Cut Loose

This is a continuation of Fall, which is a Memoir.

It has been, at this point, close to four months since my injury and I am tired. Tired of using my cane, and wearing the brace to hobble my way through this socioeconomic blight of a neighborhood, down to the convenience store that is five blocks away, bright and early, and fully hung, over three mornings a week to catch the bus out to my physical therapy and then to hurry across several lanes of traffic to make it to the bus back when I am done. I am sorely tired of leaning on my daughter’s stroller as I limp a mile and a half each way, several times a week to the grocery store to pick up what limited provisions I can carry on my back. I am tired of being the one waiting up for my significant other to get home from work; even the slight hint of irony to our role reversals just pisses me off more.

Therapy for my knee has become more aggravating. One recent pool session involved playing race the clock as the water slowly drained out so they could fix the aquatic treadmill; the device that is supposed to be an integral part of my treatment and yet has been out of service since the day before my first appointment. Upon my arrival for what has turned out to my final encounter with Jude and the pool the treadmill was working but, it turns out to be almost unnecessary due to how far along I am in my recovery anyway. What is perhaps even more annoying, my last land appointment my therapist was absent and so I was left in the care of someone who actually listened to my concerns and made an attempt to involve himself as I did my exercises, all while handling two other patients and never once fidgeting with his fancy new smart phone nor going and hanging out at the desk in the middle of the gym. This only reinforces my opinion that my regular guy is an irreparable douche with a bush broom attached to his upper lip. All of this while my anxiety is growing over the tiny little fact that my limited insurance is about to top out on how many of these oh so extremely therapeutic appointments are going to be paid for.

With all of these things in mind I go to my evaluation at the orthopedic clinic that is handling my case. The same as always Physicians Assistant scowls at me because I am still using my cane which I was presented with the last time I saw him. On that previous visit he tried to ream me because I could barely flex my knee at all despite having been to therapy a grand total of once, and now I have to show how far I have come since. Standing with my back to the wall and holding on to the back of a chair for balance I slowly raise my emaciated leg, I force my foot farther and farther back towards the wall despite the stiffness and pain. My weeks in the vice like contraptions in the physical therapy room have paid off as I manage to eek out the ninety degrees that is required for the PA’s satisfaction. He tells me I can sit down and he scampers off with my latest set of x-rays to go see his master, the actual doctor in charge of my case.

It seems it is another busy day for the clinic and my attendant doesn’t return for half an hour. When he returns I am told the good news, the thing I have wanted the most since I started coming to this building. I am getting out of the brace. I can hardly believe it at all. I find myself excitedly asking about how much longer before I can stop using the cane and get back to my job at the restaurant.

He says, “Right away, you can take that brace and cane home and burn them, Dr. Vlasic says to cut you loose.”

And just like that I am ticked off all over again. “Cut me loose.” This phrase should have been a great relief to me. Instead, I what I hear is that some jackhole of a doctor whose name sounds like a brand of pickles and hasn’t talked to me or even looked at me once since the second or third day after I woke up in the hospital, who may have a piece of paper in his files that lists my occupation as a cook is letting his testy little minion tell me that I have been dismissed from their collective presence and I am free to figure out on my own how I am supposed to return to work with what limited mobility I have. I am not their problem anymore, that is what is really be explained here in not so many words. I am a poor person, with the type of insurance that poor people have and that is not going to last very much longer so I am being “cut loose” before they are stuck trying to squeeze money from my limited personal finances instead.

At the end of the day I am left with a certifying that I am fit to return to my job that hastily scrawled by someone who’s probably closest experience to what I do for a living is that the have at one point eaten in a restaurant, and the kind of deep seeded anger and depression that could almost be mistaken like optimism from the outside. I manage to shove the accursed and by this time foul-smelling brace into my back pack and then, out of habit, lean on my cane as I make my way past the reception desk to the elevators. I have a bus to catch and I’m pretty sure it’s going to be a one way ride this time.

Therapy : What are your goals for treatment?

This is a continuation of Fall.

I arrive at physical therapy, enter the locker room, take off my shoes and socks, unstrap my brace, and change into my swim trunks; a time consuming process with little a knee that bends like there is a steel rod running through it. I enter the pool room and see that Jude, the PTA in charge of the pool, is still occupied with the older woman with the bad dye job and entirely too vocal opinions about things she little informed of; the cupric hue of her hair and the abrasive drone of her voice confirms that it is Monday morning. I have started drinking again and despite my efforts to conceal it I know the smell of cheap stale beer is escaping through my pores; I can’t really bring myself to care. Jude begins the usual assortment of questions by asking if I have taken any pain killers and what my pain level is. I like Jude, he’s a good guy who really likes people or if nothing else good at pretending that he really likes people; either way it makes him well suited for his job. We’ve gotten to know each other fairly well over the past few weeks, his family is from Haiti, but he grew up largely here in Florida, his dad is a chef, etc. I think he likes me, even if only due to the fact that I am not one of the regular remnants of the baby boom he has as clients, who always seem to know more about what they should be doing for treatment than someone who clearly has studied it professionally. I have, however, grown tired of these particular questions; I have repeatedly explained to him that I stop using any medications at least four hours prior to therapy so I can take some right after we’re through to fight the inflammation that results. I find the second question always perplexing. I am supposed to rate my pain on a scale of one to ten, I always feel like I am playing some sort of  guessing game as I have only three levels of pain on my own yardstick:

  1. No pain.
  2. Pain I can tolerate.
  3. Get me to a god damned hospital!

Today I arbitrarily pick three out of ten, I haven’t really noticed him change my routine based on my answer.

I am early today, as directed by the mustache called Brent, or Trent, or whatever, in charge of my treatment. I am now supposed to start off every therapy session by using The Flexinator for at least fifteen minutes. This medieval contraption is essentially a vise that pushes my foot up towards my hip forcing the knee to bend, breaking up the internal scar tissue left over from surgery; the best part is that I have to manually crank it up there with a lever, instilling the illusion of control of how fast I might regain normal motion in my joint, increasing the likely hood that someone like myself would push their level of discomfort further and further in the naive hope that is was doing them good. Torquemada would be proud . I wonder why they never ask me about pain after I spend my time with this machine?

The water in the pool is just below body temperature and helps soothe the ache the torturous device has conjured in my knee; the underwater treadmill is still broken, as it has been since the day before I started my pool sessions. So, instead, I walk the length of it first forward and then backwards, the furious headache and sore muscles from the hangover I have makes keeping my balance a tough challenge. Today I am practicing standing on one leg with my eyes closed. Jude finds it amusing that when I attempt to do this with my uninjured left leg that I manage to spin a full three hundred sixty  degrees while attempting to maintain my balance without knowing. While I am concentrating on my exercises Jude asks, “What are your goals for treatment?”

So it’s going to be this kind of day. I have reached a point of dealing my knee where keeping a positive a positive frame of mind is just to exhausting and now I can only hope that my attempts at paying lip service to questions such as these aren’t as transparent as they sound. To be honest I don’t even hear the answers that I give the therapists, nurses, and physician’s assistants that ask them anymore. It doesn’t help approach that I haven’t seen anyone with the letters MD after their name since I left the hospital, if they can’t be bothered to care why should I. So, in lieu of my actual verbal response to this tired old query I only hear my internal dialogue.

“I want to jump up out of this god damned pool, grab my cane, beat you to death with it and then be able to leg it, full speed away before the cops get here. I want to walk, I want to run, I want to jump. I look out of the floor to ceiling windows on the other side of the pool at the land therapy room and see all these other jack assed, shit bags on treadmills and stationary bikes and I want to be them, instead of dicking around in this piss warm water like a god damned little kid. I want to never have to strap on that fucking ugly, sweaty, and cumbersome articulated contraption of a brace ever again! I want to kick that relic of The Inquisition that I am killing myself on three times weekly, until it is smashed in a million pieces! I want to never have to hobble on in here again, or watch that mustachioed douche bag fiddle fuck around with his iPhone! That, my friend, are my goals for treatment!”

I don’t say any of this to Jude, because I like him and he is good at his job, and none of this is his fault.

Therapy : One On Land, Two On Water

This is a continuation of Fall.

I wake up, I pry the three year old off of me; she has insisted on co-sleeping with us, again. This would be fine right now as it’s winter and this apartment has more holes in it than a colander, the extra body heat is welcome. The shit part of this arrangement isn’t the lack of privacy it’s the fact that my right leg is still extra sensitive from being fresh out of the cast that has shielded it for the last couple of months, and she manages to kick me in the knee several times a night; the one with the screws in it.

This morning my left leg has a sharp pain running up and down it, I assume that it’s just a cramp and force my way up and out of bed. Fumbling for one the damned crutches I make my way out of the bedroom and travel to the other end of the domestic hallway. Calling where I emerge a living room would be funny except I keep getting told the same joke everyday, It is more like having a foyer attached to your bathroom. My wife is in the section of this area best described as a kitchen, making breakfast for all of us. Today I am going to need my strength.

It’s my first day of physical therapy today. I am nervous. I haven’t walked without my leg in some sort of contrivance since I fell in January. I know that today I am going to have to lose the brace for at least part of it. This is a hard thing for me to imagine at this point; on the few times since that day that I have seen my naked leg it is remarkable how emaciated it looks, it is only a third of the size of the left leg and that is probably a kind estimate. When I move it in the limited capacity that I am able it still feels awkward and alien, not at all like it is really any part of me; it’s more like another being willing to do what I ask but it just doesn’t speak the local language. I have my doubts that it will support my weight and I am terrified to find out.

I have my choice of bus routes to the sports medicine facility that I have been approved for. I have My choice of either a long, contrived and winding way through the unknown areas of a college campus with several transfers or a shorter more direct path that only requires use of two buses but includes hobbling  my way across four lanes of traffic and a strip mall’s parking lot to get to the second stop. Both have the potential to be a huge pain in the ass. I opt to leave early for the shorter route, in case I miss the transfer bus this will give me an extra half hour to catch the next one. I took the longer one for my last orthopedic appointment and it just made me mad by the time I got there.

I manage to arrive early for my appointment and try to fill the time with the out of date magazines supplied to me. Mostly old copies of The New Yorker, I’m not really reading them just fidgeting. I make mental note to bring a book next time. Eventually I am buzzed back into the gym like cavern behind the solid wood doors where I am greeted by a man with a mustache that reminds me of Officer Dangle, if someone forced him to wear cargo pants. I explain my concerns about my knee and confess to being more than a little nervous about using my leg without the brace, he makes a lame joke about wanting me to climb a tree. I climb onto one of the tables and he takes a measurement of my ability to bend my knee, I am not sure if appalling is a number but it should be in this case.

The remainder of the session is him giving me brief instruction on stretches and isometric exercises, intermingled with him running off to dick around with his iPhone at the main desk while I attempt them not quite sure if it’s right or not. I think about saying something but given the level of interest his coworkers are exhibiting in his fancy new gizmo I doubt it will do any good. The exercises leave me tired and sore, I wonder if this is a positive sign.

My knee is iced while he prints out blurry copies of instructions for stretches to do at home. I am told that I would be a good candidate for therapy in the pool, and he introduces me to the guy who does this. I read this as, “Let me make you someone else’s problem.” The therapist tells me it is probably best if I still use both crutches for now. I am sent on my way to catch my bus stop and am told to stop back to get my full therapy schedule when I come in for my follow-up with the orthopedist.

Later that week I am berated by the Physicians Assistant in the clinic for still using my crutches and for not being able to bend my knee back far enough. Apparently one therapy session should have been enough to go from zero to ninety degrees. After realizing that I actually have some sort of insurance that is paying for all of this he calms down and provides me with a shiny new cane.

Downstairs I meet with Physical Therapist Dangle, I think his real name is Trent and am fairly certain I am not going start liking him anytime soon, I know for sure that his mustache is annoying the crap out of me. He tells me that I will need three therapy sessions a week for the next eight weeks. One on land, and Two on water. Two more months of my life being on hold. Two whole months of looking at his stupid ass mustache. Life is peachy.