Art Versus Science

Almost exactly one year ago to the day, I sprained my right ankle playing volleyball in a men’s league at Michael J. Fox high school. Luckily, three other players were in the medical profession: a nurse, a physiotherapist and a paramedic. If that were the beginning of a joke, it was on me.

My friends Cori and Phil arrived to take me home. Phil had sprained his ankle in similar style years before (I had been at that game and watched his face turn green), and being a gear head, he had purchased all the toys an injured athlete could need. In particular, I have to draw attention to the Cryo-cuff. This is a boot with velcro strap and a bladder that you can fill with cold water to provide the ice and compression effects that are crucial to healing a new injury. More importantly, it feels good. Really, really good. So good, that I began to think the injury was no big deal, and didn’t rush to have an xray.

The sprain was, as they say, “a good one.” The docs in the emergency ward at Vancouver General Hospital (VGH) thought it was fresh, when it was actually several days old. Most of my lower leg was purple or green or black. It was swollen solid but had the squishy texture of play-doh. In retrospect, from the knee down, I was a ripe avocado.

Ed’s Note: In medi-speak, this is called “pitted edema.” You push your thumb into the swollen flesh, and when you take your thumb out, the flesh stays pushed in: a little “pit.” That’s right, just like old people!

Xrays bombarded. Film was developed. The doctor said there was something suspicious, and she wanted me to have a CT scan. OK, that sounds like fun.

Many days later, I went back to VGH for the scan. A different doctor looked at my leg. I took a sick pride in the fact that he thought it was fresh, this now being two weeks after it happened. The CT scan was completed at 7:50 AM. At 7:54 AM I was placed in an observation room to await the results. At 11:45 AM they told me they couldn’t find anyone who knew how to read an ankle CT scan. I offered to give it a shot. No dice. At 12:25 AM they called in the head of radiology, who concluded that there might be a bone chip in there, but eh, who knows? Go home. We can’t help you here.

I went to physiotherapy. After a month, I was walking normally, but I couldn’t “dorsi flex” my right foot very much (bring my toes towards my head). This stops me from jumping, running, and basically doing the kinds of things I like to do. (That’s right, I like to run and jump.)

And so here we are, a year later. My last stand is a CT scan that I had two weeks ago. The hope is that there’s some piece of bone blocking the joint; a piece of bone is easily removed or reattached. If it’s not a piece of bone, there’s probably nothing that can be done to improve the joint; soft tissue injuries are an enigma, shrouded in mystery, wrapped in ligaments, apparently.

Dr. Wing, my unexpectedly un-asian orthopaedic surgeon, greets me and introduces me to the inevitable grinning intern. Off with my shoes and socks. After asking me a few questions and sliding my ankle joint back and forth a few times, he hits me with the news. “Well, you have a nice bone chip sitting in your ankle joint.”

We go into his office and he shows me the CT scan. It’s beautiful. In slow cross-section, we glide through slice after black-and-white slice of me. At first, it looks like a regular ankle. Than, a small dot appears in the upper corner of my talus (pronounced “TAY-less”). Next slice: the dot is wider. Next slice: the dot is a blob, and there is a chip showing in the talus. This is amazing. I want to hang this image on my wall. Medicine is art.

We discuss the surgical procedure. Worst-case scenario involves cutting out a piece of my fibula (leg bone connected to da… knee bone!) in order to screw the chip back into place. I want to stay awake and watch. He’s OK with that.

Ed’s note: Off on a tangent, Josh had a discussion with his new roommate, Dave, regarding their mutual apprehension of potentially having moved in with a psycho, since they didn’t really know each other prior to sharing an apartment. They compromised that they were both probably a little bit psycho, but in a healthy, I-would-only-PRETEND-to-stab-you-in-the-shower way. After hearing that Josh wanted to watch his leg being sawed off, Dave has concluded that Josh is more psycho.

Recovery takes six weeks, and there’s no guarantee that the surgery will fix anything, but it’s worth a shot. I sigh. Thank God. Cut me open. Scalpel. Suction. Bone saw. Whatever. I’m in.

I go under the knife July 2nd. Archie comics and ice cream appreciated.

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