Hans, the Finger and the Dyke

Yohan’s Surgery #13: Hans, the Finger and the Dike

August 21, 2016


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Since Yohan had his cast removed last Thursday, I feel like that Dutch kid, Hans, whose dike-plugging skills prevented a disastrous flood from annihilating his village. Here’s why: Dr. Pfeffer told us at least 99 times that when the cast comes off and the walking boot goes on, “Yohan’s foot is not allowed to drop AT ALL – NOT EVEN FOR A MOMENT.” In other words, if Yohan plantarflexes, or “steps on the gas pedal,” the tendon transfer will rip out and be completely and utterly ruined. Back to the operating table! Like Hans, I got the job no one else wants: hold that foot up or pay the consequences. Unlike Hans, who must have nerves of steel, my nerves are all mushy – like over-cooked pasta.

Because of the expense and distance, we chose not to return to Cedars for the cast removing ceremony, and opted to make an appointment here in the Bay Area with a highly-regarded orthopedic surgeon.

I woke up Thursday morning feeling sick. I had a bad case of the jitters. Would Yohan be able to walk? Would the screws in his heel cause him pain upon weight bearing? I was more nervous today than the day he had the surgery. And when I become anxious, I get all amped up and overly-excited, sort of like someone with bipolar in a manic phase. On the way to the appointment, I was talking a mile-a-minute, without much cohesion to my sentences. In the waiting room, my foot tapped uncontrollably to the rhythm of some imaginary triple time beat. In the cast room, I zoomed around on the doctor’s stool, touching everything and making loud nonsensical conversation….with myself. When Yohan glared at me and told me to “shush” by putting his index finger to his lips, I felt irritated. “Sorry, I left my inside voice at the library yesterday.”

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The tech arrived and started to cut away the top layer of the cast, but not before I shoved my iPhone in her face, making her read every word of Dr. Pfeffer’s instructions. His email specifically stated, “As he comes out of the cast tomorrow, do not let his ankle flex down accidentally. Even for a moment. Hold his foot up, his ankle at 90 degrees, as the cast is taken off. He should go right into a cast boot, which will hold his ankle at 90 degrees. Have it ready as the cast comes off.”

We had never met the doctor we were about to see, but I had Googled him beforehand to make sure I approved of his credentials and his looks. I also did some research on Angie’s List to make sure he had excellent reviews. He did.
So when he walked into the room, I felt as though I knew him intimately. “Good morning, Dr Ortho” (made up name), I sung as if I was greeting a class of 1st graders on the first day of school. Chin down, he peered warily at me at from above the top rim of his glasses, and then he glanced at Yohan and then at Gilles. “Do I know you?” he asked with a hint of both confusion and fear.

“Nope. No, you don’t. But, I know you”, I responded with much too much enthusiasm. Then, here is where I take control of our appointment, “This is what’s going to happen here today. “Read this,” I commanded, as I placed my cell under his nose, on top of a pile of medical records. He obliged. Compared to the cast lady, he took his job to heart and carefully read every word of Dr. Pfeffer’s email.

Still not quite understanding his role in this process, he briefly eyed Yohan’s foot, shrugged and casually wished us well as he shuffled out of the room. Just as I started to relax, I realized that cast lady was once again in charge and respectfully, she looked a bit on the clueless side.

Suddenly, in a blink of an eye, she started to pull Yohan’s cast off, WITHOUT PAYING HEED TO THE POSITIONING OF HIS FOOT! Gilles, jumped up and for some reason, I reacted by giving succinct commands as if I were riding my horse,” Whoa! Whoa! Whoa!” Before any real damage was done, Gilles grabbed Yohan’s foot, held it securely in the 90 degree position as I slipped the walking boot underneath his leg and foot. Disaster averted!
After 8 weeks of non-weight bearing, Yohan put his foot on the floor, and with the help of his crutches, he walked out of the room, down the hallway and into the car. Apparently, his foot felt “weird” whatever that meant, but he was walking. Yes!

Watch him walk:

By that time, I had a terrible headache, and I was exhausted. Any energy I had was all used up. I was running on empty. When we got home, Yohan wanted to take wash his foot. All I wanted to do was take some Excedrin and lie down. But, fair enough. I threw down a couple of pain killers and then helped Yohan soak his foot, which was immediately overwhelmingly taxing. It takes a lot of concentration and 2-way communication to get that foot out of the boot and into the bathtub without losing that 90 degree angle. Due to weakened lower leg muscles and lack of sensation, Yohan tried to keep his foot up, but his effort alone would not be enough. He needed a hand to stabilize and guide him. And that hand happened to be mine.

He put his booted foot into the tub, and before removing it, I had to sit on the edge of the tub, and stretch way down at the most awkward angle, almost throwing my back out, to hold his foot up while he removed it from the boot and put it down nice and flat. I told him to wash that foot really well, because I was not repeating this charade for a while.

As I mentioned at the beginning of the story, when dealing with Yo’s foot, I can totally relate to Hans. How I empathize with that sweet little boy. The future of his world was riding on his determination and persistence. I might not have his depth of character, but, don’t worry about us. Our story will end well too. Here’s my solution to success: No bathing until the boot comes off in two weeks. It’s as simple as that.

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