Each year it seems there are more body parts that need repair. Just this week I had a carpectomy: removal of 3 bones in my wrist. The surgery was pre-ordained almost 50 years ago, on my 16^th birthday.

When I was growing up, teenagers were just as irresponsible as they are today, but unlike today, we all made sure that we secured our driver’s license as soon as legally possible…on our 16^th birthday. Now this was no small task, as a visit to the Department of Motor Vehicles in New York was the most dreaded outing one could imagine. I’ve had the pleasure of going to

the DMV in 5 different states and I can tell you with absolute certainty that the black hole that is the DMV in NY is easily the worst. Friends in Illinois disagree, and they tell me that people have to take the day off work just to finish transactions at the IL DMV. Day off!?! Ha! In NY people take a LEAVE OF ABSENCE! Trust me. One day I waited in line for over an hour just to ensure that I had the right paperwork. Then I was shuttled to another hour-long line just to ensure that I had filled out the correct paperwork, correctly. Entire days are lost at a NY DMV. Well, at least you are surrounded by pleasant people (!)

Anyway, I had miraculously navigated the local DMV to secure my ticket to freedom…my official New York State license to drive. My first destination was my cousin Frank’s house. He wasn’t actually a cousin, but his parents were best friends with my parents and they had moved out of Brooklyn to Long Island around the same time as we did. We called them “Uncle Mel and Aunt Genevieve” and the 3 kids, Frank, Vincent and Anthony, were our “cousins”. I headed to their house for an informal 16^th birthday celebration.

I was very tentative on that first solo drive. I approached a traffic light which rudely turned yellow as I entered the intersection.

Fearful that I’d actually run my first official red light, I slammed on the brakes and skidded loudly to a stop…right in the middle of the intersection under the traffic light. Not a good place to be. I sheepishly took my foot off the brake and coasted through the intersection (and red light)  to continue on my merry way. That was the last time I ever touched the brakes on a yellow light.

Frank’s family lived in East Farmingdale, a bit more upscale than my neighborhood. They had a big house and lots of toys. Sadly, tragedy struck this family twice in 4 years. First, Frank’s father developed lung cancer (a non-smoker!) and died within 3 months of his diagnosis. Then, the youngest child Anthony, who was a complete joy to be around, died of brain cancer a few years later. This of course changed the family. My “Aunt” Genevieve was always a sparkplug and she threw herself full force into fund raising for the American Cancer Society. One way was through her Christmas decorations.

Frank’s family had always gone over the top with their Christmas decorations, but after the family tragedies they took it to the next level. I remember going over to Frank’s house most days after high school in November to join a team working on the display. We had an endless budget and did some amazing things. There were decorations everywhere, and a walkway around the U-shaped driveway, leading to the garage where Santa’s workshop scene unfolded, complete with moving figures. I built a light box out of a kit from Radio Shack which pulsed to the Christmas music playing across the property. We had Santa’s sled and reindeer taking off from the roof headed up into the huge maple tree next door. In a quieter area, we set up a wonderful Nativity scene. There were hundreds, no thousands, of lights everywhere you turned. I wish I had a few pictures, and it probably doesn’t compare to some of the out-sized displays done these days, but it was enough to be a destination in the early 70s. Hundreds of cars loaded down with little ones would come during December to stroll the property and make donations to the ACS. We even held an annual parade down the block, complete with Santa on Saturdays.

One year when we were decorating, I was on the roof of this tall house with my other friend Frank laying down a string of lights. (Yes, three Franks). I was crawling backward on the apex of the roof while Frank followed by stapling the string down. I was getting close to the end of the roof so I slowed my backing down a bit to let Frank catch up and secure the last few bulbs. Frank, however, was busy concentrating on his task and did not slow down. Instead he kept coming and bumped me in the shoulder, sending one of my legs over the roof. I quickly fell flat on the roof and Frank grabbed my coat to pull me up. I looked up with wild eyes into Frank’s alarmed face. He said the only thing he could: “Sorry.” We both crawled back down and laughed until we cried.

Anyway, I’m headed to Frank’s house on my maiden license voyage and the rest of my journey is uneventful. But I am early. Only Frank and his family are there. No other friends yet; no other relatives. So I hit on a brilliant idea. I will hide in the tree in the front yard and jump out when someone arrives. Being an agile, if not ridiculous, 16 year old, I easily scaled the tree and began my way upward moving from branch to branch. I’m well concealed but decide to move a bit higher by grabbing an overhead branch with both hands. As I prepare to hoist myself up, the new branch voices it’s concern by snapping loudly. It all happened quickly, but the new branch decided that it was not robust enough to support my weight, so it broke cleanly off at the trunk, sending me plummeting to earth. I tell everyone that I fell in slow motion, with enough time to decide how I was going to land. I am convinced that I had time to stick out my arm to break the fall, then decide to pull it back to hit on my shoulder, then reverse course to stick out my hand again. Of course, it is much more likely that it happened much too fast for me to make any calculated moves, and that instinct alone caused me to reach my arm out to the ground, but I remain convinced that I had the time and wherewithal to make a conscious decision. Delusional, I know.

I hit the ground hard and popped up holding my arm which now had a lovely S shape at the wrist. It did not take a medical degree to diagnose. As I stood up, I noticed my parents driving up to the house. I quietly walked over to the car, opened the rear door and got in, explaining to my Dad that I had just broken my wrist. My Mother freaked out and off we sped to the emergency room.  I was probably in a bit of shock as there was no pain and I was cool, calm and collected.

The ER doc put a nerve block on my right arm so I had no feeling or control. I marveled at the dead limb as I picked it up and let it fall on my face, just as the doc warned about that very thing. It’s amazing how much your dead arm weighs, probably 10-12 pounds. The fall to my face did not hurt my arm, but my nose didn’t appreciate it. The doc then laid my arm on the examination table, knelt on the table and enfolded my wrist in his over-sized hands. He told me to brace myself, but I knew that my arm was dead and that I wouldn’t feel a thing as he prepared to squeeze the wrist to set the bones back in place. I was wrong. When he bore down on my wrist, I felt an excruciating sharp pain the likes of which I had never felt before, or since. I probably screamed. No matter. It was done, but in retrospect, it didn’t seem to be a very precise way to reset the bones. I left in a full arm cast. Which meant that my first few months of driving were not textbook 10-2 on the wheel, but more like left hand at 11 and knees at 6.

As the years passed it became obvious that something was wrong with my wrist. I had limited range of motion and the intermittent pain had worsened. So about 10 years ago I decided to see an Orthopedic Surgeon about it. He walked into the examination room and I gave him my history, complete with the novel bone-setting technique employed by the ER physician. He asked me to put both arms on the table, looked down, and immediately announced that it was a classic case of “gobbledygook nexus osseo dysphoria” (or some such words). They just looked like regular wrists to me. He said they would do x-rays of course but he was sure that the wrist bones had not healed at the correct angle with the radius and ulna. He then explained the fix:

• First, we go into your thigh to slice out a
  wedge of bone from your femur.
• Then we open your wrist, cut open the radius and
  graft the femur slice into it.
• Then we close up both wounds

I just looked at him, gave my thanks and left the room. I hugged the hallway wall as I snuck back through the reception area and out the door to freedom. I was relieved to see a white panel truck skid to a stop at the entrance, and two guys jump out dressed in white jumpsuits, carrying what looked to be a straight jacket with buckles and straps dangling.

They burst through the automatic doors and I’m confident they were converging on the nutcase who was posing as a doctor in my examination room.

Time wore on and the cartilage in my wrist wore down. It hurt more frequently and interfered with all sports and most activities of daily living. Wrist pain even limited how much I could do in a day while remodeling my house. So a few months ago I screwed up the courage to see a medical professional again. A well-regarded hand specialist told me that, although I had residual cracks in a couple of carpal bones, my main problem was that the end of the radius sustained a break which hadn’t healed correctly, causing degeneration of cartilage and invasive arthritis. Solution was either removal of 3 of 8 carpal bones or completely fuse the wrist. At least there was no femur involvement! After additional research, I set the date for removal of 3 carpal bones.

I’m a bit nervous about operations so I prepare by ratcheting up my optimism and enthusiasm as I enter the facility. At one point a nurse administered an ElectroCardioGram and told me that my summary cardiovascular profile estimated my age at 35 years old. She added that my paperwork read 64, but that I looked younger, like in my mid-50s. “Thanks”, I said, “my wife also tells me that I act younger, like in my late teens.” Nothing.

Then she asked me where I wanted the IV, hand or arm. Your choice, I offered. She then pressed the IV needle into the back of my hand, into a vein, through the vein, and out the other side of the vein. “Oops”, she said. But she was blessed with delusional confidence and declared that “we are going to save this”. Oh good. She then manipulated the needle in my hand for a good 30 seconds while repeating her mission to “save this”. I do believe she discovered a new torture technique. Forget waterboarding, just send this woman down to Guantanamo and let her put in a few IVs.

Eventually she relented and said she’d have to give up on this site and try the smaller vein right above it. My mind screamed “NO!” but I heard my mouth say “OK”. It took her a while but eventually the IV was set, but my hand looked like I slammed it in a car door. Repeatedly.

In walks the anesthesiologist who turns out to be Indian-American and one of the most handsome men I’d ever seen. Really. I decided not to tell him because you really don’t want to risk any strangeness between you and the guy charged with knocking you out. He asked me if I needed a Work Status report to bring to work detailing restrictions. “No,” I told him, “but I could use one for Home”. Nothing.

He explained that I’d be receiving a nerve block on my entire arm. I shared my experience with breakthrough pain during the nerve block those many years ago and he told me that was unlikely given the newer drugs, but since he was also giving me some Versed, if there is pain, I won’t remember it anyway.   “Oh…good?”    I think he took my story to heart and accepted the challenge, because this was one effective nerve block. The doc and the paperwork said it could last from 6 to 20 hours, but my arm was completely dead for almost 30 hours.

He moved around me to administer the Versed in my IV, looked down at my battered hand and said “Oh my”. Then he told to count backward from 10.

“10…9…fhree…

Now as I type this, (with some difficulty) I have a sling and bandage, 3 fewer carpal bones, a shaved terminus of the radius and removed carpal nerves. I

am also 9 months into treatment for an advanced case of bilateral Plantar Fasciitis. Preliminary treatment hasn’t had much of an impact, including cortisone shots (two sets), orthotics, a sleep splint, 6 weeks of PT, and several rounds of steroid dose packs. I’m now using an incredibly clumsy full boot which may be helping. Here’s hoping, because the next step will be surgery and then I’ll have an irrational need to tell you all about it!

Be well and thanks for reading

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