Yesterday’s outing with a tourguide friend to a San Francisco Tour Guide meeting brought a surprise: another tourguide, a woman about 60, very sporty, had sprained her ankle and her Achilles’ Tendon. She was 2.5 miles up Mt. Tamalpais on a hike, and took four hours to limp/wince down to the car. The doctor did not see a rupture, hence no surgery was needed. But she had to be put in the boot for five weeks, to prevent rupture, and had just become two-shoes, was still limping a lot. Commiseration was sweet!
I asked her if she had been taking antibiotics, this newly implicated one, Ciproxin. She said, “No.” Meanwhile, earlier while shopping, I ran into a retired doctor I’d known as a neighbor. He immediately wondered if I had had an underlying condition, such as wearing the wrong shoes, or antibiotics. Again, I had to say, “No.”
Back at home, cleaning up years of accumulation, I found an almost-empty container of LAMISIL, an antifungal, terbinofin hydrochloride. Very expensive pills ($10 each, needed for min. 3 months) were something I’d taken two years ago, and completely forgotten about. BTW, cheaper to buy them in Europe: only $3/pill in Switzerland with the US prescription.
Now I have been trying to find out if there could be a connection, but so far, most side effects have been lost of taste, weight loss, severe rashes and hair loss. I had none in those months. My big toe cleared up beautifully after years of extreme ugliness.
Anyone here ever take Lamisi in the recent past?
If you search the Net for causes of the ATR, one cause is a sedentary lifestyle. Yet it seems that most here were active, if not downright supersporty, and managed to be thrown into bedrest by their exertions. I sometimes feel that I am this weird exception that is not sporty, not driven to exercise, and much more inclined to chat, reading and films naturally. Nothing wrong with sport, of course, it just bores me. Even in sixth grade, under duress, I had to join a team in school, so I choose softball (girls’ baseball back then in USA) since you could hang around the bench quite a bit and not really DO anything. Sure enough, the others and the mothers/coaches could see my inclination, and sent me out to left field. There I kept a book in a pocket to read while “waiting”, since it’s mostly waiting. All of this is long forgotten, until last year my boss treated all of us tourguides to a baseball game at the new AT&T stadium here in San Francisco. Built April 2000, I of all the guides had never been inside. It was big and impressive, but the game was such a yawn that I started wandering the stands.
WELL! To bring me to the probable cause of my ATR: with an inclination to sit and chat, with a car to get me everywhere, and so on, clearly I cannot be in good shape, and yes, I am overweight. I still love dancing, but don’t do it so much. My surgeon, when I asked him if the long hours of driving could have done the damage (”hyperpronation” of the right foot through long days of busdriving???), he said, “No, it just happens; tendons get worn out over time, etc.” Was he trying to say, “You’re getting old?”
I’m 48. I don’t think I’m old. But maybe, medically speaking, I am. I just never pay attention to all these health issues in our press and media; it seems idiotically narcissistic to watch our every freckle, pimple, twitch or pain. Again I could be wrong: perhaps I should start paying attention at 48?
When I first began to realize the length of time involved with both the cast and the PT, one thing I feared was simply going to some gym-like place, where everyone’s exercising and getting tips on their health. The whole idea of body-centeredness thinking disturbs me. Perhaps I would like to live entirely in my head and not give the physical reality any thought - similar to not thinking much about one’s car until it stops on the freeway.
Losing a bit of weight this past few months is good, brings compliments, makes the clothes much loser, and will make the PT easier.
Lest any of you reading this think, “Well, she’s middle-aged, and many women start to be like that around their 40’s”, think again! I have ALWAYS been like this! In high school and college, I focused on academics, and got exercise through riding my bike and going swimming (only for FUN!) In my 20’s, I took up folkdancing and went at it five nights a week all over the Bay Area - Hungarian, Scandanavian, Bulgarian, Irish, Romanian, whatever! In my 30’s I lost interest and dropped away from it except as a spectator at the festivals. Also, the tourbusiness commitment plunged me into long and happy hours with foreign languages and very interesting assignments, so no longer did the social world of after-hours tempt me. The daytime contact with so many different people satisfied any need to “meet new people”, and hence the inclination to go home, read and watch films grew.
So here I am, thrown back on my own self, without much outside stimulation (i.e. foreigners or colleagues), pretty much talking to a handful of good friends and immediate family. Boredom is a big problem, in spite of a pile of books and this laptop. The idea of exercise? Never crosses my mind, can’t miss what you never had.
Two of my sisters are fitness fanatics, extremely fit and thin. So it’s not a family trait! Just me! And it’s not the environment: I live in fitness-crazed California. They’re jogging all around me. When they pass us on the bus with their bicycles and jogging, I tell the tourists that “this is a new parolee program from Arnold Schwarzenegger; if they stay fit, they don’t have to go back to prison.”
Katie from Boston, 4.8 years old, is visiting me and my parents from Boston. She is fascinated by my cast. I gave her the whole long story of the operation, including the “knock-out dope” in the arm, taking off one’s clothes and putting on the gown, getting pushed on the bed to the OR, etc.
Apparently this gruesome story took hold in her mind until she had to “play operation” herself! She particularly found the idea of taking off one’s clothes very exciting. Everything off, yes!
I was the doctor, my sister the nurse, and we put her in an old white T-shirt “hospital gown”. The actual “cast” was a white dishtowel, wrapped up with a white Ace bandage, with a baggie on the foot to keep it dry. She loved being a patient! And now she can walk around the house limping, just like Aunt Mary, and tell people to be careful of her foot!
Yes, children love make-believe. I wish my injury were make-believe.
This morning’s passing thought in bed: can it be that I am having pain in the other Achilles tendon? I was trying to do some leg-lifts and such in bed, when I noticed, for the first time ever, that the other tendon hurt in a certain position. Could it be that all along I have had tendonitis or tendenosis, but never felt it? Or could it have been exacerbated by the lack of activity these last five weeks?
Meanwhile, another big deal in the house is the meeting of all five grown siblings (ages 40-50), about various details on the house and family will. It is very upsetting, since we do not get along well, but it has to be done. Big meeting tonight, hope I don’t vomit. It’s one thing I did think to tell the anaesthesiologist in advance: I vomit easily. He dutifully noted it in the pre-anaesthesia form.
In general, having the kids around is great fun. We watch a lot of kids’ movies together, such as BABE, STUART LITTLE, and SHREK III. The South African film DUMA, about a boy and his pet cheetah, is a great one, esp. if you like to see a true story, out in the wilderness of the African landscape. Hippos, giraffes, crocodiles and so on!
I cannot take the kids to the Redwoods, as I have done now for years as a driver/guide. But we will arrange that I could go as a passenger with them, sit in the back of the bus for a change - to keep the leg up, and then listen to another driver/guide tell the story of the Muir Woods redwood forest. Normally I tell always the same stories in my job, so it’s an interesting break to hear a colleague. For you folks about to travel - I guess you ATR folks are the wrong audience - in any case, if you ever sign up for a bustour anywhere, sign up for the smallest buses or vans available, and pay a bit more than the cheaper ones. Guaranteed that you will have a better time: not so crowded or difficult with a smaller group of people; you can even talk to each other more easily, and time is more flexible, than with 50-plus on a big 45-foot bus.
http://frwhiskey.diaryland.com is my blog about being a driver/guide in San Francisco Bay Area.
The big day at Highland Hospital’s Orthopedics clinic came. Lots of waiting, lots of people in casts, and nothing to eat or read if you don’t bring it yourself. But the building is new and modern, with some of the top orthopedic people in the USA there. When you think of all the shooting and mayhem in Oakland, think of a hospital with the best surgeons ready.
Perhaps all these bad kids in the local Oakland high schools should be forced to walk around in a cast, on crutches, for four weeks NWB, just to understand what an injury can do to a person. Eh? Like that idea a few years back, to make teenagers carry a five-lb. sack of sugar around with them all day and night, so that they would know the burden that a baby is.
My splint was cracked open by Brad, the Ortho tech, in the casting room. The surgeon came in, declared the wound wonderfully healed. There were no stitches or staples. He had used a dissolving tape to hold it shut, and it had indeed dissolved away. My leg was very white, like the rest of me, and of course hairy.
To my astonishment, the doctor declared that I could walk on the cast, and that I did not even need to use the crutches, unless I felt I needed them for balance. I was stunned. Everything I had read online showed that I was so far ahead of the curve, that I was not even going through a PWB period, that I could not believe it.
Questions about the future he did not welcome. Whether a boot would be involved, he seemed to say “no”, but just the serial casting, and some 2″ shoes such as cowboy boots. So all these doctors have very different ideas, yet I trust this one because he has been doing surgery since the 1960’s.
I have lost another ten pounds due to anxiety-induced lack of appetite. My parents continue to cook plain and good food every night, including boiled vegetables and potatoes, meat or fish, yet I cannot somehow eat so much. My favorites seem to be bananas, apples and pea soup. Because I have high blood pressure, I am also eating no salt, and no sugar in my tea. No wine or other alcohol, some coffee, lots of water. It would be a great step forward for my health if this big setback in life did lead to weight loss and lower BP, since those were my general doctor’s orders in any case.
Feeling elated, I walked in my new cast with the crutches. The doctor said, “You won’t need the crutches anymore, but you can use them for balance.”
“Really? So fast?” I was in a shock that I was even standing on two legs. I haven’t read of anyone here who’s been made weight-bearing only 15 days after surgery.
I asked about the boot, if that would be the next step. He said, “No, we’ll do serial casting, changing the angle.” Each doctor has his/her own ideas, apparently, and there is no arguing with them. I think of the other fellow here in San Francisco, 26, who has been seven weeks in a cast, NWB. What strange differences in protocols!
So now I am humping/harrumphing around the house, up and down the stairs, even getting my own food without any trouble, two hands free. Only going up or down on stairs makes me a no-hands-free person.
My sister Teresa is coming fromBoston to stay here with my parents - and me - for 3 weeks, with her two kids, 10 and 5 years old. Should be fun! I will let the younger, Katie, write on the cast. She loves painting. I will force her to write a design on paper first, so that I can see what she intends.
After all, kids are the best step’n'fetchits in the world, if they want to be. Michael, the elder, will expect “tips” for his service, i.e. cash for his video games.
How much I did not appreciate my health and mobility, I realize! So many tourists on my buses had recently had surgery for hips and knees all the time, or even back surgery, and would bring it up now and then when the ride on San Francisco’s hills got a little bumpy. They were generally cheerful, if visibly limping. Now and again, a handicapped person has yelled at me for having no wheelchair lift. Some think that ADA requires all buses to be so equipped, but that is not the case; private buses can choose to have it. A local company specializes in giving tours to people in wheelchairs, I always tell them, which mollifies them only a little bit.
After a weekon crutches in the Oakland hill rental, I finally faced a real fact: to be alone in a big house hopping on one foot was risky business. My friends would come and go, with one great fellow, York, bringing food and newspapers, and taking care of my car for me. But finally, it became clear that I would be better off back with my aging parents (79 and 81) in the basement of their San Francisco house. There was my old empty teenage bedroom with a bathroom and no stairs. I was totally chicken about the stairs, and had people bring me food down from upstairs. Poor old Dad has bad bursitis in one knee, and Mom has callouses and bunions giving her great walking pain, but there was no other way. They had great sympathy and insisted that above all, the wound should heal, that I should stay mainly in bed with the foot elevated, and that radio, books, Internet and telephone should be enough distraction. They are from Ireland, so they are typically old-fashioned and certainly were stern with us five kids growing up. Yet when one is in real trouble, due to no fault of one’s own, then they are very, very supportive. They believe in doctors and medicine in a rigid, no-nonsense way.
My brother is also around, having moved back temporarily to save money. He’s out most of the time, and of course (Irish) completely useless in helping a lame sister, yet his odd jokes and commentary on life were better than silly TV sit-coms. He works as an optometrist, therefore, has very little confidence in doctors, hospitals, any medications or any therapies at all. He always assures me that I made the right decision in dropping out of nursing school after one year, at age 18. I tell him that although I am glad I didn’t go into medicine, I am glad that the long year at USF with difficult anatomy and physiology, microbiology and chemistry, have proven useful over the years. In fact, it may be that everyone should study these things and do some work in a hospital while young, if they want to learn useful skills for the rest of their lives, instead of joining the army.
Well, I am not the one to give anyone advice, so let’s cease and desist with that sidetrack.
Meanwhile, Disability payments began. Officially I am a “tourbus driver”, so I can receive this until October 1, according to the doctor’s scribbles. It amazes me to read that so many here on these blogs go quickly back to work with their feet up. I am grateful indeed that my job cannot be practiced until the foot is better, so that I can study, read and relax. Boredom comes mainly from the lack of movement outdoors. The car is with York, over in Oakland, since San Francisco street parking is restricted to two hours at a time, without a residental permit.
WINDS OF WAR by Herman Wouk I am now ploughing through, having seen the 1980’s series on DVD, with Robert Mitchem and Ali McGraw. The book is well-written but has some egregiously false statements about the Germans. A reader who’s never been there could well think of them as idiotic automatons who obey every order, with no minds of their own, with no brains in their heads… at least according to Wouk. My own work involves many, many busloads of German tourists, and as far as I can see these many long years, they are the best-informed and most determined of all the groups: they know their own minds, they are not easily swayed, they discuss clearly and logically their options, and they are far from the me-me-me view of the world that Americans fall into. I find them a pleasure to have on board because they are so well-prepared and well-informed in general.
But I digress.
The whole experience of being “trapped in the basement”, a blessing in that it is always cooler than the upstairs part of the house, can make for severe cabin fever. Years of accumulated possessions fill the basement and also this old room. Very hard to clear out some clutter on crutches! So I just shove things around as best I can to keep the pathways clear.
I must go with York back to the same surgeon on Thursday, to finally have a post-op visit, presumably get the stitches out and the first real cast. I am really looking forward to this! Mom never learned to drive and DAd will not cross the Bay Bridge - a true San Franciscan from the 1930’s, he knows that there’s NOTHING THERE . BErkeley and Oakland seem like trouble, trouble and more trouble to his mind, as if here in SF everything is hunky-dory! Don’t get me going about Gavin!
Does it really matter how we rupture our AT? Well, it’s always good for a laugh, if it’s a case of dancing to Harry Belafonte’s “Mommy look a-boo a-boo” on Youtube.com. Can you believe, I thought a bit of dance/xercise would help me sleep better… lose a few pounds… Close to midnight, I was looking at Youtube, caught Harry’s beautiful voice, where he performs with Nat King Cole. That was it! One dance, barefoot on the wooden floor, resulted in a loud BANG!
At first I thought, living in the hills of Oakland, that the crime of the lowlands had come to my backyard. In the seconds before stumbling forward on to the computer desk, I honestly thought 1. someone’s shot a gun right beside the house, or 2. I broke the floorboard in this old house. A master of postponement, I hobbled in fear, or rather hopped in alarm, to the bedroom, hoping to wake up the next morning fit as a fiddle. Why fuss over a sprained ankle? No work the next day, I thought, “I’ll take it easy, lounge and read in bed…”:
Oh yes! I had no idea how many weeks of “lounging and reading” were in store for me!
And the pain came quickly enough. An hour later, throbbing came with the swelling, so it was hop/hobble to the bathroom, get the Tylenol, and try to sleep.
One day in bed, in full denial, taking it easy… no great swelling visible, but walking was impossible.
Sunday morning, Father’s Day, I drove to the local ER of Highland Hospital, known as the #2 Trauma Center in the USA, also known as a great place for sports injuries and great orthopedists. I wasn’t completely aware of all this beforehand, but it was the closest, about 10 blocks from the house. Street parking was no problem, dragged myself to X-rays and so on, saw the Orthopedists two days later, then went for Surgery on June 26th.
My fears were numerous. I had a job I loved, working as a tourbus driver and tourguide. Our small family-owned company, with only 8 vehicles, was completely hitting the high season. Europeans were flooding into the SF Bay Area, especially Germans and British. I was one of the German-speaking guides. It was going to be a great summer, I thought, with lots of work and lots of fun, explaining whacko SF and even whackier US policies to the ever-curious, super well-informed Germans.
Well, what was the internet for, but to find out all about one’s own diseases? Quick searches sent my stomach plummeting. For 8 or 10 weeks minimum, the best time of year to sock away money for the slow winter season, I would be on crutches, mostly confined to lying around. Disability peanuts would hardly pay the rent. None of the medical staff wanted to talk about any of this. I could not drive my own car, either, an old Toyota stickshift. A friend took over the necessary driving, having no car of his own, so he could keep it at his house nearby, and come over if I called him. This great old friend, York, retired gentleman of 79, was the one who really took care of me after my surgery.
Loneliness and isolation really hit me after the surgery. A few friends, the boss and the colleagues would call, and I could call them. But how often can one do this?
I realized that I was one of many millions on the planet suddenly thrown by injury or accident into inactivity in the prime of life. The sheer frustration of becoming incapable of doing things, carrying things, always fretful about the bathroom and the shower, could make any once-healthy person crazy. Most of us seem to be active, even very sporty, people who get this injury, so we take it the hardest at first. The crutches hurt, and the time drags, and the world seems to recede in spite of Internet, TV and newspapers.
The house dog, DJ, a sweet female Golden Retriever, really took to me after I took to my bed. She was beside me every minute, and practically on top of me every night, licking my arms and face in great sympathy. She was very wary of the crutches. The house owner was away, from whom I was renting, and it was an agreement to watch DJ, but this became a major problem. How to take her for a walk? My friend York was not so nimble or so inclined to have a young, healthy dog pulling him down the street. We let her out more and more to fumble around in the bushes behind the house, or just tie her to a chain in the small side garden, so she could piss out there.
Everyone was concerned about me, but still I fought a terrible feeling of loneliness and isolation. I wanted everyone to come and see me, and stay with me. But there I was, mostly on my own, since York came mainly in the afternoons.
I started reading THE WORLD ACCORDING TO GARP. This book I recommend to all you AT rupturers! It’s full of hospitals, dreadful accidents and long rehabs.
Highland Hospital’s surgery is a modern 2004 building, with eight OR’s. Everything went quickly: in at 6:00 AM, with plenty of water in me from the day before, until midnight; Surgery promptly at 8:00 Am with a top senior surgeon, assigned to me, who mentioned he had not done an ATR surgery on a woman in 5 years.
I slept long and hard, was woken up by a great nurse called Thea, who got me on to those crutches and off to the bathroom lickety-split. A quick sense of nausea hit me upon standing, but it passed. A wheelchair was brought as I dressed, then York came and got me. Straight back to the house, feeling amazingly well, with no pain, but in a suppressed shock at my helplessness. Even the few steps to cut through from a neighbor’s driveway to the front door of this hillside Oakland house, to avoid the treacherous and winding stairs of our own, was frightening beyond belief. I skidded and scooted on my tusch.
My sister Ellen came with a hospital potty chair. It turned out to be a lifesaver, with all the fluids I was drinking.
Vicodin did give me some constipation, but I took a stool softener, suffering only a bit. I ate a lot of fruit and water and tea, but otherwise had no appetite. The TV could not be brought into the room, so mostly I slept and read my stack of books.
A few days later, only taking Motrin, I felt well enough to get on the computer, but the awkwardness of the elevated leg gave me upper leg cramps, so it was back to bed.
How unreal the world seemed, as I watched the TV news in the computer room! Were people really still out there running around so violently and passionately, when I could only focus on the bathroom?
It is a big, humbling experience for a healthy person to go through this. If it doesn’t teach us some empathy, nothing will.
I still blame Harry Belafonte, that foxy devil with that honey voice. Check it out on YOUTUBE.Com!
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