Friday, March 26, 2010
Cast Number 2
After I received my flashy purple cast, I was scheduled to go and see Dr. P, the Orthopedic Surgeon about 6 days later. I was not looking forward to this appointment because I knew there would be a lot of pain involved. I was right!
I hobbled into the appointment around 8 a.m. Dr. P did not show up until 8:15, which was okay for me! More time to try to relax and not hyperventilate at the thought of having my cast sawed off! Dr. P immediately recognized me (in an earlier post, I had mentioned that I work with Dr. P) and he exclaimed with amazement and laughter shinning through his eyes, "What are you doing here!?" His nurse got to work sawing off my cast. She started sawing down my cast on the left side of my cast. I felt pressure and that was about it, then she started going down the right side of my cast and that is when I felt pain. In the middle of it she said, "You know I'm not going to cut you?" How did I know that? The saw felt like it was right against my skin and when she went over my ankle, which is where the break was, I started getting really tense!
Thankfully, it was over within minutes and she removed the top portion of my cast but left the rest of my leg in the rest of the cast. She then wrapped a tensor bandage around the cast to keep my leg in the cast while I went to the urgent care clinic down the street to have a new set of xrays taken.
Mom and I then went to the urgent care clinic for xrays and was I in for a very challenging surprise. The xrays were the kind were you simply lie down on the bed. Nope, these were the tortourous, jump up 2 steep stairs without your crutches, put your foot right down on the platform, then turn your broken ankle/foot to the right and then once again to the left kind of xrays! Not pleasant at all!
Hoping up the 2 stairs was really quite difficult since my leg was no longer in a cast (Mom had to remove the tensor bandages and the cast before I went for xrays) so my right leg had no support. I was in pain due to the sawing off my cast and now I was just scared to even move for fear of me falling and landing on my unprotected right foot. It was a nightmarish experience and I was incredibly thankful when it was over and I was safely back in my wheelchair in the waiting room.
I then returned to Dr. P's office. He recasted my right leg but this time I didn't get the fun task of choosing a fun colour. All he had in his office was boring white fiberglass! I had to lay on my stomach, bend my right knee and together with his nurse he pushed my foot down at a 90' angle and spent a good 5-10 minutes wrapping my leg with thick gauze and fiberglass. I talked nonstop-out of fear and out of pain.
When it was over, I had on a very heavy and long cast on my right leg. My original cast was from below my toes to about 5" away from the bottom of my knee cap. This cast was covering my toes and went up to about 1" away from the bottom of my knee cap. It was heavy and awkward and I could feel my leg swelling within the cast.
Dr. P had two concerns: The first concern was the swelling to my leg and the second concern was fear of foot drop. Foot drop basically occurs when the muscles in your foot atrophy (weakend) due to lack of use and lack of muscle tone. I know that my patients who have had foot drop really struggle with walking and foot drop is not easily resolved. I knew that if I did suffer from foot drop due to improper casting techniques, then I would be in for many many months of physiotherapy and I might possibly always walk with a limp. I certainly did not want that!
Dr. P suggested I ice my leg frequently! I had no idea that the coldness of ice would even penetrate through the thick and heavy fiberglass cast, but after talking to a family friend who is a chiropractor, he told me that the ice would eventually lower my body temperature to at least 45'. When this occurs ,then an enzyme is released into my body and pain is resolved and the swelling will reduce. Who knew?!
Dr. P then gave me a lesson on how to walk with crutches. I guess I had been doing it all wrong! I have actually looked through some you tube videos and they too do not have the correct technique! Even though it was incredibly awkward adjusting the hobbling that I had been doing with my crutches for a week in order to master Dr. P's method, in the end I was greatful for the lesson.
We then went into his office for me to look at the xrays. The xrays were amazing to see and we spent a good 10 minutes discussing my break, surgery and the plan for me. I was very thankful for the time that he spent with me and I had a feeling that he was spending more time with me since 1. He loves me! (we always have fun together when we are working and 2. He knows me (like I said before, I had been in to observe one of his surgeries. I thanked him for his time and Mom and I headed home!
My next appointment is April 5th, where Dr. P and I will discuss whether or not I need surgery! The idea of surgery does scare me, but I know that if I do need surgery, I'll be in good hands with Dr. P. During my next appointment, I will unfortunately have to go through the same ordeal as I did during this appointment: cast being sawed off, trip to urgent care clinic to have xrays done and another cast put on my right leg. At least for my next appointment, I will know what to expect.
Here is a video of a cast being sawed off...the girl doesn't look like she is in pain, but when the nurse sawed off my cast, it was really painful!