learn how to fall well, another perverse benefit of a palsied leg (or legs) is that the body compensates by making the arms and shoulders abnormally strong; this is helping me now as I frequently have to hoist myself around by main strength. Just getting from the floor to a toilet seat isn’t entirely trivial even so.
I’ve ordered a pair of carpenter’s kneepads for next-day shipping from Amazon. Improvise, adapt, overcome!
Cooking isn’t practical; the ritual of The Breakfast is denied to me until I’m back on my feet. Fortunately I can sit at my desk and type with my right leg elevated, as I am now doing.
There’s no real pain yet; the nerve block is still operating. That will probably change within the next 24 hours. When it does, there’s a vial of Percocet (oxycodone and acetaminophen) pills a’waitin. Which I’m going to try hard not to take, because opiates scare me shitless. Still, my stoicism has limits and they might be tested this time.
There was some damage to the cartilage. The orthopedist said that if it fails to heal well I may need an ankle joint replacement. I am guardedly optimistic about this, as I do have a history of healing quickly and well from trauma (that nasty scalp laceration cleared up inside of a week). But the downside could be dire.
Finally…if you’ve ever thought that you might join my Patreon feed, now would be a really good time. This…adventure..has blown a $6000 hole in my budget and the expenses aren’t over yet. There’s that post-op check at minimum, and probably physical therapy afterwards, and that’s if all heals well; otherwise it’ll be much, much more expensive.
UPDATE: For the rest of the story, read the next post…