Showing posts with label cast management. Show all posts

There is nothing like getting a cast taken off. In general this is a happy day, but I have had enough casts taken off that I would like to share some tips on how to experience the best cast-taking-off moment:

1. Get excited. Your arm, leg, toe, finger, shoulder etc. has been immobilized for however many weeks or months. Today is the day that it will taste freedom again! Its skin will be able to breathe through the cotton of your shirt, feel the warm air of spring, the cold tingle of snowflakes falling. In your head you are excited to be able to do all those regular things you normally do, but appreciate the small things too!

2. Bring something to wear. I don't mean your best party dress, or a freshly ironed shirt. I mean that once you have your cast off - you'll probably be able to wear that t-shirt you've been dying to fit your arm through. Or maybe you've been wanting to throw on that skirt without having an awkward boot sticking out from underneath. You're finally able to resume life as you've been meaning to, and now is the day to make the switch. Go ahead, jump into those squeaky new sneakers, put on that watch over that wrist!

3. Laugh at the buzzing. The cast technicians will probably use what looks like an electric pizza-cutter. Its blades will rotate to chew through the fiber glass, and there will be a weird vibrating sensation. Don't try to hold it in, it never works. Laugh because it's like being tickled by a giant limb-freeing monster. Or if you do hold it in, let me know what your secret is because I can never hold it in.

4. Wiggle. I know, I know, they will say "I haven't cut it off completely yet! Wait a sec.." But at the first breath of air that touches your skin, you will want to flex your long-unused limb. You will want to just rip off the flimsy and frumpy looking cast, its cotton foaming at the edges like a hungry rabid dog - and this time you know that you will win this fight. There is something about being able to make those minute flexes for the first time that says: wow, my bone is really totally and completely healed. And only I can feel that wholeness! They can have their x-rays, they can keep your old casts, but you? You get to have a whole free limb again!

5. Don't scratch. This is the toughest one. And I almost always fail this step 95% of the time. Once the cast is off it might take you a few seconds to reconnect with that alien looking limb again. It looks scrawny doesn't it? It might look weird because you had an operation. It might look hairier, maybe it's covered in tectonic plates of old flecks of skin itching to be scratched off. I have gone from outright and ruthless scratching, or to the point of sly and discreet rubbing my palms against the newly freed arm. Because before you know it they will come with a wet washcloth and you will ask "is this going to sting?" (for the hundredth time) and they will say "if you didn't scratch, this won't sting." And of course it stings...

6. Smile. ...But you don't care because it's a sting that is like a love-nibble in comparison to the fractured bone you experienced months earlier. You smile because it is a sting that is refreshing, and then it will tingle - dancing its little invisible feet all over the top of your skin, clapping its hands in joyous relief that you are finally free and healed.

Many readers already know that having a fracture isn't the only source of bone pain. I know that I'm very fortunate to not experience chronic bone pain, so for this entry I thought I'd do my best to describe the various kinds of aches & burns that I have difficulty explaining to my un-affected family, doctors, or friends... so, in other words.. I've never actually told anyone about this.


1. The Dull Ache That Spreads. It might start in my elbow or in my knee, an ache that just pops its head in the neighborhood because it was bored. After it settles in for a bit it'll take a little jaunt down the length of my arm or up my shoulder, or maybe it'll troop up my femur to check out the scene. Sometimes I wish I could just tell it to get lost or say something like, "nope, nothing's changed. Still 3ft tall and stillll not walking. Thanks for swinging by though, tell your mom I say hi!" This next bit is going to sound weird but if it happens in my arm, if I crack my knuckles it'll feel better. Or sometimes if I change sitting positions it'll fade a bit, I imagine when I do that the pain gets all discombobulated as I jostle it around - giving it a whirl before it regains its original pain in the ass mission again.

2. The Burn At The Peak. This happened nightly during the months and weeks when my tibias were at their worse. When I was younger both of my tibia bones was at near right angle degrees, it looked like I had two knees before they were finally rodded (several times). On the x-rays there was no visible fracture but my doctor would tell me that there are probably several tiny microscopic fractures at the peak of the tibia bone, and every night for awhile it would burn. Several times I would wake up and throw the covers off, touching the top of my shin making sure that the skin hadn't just burned off. I wanted to ask what the microscopic fractures were doing on top of that peak, having some kind of bonfire party before the big operation? Once I'd finally found a comfortable position to sleep in of course the burning would happen the next night, and then I'd try to sleep again in that position but it would never work. I had to cycle through various sleeping positions, constantly trying to find the next coldest spot in my bed for my leg.

3. The Ache Inside The Cast. You would think that once inside the cast the sharp pain and aches just stop. But somehow that isn't always true. Sometimes no amount of fiber glass and cotton can subdue the ache, and these can sometimes be the worst. And most of the time the aches aren't even in the same area where the fracture was! At first I'll think that it's just a muscle spasm, but then I realize it hasn't got that same edge; however, since there is only about 500 layers of cotton and fiber glass separating me from the ache I can't exactly go check on it like I usually do. Instead I'm resorting to wiggling inside the cast, and when I say wiggling I mean moving microscopic millimeters so as not to disturb the actual pain of the fracture. I might as well be trying to walk through a cave of sleeping lions!

4. The Sharp Ache That's Not Sharp Enough. It isn't the same sharp breath-stealing, heart-pumping, sweat-pouring pain that a fracture brings on, instead it's just a few steps below it. It's like the long lost cousin of the actual fracture that shows up at a family reunion, and no one knows how to react to him. He's kinda awkward - doesn't exactly have the best manners, has a shady history, and a weird mole on his eyelid. But he's there at the family reunion and absolutely insists on being in every single picture. Most of the time, this is the ache that happens in the same area where I will have my next fracture; it's like the foreshadowing of the hot mess events to come. Usually I just quietly stow it away in my head, smiling into the camera anyway and trying my best to keep this weird long lost cousin at arms length away.

"Snap, crack, pop" those sounds are the catalyst for split-second assessments, instinctual decisions, and tears that fall somewhere between wailing and shrieking. Sometimes, unfortunately, these motions are routine. Here is one routine of the many -
(The below actually happened, the times of course are roughly estimated).

• 10:18:27AM - A rubber ball in a game of four square bounces off my arm the wrong way in P.E. class in the 5th grade. 
• 10:18:33AM - I am gripping my forearm; I look at my teacher and in those 6 seconds I try with every millimeter of my wide eyes to send her the message that "something bad happened."
• 10:19:04AM - I've been ushered out of class and someone has run to get the school nurse. I wait in the hallway with my aide. My tongue is bleeding because I bit it; still, I am trying to hold the screams in. I'm not far enough away from my classmates.     
• 10:22:14AM - Running down the hall is the school nurse with a bag of my slings, splints, and other bandages. She tries to do an assessment, I don't let her touch me, and pull my arm closer towards my body. Whimpering for my mother.
• 10:24:08AM - My mother has been contacted. I am now sitting in the nurses office. The burn of the fresh fracture has somewhat subsided. I continue to grip tightly and hold still, I found the place and position where it doesn't hurt and by god I'm going to keep it there for as long as possible. I've begun to sweat through my clothes. 
• 10:40:12AM - My mother arrives at the school, she has a sling. I tell her that it hurts too badly for me to go back to class this time. I tell her that I know it's two fractures in my upper arm. She knows how much I love school, I would never willingly miss time with my friends; she understands that this time it's serious - she calls Dr. Shapiro from the nurse's office.
• 10:50:02AM - Dr. Shapiro will see me in the cast room once we get there. We just page him once we arrive, it's business as usual.
• 10:52:15AM - With great care and coaxing my mom has transferred me from my wheelchair and into the car. My arm is jostled slightly from the transfer and that's when I let the screams out. 
• 11:48:32AM - We arrive at Children's Hospital in Boston and race to the second floor. The cast technician recognizes me, but instead of a cheery hello his face quickly frowns when he sees that I am hunched over my arm, my face twisted in discomfort. He knows the deal, Dr. Shapiro is paged. 
• 11:49:18AM - Dr. Shapiro has been paged and now the waiting begins. I am 10 years old but I know that we will be waiting for at least an hour or more. Dr. Shapiro is also the attending orthopedic surgeon; of course, today is his operating day and he is in surgery. I slip into a quick nap, my body growing cold in places because I refuse to move. I try to get some rest before the dreaded part comes, the x-ray.
• 3:36:12PM - He strolls slowly down the hallway, everyone knows Dr. Shapiro is notoriously slow and unbelievably friendly. I see his bowed head looking downwards at the floor, his posture belies his reputation as 'hot-shot surgeon & O.I. expert.' Always in a dark suit and jacket, never in a hurry - the sight of him fills me with relief. We may have waited over 2 hours but he is always worth it, he always makes things better, most importantly -- he's the only one we trust. 
• 3:46:17PM - First question from the doctor is always "where does it hurt?" He then places his fingers around the sore area, the first person aside from myself to touch the injury. Every time he does this I remember in Kindergarten how I thought his fingers were actually spider legs with x-ray vision at their tips. He never hurts me, and when he does his face winces in advance so I know that the discomfort is coming; to this day I have no idea how he knows! He scribbles out directions for the x-ray order form, telling me aloud everything he writes so that by the time I am in 7th grade we both know that I could probably fill out the form myself.
• 3:50:12PM - My mom and I are waiting in the waiting room of radiology. It is only down the hall and no matter how many times I've been in this room there is always something new to distract me from the pain. The faces of children all around the world smile down at me from the ceiling in bright primary colors; there are actual x-rays of stuffed animals, robots, dinosaurs, and clown faces on the walls; the t.v. is always on; coloring books litter the tables. My mom settles in next to me after she has called home to make sure my older brother is home from school, she has updated him on what happened to me. He is my older brother and knows how to take care of himself my mom tells me, he is used to this too.  
• 4:07:09PM - A radiologist finally calls my name, she looks at the form Dr. Shapiro had filled out and I plead with her silently to pay attention to the part that says "O.I. type III, fragile." She tells me we are just going to take a few pictures, I know the deal and zone her out. As we go down the hall to the x-ray room my heart is racing, I begin to sweat again. 
• 4:08:12PM - My mother suits up and puts on an apron, she carries me onto the table and lays me down on my back. Already I am beginning to get uncomfortable. This is the first time all day that I was in this position with my broken arm, I had not yet found the 'comfort' position for laying down. As the radiologist asks me to put my arm down along my side the tears begin. My mom has to hold my arm down for me, and hold my other arm away from it. I squirm and cry through the entire process, it seems like I lay there for a year on that metal table.   
• 4:20:03PM - Finally the pictures are done and I fold my arm back inwards. But now my bones are all riled up, confused and broken, they are uncertain of where to go to get comfortable again. I glare at the radiologist on the way out, she had done this to my arm. Stupid. Moron. Idiot. We go out to the waiting room and wait for her to give us the pictures to present to Dr. Shapiro.
• 4:37:19PM - Finally the pictures arrive in a large red folder that covers my entire body. It is heavy. (This was sometime in the 90's so digital x-rays had not yet existed). We make our way back to the cast room, I hope that Dr. Shapiro would be waiting for us there, I wish with all my might that he hadn't gone back to the operating room. But of course that never happens. We will have to wait for him to come back. 
• 5:03:21PM - Dr. Shapiro flicks on the light table and snaps the x-ray on top. He confirms what I had already known that morning, there were two cracks in my humerus, it was time for a cast. He put on his apron and Odie the cast guy got the fiber glass ready. "Dark blue" I say, "just like always" and that is the first time in the whole day I thought about something other than the fractures in my arm.  

*Side Note: I'm not necessarily endorsing these ideas, they are just things that I have put down my cast. Repeat at your own risk!*

1. Ruler. The wooden ones with the metal or brass edge. Just enough of an edge to itch that impossible spot that always stirs me awake at 2:45AM and then every hour after that.. GOD DAMN IT!
2. Pen/Pencil/Marker. Because these are on the shorter side they are more effective tools to itch an arm or a short leg cast. The cylindrical shape, for me, doesn't tickle the bottom of my foot in an unbearably gigglish way whenever I resort to this technique. Be careful of tips breaking or losing the caps somewhere in that dark and itchy abyss.
3. Money. If you have an issue with spending you could always take matters into your own hands by stuffing your budget in there, 2-5 months later and you'll find that you're able to teach yourself self-control! Or if you were a six year old like me and was suspicious of whether or not the piggy bank actually just ingested it all on its own.... 
4. Coat hanger. Who says that coat hangers are only good for unlocking doors of a car? These suckers can hang that itch in no time! But be make sure you stash it somewhere safe so that your parents don't yell at you when they find a bunch of wrangled coat hangers under your bed. "It was for school..." doesn't exactly fly. 
5. Freeze chopsticks. I know this sounds really weird so before you go putting your judgy face on, let me explain! One summer I was stuck in a long leg cast and it was sweltering. Like most O.I. people I hate the heat and my body doesn't do well, having an extra 10 pounds of cotton and fiber glass certainly didn't help. I wanted to cool off but I couldn't get my cast wet... so I pilfered a few chopsticks and put them in the freezer, stuck those down my cast and it was instant relief! 
6. Cotton swabs. I don't know what possessed me to want to add MORE cotton in there but it happened. I put cotton swabs at the end of an un-sharpened pencil and in my mind it was like a soft plow, pushing away all that psycho itchiness somewhere deeper. 
7. Air. I have literally taken a hair dryer and aimed it down the cast. 
8. Makeshift hooks. I have bent paper clips out of shape and into the necessary hook form, then tied my 'creation' to shoelace or a string then literally tried to bait that scratch out into the open!
9. Medicine. Kids can be very innocently literal. I took my pain medication and decided to dump it down there because... well... that was where the pain & itch was! D'UH! 
10. Lego people. Don't ask, I don't know what I was thinking, don't tell my brothers. But yeah it happened. I think those miniature Lego figurines all hate me now. They've sent word throughout the rest of Lego Kingdom -- warning their brethren of the insane human who has suffocated so many of their fellow beings between skin and fiber glass. (Sometimes they come and haunt me in my dreams!) 

The one thing I dread most about being discharged from the hospital after an operation or after I get my cast off is the physical therapy that follows. If you are a Physical Therapist I'm sorry, but all the PTs before you ruined it for me. As I am laying on the plush blue mat, they are always kneeling besides me with the condescending smile frozen on their faces:

"Can you bend your knee aaallll the way up to your chest for me?" She says as she tries to collapse my freshly de-casted leg towards me as if it were an accordion. Then it always gets to a certain point where my finger tips are digging into the mat, my face contorts into a wince, and I am trying to wriggle free from her grasp. My body is confused because it isn't sure how to interpret the strange sensation in my leg: is that sharp pain that I am trying to resist really just a muscle that hasn't been used in 5 months? Or is what I'm feeling a fracture on the verge of happening? Because whenever a P.T. is flexing, bending, or stretching me I always assume that she will snap something in half. I start to sweat, my stomach tightens into a knot, and I am literally waiting for that snap and then the burning sensation.
No dammit, I can't bend my knee all the way up to my chest for you! In fact I don't want to do anything for you! But of course I am old enough to know better than to snap at her, have had too many experiences to know that she won't break anything; and yet there I am, my body always resisting what she is trying to get it to do. Instinct? A deep mistrust I have of anyone touching me? Maybe it's because it always feels like she is forcing my joints to break through the rust? And doesn't that just sound painful?
Part of it is also because my body has memorized and internalized a lot of painful incidents. So as the PT is handling the latest traumatized limb or area of my body, I imagine that it is freaking out as she drags it kicking and screaming to re-visit the motions of the injury - except this time to do it correctly, safely, and in a way that won't put me back in fiber glass for another 3 months.

Several weeks later it'll be completely different:
"Wow! Look at that! See? I knew you could do it all along! You've re-gained complete range of motion in your leg again!" They are always right in the end, in my experience anyway.

Every physical therapy session I have attended is always a test to see what my body is capable of. It's probably because of the nature of the OI that this in of itself sounds so terrifying. Because usually when I have inadvertently learned what my body is capable of, it results in an injury, some painful fracture. So as I'm laying on the blue mat for 45 min at a time, I am usually trying desperately to be as mentally positive as possible - anything to make the flexing and stretching easier on me.


On Physical Therapy:

• I have yet to meet anyone who looks forward to attending physical therapy sessions. It isn't supposed to be fun! Having more realistic expectations of what PT is meant to accomplish can make the struggle less challenging
• As I have gotten older (both in part from the lectures my PT/ortho gave me, and from personal experience) I have learned that the rehab time following an injury is just as important as getting a cast on in the healing process
• Regularly including PT in the fracture management process helps young kids understand that rehab and PT are not separate to fracture care. Just because your leg is no longer in three pieces, or just because you have the cast off and everything feels fine - doesn't mean that we are in the clear
• PT sessions are not just limited to regaining range of motion or strength. There have been many instances when my body has gotten stronger than I expected it to, when I came out of PT more physically independent than I thought was possible. 
• And you know what they say, no pain no gain!

At this point I just laugh to myself whenever I see the ridiculous set-up of most public bathrooms. Grab bars are angled funny and about 5ft away from...anything. And the toilet paper dispenser is either 2ft above my head or 3ft away from the toilet! Since disabilities vary so much I can see the challenge presented when building a "standard" accessible bathroom (or standard accessible anything for that matter); actually, when you really think about it, it is pretty much impossible. Today I am wanted to write about how I navigate inaccessible accessibility - not just public structures but the day-to-day living necessities:

Accessible Clothing

Most O.I.'ers are smaller in stature so it's pretty obvious that our clothes need to be as well. But there are other tips involved than just shopping in the child or junior department, or getting the smaller size of adult clothing - what happens if you wind up in a spica cast? Or what are the easiest pants to put on over that long-leg cast? What shoes do you wear right after your leg comes out of a cast? Here are a few things that might help:

1. Zip-Off pants/shorts: These are incredibly handy and I would hug the person who invented them. It's pretty self explanatory, but now you can go without the awkwardness of one foot freezing and the other snug in a cast!  

2. Athletic warm-up pants: I like these because of their stretchy material, and the zipper piece on the side of the leg. Another added bonus is their elastic waist band makes bathroom trips less of a hassle when you already have a bulky cast to deal with. Also the polyester stuff doesn't make it feel like an oven in your cast! 

3. Crocs/slip ons/flip-flops: For me, putting a sneaker or a shoe on after I just got out of a cast can agitate my leg. My ankle is not used to the added weight (and unsupported weight) at the end of my  leg. Not to mention, most times sneakers require a bit of pushing, shoving, and wiggling to get your foot comfortably inside - trying to do that after 5 months in a cast can be pretty painful! So after learning many lessons I now slip on my flip flops, or I break out my light weight Crocs, I also have slip on Chuck Taylor sneaks that I love!

4. Leggings/Over sized shorts: These are stretchy and work particularly well if you are lucky enough to have one leg free from a spica cast. I spent way too much time in spica casts when I was younger, I pretty much looked as thrilled as this kid below whenever I was in one:  

4. Zip-up hoodies/Button Up shirts/Vests: I pretty much lived in a hoody when I was in high school, but aside from their being timelessly trendy these are incredibly useful when you have a broken arm. You can get them in various sizes to accommodate casts that require larger arm holes, or if you can't fit the cast through, just zip-it up and you're still snug! Vests are a cinch to throw over because you don't need to play tug-of-war with the sleeve as you try to get the cast through.

Fracture-Related Accommodations:

When I was much younger (elementary school aged) I broke my legs frequently. This meant that I would be stuck in a long leg cast or a spica cast - making things like showering and getting myself dressed difficult without my parents' help. My mother would used to hold me on her lap with just my head in the shower as she washed my hair for me - it was annoying and I hated the dependence. By the time I was in middle school (and fractured my femur at least 4 times) I announced to my parents that I figured out a way to wash my hair on my own, here's how:

1. My shower was accessible, this means the shower head was attached to a long metallic hose that could be held in my hand

2. I asked my parents to turn the shower on for me and place the shower head in a place that I could reach

3. I reclined my wheelchair and parked it so that the handle bars and the top of my head pointed in to the shower

4. I then slid myself all the way to the top of my reclined wheelchair and was able to wash my hair like that... for the next 3-5 months of being in the cast 

***

I also learned how to angle my wheelchair next to the toilet so that instead of a long-leg cast just hanging off the toilet seat and dangling around, it could rest on the seat of my wheelchair or on an extended foot rest while I went about my business. 

***

Since I fracture my femurs and legs most often, I have always had a recline-able wheelchair. Even these however were unfit for bulky spica casts or long-leg casts that were longer than the length of a fully extended leg rest; as a result, I would have to rent a special recline-able manual wheelchair from my medical insurance company. These wheelchairs would always take forever to order, and often by the time they arrived I no longer needed to lay flat on my back! After years of this repeat performance and frustration of dealing with medical companies, my mother decided to take matters into her own hands: 

This board has around since the 7th grade

She measured out a wood board that was as long as a long-leg cast, cut out a piece of foam mattress the same length, then covered the entire thing with a piece of water-proof plastic (blue, my favorite color). At the edge of the board she put two hooks in and threaded shoe lace through the hooks - now I essentially had a portable recliner! Whenever I broke my leg she would whip out the board and tie it at the appropriate angle to the back of my wheelchair. It was comfy to sit on, durable, and always on hand! 

See how happy I am with the board? Oh, and w/friends too :-)

No I don't wish to throw summer away, not after this epic brutal winter we had. I mean the other kind of cast-off: the fiber glass, cotton-stuffed, endless layers, sweat sticking, itch inducing lug of a thing. Despite the hundreds of casts I have had the excitement that comes with getting it off never bores me. Especially during the summer.

Getting a cast off in the summer, for me, is like an odd kind of defrosting. Be it my leg or arm I always look forward to being able to flex the muscle and unfreeze the joints. Sometimes those joints have been frozen for only 2 weeks, 3 weeks, or at worse 3 months. But the morning of getting a cast off my leg and arm is already wiggling impatiently inside, squirming around like a butterfly seconds before it bursts from the cocoon. When I was younger I would always plead my parents to just cut it off themselves, "Why do we need to go to the doctor to cut it off? I'm just getting it off! Just cut it off!" Usually this would be paired with me grabbing onto the cast and trying to literally, tug it off my body. Then in the cast room I would ask my parents if they could buy the special cast-saw from them: "Mom can't you just ask? Can't you just ask them where they bought it? Maybe we could get one for my room and then we wouldn't have to drive alllll this way every time for only 10 min of work!" 


I never hear what the doctor is saying to me after the cast is taken off. He usually gives a "phew! Well that's done!" And after that I am too busy itching like a maniac, the dry flecks of skin molting off and falling onto the table. "Don't scratch! Don't scratch! You'll damage the skin..." It's been two decades, I mean really, you would think they could at least come up with something more creative to tell me. After a good 5 or 10 min of leaving me alone with my un-mummified limb I am satisfied. The frenzy that had consumed my entire mentality and body fades; all that's left are the chalky lines from my fingernails against my skin that remain like faint lines on a freshly mowed lawn. Someone usually hands me a damp washcloth and as a cat licks her wounds I gently put water against my skin for the first time in weeks.
It always stings. And I am always surprised how much it stings (let's not even mention how much I am cringing when they tell me to wash it off with rubbing alcohol!) Suddenly my skin springs to life, there is a tingling effect that travels down the length of where the cast used to be - I always pretend that I am some supernatural power pouring water over the Sahara desert for the first time ever. The skin is raw and red in some places, and my arm or leg is usually looking drastically scrawnier than it used to be.

It's not until I have sedated the jittery itch monster that I flex, twist, bend, stretch, move. The first time the limb is lifted from the cast happens around now. If it was a serious fracture my doctor usually helps me lift out of the now hollowed out fiber glass shell - then he'll gently place it down on a pillow and the revival process begins. He'll put the palm of his hand against the sole of my foot and tell me to flex my ankle downwards - only the slightest flutter of force is applied back. If it's my arm he'll gently move my lower arm up and down; all of this is like a gentle reminder to my body of what I was capable of before it was thrown into a state of immobilization.

From 2 summers ago after a re-rodding operation

• Scratching is going to happen; I'm not sure what reality doctors and parents are living in but you can't expect us to not itch! But if we're going to scratch then we should expect there to be consequences, like the stinging sensation that always follows.
• After getting casts off I always sit in a bath tub for hours to soak and to feel 110% clean for the first time in weeks!
• Any kind of lotion will help the dryness of skin but I usually use Lubriderm. The no-scent non-fuss stuff helps to continue reviving life into my limb
• For some reason going to sleep for the first few nights without my cast on is always... distracting. I am always gleefully ecstatic to be able to feel my sheets and covers. In the middle of the night though I sometimes jolt awake from muscle spasms or other aches in the formerly injured area. I'll freak out and wonder where my cast went but then remember that everything is okay and it's supposed to be off. It is helpful in these instances for  me to continue to have my arm or leg propped up on a pillow, this way it still feels the same and then after a few days I am able to sleep the same as always again.
• I'll be honest: when doctor's tell me that I should have a brace or a bi-val cast on at night I rarely if ever wear it at night. Instead what I will sometimes do is put my leg in the bottom half of the brace or cast and leave the top part of it off

Continued from previous post

Sometimes it can be a few minutes, at worse it will be days. But the moments between a fresh snap of bone and stabilizing it are excruciating. If I could map out a linear graph of the pain in those moments it would be absolutely spastic. I would draw a row of shark teeth and then a random plateau amongst the daggers.
My mother never looks directly at me when I first have a fracture, she first looks at where and what I'm holding. She always seems to use her X-Ray Mother Vision to pierce through my grip of the injured area. With every last cubic inch of muscle I have I pore it all into two places at this point: 1. my eyes 2. the hold on my femur. There is nothing that could escape the wild pained look of my eyes during this moment. I am aware of how many centimeters the bed has sunk as my mother shifts her weight next to me, I am aware of how she has opened the splint in her hand, I am aware of my dad standing by silently looking on - all of these thoughts are calculated into my head in preparation. To get myself ready for: The First Positional Move.

As I wait for someone to get the proper medical equipment to stabilize a fracture it might look as though I am just lying there whimpering. But I'm not. I have first tried to internally shift the muscles and my body into a position where the pain is bearable, careful to not relax or tighten muscles too quickly or slowly; then it's my breathing - it has slowed but is still nervous and unsteady, like an infant's unsteady first wobble. Most of the time I have managed to stop sweating, my body and skin cooling off but I know this only lasts for a few minutes until the broken limb is moved.
Now my mother looks at me. Her face is blank each time, blank with the determination and readiness of a runner at the start line. That is the face she puts on just before The First Positional Move. Her face is the canvas that this particular fracture's pain will be visualized, it will be reflected as she winces with me and says "ow" along side me. She and my doctor always let me help to hold the broken limb, especially during The First Positional Move. This time it's my femur and as she cradles the palm of her hand beneath my lower leg and knee the upper half of my entire body tenses. I try to ready myself and even, if possible, recall the pain from a previous fracture - as if to use my memory as a kind of buffer for the real thing. I squeeze my face and shut my eyes, and after she says "2,3, go.." I hold my breath as she slips the old splint underneath my leg and puts the velcro straps across it. My body once again returns to a state of frantic cooling off, of an unsteady gait-like breathing.

When the limb is first stabilized the transition into the car or ambulance is not as painful. It's uncomfortable in comparison to the rest of The Positional Moves - and there are countless others. The varying x-ray positions, the first time that old splint gets taken off for a new cast, when pants are slow-wiggled n' slid off, then the screaming and the crying begins again. But even in this time as the cast sock is slid on, and the endless rolls of cotton is slowly wrapped around and around, my fingers have barely budged from the position. My doctor and mother follow my lead, but their directions are given in the form of every cringe of my nose bridge or breath held and eyes closed.
The next part is my favorite. Yes, I have a favorite part of the whole fracture stability process - I'm an odd duck I know. But when the cast technician dips the wrap into the warm water I am finally able to breathe regularly again, almost, in a sense to return to my groove. And all of the chaos inside of me that resulted from the havoc that was wreaked is magically restored as the warmth and heaviness of an assured bandage takes over for me.

Happy Fracture Free Friday everyone!
This will be the first of many more 'Fracture Free Friday' posts. These entries will take the time to mention a few things/people that I am thankful for because I am fracture free this Friday. I also will use this post to share some flashbacks from my childhood, some will be fond memories and others will be not so fond memories. The point of these entries is to help us all take some time to reflect on goals and accomplishments we have achieved this week, and even in our lifetime!
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Lately it's been raining and feeling like the kind of weather that sneaks in between October and November. My entire body has been aching and as I'm wondering if this is what it's like to feel 100 years-old I'm thankful to not be traveling in this weather with a cast. There is something about sitting in a wet wheelchair that is already miserable. If you catch me in a downpour I will be racing to the nearest public bathroom not because I need to go really badly, but because I want to dry off and will sit underneath the automatic hand dryer machines for as long as necessary. When I was younger I used to wish that I could be like Inspector Gadget and say "go go gadget 'brella!" And out would pop an umbrella from my wheelchair .... someone out there, get on that! But traveling in rainy weather with a cast can be even more annoying. The hassle of plastic bags, or sometimes when you forget about the plastic bag the cast itself may get wet - then you're stuck itching like crazy, or you may end up covered in baby powder in the attempt to dry off. If it's an arm that's in a cast the trouble with raincoats and ponchos can be that the arm-hole may never be large enough or angled correctly to get your arm through. I always felt like a lopsided bird whenever this would happen, kind of awkwardly nudging my wheelchair along with one hand as I grab onto walls and rails to pull myself along.

Speaking of getting around, when I was younger I had one of three ways of getting around the house: 1. my manual wheelchair 2. the scoot-shuffle-crawl method 3. my tricycle. I loved my tricycle. It was the only pink colored thing I have ever loved and probably will ever love. I would race around the house going on epic adventures that could only be seen in my head. The trike had an electric button that when pressed would make the front piece light up and make this awesome sound that quickly died from over-use. Even when the lights and sound effects became muted forever I would still push the button and create my own sound effects. Around that time I was also watching Star Trek with my older brother; does anyone remember the phrase "beam me up Scotty" ?? I would be zooming back to my own version of the starship base - typically this would be when my mom started yelling at me about god only knows what.

I don't do this with strangers often so you should feel privileged to see a picture of me when I was much younger. But I hope the above blurb reminds us of the distance and adventures we have all traversed whether imaginary or real.