Monday, October 13, 2008

A Working Guardian Angel

Sixteen years or so ago, a friend persuaded me to take a karate class together.

One of the scheduled days, our class was diverted from the gym where we usually met to a mat room on account of a basketball tourney. Since the room had wonderful thick mats, our instructor decided to teach Judo moves that day.

A great many years ago, I belonged to a Judo group that met at the Y, and I was pretty good at it. I remembered the move being shown to us, and more importantly, my muscles remembered it.

I neglected to factor in the plastic mats we were standing on, which gripped skin well, unlike the canvas covered mats on which I learned. Neither did I account for years without practicing, nor a currently more sedentary lifestyle.

On the command to try this move, I drew my partner/opponent's weight onto my shoulder, pivoted on my right foot, and deposited my partner on the mat.

That's what should have happened. I got as far as 'pivot', and my foot stuck to the plastic. My ankle held, my hip held, but my knee emitted a pop audible to my partner, and produced a bright intense flare of pain like a baby nova behind the left side of my kneecap.

I tested the knee, and decided I'd done something awful to it, something stupid, clumsy and thoughtless. Bah. I told my partner I had to go home, then sought the teacher to inform him I'd be leaving and why.

I stopped at the family doctor's walk-in clinic instead of going straight home (they had regular appointment hours, and then held walk-in hours after). When I saw my doctor, he moved my foot around, and one of the manipulations made me levitate from the exam table in pain. He said I had pulled the medial collateral ligament, then gave me directions for care, and a prescription for anti-inflammatory. He said I should be fine within 4 to 6 weeks, if I followed directions, and if I was not, to let him know as I might have torn the cartilage.

I went home, and cared for my knee according to directions. (This was a BIG thing for me, I can follow directions, but do not always do so.)

About six weeks later, I noticed that I was still feeling a twinge as I got into or out of my car with weight on that foot, and the foot not directly under my body. I called the doctor to discuss this, and he sent me to see an orthopedic surgeon.

The orthopedic doc manipulated my leg through a series of movements. some of which made me go Ow! When one particular movement was more than just Ow!, I said, "Hey, that really hurt!" Doc O apologized, and explained the movements told him what was wrong by the where I felt pain, and he was almost done.

He pointed out on the knee diagram on the wall of the exam room the places he believed I had damaged. (I'm fascinated by those diagrams - I have a paperbound copy of Grey's Anatomy with which I am similarly fascinated) He went on to talk about smoothing a rough spot on the cartilage using arthroscopic surgery. We discussed the possibility of using local anesthetic so I could watch, awake, and view, on a screen, the whole procedure. We discussed my tolerance of the Ick! factor, and then he agreed.

Next he sent me down the hall for a routine xray of the knee, to see if there was arthritis, or anything else unexpected.

He came back to the exam room looking serious, and showed me the xray. He pointed out a shadow just above the knee, where no shadow should have been. He asked if I would be willing to have another xray, one that would show the whole bone. I agreed.

He brought the xrays in and stuck them up on the light box. The funny shadow reached from the knee half way up the femur.

He stood looking at the xrays with crossed arms, and thinking out loud for my benefit. "That shadow looks old. It's entirely inside the bone, and it hasn't pushed the bone out anywhere."

He turned to me and said, "It may be nothing, but I'd like to have more information. Would you be willing to go for a bone scan?"

I was, and the scan lab got me in on Friday of the same week. The gamma cameras were fixed, and I had to change positions to accomodate the views the doctor had ordered. My position for the outside of one knee and the inside of the other had me facing the console, on which was a realtime repeater of what the gamma camera saw. For the outside view, I saw a nice outline of the bones, inside the outline only slightly lighter than the background. On the inside view, the other leg, the leg with the pulled ligament, the entire area occupied by the shadow was bright. Very bright. So bright it almost hurt my eyes.

Husband and I went out to dinner with acquaintances, and I enjoyed the meal and the company. I was intent on squashing the funny feeling what I'd seen during the scan, and was almost successful.

That night, I had nightmares. Not just one nightmare, but a series, each worse than the one before.

First I was swimming at the beach, and a shark bit off my leg.

Next I was waiting for the subway in New York City, got pushed off the platform onto the track as a train was coming. I rolled to the side, but the train severed my leg.

After that, I was helping with the haying at my grandma's farm, standing on the hay wagon, tossing hay to the baler. I slipped, and the baler grabbed my foot and wrenched my leg off before it could be shut down.

In the next episode I was walking along with my uncle, checking the integrity of the ensilage conveyer (they never had an ensilage conveyer on the farm to the best of my knowledge) when I slipped, my foot hit an improperly fastened access cover, and plunged into the conveyor where the screw feed crunched up my leg in segments, finally ripping it off at the hip joint, leaving me to fall, bleeding like a fountain, to the ground below.

At this point I woke up to find myself screaming, and my throat sore. Hubby had slept right through. I shook him violently to wake him up, my terrified heart trying to beat its way out of my chest. He muzzily opened his eyes, and asked what's wrong. I asked him if he would still love me if I lost my leg.

This wonderful man blinked at me for just a second, said, "I love all of you, however much of you there is to love," then wrapped his arm around me and pulled me tight against him as he fell back to sleep.

Monday morning the doctor's office called me at work before I had a chance to call them. Chunks of ice formed behind my sternum as the girl said the bone scan had raised a few questions, and they'd scheduled me for an MRI late that afternoon. Could I make it? Yes, I could. Good, she said, you can ask for a copy of the scan and the MRI to take with you... Now the ice ran up my spine and down into the pit of my stomach. ...because we've made an appointment for you with a specialist in New York City.

I went to my supervisor and asked for the next day off. After explanations, he offered to let me go home right away. Envisioning me chewing my nails to the knuckle, and scaring myself into a terrible state, I turned him down. Better stay at work, and accomplish something useful, anything useful, than go home alone and steep in my fears.

The specialist, an orthopedic oncologist, strode into the room with a handful of my films. "Looks like chondrosarcoma* to me," he said. I couldn't believe he sounded so cheerful.

He had with him another doctor, a very pleasant and polite man, who asked me a series of questions including, when did it start hurting? My reply was, when I twisted my knee. Dr. Specialist grinned and said, "See? They don't all present with pain."

He explained how many chondrosarcomas are discovered as an incidental finding during treatment of something else, like my twisted knee, or when someone is walking and falls down because the bone breaks.

I had to ask him, "Am I going to lose my leg?" and felt a certain amount of relief when he said "No." He went on to describe a diplomat whose leg he had saved, even though that person had experienced a fracture due to his tumor. Mine, he assured me, had been discovered far earlier, so I get to keep my leg.

After more discussion, he called his secretary to schedule a surgery time for me. She came back with a Monday, two weeks away. "Not soon enough," he replied, and asked her to find OR time for me this week. She came back again with Thursday, and as an OR becomes available, which was good enough for him.

I had my surgery. Actually two surgeries, because Dr Specialist did not like the way the tumor looked when he removed it, and waited for the full pathology report before doing a reconstruction. The report held good news: my tumor was not nearly as aggressive as it appeared. I was discharged, but went back for follow up at 3 weeks, 6 weeks, and so on, the time between visits gradually increasing to 3 months, 6 months, a year, and then once a year every year.

A few years ago I went back for yet another follow up visit. The doctor, not Dr Specialist, but his successor, told me, with a big smile, that I graduated. I am welcome to return for further followups, but they are not required. Likewise I am welcome to return if I have any more problems with the leg.

The leg works fine, and except for a tendency to ache when the weather changes, or when I fly (easily dealt with by some ibuprofen) it doesn't bother me.

I've been told by some I have a guardian angel. If so, that angel has a warped sense of humor since it took something clumsy, done without thinking things through all the way, to reveal my tumor. Ah, well. I'm here. I have had no recurrence. If this is the sort of help one gets from a guardian angel, I can live with that warped humor.

* chondrosarcoma - a bone tumor arising from cartilage.


SeaSpray said...

Hi-I will come back to read but I left you a comment on your know you are the Parent... you wrote in September. :)

Ann of the Incredible Gift said...

Thank you SeaSpray, and you're welcome to come back any time.