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(Story Day) The Year of the Stress Fracture

With my diagnosis from Dr. C— in hand (see "In the beginning..."), I picked up my useless left shoe—replaced by the big black walking boot—left the medical center, and went by the pharmacy to fill the script for pain medicine. Then I bravely went to the office to face the musical production of “I told you so,” with intermissions filled by unsolicited commentaries about men, their refusal to go to the doctor, and their inability to listen.

A month later, after trudging around campus and kicking the back of my good ankle, I returned to see Dr. C— with one desire: his permission to take that boot and shove it deep into the recesses of my closet, or better—use it as an anchor for my boat. But in the x-ray, the little white line was still too obvious. It wasn’t until early July, when I returned for a second time, that Dr. C— said: “Well, amigo, the bone still needs to strengthen. But as long as you are careful you can go back to your regular shoe” (which I just happened to have with me in the car). So, after three to four months of ignoring the pain and another two months in a boot, I was free at last—free at last!

A few weeks after I was released from the tyranny of the tiny white line, I loaded the boat, packed the car, and joined my extended family for one more extra long weekend at Lake Whitney, Texas, before school started. The first two afternoons at the lake I pulled riders in a tube behind my boat and even managed to get a skier or two up on the water; not bad for a sixteen-foot Bass Tracker with a motor the Brotherhood of Semi-Avid Slow Joggers would be proud of. I even rode the tube once or twice, slowly. With apologies to the Brotherhood, I was a model for following my doctor’s instructions.

On the third afternoon, I was pulling my daughter and her cousin in the tube when I spotted a perfect setup and lost all self-control. We passed a bigger and much faster boat churning up a beautiful set of waves on our port (left) side. So I made a sharp turn and crossed the waves—throwing the girls high in the air and ripping the tube wide open—thus ending our tubing experience for the trip.

As much as I enjoyed the villainy of piloting the boat for the kids (one reason for the boat), I bought the boat several years earlier primarily for bass fishing. We were in Oklahoma and my son David was in those tough teenage years—and yet almost any time I asked, he was ready to go fishing (a benefit beyond the price of the boat). I joined BASS, the Bass Anglers Sportsman Society and bought more rods, reels, lures, and other gear than I could fit into two boats. Stores like the Bass Pro Shops™, Cabela’s™, and Academy Sports & Outdoors™ knew how to lure me in (they could see me coming) and hook every dollar I had out of my pocket. I was a much better fish than fisherman.

Unfortunately, David was most often at school or work when my schedule allowed me to get on the water. So I recruited a buddy or fished alone and learned to enjoy the serenity and peace. I loved to catch fish, but it wasn’t necessary to restore my spirit. I just needed to be on the water. By the time we moved to Abilene, a Saturday morning on the water could evaporate a week’s worth of stress at the office. Give me three or four days like this trip, and I’d be ready for the semester.

So at Lake Whitney, I devoted early mornings and late evenings to chasing bass—sometimes with my dad or with my sister and her husband—but most often alone. On the third morning it was misty-wet; good for fishing despite my lack of catching. I’d been on the water for two or three hours when I decided to head back to the boat slip. The trolling motor, still in the water, required a firm tug of a rope to lift and fold it onto the boat’s front deck. I’d learned the hard way that unless I reached out a little over the end of the boat and pulled upward, the motor wouldn’t lift—and sometimes the rope would even break. So, with confidence from pulling the trolling motor up hundreds of times, I put my right foot on the bow of the boat and gave the rope a firm tug.

When my right foot slipped, I had a split-second decision to make: I could fall backwards into the boat, landing on the deck with all the rods, lures, and their hooks,or I could fall forward into the water. I decided that a controlled fall forward into the lake was much better than an uncontrolled fall backward. At least it seemed like a good decision, until I hit the thick aluminum bar lining the top bow of the boat with the top of my left foot as I entered the water; the only part of me that clashed with the boat in an otherwise perfect plan.

You’ll be proud to know that I didn’t wait three months to make an appointment to see Dr. C—; I only waited a month--six weeks tops, until I was certain the pain was genuine and not resolving on its own. This time, after listening to my story he didn’t bother with x-rays. He just ordered me back into the boot, and told me his office would arrange for me to see a new podiatrist in town.

Dr. B— was new to Abilene. He was a young man with a gregarious smile, chiseled features, and empathetic eyes; it was obvious that his work made his heart sing. He listened intently, asked probing questions, and explained the necessary course of action or available options—almost to a fault. When I first I met Dr. B— in October of 2006, a few patients gathered on his side of the lobby; a year later a word-of-mouth campaign had created a flourishing practice with SRO (theatre slang for Standing Room Only). Almost everyone waited patiently past their appointment time, knowing that no matter how far behind he might be, Dr. B— would give all of us all the time and attention we needed.

The day we met, the first order of the day called for more x-rays. This time my eyes found the same hairline fracture in the middle of my foot about the same time Dr. B—pointed it out. So they put my foot back into the boot, tightened up all the straps (much tighter than before), told me to take vitamin D twice a day, and gave me a script to decrease the inflammation. Doctor B— explained: “We’ll try the boot for a few weeks. But if we don’t see any progress, we may need to try a Bone Growth Stimulator.”

I returned in November, just before Thanksgiving, and took another trip down memory lane for x-rays. Today when Dr. Brown put the x-ray film on the light box he asked, “Do you see where the fracture was?”

I nodded yes, though even I could see there had been a change.

He pointed to the middle of my foot (the third metatarsal). “See this faint trace of a line and this white stuff around it, this callousing? That’s what we wanted to see. The bone is healing, and it’s not moving around. It still needs to get stronger, but you can do that in your regular shoe. I want you to start slow and light, then build up to your normal pace over a couple of weeks. You should do fine. Any questions?”

“Should I keep taking the vitamin D?”

“It wouldn’t hurt to continue with it. And if you wouldn’t mind, I’d really like to see you back in a month—just to make sure the bone is still healing. Meanwhile, if it starts giving you trouble, don’t hesitate to call us and come back in.”

We shook hands, and he left the room. The nurse helped me strap on the boot one last time. I made my appointment, went to the car, took the boot off, tossed it into the back seat, and put my shoe back on.

For the first two weeks my foot continued to hurt a little. But when I returned to his office just before Christmas, the pain had gone away and the last set of x-rays looked good. Dr. B— wrote in my chart, “Stress fracture left third metatarsal, healed.”

The year of the stress fracture was over and I was set to enjoy the Christmas break of 2006… and the last few completely pain-free weeks of my life. Somewhere deep inside the  mystery of the human nervous system, something or someone was tickling the nose of a sleeping giant with a feather.

to be continued—

Excerpt from a working manuscript,A Fire in My Bones: A Memoir of Life with CRPS (copyright Glenn Pemberton)

See other entries in this series at A Fire in My Bones.