Tuesday, August 20, 2013

Myron

It occurred to me, as I was writing the last post, that I have not explained Myron.

As you know, I've been having some wrist issues, possibly related to the car accident I was in four years ago, possibly not.

X-rays and an MRI were inconclusive.

I waited weeks for the hand specialist to finally say he'd see me.  It took over a month between the referral and the call for me to schedule an appointment, and another week after that before I could be seen.

My appointment was last week on Wednesday.  I had the CD with my MRI scans on it with me, but none of the previous x-rays.  (Because I never had them, you see.)

I'd managed to forget the PIP exhaustion letter that my old insurance company had faxed to me.  Oops.  Thankfully, I'd called the adjuster from my cell phone and still had the number in the log, and they were able to fax another copy directly to my specialist's office.  Never mind that I didn't think this wrist issue, with its swelling along the outside of the wrist, along the pinky side of my hand, had anything to do with the dual break in my ulna from four years ago.  Just in case it was related, the office needed that PIP exhaustion form.

I have a love/hate relationship with insurance companies.  But I digress.

Dr. M came in, and I explained my symptoms, onset, and pain levels.  He asked about x-rays from prior to the MRI.  I said I didn't have those.  He sent me for x-rays right then, because he really needed to see those.

I did not enjoy the x-rays.  Holding my hand at a right angle to the table HURT.  Laying it nearly flat for the next view was marginally better.

I sat and waited in the exam room for another ten minutes for Dr. M. to come back.

And we have an answer.

He snapped the x-rays onto the wall lightbox.  "There's the old break here," he said, pointing to the healed break on the ulna.  "And there's an avulsion fracture."

The night before my appointment, I had been going through the paperwork they'd mailed me, hoping I'd remembered all of my major medical/surgical/hospitalization events.  So I made a list on my tablet (I love Wunderlist).  Being my mother's daughter, this sent me hunting through Wikipedia and searching through Google to find the right terms for my ankle surgery.

This led to me learning that a medical "reduction," in terms of fractures, simply means putting the bones back together the way they're supposed to.

I had a vague recollection of the twenty-letter term used for the type of injury my ankle sustained, and how they fixed it.  Ah-ha!  Yeah, that's it.  A bimalleolar fracture.  (And yes, how they fixed it is exactly how the article says such a fracture is treated, and the pictures are very similar to my own x-rays, except that I had a single screw in each side.)

In the process of finding all that out, I read about different types of bone fractures: linear (a break parallel to the bone's long axis); transverse (a break at a right angle to the bone's long axis), oblique (a break at a diagonal to the bone's long axis); open (compound), in which there's other wounds along with the fracture; closed (simple), where the skin remains intact over the break; complete (the break goes all the way through); incomplete (the break only extends part of the way through the bone); spiral (at least part of the bone has twisted due to the fracture); comminuted (the bone is broken into several pieces); and avulsion (where a piece of bone is broken off from the main bone).

So, when Dr. M told me I had an avulsion fracture, I knew exactly what he was talking about.  And the bimalleolar fracture in my ankle was really a pair of avulsion fractures.

That I had one in my wrist was news.

Not only that, it had been missed four years ago, and the piece of bone that was chipped off had never healed back into the ulna, from whence it came.  It was completely severed from the bone, and never did the twain meet again.  It was a result of the accident.

Dr. M drew a small circle around the spot on the x-ray, which previously didn't really show up (apparently) when the radiologist viewed it.  He explained that the small chunk of bone had traveled from the side of my wrist, where it had broken in the accident, up along the back of my hand, so that it now rested above the eight bones of the carpus but beneath the ligaments and tendons that control the wrist's movement.

He palpated the area of swelling on the side of my hand.  That was uncomfortable.  Then he gently pressed around the back of my hand and wrist.  I yelped loudly.  Yep, he was right on the money.  That spot brought serious pain, where the swelling was merely discomfort by comparison.  The ligaments and tendons were probably fed up with scraping over that piece of bone for, oh, close to four years, and thus, my wrist was swollen and in pain.

He asked why my previous orthopedist hadn't given me a cortisone injection.  I said that Dr. W didn't think it would be worth it.  Dr. M shook his head.

Dr. M opted to try a cortisone shot.  I agreed, liking this guy even more the longer I talked with him.  He asked if I needed to lay down, or if I would be okay sitting up for this.  Given everything in my health history now, I figured I could handle this.  "I'll be fine sitting."

He chuckled.  "Usually it's the men who have to lay down."

"Oh, really?"

"Oh, yeah.  Eight to one, the men will faint before women."  We both laughed.  "A bit of a pinch here."  I watched the needle flex as he moved it around and winced repeatedly.  "Sorry.  I'm trying to give you good coverage all the way around."

"It's okay."  I can be pretty stoic about needles, but watching that sucker bend was really very odd.

"I'm not looking at giving you a cortisone shot every month," he said.  "Either this works or it doesn't.  Come back in 2–3 weeks, and if it still hurts, or if your symptoms have gone away and come back, we'll discuss removing it."

So...that's where I am, waiting once again.  But this time I have an appointment!  I was told it would take 3-4 days for the cortisone to really take effect, and a week or so for it to reach full strength.

By Wednesday night of last week, I had decided that my little traveling bone needed a name.  My friend Her Total Awesomeness has names for her medical additions.  (And, despite her warnings about me staging things so that I pull ahead in the Interesting Health Dilemmas Sweepstakes, she did say that only I could manage to have a migrating bone.)  The idea amused me.

I needed amusement.

And so...Myron the Migrant is my traveling chip of bone.

2 comments:

  1. Ouch! Hope it gets better! I'll stop whining about a sore shoulder now.

    ReplyDelete
    Replies
    1. I'll trade Myron for your sore shoulder...

      Delete

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