Pretty Smashed Up

Ten years ago in April, I wrote this to friends and family, in a regular newsletter about Catherine’s cancer treatment, subject line The Bones are Alright:

After a bone scan a few weeks ago (after which Catherine was warned not to sleep too close to me lest I become irradiated), Catherine had an appointment with Dr. Wotherspoon, the orthopaedic surgeon, today at the hospital to learn more about how her bones are doing.

After a brief bit of confusion – there was another Catherine Miller in the clinic to have a cast removed and the nurse seemed insistent, for a moment or two at least, that Catherine must have a cast removed; only a birth date comparison convinced her otherwise – Catherine (our Catherine) had an X-ray of her spine
and of her femur, and then we got to review these, along with the bone scan, with the doctor.

The good news is that nothing’s changed in Catherine’s bones: there’s no sign of any additional cancer in any additional bones, and the spots on the femur where cancer is thought to be present haven’t gotten any worse. Which is exactly the news you want to hear.

By happenstance, the selfsame Dr. Wotherspoon is now  my orthopaedic surgeon, treating the elbow I broke two weeks ago. 

After a CT scan on Monday, I had my follow up appointment with him today. His formal medical diagnosis: my elbow is “pretty smashed up.”

The actual formal classification for radial head fractures has its roots in a 1954 paper in the British Medical Journal by Mark Mason, Some observations on fractures of the head of the radius with a review of one hundred cases. 

In the Mason classification system, radial head fractures are classified like this:

Type 1 — Fissure or marginal fractures without displacement.
Type 2 — Marginal sector fractures with displacement (Segment of the lateral border of the radial head is separated from the other quadrants, is impacted and depressed, or is tilted out of line).
Type 3 — Comminuted fractures involving the whole head of the radius.

Coming out of the ER a couple of weeks ago, I was left with the impression I probably had a type 1 fracture; my guess, although it was never said out loud today, is that I actually have a type 3 fracture. 

Both the x-ray, and the CT scan, show that my fracture is comminuted—“pretty smashed up”—with at least three pieces of bone and evidence, floating around. 

As a result, sometime this weekend, the radial head in my right arm will be replaced with a titanium one. I’d hoped that this might happen today, but there was no room in the schedule, so I’ve been told to have a coffee at 6:00 a.m. tomorrow morning, and then stand by my phone waiting for a call from surgical scheduling.

Dr. Wotherspoon’s last act before I left was to formally mark the arm involved, presumably standard operating procedure to avoid replacing the wrong radial head: 

Although I’m impatient, anxious, and confused about how to settle in to being on the end of caregiving than I’m used to, I am, yet again, grateful to live in a country with socialized medicine, with quick access to a skilled surgeon, and the wraparound support of friends and family.