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.