Friday, May 28, 2010

moving bibendum's joints

"When your splint comes off, I will give you a cane, and you will walk like a man."

That was how my surgeon in Mexico responded when I asked him about physical therapy.

He scoffed at such American frivolity.  His notion: I had already learned to walk as a child.  I just needed to do what I already knew.

Not so here in Oregon.  As soon as my splint came off, my orthopedist gave me a prescription for physical therapy.  And quite a detailed prescription. 

He wanted improved range of motion, strength, weight bearing, and endurance in my ankle through physical therapy three times each week for 2 to 4 weeks.

Nothing unusual.  I have seen the same prescription numerous times during my litigation career.

But he also checked an additional box: lymphedema care. 

I know my Latin.  I also saw my foot when it came out of the splint.  It was blown up like a balloon.  Within a day, my calf, knee, and thigh joined in the Michelin man impression.  (The swelling is what caused my family physician to order tests to determine if I had a blood clot.  As you know, I did.) 

The cause of all the swelling?  My lymph nodes were blocked.

The prescription was written two weeks ago.  On Thursday I had my first physical therapy appointment.

The reason for the delay?  The hospital where I was referred does not provide lymphedema therapy.  So said the receptionist when I called last week.  But the director was reviewing the request.

My first reaction was: Why would I want the director to approve the referral if the hospital could not give the requested care?  Even though "lymphedema care" is listed as one of the options on the hospital's referral form.

I was starting to believe that my surgeon in Mexico was a very wise man.  Or that the American medical system was simply showing its litigation-phobia again.  Or both.

It turns out I was half wrong.

My physical therapy began Thursday afternoon.  And it went far better than I had hoped.  The apparent confusion over the edema issue was merely that -- confusion.  The director wanted to be certain I did not need special therapy.  I didn't.

My therapist, Mark, took me through a series of exercises I can do at work or at home.  The hitch is I am supposed to do the exercises three times daily.  Several of them will require me to get down on the floor.  That should be interesting at the office.  Of course, it just might add interest to some of my longer meetings.

The best thing to come out of Thursday's therapy session was very simple.  I have started walking on the ball of my right foot -- with the aid of my crutches.  Not much weight bearing, but I can start getting back to a normal gait, rather than my Quasimodo swing.

I will keep you posted now and then on how the foot is developing.

But I actually have other things going on my life, as well.

I promise. 


Anonymous said...

Jan. 1986 I was involved in a terrible car accident. It was called an underide type accident. Many lawyers know this term. The gist is, I came out of this ordeal with disc damage only (c6) and the therapy prescribed worked so well, I signed up for an additional 2 weeks. I called it the "Rack" and it was a Godsend.

Rosas Clan in Tulum said...

I have spent the past 7 years recovering from sever hand injuries... DO THE EXCERSICES- forget how you look. I could have saved myself a lot of greif if I would have been ore diligent with my PT and OT.

But I am so glad that you are feeling better. And your friends were right- Life is great on the Atlantic side and our sea is to die for.

Al said...

Would you share with us how you came up with the title for your post?

Felipe said...

What in God´s Name you are doing back up there in an office is a source of much head-scratching for me. Incredible. You´re probably even wearing a tie. I know full well you do not need the money.

The human soul is hard to fathom.

And back in the clutches of the American health-care monster to boot! I know you know better.

Steve Cotton said...

Francisco -- I am amazed at how quickly I have gone from holding up my foot (yesterday) to walking (gingerly) on it (this morning). PT is great.

Rosas Clan -- So far, I have been very good at doing my exercises. I tried doing some of them this morning at breakfast in the company cafeteria. But people kept stopping by my table to talk. Hard to count repetitions that way.

Al -- Bibendium is the name of the Michelin Man -- an icon of my youth in Powers. His swollen figure reminds me of my right ankle. Thus, I am bending Bibendium's joints through PT. It also has a nice flow.

Anonymous said...

Steve, so gad you are taking your pt seriously. It is so important at this stage in the game. Without it you could end up somewhat crippled with a very stiff ankle. Keep up the good work.

Islagringo said...

I notice you ignored Felipe's comment. For a change, a good point. I was surprised by your Mx dr's advice. Even on this tiny island we have a physical rehab center that is very well used.

Steve Cotton said...

Felipe -- I am back at my desk for one purpose: to train my successor. As soon as he picks up the rhythm of the job, I will be back in Melaque to pick up where I left off in Mexico. My company has been incredibly generous to me over the years. I just wanted to repay the favor.

I will look forward to heading back to the Mexican medical system. However, I must commend the physical therapy I have received. So far, the costs have been baffling. Not large. Simply illogical.

Anonymous -- I will take my physical therapy seriously because the therapist knows far more about recovery than I do. I just wish some of my clients would use the same formula.

Islagringo -- I suspect my doctor in Mexico was simply joking. He has a great sense of humor, and he knows my tendencies to take nothing in life seriously. For all I know, he would have me in the same therapy.

Irene said...

Good luck with your physical therapy. I know from my own experience how important and helpful it is. You can continue to use what you learn after the treatments end to keep your ankle strong and healthy. And, although this may be difficult, stay away from ziplines!

Laurie said...

On a MORE depressing note, have you ever watched My Left Foot? A movie about an Irish guy who could use his left foot only. You have the opposite problem. One limb impaired not three. I loved that movie.

Larry in Mazatlan said...

I always scoffed at PT. Until I messed up an ankle on a soccer field a few years ago. They had be back jogging in six weeks. The doctor and PT guy both explained that the ankle had been so badly damaged that it had to practically relearn how to walk. Something about nerve damage that repaired itself.


Steve Cotton said...

Irene -- After resting my foot over the weekend, I was actually able to put on a shoe -- for the first time in three months. The exercises certainly help.

Laurie -- My Left Foot is one of the movies I want to see -- now that I have access to Netflix.

Larry -- I hope I have results just as good.