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Surgery 2.0

I would have preferred to have my ankle fixed before the Masters, but that did not happen.  The Masters is a week where no one is allowed to complain, and I wore my giant CAM boot the entire week.  The CAM boot kept my ankle from hurting, but it threw off my gait just enough and weighed enough to make the rest of my body hurt.  I found muscles I never knew existed while climbing the hills at the Augusta National in my boot.  I was also surprised to see how many other people were at the tournament in boots, and scooters, and wheel chairs.  The random comments of strangers was entertaining.  A lot of people told me they were “proud” of me.  I found this to be the most amusing comment.

I returned to Charleston on Monday, only to leave again on Wednesday afternoon.  Robyn was sweet enough to drive me to Charlotte, and to let Kate and me stay at her house in Charlotte. Although Dr. Davis told me that I would be able to weight bear immediately, the post-surgical people at OrthoCarolina called me on Wednesday and told me that the doctor had ordered a knee scooter for me for three weeks.  This freaked me out, but I was able to contact Dr. Davis’s nurse, who re-assured me I would not be non-weight bearing, and that I did not need a knee scooter.   When I mentioned this freak out to several close friends, they all responded with something along the lines of, “It would be terrible if you had to be non-weight bearing, but it would be awesome and hilarious if you had a knee scooter.”

Thursday morning, Kate and I got in the car, and drove to the wrong OrthoCarolina surgical center.  I was vaguely horrified by the traffic in Charlotte.  Once we found the right surgical center, around 9 am, thirty minutes late, everything was exceedingly pleasant and easy, with the exception of the ankle fellowship resident who came in and told me that I would be non-weight bearing for at least three weeks following surgery.  I had another freak out, and I told him that Dr. Davis told me I would be able to walk on my foot immediately, and the resident said he was under the impression I would be non-weight bearing.  I hate that I kept having mini panic attacks about this, but my house is not in the least bit cripple friendly, and I was only planning on being incapacitated in Augusta for a week.  Also, why is everyone telling me something different?

Eventually Dr. Davis came in and told me that I would be able to walk on my foot immediately and that he wanted me to move it as much as possible after surgery.  He said that I would be in a surgical shoe for a week, with my foot in a bandage, and that after a week I would be able to take the bandage off and wear regular shoes, and that I would not have to wear the boot again.  After my last surgery, I had to sleep in a boot for a week, so not having to wear the boot at all is blissful.

The surgery took about 45 minutes, and I woke up from anesthesia feeling like a bazillion dollars.  Dr. Davis said that my FHL tendon was torn, and that he cleaned up the tear and removed all of the scar tissue, and that the tendon would grow back on its own and that it wouldn’t bother me anymore.

Kate took me back Robyn’s house, where I was piled up on the couch with pillows and ice and percocet.  Robyn had to go back to Charleston, but Kate and I spent a lovely evening watching television with Whole Foods lasagna and salad.  I was able to walk in the surgical shoe by Thursday afternoon, and I slept like a professional sleeper Thursday night.  Friday, we returned to Augusta, and I’ve been happily recovering all weekend, and the dogs are taking good care of me.  I’ve been able to taper down the narcotics, and increase my activity.  Fingers crossed the worst is over, and that I will be able to return to the regular scheduled programming soon.  Dr. Davis said I would be able to play tennis three months from now, but I have to admit that I don’t actually believe him, and that I’m going to take things slow.  I would never play tennis again if it kept me from having this problem ever again.  I’m going to try to trust his professional opinion.  I’m so excited about being able to run, hike, swim, ride bikes, and go to yoga.  I am also looking forward to being back in Charleston in a routine and being a normal person again.  I will keep y’all posted on my progress!

OrthoCarolina

My long anticipated appointment at OrthoCarolina in Charlotte. was for 1:30 on Monday, March 23.  I was battling a cold and terrible allergies, and Susan-Elizabeth and crew stayed with me over the weekend.  I woke up Monday morning feeling terrible, but nothing was going to stop me from making my appointment in Charlotte.  I met my mom, Kate, in Columbia, and rode with her to Charlotte.  I left my insurance card, of course, but other than that, the visit went off without a hitch.  Dr. Hodges Davis met with me and watched me walk, and examined my ankle, testing the range of motion and the strength, and asking me questions.  Dr. Davis pulled up MRI and showed us the one slide that showed a tear in my Flexor Hallucis Longus Tendon, and that the tear would not have been visible during my previous surgery because of the location and the surgical approach.  Dr. Davis said that tendons tear like a rope frays, and that once it gets frayed, it will get stuck in the tendon sheath and not move correctly. Dr. Davis said that when my big toe seemed to get stuck, and when my ankle seemed to be stuck in a certain position, that it was actually the tendon tear getting stuck in the tendon sheath.

Dr. Davis said that he could fix the tear with arthroscopy, and that I would be in a boot for three weeks, and then I would be able to go back to my regular activities, with maybe a couple weeks of physical therapy.  This sounded too good to be true, but I was happy to have a doctor who was confident in what was wrong with me and in their ability to fix the problem.

I drove home from Charlotte pleased with the result of the visit, but generally not feeling very well.  When I got home, I had a fever of 102.2.  I spent the next three days in bed.  My surgery was scheduled for April 16.

Remember that time I thought my foot was broken, and then it wasn’t broken, and I had unexplained ankle pain for about a year before anyone could tell me what was wrong, and then one of the doctors decided he knew what was wrong, and they took out the extra bone in my foot and got mostly better and I did fun things???  Well, as of January 2015, I was pretty much back where I was in January 2013, just with a more complicated treatment history.

I had ankle surgery in October 2013, and in Spring 2014, once I started running and working out again, I played two tennis matches because my tennis team needed someone to play.  I did okay for not having played in a year and a half, but I didn’t feel great about it, and I figured I would sit out the summer and be all well and rested for fall tennis. I ran about ten miles a week in June and July, and did yoga a couple of times a week.  I had some tweaks of pain on occasion, but I was thrilled by this level of activity, as a year previously I had basically resigned myself to the fact that I might never run more than a mile again.

In August 2014, I decided I was ready to start playing tennis again.  I even took a couple clinics.  Being out on the courts felt good, even though I was still a little leery of my foot.  The last week of September, I ran three miles on Monday, took a tennis clinic on Wednesday, and played my first tennis match of the season on Thursday.  My tennis opponent made swift work of me, and ours was the only match that was finished by the time it started raining.  I was relieved that it was over, because I didn’t feel good about my ankle, but I didn’t feel any worse than I did during the spring matches, and I figured it was all in my head.

Friday, Saturday, Sunday are normal days.  Sunday night, I get a hankering for Jestine’s.  Jestine’s is just over a half mile from my house, and if I don’t want it bad enough to walk a mile for it, I probably don’t deserve it.   Plus, it always tastes so much better, and Briscoe likes to walk.  Briscoe and I happily and successfully make it to Jestine’s and almost back to the house with no trouble.  Half a block from my house, mid step, my ankle locked up and each step resulted in blinding pain.  If I had been more than half a block from my house, I would have required rescuing.  As it was, I hobbled home in near tears, and stumbled up my stairs, collapsing on the couch in the worst pain in recent memory.  I dug through my medicine cabinet and found some pain killers from my surgery, but when I woke up the next day I was still in pretty serious pain.  I dug out the ole trusty walking CAM boot, and tried not to scream in frustration.

I made an appointment with my Augusta surgeon, and with the ankle guy at MUSC.  Augusta Surgeon could see me Friday, MUSC said I was in luck, that their Ankle guy could see me December 15th. Augusta Surgeon was completely nonplussed by my regression.  He said that it’s not uncommon for scar tissue to break up about a year after surgery, and that I should wear the boot until I didn’t need to anymore, and call him back in six weeks if it was still painful.  I went back five weeks later and he fitted me with a lace up brace, and ordered an MRI.  I had an MRI thanksgiving week. The MRI showed some swelling and inflammation of my FHL and PTT tendon, but nothing was torn or broken.  I went back to Augusta Surgeon the week after the MRI, and he told me I should just be patient, that inflammation like this can take 3-4 months to heal, and that I should try to take it easy until January.  He said he felt sure it would be better by January.  I asked him what would happen if it wasn’t better by January.  He said that if it wasn’t better by January, it meant there was something else wrong with the ankle that the MRI didn’t show.  Great.

I was able to transition from the CAM boot to a lace up brace.  Before I knew it, it was December 15, and I was able to see the MUSC ankle guy.  I was told that most people wait six months to see the MUSC ankle guy, and I was lucky I only had to wait 2.5 months.  Dr. MUSC said that he wanted to review my MRI with his radiologist and that he would contact me after he came up with a treatment plan.  Dr. MUSC’s PA called me on December 31, and asked if I could come in that morning for an ankle injection.  Dr. MUSC said that he believed that there was something wrong with my FHL tendon, but that his radiologist disagreed.  Dr. MUSC injected my posterior tibial tendon sheath with ropivocaine.  This was an interesting experience, as the doctor took x-rays with this x-ray arm thing while he was injecting my foot.  I was instructed to go out and do whatever I would normally do that day.

“Normally” is such an interesting thing.  What is normal?  Seeing as it was New Year’s Eve, I wore heels.  I had not worn heels in months.  The injection made my foot feel infinitely better, and I was able to wear heels all night NYE, and I was able to go to two yoga classes the next week – on Monday and on Friday. I was at about 70% for the yoga classes, but I was so happy to be active, I had forgotten how much I enjoyed working out and how much I had missed it.  I returned to MUSC on Monday, January 12, 2015, and Dr. MUSC injected my ankle joint with ropivocaine, to see if injecting the ankle joint would also result in improvement.  The actual injection did not hurt, but a few hours after the injection, the pain increased drastically.  By Tuesday morning, I was unable to walk.  Dr. MUSC said he performed hundreds of injections a year, and that he could not remember the last time an injection had increased a patient’s pain.

It is my belief that I further injured my ankle wearing heels and going to the two yoga classes, and that the ankle injection just happened to be at the same time. I was prescribed mobic and ultram, but I only took the ultram at night because it made me feel weird. The pain was severe enough the second and third week of January that Dr. MUSC put me in a hard walking cast for three weeks.

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Dr. MUSC took my cast off on February 22, 2015, and told me that he was not confident enough about my diagnosis to operate, and he referred me to OrthoCarolina for another opinion.  I had to wait until March 22 for an appointment, and the pain forced me to continue wearing the boot.

Twenty-Fourteen was a great year overall.  Twenty-Fifteen needs an attitude adjustment.  I know I promised to write all the blogs I missed in 2014, and I actually have a great one that I am almost finished with, but 2015 is so loud right now that I’m unable to focus on the past.

Tuesday, January 20, 2015, the day after MLK holiday.  Sunny dry conditions.

Downtown Charleston.

My work desk at home overlooks a residential street that borders a more commercial area.  I live where the slate sidewalks end, and I spend my days watching College of Charleston kids ride by on skateboards and bikes.  I observe my neighbors on their routine to and fro, with or without their children and dogs.  There is the greyhound who wears a jacket when it is cold, and he seems to skip with delight when wearing the jacket, either from the cold or from the sheer pleasure of being stylish.  I like to people watch, and I’ve never been able to resist attaching make believe characteristics to people I see every day but know nothing about.

4 pm, I’m sitting at my desk at home, furiously trying to finish a project before a 5 pm meeting.  I hear tires squeal and a crash.  I momentarily consider walking down stairs and investigating, but with my walking air cast boot (See Part II) and my impending deadline, I decide to fight the ADHD and stay at my desk.  I finish my project and take Briscoe outside around 4:45, at which point I discover that not only was there a car wreck, the car wreck involved my parked car.  I peer pressured Briscoe into hastily finishing her business, and I whisked her back upstairs.  Briscoe did not appreciate her afternoon stroll being cut short, and headbutted my knee and pretended like she might bite me once we got back inside.  I called Philippa to tell her I was unable to drive to our Florence Crittenton meeting, and she was nice enough to come pick me up.

Back out on the street, I see that the gold jeep liberty that hit my car is entirely stuffed with, including a piece of luggage spilling into the cab from the backseat, along with a tall boy aluminum can wrapped in a paper bag in the console.  The airbag is visible on first glance, but the responding office told me that it was a pillow, as he pulled numerous curious objects from the front seats of the car.  These objects included a panhandling sign that said – HOMELESS – OUT OF WORK – ANYTHING HELPS, numerous empty 24 ounce cans of Four Lokos and Icehouse, empty liquor bottles of what appeared to be gin or vodka, along with numerous needles and a black dish that was about the size of an ashtray.  I took a few pictures because I have no self control and I’m an interested party.

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The driver was still in the car when the police rolled up, and he was in the back of the cruiser by the time I got there.   I literally could not, because I had somewhere to be, so I gave my driver’s license and insurance card to the responding officer, who promised to put the accident report and my driver’s license in my mail box, and I hopped in the car with Philippa.

After two hours of meetings, and then a decompression dinner with wine, I arrived home around 9 pm to find that there was no accident report or license in the mailbox.  A few phone calls later, the responding officer tells me that he is at the hospital with the driver, that things are crazy, but that he will bring me my license and the accident report within the hour.  10 pm rolls around, and I start to get a little concerned.  I texted my new police friend at 10:15, and he tells me he is on the way.  10:30 pm finds me on my front porch, in my pajamas, talking to a police officer about how the man who slammed into my car tried to hide his drugs where the sun doesn’t shine, and how they had to take him to the hospital for x-rays and extraction.  The good news was that the driver hit the stop sign, and possibly a few other things, before he hit my car, and that this was his fourth DUI, so he would be in jail indefinitely.  The other good news was that it was his girlfriend’s car, and that they thought she had insurance.  The bad news that they had no current location on the girlfriend.

This was all a lot to process, and these sorts of things are always better left to worry about tomorrow.  The following day I had my car looked at by various body shops, and I discovered that the name of the car owner was incorrect on the accident report.  After an inordinate amount of back and fourth with Allstate, and a conversation with my new police friend, I learned the owner girlfriend’s actual name, and I discovered that yes, she did have insurance at some point in time, but that her policy was cancelled in October 2014 for non-payment.

My insurance claims man acted like the fact that the policy had been cancelled in October was the greatest news ever, because he was convinced that if the girlfriend DID have insurance, that allstate would deny the claim because the accident was in the commission of a crime.  And if there was NO insurance, I could use my uninsured motorist coverage, with a $200 deductible, but if it was denied because it was in the commission of a crime, that I would be forced to use my collision insurance, which has a $1000 deductible.  Just to be clear, my undergraduate degree is in Risk Management and Insurance, and I went to Law School, I am a member of two bar associates, including the state where this accident happened.  All of this was news to me, along with sounding unreasonable, totally insane, and confusing.  I pretty much just nodded and smiled and acted like I understood.  South Carolina, if it is in fact true that my uninsured motorist coverage is not triggered in the scenario of my car being damaged by an insured crime committing moron whose coverage is invalidated by his crime, then I don’t understand the policy reasons for uninsured motorist coverage.  Isn’t every uninsured motorist committing a crime?  Isn’t having valid liability insurance required by law?  If this is true, I call bullshit.  If I had the time or the effort available I would do some case law research to discover the validity of my insurance company’s claim.  However, since this loophole did not actually apply to me, and because I have a lot of ridiculousness to worry about right this second, I’m going to leave this question to the professionals.

Since this time, my car has been delivered to the repair shop, and I discovered that the driver’s girlfriend got a DUI in early January 2015, but since it was her first offense, she got out fairly quickly.  I have spent a lot of time thinking about these people. One insurance person that I spoke to said that she would be FURIOUS if this happened to her.  I thought this was interesting.  Because I’m not furious.  I’m really not even mad.  I would be mad if I had to pay $1000 deductible, but I don’t.  I’m disappointed that my fairly new car has lost value, but it’s a car, and that’s what insurance is for, right?  More than anything, it just makes me sad.  It makes me sad that this idiot would stand on a street corner, playing on the heart strings of the privileged but feel guilty about it, only to turn around and use the money to buy drugs and four loko and get behind the wheel and endanger the rest of us.  At 4 pm on a Tuesday afternoon.  But I’m even more sad for whoever is on the receiving end of the phone call they make from jail.

I remember one time in Athens, Christy and I were sitting outside of the Globe, eating hamburgers and enjoying our drink of choice (Christy was probably drinking rum and diet coke with no ice and I was probably drinking a tall paulaner), and she gave a panhandler $5, and I said, “Christy!  You know he’s just going to go buy booze!” and she said, “Yeah, but that was what I was going to do with it, so whatever.”  Christy had a really excellent point, and since that time I don’t begrudge a panhandler spending some of his money on booze.  But I’m deeply troubled that incredibly intoxicated individuals are driving cars through my neighborhood at 4 pm on a Tuesday afternoon.   4 am on a Friday is one thing, 4 pm on a Tuesday is a whole different beast.

Next thing you know I’m going to be standing on my front porch with a shotgun yelling at kids to get the hell off my lawn.

2014

In the past, I have tried to write a recap post around the new year, but this year I have been so super slack about posting in general that I’m going to go back and write a series of blog posts that I should have written throughout the year. This is my new year’s resolution. I want to commit to 12 posts – one for each month, but I think that might set me up for failure, so I’m true commitment problem/inability to handle structure fashion I will refrain from being specific about this goal. I’m going to think real hard and try to focus on some fun things that happened that I didn’t get around to posting about, and throw in some books and movies and tv shows I enjoyed. TBD. Overall, 2014 was an excellent year. Happy New Year, I hope 2015 is joyous for us all!

This is a couple of days late, but since Briscoe doesn’t have a cell phone* or know how to use the internet**, I’m hoping she doesn’t notice.  Also, this can be a throw back Thursday, or Briscoe’s Greatest Hits.

HAPPY 8th BIRTHDAY TO THE FLUFFIEST, HAPPIEST, GREATEST, MOST BIG-HEADED DOG IN THE WORLD!  Thanks for being my best friend and favorite creature.

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*She doesn’t have a cell phone because she is broke because she doesn’t have a job.

**She doesn’t know how to use the internet because she doesn’t have thumbs and she sucks at typing.

I wrote a lot of this post in August, but then I got nitpicky and didn’t publish it.  I’ve kept the date I originally wrote it to keep the blog in sequential order, but it wasn’t finally published until January 9, 2015. 

(Napa Valley generally, assume St. Helena specifically unless otherwise noted)

My dear friend Philippa invited myself and two other great friends, Carla and Valerie, to accompany her home to St. Helena California for a long weekend this summer. Philippa had a wedding, and this was going to be one of numerous trips home in 2014, and she thought it could be fun to combine the wedding weekend with a girl’s trip to the wine country.

Truthfully, my responsible self felt that I had already exhausted my reasonable allotment of vacation time and money for 2014. However, my justification self remembered that several plans had been cancelled in 2013 due to ankle problems, and that I had sworn that I would do all the fun things in 2014, after five months being in a boot in 2013. Additionally, as a life rule, such exceptional invitations should always be accepted with glee.

California is a spot I have been meaning to visit for most of my life. To date, I have had a dearth of travel experiences west of Utah. I went to Hawaii in college, but I’m not sure that really counts. Somehow I always get caught in the mountains of Colorado.

We flew out of Charleston early Thursday morning, August 8th. Everyone else arrived at SFO around noon PST. I got stuck in the Dulles airport with mechanical issues, arriving in SFO around 8 pm PST, and ubered to the restaurant on Yountville, just when everyone else was finishing dinner. It was a wonderful weekend full of friends, wine, laughter, and sunshine. Without further ado –

Things I learned in Napa

1. Everyone who lives in St. Helena is involved in wine making. Small vintners, medium vintners, real estate agents, grape growers, landowners, wine sellers – the list of participants is vast.

2. Everyone involved in winemaking has a strong science and agricultural background. They have undergraduate degrees in biology for UC-fill in the blank, with a masters in Agra-genetic engineering from UC-pick a different one. It’s amazing, and impressive, and makes for excellent wine fueled Agra-science lessons about fault lines and soil density, runoff, and the importance of sunlight differentiation depending on the slope. I FEEL smarter. I LOVE agra-business.

3. I actually made up the degree of Agra-genetic engineering, but I did learn that grapes come in different hybrids, many of which were brought over from France, with cool names like Dijon 809. That’s not a mustard folks! It’s a grape! (actually, I think Dijon is a region of France, but Dijon 809 is a grape)  I had no idea. Previously, the entirety of my grape knowledge consisted of the fact that white wine could be made with red grape, sans skin.

4. People in Napa have strong ties to the wine regions of France. There are a lot of French people who moved to Napa to work in the wine industry, and all the Napa people have spent time in the French wine areas.

5. Everyone who has a dog and works at a vineyard brings their dog to work with them. There were dogs everywhere. It was awesome. Briscoe sniffed everything in my bag when I returned home with great disdain.

6. It is possible to cook quinoa in a manner that is both delicious and satisfying. I thought this to be a lie, perpetuated by veggie loving communists, and I only ate the quinoa because it seemed to be the culturally expected thing to do in California, expecting to take a few polite bites and move on, but I ended up having seconds. I need to get that recipe and figure out this magical trick.

7. When wine is aging in barrels, a noticeable amount evaporates, so the barrels have to topped off occasionally. The evaporated portion is called the “angel’s share”.

8. The state of California does not allow shark tagging because there are a bunch of activists who are against this project.  This is sad, because Mary Lee, Katharine, and Ocearch have taught me a lot about sharks.

9. The Napa Valley Vintner’s association is something like the tourist bureau and better business bureau all wrapped up in a beautiful barn like office made of reclaimed timber. Bernadette would be proud. Part of being a member of NVV involves donating a barrel to one of the annual auctions, Auction Napa Valley and Premier Napa Valley. A barrel is 25 cases of wine, or 300 bottles. The proceeds from Auction Napa Valley provide funding for healthcare and education for the entire region, especially for migrant workers and their families.  I think this is totally amazing.

10.  In Napa, you need a different set of clothing depending on whether you are standing in the sun or in the shade.  (From the brief time I spent in San Francisco, you need a coat all the time, especially in the summer.)

11. Wine out of the barrel is delicious, as are grapes off the vine.  I expected grapes off the vine to be bitter, but I found them to be extremely pleasant.

12.  I am too old to do backhand springs, even on a trampoline.  I should never do another backhand spring, ever again, under any circumstances, regardless of how springy the ground beneath me happens to be.

13.  According to Pavi’s daughters, Eliana and Alessia, my southern accent is significantly more pronounced in the morning, when I have just woken up.  I can only assume this is because I have yet to hear myself in comparison to the other people around me, and I am not yet awake enough to possess the mental capacity to enunciate properly.  I thought this was an interesting observation.  I’m aware I modify my speech when I am in places where I can hear myself, I guess I just never thought about at what part of the day I made the modification.

14.  If you are out to dinner with a person you do not know very well, and everyone has been drinking wine for the greater part of the day, and the person you do not know asks you a question about an important decision they are about to make, or not make, you should not give emphatic advice on the subject.  Regardless of how convicted you are on there being no question as to the proper choice, just stop talking.  STOP. TALKING.

15.  Chickens can easily mistake a wine glass for a food container.  Freshly gathered eggs do not require refrigeration, but that does not mean you should take the eggs out to dinner with you.  Eggs make poor dinner companions.

16.  Any time after 10 pm is late in Napa.  The days are too glorious to not get up early.

17.   I’m determined to work harvest next year.

 

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