We have wrist-off!

Thursday, April 12 was a special day for me as I was hopeful that it would be my final visit with Dr. Jurist and the completion of the wrist saga. I arrived early at the doctor's office partly excited to see how my wrist is healing, and partly excited to read some of the excellent magazines that the staff maintains there.

I obtained the usual x-ray first thing, check it out:

The first thing you might notice is how much better I'm getting at photographing x-rays. I don't think this is a marketable skill, but I've had enough practice at it that my pictures are turning out pretty good.

You will need a trained eye and a good imagination if you think you can see a fracture! You can't tell anything was ever wrong with the bone, except for a chunk of titanium and a few random screws. Everything fit back together perfectly and has knit, this is my best picture yet!

Dr. Jurist was elated. He looked at the x-rays and was really impressed. He felt the hand carefully, checking it all out. Then came the moment of truth.

During my previous office visit, the good doc gave me some exercises to do believing I would work hard and not need to see a physical therapist. For the past two weeks I have been working the wrist almost constantly, making it hurt to gain mobility while I can. Diane has expressed something of a contrary opinion, pointing out that the doctor didn't talk about maniacal persistence of exercise, just some exercise every hour. Usually Diane is right about stuff like this, but I felt in my bones that working hard was the right thing to do.

Thank goodness I was right. Or at least not completely wrong. When Dr. Jurist had me move the wrist he was so happy with my flexibility that he almost cried. He had me move it over and over. In a long career of fixing wrists, he's never had one heal this well or this quickly. He was very pleased. Emotionally and deeply pleased.

He told me the bones are healed, the wrist is good, I can do whatever I want. No need to wear a brace any longer. I need to be careful because the wrist has no strength and I might hurt myself, and indeed I've observed that I can't even pick up my coat with the left hand. But by doing hand strengthening exercises and continuing to twist to regain more mobility, he felt confident I would heal fast.

'So the golden question is, can I ride a bike?', I asked.
'Looks like the weather is going to work against you this weekend, but sure, you can ride a bike', he replied, 'just be careful, it isn't very strong.'
'My question to you,' he continued, 'are you going to wander into terrain parks and take big jumps when you go skiing next year?'
'Yes, I believe I will,' I replied. 'I've done hundred of jumps like that before and only messed up once. I don't see why I would stop now.'
He gave me a big smile, 'I thought you might.'

I am truly grateful to the competence and skill of Dr. Jurist, and I thanked him profusely. I also thanked the good ladies at the front desk and once again complimented them on their excellent magazine selection, and they promised they'd get some new ones for me if I called ahead, I don't even need to get hurt again to come by and read.

The weather forecast for Thursday was rain and snow, but when I walked out of the office the roads were dry. When I arrived home it still hadn't started raining so I quickly changed and took off on my mountain bike; I figured the shocks would keep the hand from taking any hard jolts. It was just starting to rain when I left the driveway. When I turned around after topping the hill to Westford Center it was sleeting and coming down pretty hard, but I was having so much fun just riding a bike that I ignored it. At about 4 miles it wasn't much of a ride, but it felt great!

Before I bring this story to a close, there are a couple of loose ends to tie up, although you may not realize it.

Several people have wondered if I was able to work while my wrist healed. The people I work with know I missed very little work over this. In fact, just to help me be productive, Rob, my manager, got me a prosthetic:


This is a mechanical hand that came in a box labelled "The Pianist", so I tried to play the piano with it. You have probably already noticed that it's another RIGHT hand, so not as useful as you might hope. I also took a picture of the instructions:


Oh, the irony! The cruelty! Sure, it seems like such a noble gesture to provide an extra hand when I can't use my own. But requiring someone with a broken wrist to clap is just cruel!

In closing, we live in an age of wonders and miracles, and yet they are so commonplace that we hardly notice them. If an injury such as this had occurred when I was a boy, my arm would never have been right and would have caused me pain the rest of my life. Yet here I am nearly completely healed, only a short time since a serious-ish injury. And I continue to marvel at the human body, a serious bit of engineering with the ability to heal itself and recover from the abuse we give ourselves.

I'll update this blog again when something interesting happens to me. If the past is any indicator, give it 3-4 months.

Happy Cast-Off Day!

Today was the big day to get the cast off! What a glorious day it has been too!

When the cast was put on three weeks ago it was pretty uncomfortable. It became very tight if I left my arm below my heart and tended to cause my wrist to throb. Holding my hand above my heart caused the blood to drain out and restore balance to The Force, but it was tedious. Still, I've been able to type, which means I could go to work, and I've been getting along pretty well.

The second week of the cast was comfortable. The wrist needed the support and the cast was just loose enough to be warm and comfy on the arm. But the third week, well that's when the itching began. In the past I've had a good laugh at people in casts trying to scratch an itch, and now it was my turn. I found large flat spoon handles to work pretty well, but everyone seems to have their favorite method.

The other funky thing is the amount of skin that started sloughing off. It occurs to me that our hands lose a bit of skin all the time, but we use them so much we barely notice it. But with a cast, I noticed I was leaving small DNA samples everywhere I stopped, a veritable shower of small skin particles. I heard somewhere that you lose around 10 lbs of skin a year and I used to think that was remarkable; but after seeing how much came off my hands, I think it's a pretty conservative estimate.

Last night was Cast-Off Eve, and today was the big event.

I arrived at Dr. Jurist's office and wished everyone a happy Cast-Off Day. The nurses & women behind the desk wished the same to me and apologized for not having a cake. Oh well, maybe next year.

Taking a cast off it quick and painless. It is also loud. They use a power tool that is sort of part saw and part hand mixer; it vibrates really fast and will cut through stiff material quickly, but won't harm your skin. They cut the cast in front and back, then use a reverse-pliers tool to pry it off.

Seeing my arm again reminded me once again how much I love these body parts of mine! The wrist looks a bit worse for wear, but I recognized the little buckaroo and was pleased to see him doing so well!



The small tape-bandages have been on under the cast the entire time. I thought for sure they were curling and causing the arm to itch, but they were intact the entire time.

With the cast off, it was time for X-rays. Check these babies out:


You really have to look carefully to see the fracture lines now! Dr. Jurist was pretty excited about these pictures, everything lines up perfectly and it's really healing well. I told him I love the pictures, but I'm biased because it's me. He said he loves the pictures, but he's biased because it's his work. Big love fest for the pictures...

The doc had me move the hand around. I've secretly been moving it as much as I could over the past week, squeezing a soft ball with my fingers and trying to work it a bit. I've also been running, having a belief in the healing power of blood being pumped through the system. I think this helped.

My movement exceeded expectations. I can bend the wrist more than you would think. I can make a fist. And it will turn both ways. Things are looking pretty good at this stage in the game.

The doc and I agreed to try exercising it by myself without going to physical therapy. We'll try it for two weeks, then reevaluate. He thinks I could do it on my own and wants to see me try.

In the meanwhile, I need to wear a removable brace. I can't pull or lift anything, but I can move the wrist and do exercises. And type. I need to have the brace on whenever I move around just in case I hit the wrist, it won't take much of a hit to set it back.

So here's a picture of the arm today:


One of the most amazing things about this experience is how common this injury is. I will wager I've met more than 20 people who have a scar exactly like this one! If I started a club for people who have had this injury, we'd need a pretty big hall to hold meetings! Someone at work is even recovering from it at the same time, it really is common. As an aside, I told Greg that with my titanium plate I am going to start a second career with the X-men as Bottle Opener Man; he said he is going to be Set-Off-Airport-Security Man, but he thinks his secret identity will be blown every time he travels.

I still wish I would have gotten retractable claws.

Meanwhile, I'm thinking about a new project: Broken Wrist, The Musical. I think it has BIG potential!

I'll update this blog if anything interesting happens, but for sure will report in April 12, after my next appointment. I'm moving into the recovery phase, getting close to the time when I can take this baby out and open 'er up, and see what she'll do.

Central Casting

Today was my big day, or at least the day I have been looking forward too. The swelling in my arm has gone down steadily since the operation, and the half-cast ace bandage thing was getting loose. Every day my fingers move with less pain, and I've been able to sleep a little easier. Last night was the first night I didn't sleep like a baby: wake up every two hours and cry...

Because the back half of my arm was unsupported, I haven't been able to use it for anything. Not so much as hang a towel from it without incurring undue pain. The other day I really, really wanted to go for a run, as the sun was shining and the roads dry and I have been doing nothing since the accident. But even movement caused me pain, so no run. Pretty pathetic. It drives me crazy not being able to help my wife and family around the house. I'm not someone that likes to sit around and be pampered.

This morning I went to see Dr. Jurist and check progress, I was pretty excited. The office was very busy, but I finally tore myself away from a 6 month old Newsweek magazine was led into an exam room. A nurse used scissors to cut off my bandages, revealing a long scar with 25 stitches. She asked me to lay my arm down to remove stitches, but first I took a picture!



So you might think it looks kinda gross, but I haven't seen my arm in almost two weeks and I was pretty happy to see it is still there, and in fact it has absolutely been thriving under all of those bandages.

Before the nurse took any stitches out, she led me into X-ray to take some pictures. It just doesn't get any better than this, I was hoping and praying I could get an x-ray to see what had happened! Dr. Jurist saw me in the x-ray room and stuck his head in, "you're going to love these pictures!" he exclaimed. I'm pumped now!

Back in the exam room the nurse took out a single stitch, then Dr. Jurist came in and said he would do that if she would fetch the pictures, we're excited to see them. I didn't say much as I was counting: 25 in all. The doc joked that he probably could have done it in less, but wanted me to have a good story to tell.

I've been flexing my fingers a lot every day trying to loosen them up, and the doc is pleased. I can't do much with the thumb, but the bandages prevented me from moving it. Hopefully I'll be able to wiggle around more with the cast on.

Now we get to see the x-rays:



So the first and most obvious thing is that I didn't get retractable claws. I expressed my disappointment to the good doctor, and he apologized. Still, look at the way dem bones line up, pretty impressive! You can see the titanium plate and screws in the lower part of the arm, and the pins coming off of the plate in the upper. I also notice that the plate has an interesting cut out in the middle: it looks for all the world like a bottle opener. I have no idea how I'm going to get to it to open a bottle, but I appreciate the thought.

You can see in the picture that the bones are not knit, but they are in nearly perfect alignment and things are starting to fuse. Actually, the bones could only be aligned better if they were held using zip ties, I'm convinced that is a patentable idea.

The doc is very pleased with how things worked out. He says these plates are sort of a new thing, they used to have to really open the arm up in order to put the necessary supports in, and now it's all pretty simple. Just in time too, he says he was getting too old to be cutting on people like that.

Dr. Jurist thought it was cool that I was taking pictures of everything, so we threw the original x-rays up for easy comparison:



This picture was taken before the initial reduction, so you can see that the top of the Radius is pushed way down and the hand is out of place. Now that I've been looking at these for a while, I realize how messed up it was.

The doc told me that often at this point they often provide a removable splint, but given the severity of this break they will cast it for 3 weeks, then we'll go to the splint. I was able to chose from a number of cast colors, but they were all varying shades of ugly. I decided to go with black, it goes with everything.



Notice that I have a lot more finger showing. Yes, I can finally type with 2 hands again! It isn't completely natural as you typically twist your wrist to contact the keyboard, but I've typed this entire blog entry in roughly the time it takes me to do a paragraph or two! I feel like lightening on the keyboard, comparatively speaking.

In exactly 3 weeks from tomorrow, I go for my next exam. They will remove the cast at that point and put on a removable brace. I'm still 6 weeks from starting physical therapy and regaining my full range of motion, but it's clear I'm making progress. The doc says I'm probably about 8 weeks from getting on a bike, but it's something we'll be watching. Evidently he had a patient last year who had the same operation and was able to do the Mt Washington hill climb
four months later. Cool! I've already missed registration for the hill climb this year, but wasn't planning on racing it anyway.

jump pic

Hey, I found a picture of the jump I went off at the Waterville Valley web site, check it out.

What's next?

I now have another cast, or at least another half cast with ace bandages. I have an appointment next Wednesday to remove the stitches and put on a real cast. I've included before & after pictures. Check out the evil condition of my hand in the 'before' shot. In these pictures they don't look all that much different, but there is at least 4 lbs & 30' of ace bandage separating them.

One other note: I've always heard how great Percaset is. I didn't like it at all, and didn't take it beyond one dose at home; I'd rather deal with the pain. It's been 48 hours since the operation and I still can't focus as well as usual and I blame the drugs. There are plenty of people who go through really serious stuff and I have little doubt that pharmaceuticals help them make it, I'm glad they are available; but I'll avoid them when I can, thank you very much.

operating operationally

I've heard a complaint that my story is too long, so my previous entry is the executive summary; and I lived happily ever after, the end.

For anyone else still reading: it takes a long time to type this in one handed, I hope you read it slowly... I'm still woozy in a woozened sort of way, so let's see how this goes.

Allow me to doff my hat to the very competent staff at the NorthWest Regional hospital in Framingham. I have never met a nicer group of people or felt more cared for. With the exception of nurse Ratchet (not her real name), these people exude confidence. I m grateful for their care.

I arrived in the Day Surgery waiting room dressed in my sweats. I was only there a few minutes before being ushered into surgery prep. I was instructed to remove all of my clothing and put on a 'johnny'. I looked the nurse in the eye and pointed out that I was wearing sweats, so surely they would prefer me to keep them on to keep me warm. She explained an emergency procedure that would require access to a thigh, so they require all clothing to be removed when using anesthesia, except for socks. So much for my Jedi mind-trick powers.

My johnny would have been a perfect fit if I was 9 years old. On my 6' 2" frame it was a mini skirt. And of course with only one hand I couldn't tie it in the back, so it was a bit breezy. I doubt anyone would admit to designing the johnny, it is a monument to utility and bad taste. You can bet it was designed by a man. The nurse came in and tied it for me. I hope that these good nurses get Danger Pay for having to see the backsides of middle aged men on their way to surgery; that and free trauma counselling.

They put an IV in , and soon someone came over and shot some Versed into it. Why the Versed? To take the edge off. What edge? You know, The Edge. Let's pretend I have no idea what you are talking about, what edge? All good questions, and she wandered off.

So now there is Versed, antibiotics, and standard saline dripping into me and things are getting just a little surreal. I meet a nurse who has heard about the 'ski guy' and asks me for details of my accident; turns out she is also in a 'mixed marriage', although in her case she skis and her husband doesn't. A woman that looks like she could use some sleep sits down next to me and announces she is my anesthetist;
'I assume someone has talked to you about what we do?'
'No, no one has.'
'We put you to sleep.'
She looks at me expectantly, then gets up and wanders off. I'm not sure that went so well.

Dr Jurist comes by to say hello, and I'm glad he does! He's alert, jovial, and the right guy for the job. He marks my left arm with a pen. I pointed out that if he gets in there and doesn't remember which arm, do the one with two casts and 400 yards of Ace bandages. He thanks me for this insight. I also told him that I've been thinking about my x-rays, and it occurs to me that putting big screws into the bone is not the best way to fix this type of thing.

'Really?' he asked, 'do you have a better way?'
'Zip ties,' I respond. 'Put the plate in and zip it down.'

He's kinda taken back by this, his mouth is working like he's going to rebut the idea, but then he shakes his head. 'Medical grade zip ties, what a great idea!'

Next, a jovial fellow sits by me and announces he is my anesthetist. I told him I've already talked to an anesthetist, and she said she was going to put me to sleep. He seems surprised by this and asks if I remember her name. Nope. So, what's on the menu today? Protopol; it replaced Pentathol 10 years ago. Gas? No, strictly through the IV, although there is an oxygen mask.

We are good to go, so a nurse wheels me in to the OR. On the way we stop at a cupboard and hot blankets are put on top of me, they feel glorious. It must be 15 degrees colder in the OR.

When we arrive inside I see Dr Jurist poring over a trail map for Alta. Kinda scary that I've skied there enough to recognize it by trails alone. I told the doc to come over with a pen and I'll tell him where my favorite runs are; he's got to hike up to The Apron, you can almost always find powder there, if you don't have an aneurysm hiking up in the thin air of 10,500'.

'So doc,' I begin, 'I've figured you orthos out. You re' just itching to put a cast on me, 'cause that's how you mark your territory.
He smiles wickedly and replies, 'Not me. I'm signing your body with a metal plate and a scar.'
Oo, good point!

I asked the doc what kind of metal he's going to put in me. Titanium, why? A friend's father is a doctor and has been campaigning against stainless steel because it corrodes in the body. He responds that could be true in a socket or something, but not in a simple structure plate.

'Let me level with you,' I say.
'What?'
'Adimantium. I want adimantium.'
'Hmm, and why is that?' He's humoring me.
'I want retractable claws like Wolverine,' I say with a straight face.
'I'll see what we can do.'

The anesthetist walks over and puts something in my IV. 'See you later, Steve.' I wait a few seconds and I'm still awake, so I say 'I'm still here, you guys need my help with anything?' The anesthetist puts a little more in the IV and says 'nighty night, Steve'. I wait a couple more seconds and say 'I think you'll have to carry on without me'.

Next thing I know someone is shaking my gently, telling me to wake up. My hand feels different, I can move my fingers without pain. And it doesn't feel so heavy, I must have a different cast. A nurse tells me to wiggle my fingers and toes, it will help me wake up. I comply.

The doc comes by and tells me things went really well, he is very pleased. Everything fit together perfectly and tightly, it is the best possible outcome! He'll call and speak to my wife.

A nurse comes by and asks how I'm doing, and I reply I'm fine. She comes by a couple more times and we have the same exchange. Then she asks how my wrist is doing and I tell her it really hurts, but I'm OK. She rolls her eyes and asks why men need everything spelled out all the time. I'm not sure what she is talking about. Someone gives me a pill and says it is Percadan, for the pain.

I'm wheeled out of recovery into post-op. The nurse wheeling me says 'check this out!' and shows me a long scar on her wrist. 'You had the same operation? I ask. She nods her head. 'Cool! We could start a club or a user group.'

Thus far, everyone I have met has been wonderful. But now they deposit me with Nurse Cratchet, and it isn't so nice. She moves me into bed roughly, then yanks one of the fingers on my broken hand and places a heart rate monitor on it such that it pinches. This really hurts. She comes at me with a cuff for blood pressure and I ask her to please put it on the arm that isn't bandaged, she rolls her eyes but does it. She asks if I want Coke or Sprite; neither, just some water please. No, she doesn't do water because people throw it up. And she sits down across the room. My throat is extremely parched.

Fortunately, it is the end of the shift for Cratchet and she leaves. Her replacement is nurse Linda, a self labelled eXtreme Talker. Linda is an angel and takes good care of me.
We talk about all kinds of things, although with the chemicals running through me I don't think I'm keeping up. Diane picks me up at 8:00 and we head home.

Operational success

The operation was a success. Dr Jurist was very pleased and told me everything came together and lined up perfectly. I have a splint that is less than half the size of the previous. I'm still a bit woozy, I'll provide details later. And explain why the inventor of the hospital 'johnny' will never win a Nobel prize.

FAQ

Several people have sent me questions about this little ordeal, so here is my pre-op Q&A:

Q: Are you going to quit skiing now?
A: I don't understand the question. You may as well ask if I am going to quit breathing. I don't think I can do that.

Q: Are you going to slow down more now?
A: See the previous answer.

Q: What does Diane think of all this?
A: Diane is the most supportive and loving person I know, I would be lost without her. But she has thought I am crazy ever since we met. You'll have to ask her yourself, but I suspect she will tell you about some Really stupid things I've done.

Q: Are you going to grow up?
A: And be what? I don't think I understand the question.

Q: Aren't you afraid you are going to get killed?
A: Um, a broken wrist is pretty far from life threatening. Even so, I love life a lot more than I fear death.

Q: They aren't going to replace your wrist bones with adimantium like Wolverine has.
A: That's not a question. And I'm not going to show you my retractable claws, just for that.

Q: How long until you can get back on a bike?
A: Don't know yet. Hopefully 8 weeks.

Q: Are you ever going to beat Chris in a sprint?
A: Hey! I beat him now, sometimes. During my recuperation I'm going to come up with a new strategy. Heh.

Prepare to launch

Before I talk about the day I want point out that I put on a suit to go to church yesterday and tied a tie with one hand! I would not have thought it possible.

When I was young I took a small thrill when I exceeded expectations to the point of surprising my teachers and earning their admiration. I don't feel the same thing around doctors; not even a little bit.

When I was ushered into a room at Dr, Jurist's office, his nurse looked at my x-rays and immediately gave up an 'Oh wow!' When Dr. Jurist came in a minute later he turned on the viewing lamp for the x-rays and said the same thing, 'Oh wow!' He looked for another minute, then turned to me and said 'This is a spectacular break!'

Note to medical community: even if it looks bad, fake it. Yawn and stretch, and look like you've seen so many of these things just this morning that it is tediously mundane to fix it. Speaking on behalf of medical overachievers everywhere, we don't want heroics, and we especially don't want to be first.

'So how did you do this?' he inquired.
'Skiing,' I replied.
'I'm betting you didn't just fall down', he opined, 'I'm going to guess you did this in the terrain park...'
'Hey, you're pretty good!'
'...probably went off a big jump. Big Air. Yeah, were you catching big air when you did this?'

I was pretty impressed now. 'Yes, I was. But I botched a landing and my weight ended up on my wrist, cushioned by a ski pole.'

Turns out the good doc is a skier himself! He confided that he doesn't do jumps any more due to bad knees. He's even headed to Alta next week. He was kinda excited I was there at Snowbird just two weeks ago.

We now got down to business. It turns out that in this office 'spectacular' isn't necessarily 'bad'. He pointed out that there are lots of pieces, but they are all where they are supposed to be. If it was bad they would be separated out and mixed up.

He asked where I live and I told him, adding that Emerson hospital has my preferred operating room. He responded that his next stop at Emerson is in two weeks, and this really wants to be set right before then. I agreed, and asked what his schedule looked like this afternoon, let's just do it! He smiled and countered with tomorrow. Sold, I know a bargain when I see it!

He explained that it will never be as good as it was. It may hurt once in a while, it might get arthritis as I get older, and the range of motion will not be as good as before. I asked if there was bad news too...

I then made a good case for saving the hand. I explained that I rock climb and needed my hand strength and dexterity. He thought I should be able to do that in less than 6 months, no problem. Excellent.

He had me take off my jacket to take a look. He asked if this was the same cast they put on at the resort. I explained the current two cast system and assured him that I don't need a third. I've figured out the 'cast system' used by orthos, it's how they mark their territory. He looked at this log of ace bandages and casts and decided it would be OK until tomorrow. I could see that he really wanted to put another cast on there.

A couple of phone calls by his able assistants and I'm expected at the hospital tomorrow at 12:45. I am impressed. They sent me over to pre-op at the hospital so they can look at me.

The MetroWest hospital is a bit confusing the first time you go there. I found it just fine, and entered the building under a big sign that says 'MetroWest Hospital'. Once inside, it doesn't look anything like a hospital, not even like a medical building. I stood there confused for a second when a nice lady pulling a cart asked if she could help me. I said I was told to go to pre-op at MetroWest Hospital. She rolled her eyes and said this happens all the time, she didn't know why people thought THIS was the hospital. I helpfully suggested it might have something to do with the huge sign above the door; she considered there might be something to that.

I found my way to pre-op and met a really nice nurse who knew I was coming. She had me fill out a form to verify I am not pregnant. I wonder if this is the new gender equality, they check males for pregnancy so they don't appear to discriminate. Puh-leeze! I handed the form back and asked if that was all.

'No, this is going to take about two hours', she said with a smile.
'You're kidding me, right?'
'No, I'm not,' she said sheepishly, 'didn't they tell you?'

They seemed to have overlooked that small bit of data. Rats.

The first woman I spoke to was incredulous that I wasn't taking pain medication. She was sure I must be. She asked me to rate my pain on a scale of 1 - 10, 10 being excruciating. I told her it really didn't hurt at all at the moment, as long as it isn't moving it is fine. She didn't believe me, and explained it again as you would to a child. I assured her I understood the scale, it just didn't hurt. Finally she just looked at me and said that a break like that really hurts, so she put me down for a 4-5 pain level. OK, we'll go with that. She was really pleasant to speak with, as was everyone I met.

I next met with a nurse and she took my vitals. She said she could see good veins from across the room, no problems with an IV. I didn't know the hospital drill, but I was sitting in a chair in a room for drawing blood; but she told me they didn't need any blood today, which sort of surprised me. We had a good chat about physical therapy, but she made me a little uncomfortable by repeatedly saying things like 'athletes like you'. When I walked back into the waiting room I saw a lot of people in frightful physical condition, so maybe I was the first guy today that actually goes for a run once in a while.

As I understand it, I'll show up tomorrow, they'll take my clothes, knock me out, slit my wrist, jam metal into me, and pump me full of drugs for a day or so; but I'll go home tomorrow night.

I still need to talk to the doctor about being able to resume my career as a concert pianist; or at least that I have ambitions to get high score on Guitar Hero. And if they are putting metal into my bones, maybe they could do something like Wolverine?

2nd look

If you've read this far you may have realized it has all been typed with one hand. It doesn't work out to be half the speed of two hands, in fact it's closer to 10%.

I didn't realize the extent of the break until I used Google to find an x-ray of a good hand and compared it to my pictures (below). It is educational.

See a good x-ray here.

It's the commonplace things that make you appreciate the use of your body. Take undressing, for instance; no can do. I was stinky from skiing all day and determined to take a shower. Diane had to undress me. I was bare chested so she could wrap my arm with Saran wrap and shivering uncontrollably; partly from the cold, partly from shock. But a hot shower felt so good! I have spent extended amounts of time in the wilderness and long ago realized that hot water on demand is pretty much the pinnacle of achievement for our civilization.

Friday, February 23

It snowed overnight and caused some delay in the opening of doctors offices. I had torn up my calf a couple years ago and been referred to an ortho in the same office as my primary physician, Dr. Martin Kafina. Dr. Kafina's office got me in to see Dr. Driscoll as soon as I could come in, sweet!

Dr, Driscoll exudes confidence. After shaking his hand you get the impression he knows his stuff. So I wasn't exactly inspired to see him shaking his head while looking at my x-rays. He pointed to the picture with the hand flat and traced the line of the break in the radius. If this is the only break, he explained, they can put in a screw or two and put it back together. But looking at the hand in the edge orientation you can see several pieces of bone floating around, so this isn't a simple break at all. It will require a plate and some new high tech stuff to put it back together.

Because of the damage he is referring me to a specialist for hands, wrists, & elbows. He provides me with the card of Dr. Jurist, and one of his assistants made an appointment for Monday. I hope Dr. Juris can do the job and doesn't refer me to someone who only works on the radius!

Dr. Driscoll asked about my occupation. And then he asked what sports I participate in. Of course, in my hubris I thought he wanted a guage of my fitness level, perhaps as an indicator of my ability to heal. Then he asked if I played any musical instruments. It finally dawned on me that he was really asking How Much Do You Love Your Left Hand! I could be a concert pianist if they fix me right, I REALLY love this hand!

To further stabilize the wrist they put a cast on the front part of my arm. They don't even take off the old bandages, just lay new stuff on top of the old. This actually makes it feel more comfortable as it moves even less. But my arm is huge with 2 casts and who-knows how many yards of ace bandage. I told the nurse that I was leery of visiting another doctor because if I get one more cast I won't be able to lift my arm!

For now the arm is stable. If I don't move, it doesn't hurt. Car rides are bad, I move a lot. I don't have any pain medication because I don't usually need it. The most painful thing is that it is a beautiful day and I'm stuck inside. And I'm not healing, I'm in a waiting pattern until they can put in some metal.

The hand saga

Yesterday I took my daughter Danielle skiing at Waterville Valley in New Hampshire. I had skied with her brother in Utah a couple weeks ago and she wanted equal time; fair enough. If my family insists I ski, should I argue? Je pense que non!

Danielle is a cautious skier, but she greatly improved over the course of the day. I would ski at a leisurely pace and wait for her, and that was how we spent the day. She's a pretty girl with a stunning smile, even from under a helmet and behind shocking pink goggles.

One time whilst waiting for her, a couple of teenage boys came to a stop near me, also looking up the mountain. I had passed them on a narrow trail a minute before. When Danielle came by one of them called out to her and it was clear their stop was no coincidence. The other boy must have felt the smouldering heat of my disapproving glare, as he looked at me briefly and made the connection between big angry scary guy and pretty girl, persuading his more forward friend that it was time to go simply by pointing at me; and they disappeared like frost in summer heat. Every once in a while I discover secret Dad powers, cool!

Sometime in the afternoon I was busting through thigh high moguls at high speed and tripped up on some ice. My legs were burning so it didn't bother me to go down and take a rest. But when I got up I was disappointed to see I had bent a pole pretty badly. It broke when I tried ever-so-carefully to straighten it out. I liked those poles too, rats! I threw the bottom away at the bottom and kept skiing with my quarter size pole. It gave me something to hang on to.

Waterville Valley has a J-bar that services their terrain park, hauling erstwhile radical dudes up a narrow track in clear view of massive jumps and rails. We passed the park every time up the high speed quad. Danielle wasn't interested in the terrain park but she wanted to try the J-bar when she finally understood its purpose. Earlier in the day I had wanted to try the jumps, but now my legs were nearly shot and my interest had waned. Still, we went up the J-bar and into the park.

We quickly debated skiing out onto the slope rather than through the park, but it was easier just to ski the park. May as well hit some jumps, as long as they are on the way. For a second I considered that I should have two poles or no poles to go off the jumps, as 1 and 1/4 left me a little out of balance. But the thought was fleeting and I've done many jumps like this before, so I lined up for one of the big ones.

As soon as I left the earth I realized I made a mistake. This is a big jump, you need to clear at least 20' of table top to hit the run out. Plenty of height, and hang time to think. Not much you can do when you are rolling infuriatingly slowly off axis. Things were not going well, but they were going fast; Mr Gravity saw to that.

I hit on my feet at an angle and both bindings popped. I was glad I hadn't cleared the run out, but I was close! I hit the ground on my butt, seriously bruising my tail bone, then launched onto my stomach further down the hill. My weight came down on my wrist, with the ski pole hand grip underneath it. I slid to a stop a few seconds later.

There is a short amount of time after taking a good hit like this where things are peaceful and calm, and you can sort of float above the preceding chaos. This isn't an out of body experience, but rather the time it takes your body to realize it's just had the stuffing kicked out of it and it needs to create some pain or go into shock or generally express displeasure. Sort of like a captain calling around the ship asking for damage reports, hoping that we can do it again if we survive.

I lay there a moment assessing. I didn't want to get up. My left wrist hurt like anything; I could move all of my fingers, but just barely. Danielle came up at that point and demanded to know if I was OK. I told her my wrist was broken, but otherwise I was fine. I walked back up the hill, snapped into my skis, and skied down to the lodge.

When I took the skis off I realized the left hand was useless. I needed to look at it, and formed a plan to use the broken ski pole to splint it until we got home. Inside the lodge I struggled out of my boots and needed help to remove my shell.

My wrist was clearly a mess. My hand was too far over to one side and you could see bones under the skin in strange places. The splint-with-a-broken-ski-pole idea went down in flames. I wandered over to a service desk to ask directions to their first aid center.

Outside I asked a resort employee to point out the First Aid center and he cheerfully did. He asked if I was hurt and I cheerfully explained that I had just broken my wrist. This guy didn't even hesitate in asking if he could help us carry our stuff; a generous offer that was gratefully accepted. He grabbed another employee and they helped us out. After we were inside the clinic they ran and fetched my truck, parking just outside the door. I didn't get their names but am most grateful to them!

In the clinic a cheerful girl greeted us and asked how she could help. I told her my wrist was broken and I was wondering if they had someone who could help me stabilize it. She helped me take off a fleece top, and once she saw the wrist I could see that she had been thinking this couldn't be too serious. I was in a lot of pain, but I never feel the need to share pain with others. She announced that this was my lucky day as it was MA vacation week and they had a doctor and an X-ray tech on staff. They sat me down and provided paper work that would allow me to claim my winnings.

It was clear the wrist was broken, the question was How Broken. We took three good pictures of my highly photogenic hand.

In less than 10 minutes of walking in the door I had my 4Runner outside, x-rays developed and sitting on the board, and was speaking to a doctor in ski gear. The last time I went to the ER they hadn't even noticed that I was bleeding all over their furniture in that amount of time. Full marks for the excellent staff at Waterville Valley!

The doc explained that the first problem was to put the hand back where it is supposed to be. They needed to do a Reduction, which is medical slang for jerk the hand back in place. This is seriously painful, so the doc fist put a bunch of lydacain into the area where bones needed to move.

A 20CC needle looks like something a vet carries around. It looks like it holds about a pint of material, more like a super soaker than a medical device. I thought he was putting me on for sure! Not only was he serious about this needle, but he had to poke it in through the back of the wrist in order to ensure it got in between the bones. I had been in some serious pain until now, but it quickly became clear I was just warming up the ol' pain scale! Most shots are in and out in a second or two; this one was close to 5 minutes! Did I mention there was a LOT of material in this cavernous needle? In addition to dislocated and broken bones, I was going to have additional tissue damage as well.

Once the shot was done the pain was relegated to a dull throb as the lydacain set in. The doc spent more time staring at the x-ray, I could see him formulating a game plan.

Before doing the reduction he first put my arm in a kind of traction. A stand in the office had a type of wire glove attached to it; but there were only fingers, no palm. Each finger looked like a wire version of those 'Chinese finger cuffs' that you get at kid's birthday parties. And this was made for a kid's hand, it barely fit over my fingertips. But once on, the doc leaned on my bicep to help stretch the wrist. I was having a vigorous internal debate on what hurt more, the shot that tore up my soft tissue or this left-over from the inquisition. Stab me with needle-zilla, then Garrot my fingers with a torture device; things didn't appear to be going in the right direction!

Finally the doc felt he had done enough or it wasn't working, but he stopped. He had his assistant hang on my bicep, grabbed my hand and pulled. He pulled straight for a second and then moved my hand down while pulling up. And suddenly, my hand was in place and it felt wonderful! I was nearly pain free, I was elated!

Back into the x-ray room for a couple more pictures and a new look. The x-rays now clearly showed the top of the radius bone was broken clean through and in several pieces. Up to this point the doctor had been hopeful that an Orthopedic surgeon could cast it, but now it was clear that it was going to require surgery. The doc thought it would probably require a plate & some work to get it put back together, but my ortho might have an idea he hadn't thought of. He also noted that he could do a better job of getting the hand to line up, but with broken bones floating around it wouldn't hold and wouldn't do any good.




They put a half cast on my arm to immobilize it. I asked the doc if I won Break Of The Day and he laughed and said "hands down!", which I took to be a bit of ortho humor.

Danielle sat near me and watched the whole thing. I was worried that she might get queasy, but it didn't seem to phase her. Good girl to have around in a pinch!

Diane, on the other hand, was beside herself with worry and concerned we wouldn't get home. She called right when we arrived at the clinic and Danielle filled her in, and I told her the rest of the story as we drove home. She was concerned about several things, but the funniest was her concern that I was driving myself home! With one hand! But I always drive with one hand.

Next: Fast in and out at the ortho as we get handed off to a specialist.