Medical Mystery Tour Vol. 4 – Fear of the Unknown

The twists of my medical adventures became even more bizarre in a saga that lasted for several months. Once again, a mystery would change the course of my life, bringing me further into the family of my close friend Yinka Ogunro. A close confidant through thick and thin, our shared love of music has been a beacon over time. For nearly twenty years, he’s enthralled me with tales of his inventive namesake father – an upper extremity orthopedic surgeon known by most as “Dr. O.”

The first time we met, Dr. O spent twenty minutes trying to dislocate my shoulder, which I thought was the source of my recurring pain. He administered a battery of tests with the loose focus of a jazz drummer setting up his kit, asking questions with an organic curiosity. He referred me to a nerve specialist who electrically tested the nerves in my arms. The problem was not the shoulder, so I took my films to a spine doctor who prescribed a series of neck injections, which proved helpful but left me with residual pain. For this, they gave me a TENS or transcutaneous electrical nerve stimulation, a unit that uses pulses to alleviate pain.

I returned to Dr. O’s office because the pain doctor had denied the electricity’s connection to the now constant pain engulfing my arm. In his first analysis, Dr. O didn’t know what to make of it. I believe the hemangioma – a sort of vascular cluster – had always been there. But there was no way for me to know that not everybody’s funny bone shot lightning into their pinkie finger. I imagine further that all of the steroids I had taken for previous maladies had helped it gain size.

They outfitted me with an arm brace that locked my arm at nearly a right angle, which required a sling. He prescribed large red anti-inflammatory pills to keep the jagged, inflamed pain at bay until the good doctor could better understand what was going on. Seemingly without warning, I could be overcome by extreme jolts downward from the elbow of heat, electricity, or even icy cold. There was an upheaval of every activity in my daily life. There were frequent office visits – including sensation tests, which demonstrated that I was losing significant feeling down the arm and into the outside fingers.

As a writer, my hands have always been instrumental in processing the ideas at the heart of whatever words I may endeavor to write. First, I compose black scribbles on loose-leaf paper. Next, I utilize the wrist’s rotational joint for the keyboard, deepening what the pen began. I struggled to implement dictation software. I don’t know if Broca or Wieneke discovered the area where my writing process issues originate. The speaking collided with my dependence on music to train my focus. Where I could modulate the music’s pace, volume, and intensity to suit my writing needs, my voice invariably made me more anxious and unresolved.

A group of us were standing on my cousin’s porch when my girlfriend pointed out a protrusion beneath my elbow that “didn’t look right.” It was like a push-button of pain, and her noticing it changed the course of treatment dramatically. When I showed Dr. O the mass, he manipulated it, moving my arm into different positions, and finally suggested an MRI might reveal our culprit. Back in the tube, my right arm was isolated, which kept me in an awkward position. I was, however, becoming adept at slipping my mind out of my body as the machine buzzed noisily around me – the hint of a popular country radio station fluttering beneath it.

Two months before my imminent surgery to remedy the worsening situation, my girlfriend and I rescued a little black dog with smoky grey bits. He was six pounds and eight weeks old, a little dirty but full of love. I immediately called him “Mingus” after the composer and bass player, Charles Mingus, who’s Beneath the Underdog has been hugely influential. With one bad arm, I did my best to keep up with my new friend, fighting off the isolation that can accompany pain from an unknown source.

The mass had grown into the ulnar nerve, and its presence was causing all sorts of confusion. As Dr. O explained it, the nerves are like the bundles of wires used in suspension bridges, and the surgeon would tease the hemangioma out tediously. He booked a surgical center with the best optics, drafting Yinka’s younger sister, Shade, to handle the four-hour procedure. Her young eyes and small hands left an elegant scar along the curve of the joint.

The next year, as my eyes were beginning to fail, the ulnar nerve’s problems returned. Every couple of months I’d have another MRI to monitor its progress. Eventually, he referred me to a Radiation Therapist at the Cancer center, ultimately prohibited by the proximity to a significant nerve prohibited. It remains in a happy medium near the nerve but not choking its internal circuitry. 

He described the nerve as a bundle of wires that required the surgeon to tease the growth out very carefully to minimize damage. There’s no way to avoid a lengthy period for the nerve to recover any sense of normalcy; five years was the expected timeline. And that would be if the hemangioma didn’t grow back, which it eventually did.

Medical Mystery Tour Vol. 3 – Turning the Screws

Fresh out of graduate school, I worked on my first ghostwriting job during the summer of 2004. The research was exceptionally engaging and allowed me the opportunity to dust off little-used past coursework like Latin, German, Roman History, and Legal Ethics. The return to my hometown allowed me to resume participation in my favorite regular basketball games around town. Saturday mornings before nine in Eastwoods Park near the UT campus, I played with a group comprised primarily of lawyers and philosophers I met through the record store.

Back at it for most of the summer, I was also in a Sunday evening game and had a couple of friends who met up during the week. A streaky jump shooter at best, I was always eager to set picks and make the extra pass. However, my natural focus had always been defensive, intending to maintain cohesion between the five positions, and feeding fast breaks off the glass. Defense consists of many habits and choices; therefore, the more aggressive we become, it follows that our decisions are less sophisticated. And in one quick down court inbounds of the ball, I would become another statistical illustration of such a notion.

Developed over years of staying engaged with the middle foreground and its periphery, my instinctual break on the ball remains frozen in time, and it would live on in infamy. I executed my play on the long pass well, the jump, and the timing, but I’d forgotten to account for my landing point somewhere along the way. The other regular game was in a nicely appointed gym; perhaps the alternating venue had my sensibilities twisted. But ultimately, there are good reasons players don’t often press full court in pick up games. After breaking up the pass, I contorted my body to avoid colliding with my opponent; as I did so, my right great toe met the concrete.

As a rookie ghostwriter at the time, I had no insurance to speak of, and therefore I did nothing to attend to the painfully jacked-up toe. I kept up with ice and taped the toe for support; years later, I would realize how futile such attempts had been. This incident was the formal conclusion of my basketball life, which had begun in the explosive aftermath of Michigan State beating Indiana State in the 1979 NCAA Championship. The game, however, has lived on within me even though my body can never play again. Watching basketball is a joyful experience as I recall the game’s lessons, especially during years where I relied on a cane to make it to the kitchen.

Nearly four years later, my knees forced me into the insurance market as they began to breakdown (https://theflashbulb.wordpress.com/2019/08/21/medical-mystery-vol-2/). Throughout this process, I lived in the upstairs apartment of a large split house, which had me up and down stairs, limping and generally putting a lot of wear and tear on my lower extremities. Between each of the knee surgeries, usually, as I was rehabbing and getting myself back into shape, that right great toe would flair up and cruelly shut me down again. When I asked my knee surgeon about the very swollen toe, she scoffed at any surgical fix and left me hopeless.

The process of becoming hobbled was one that came along in phases and delivered me just far enough from average to dislodge me from any consistent social strata. For years I was at the whim of the crumbling foundations of my poorly engineered body, but books, films, music to carry my restless mind out into the world surrounded me. Reams of paper could account for myriad false starts on my literary works, which seemed to stagnate alongside my mood.

A year after my third knee surgery, we moved into a one-story house on the Near Southside of Fort Worth. My foot only flared up a couple of times, and I was becoming more active riding my bike and shooting hoops solo a couple of times a week. But the year ended with a historically regrettable decision: walking bourbon-fueled in inappropriate footwear over a mile in the dark of night to see the live music beckoning to us on our porch. A quarter-mile into the trip, something in my foot had busted loose, and all I had was more bourbon to offset the rising tide of pain overtaking me. By the time we arrived at the venue, neither my mind nor my body could stand up, and there was quite literally nowhere to sit down. It was a long quiet, much slower trip home and seven long, painful months before I would find any relief.

My purgatory would become a podiatrist’s office in a strip mall, where I found no cure, but instead was given foam for my shoe and prescriptions to combat my body’s growing revolt. The doctor took X-rays and assured me that surgery was an option if it were necessary. But alas, when these methods fell short of improving my condition, I took my business and x-rays to an Orthopedic Surgeon specializing in foot and ankle reconstruction.

Within five minutes, my surgeon relieved me; it didn’t hurt that he carried himself with the looseness of a Big Band leader. Digital x-rays were quite the time travel from the podiatrist’s office, and as we looked at them in his spacious office, I finally saw the adversary. As we booked the upcoming procedure, he explained the truth about podiatrists, “I wish those guys wouldn’t load people up with meds like this. You know they aren’t doctors, right?” I thought mine was incompetent, but it would seem I’d fallen into a typical error loop.

The surgeon rebroke the bones and reshaped them so that the right great toe stood straight with the assistance of titanium screws after crookedly crowding its more extended neighbor for eight years. Throughout the process, I tried my best to continue covering local music. The week before I went in, I caught Loudon Wainwright at The Kessler (https://wordpress.com/post/theflashbulb.wordpress.com/45), and the week after, I had a big show booked, which I attended. It was a glorious night with a packed venue, and despite my medicated state and cane, I still found ways to dance all the same.

A year later, I returned to have the screws removed because I could feel their heads emerging beneath the skin. As my surgeon looked over the file, he commented quite emphatically, “That toe was quite a mess,” before scheduling the procedure for his main office in Dallas. The screws come out much like one would expect with a medical-grade screwdriver and repeated ratcheting of my foot. As he set to work on the first screw, he asked if I could feel what he was doing. When I acknowledged that I could, he called for more of the deadening agent, which he applied quite liberally before picking up his tool again.

Medical Mystery Tour Vol. 2 – Further Dislocations

Before my eyes began failing, I had already become well-practiced in the process of degeneration, procedure, and recovery for a decade. It was another of my congenital disabilities, a pair of bipartite patellae, where the saga of my surgeries began. A dislocated knee during 7th-grade football tryouts tipped us off to the fact that the kneecap had never appropriately fused; instead, it remained two separate bones. Most importantly, as I would mythologize later, I beat the kid next to me on the track, which had just enough of a dip in it to pop my kneecap out.

Ten years ago, while moving a 7-foot couch into my upstairs apartment, something began to break down in my left knee. The process of removing a pair of posts on the screened-in porch was intensive. Before we got the massive piece of furniture through the kitchen, my knee began to swell to the size of a large grapefruit, and I remained on the couch for the next six weeks.

Most of the next year was spent nursing the knee before I finally sought an orthopedic surgeon nearby to check it out. When the first x-rays came back, I commented about how the smaller chunk looked like a ship leaving the harbor of the more substantial piece. The most significant concern about removing the wayward bone for the surgeon was the 7-inch incision required. I waived off any issues about scars, but he wasn’t sure the procedure was necessary, choosing instead to do a basic arthroscopic clean-up of the damage.

Almost immediately after the first surgery, it became apparent more work was required. The first procedure had cleaned up the wreckage but did nothing to hinder the patella’s further separation. When I returned with a nearly melon-sized knee, the surgeon showed me a series of rather intimate pictures as evidence of how nicely he had cleaned out the joint. Of course, these were images taken during the procedure and did nothing to explain my body’s extreme reaction. Throughout this frustratingly idle process, I was limited to reading and watching movies, which allowed my usual quote harvesting to intensify and acted as a welcome distraction from the pain.

After three frustrating meetings with my surgeon, I tracked down Dr. Barbara Bergin – the orthopedic surgeon who had diagnosed the malady twenty years earlier. Our visits became frequent because my insurance refused another surgery for nine months, my only recourse was Hydrocodone and regular draining of fluid build-up. During this period, I learned about her trading a cowboy riding lessons for hand surgery, which led to competitive cut riding, and, eventually, a novel she based around her experiences. I rarely left the house by this point, because I needed the assistance of a cane; therefore, my interpersonal skills deteriorated with each passing month.

Between the first and second surgeries, I had signed on to develop story ideas for an upstart production company. However, hovering somewhere between pain and painkillers left my mind lacking clarity, and I became increasingly challenging to be around. Emotionally frazzled, I left a trail of questionable choices and confused dealings as I lived in a perpetual state of limbo. Unsurprisingly, I was giddy as a schoolchild when Dr. Bergin finally asked, “Are you ready for me to pull that thing out yet?” A month later, I was in my gown, learning about my cocktail of anesthesia as they wheeled me into the OR.

I had asked the nurses if I could have the extracted chunk of my knee cap, and it was there when I awoke in a cup on the table. That first laugh was a very long time coming — almost like seeing a defeated adversary – the conclusion of the nightmare saw a return of a more friendly version of myself. Many of my friends asked to see the bone, which I kept in the freezer; I would always indulge them by pulling it from the fridge and saying, “You can touch it if you want.”

Those three years initiated a period of personal transformation driven by the breaking down of my body. In my early 30s, I expected to spread out and challenge myself, but instead, I was comparing notes with my mother about her knee replacements and researching pain management. A large percentage of my energy was spent doing mental health upkeep. At times, I could trick myself by focusing like a sommelier on ways to describe the various types of pain stimulating my central nervous system. At times, it was as though the pain’s intensity overwhelmed my visual field, where I would see blobs of color. Tracing the dynamism of the pain along the nerve could have jagged electrical bolts or feel heavy and sludgy like lava.

With each recovery came a renewed sense of vigor, I bought a stationary bike to help me get back in shape. With each new round of swelling – when gravity and mobility become far more adversarial – life moved towards an Olympic level of absurdity. I am the sort of person who refuses assistance as a way of life; many of my falls, tumbles, close calls, and near misses were due to an irrational pigheadedness. But I found it helped to laugh as often as possible upon unintentionally finding the floor.

Only one procedure was needed to care for the issues in the right knee. For all three of the knee surgeries, I lived upstairs in an old house, which meant I was regularly hopping up and down. My bedroom was in a loft in a converted stairwell, which led to a few tumbles. As a result, my lower back and neck had taking beatings as well. Hobbled for over two years, the limping had awakened a big toe pulverized years earlier, and soon after that same toe would become an ordeal all its own.

For more than three years, everything revolved around my problematic patellae, and it became clear I was missing out on a great deal of life. My friends were getting married, having children, and starting businesses while I was a moody shell of my former self. At times I found myself feeling despondent, but for all that was lost, I have gained the appreciation of simple glories. Like the moment you successfully regain a normal gait and return to walking without limitation after not knowing if such a thing were possible.