Suitable for Work
(N.B.: I tried to find another phrase I could reuse from a Dead Can Dance song, but the closest I could come up with was "Enigma of the Absolute", which would have been too pretentious even for me.)
Previously on The Orthopedic Misadventures of Tim Swezy
Since the last update I've been in the phase of recovery where there aren't many milestones left other than just "getting back to 'normal', given proportional adjustments to the relative standards of 'normal'". The anniversary of last year's orthopedic misadventures came and went at the end of February. The wound from the surgery at the beginning of the year has almost completely healed, after a second week of using a vacuum dressing and subsequent, ongoing more standard dressing changes.
In March I had a follow up with Duke's Infectious Diseases department, where they drew blood after a thorough, somewhat self-directed discussion about the longer term ins and outs related to internal tissue and bone adjacent infections. That in itself was a fortunate milestone because when the blood work came back over the following 24 hours or so, nearly all of the markers showed and the test results came out in the green section of the chart. Many of them were in the green for the first time since the ER blood draw immediately after I broke my leg.
The main takeaway from all this is that there was essentially no evidence of any indicator, protein marker, etc. related to the infection my body had been fighting for the previous 8 months or so. Meaning that, statistically at least, the infection was gone. Given the determination that my vector of infection was staph, there's nothing preventing it from recurring since (I think) some form of it either lives in our bodies, on the surface of our skin, and / or in our environment. Again from a statistical perspective, though, as far as the region of my leg where I've had 3 surgeries in the past 15 months is concerned, the infection has been cured.
The nearly all green results also indicate that there are other aspects of health that have somehow improved even over the last time I had had blood drawn for my annual physical exam. What aspects those might be I won't know until I get caught back up with my more routine medical appointments.
This means something. This is important!
What finally prompted this update though are two significant events, both of which happened this past Wednesday:
I had what was probably my last Physical Therapy appointment
I went back to work in our office full time
For PT there's essentially nothing new left for me to do, learn, or improve physically within that context. I still have available appointments left in regards to my health insurance before the Rx expires in three months, so I might go back for a check-in before then. However, I have now passed or exceeded all of the various tests and other evaluative tools that my physical therapist has been using. I will still do my home PT regimen for the foreseeable future, at least until I'm able to transition to something more like a full body fitness practice. My plan is to set up an initial consult appointment with the Exercise Physiology department at Duke with a mind towards converting my home-based PT into a home-based exercise routine. How I came to that decision is a whole other tangent that I'll reserve for later.
Initially I went back to work as a convenience, since my long-suffering and angelically supportive partner Caroline was going to be chauffeuring me there and back. Namely the convenience involved was spending half the time traveling to and from my PT appointment, and so, half the gas needed to do so. Which meant going in to our office with her in the morning. After that day, and the two that followed, I found that I wasn't in any more discomfort or pain than I have been in recent days or weeks working from home. This was the threshold I'd been waiting for in order to make the decision to go back to work in our office.
My main concern has been the unpredictable nature of the aches, pains, and what not, in addition to my own mobility. Those are all exponentially easier and simpler to manage at home than they are at work, since our offices lack a lot of the otherwise usual creature comforts that are extremely helpful in recovering from orthopedic surgery. In the lead up to this decision, it's important to note that I haven't even touched my cane in well over a month. I can do most of the chores and other activities around the house that I used to. Even after doing PT, my musculoskeletal recovery time has minimized to the extent that I rarely have to ice my leg or take pain medication afterwards. I'm not 100% comfortable pretty much any of the time, but aside from the occasional flash of pain from moving my leg in an esoteric way or simply "waking up on the wrong side of the bed", it's all manageable and I'm now fully capable of doing so.
It's all ball bearings nowadays
Going to back to work in our office after almost a year and a half of being away, and for most of that time essentially bedridden has been and will likely continue to be an adjustment. There are still a lot of little logistical problems to solve, from:
having to adjust to wearing normal human appropriate work clothes instead of t-shirts and athletic / leisure shorts everyday (including adjusting my own work wardrobe to account for the 50+ pounds of weight I've lost in the past year
to:
more mundane things like (re-)organizing my office carrel after it had been turned into a makeshift storage surface
and:
everything in between. I don't think there's any aspect of my life that hasn't been affected by both of my legs' injuries, but now, especially, the much more extensive and involved recovery period for this most recent accident will require some amount of continued adjustment and (re-)evaluation.
There are a few unexpected aspects to deal with as well:
Time collapses and space warps, oh, yeah*
Within a day of being back in the office, I experienced a phenomenon that I'm not unfamiliar with, but that is much more pronounced than it has been. Due to my various neurodivergences, I discover that two similar events, which are part of a regular routine, end up being entangled, both metaphorically and psychologically, like a pair of proverbial quantum particles. The result is that when separated by time and / or space, regardless of the duration or distance, almost to the moment the second event occurs, all of the intervening time and / or space seems to collapse in order to restore the continuity of the two events.
The meaning of that result is that emotionally and psychologically it feels like that interstitial, even liminal time and space in between, seems to disappear. I don't actually forget about it, and evidence of that slice of spacetime remains. Put another way, it's more like the script supervisor in my brain has decided that slice is irrelevant to present and future circumstances as far as canon and continuity are concerned, so it gets filed away as part of my own personal "expanded universe". It's the psychological equivalent of a latter day Halloween sequel ignoring it's own nominal prequels to connect more directly to the original, or the tesseract in A Wrinkle in Time, or the Dark Horse Comics version of Star Wars Episodes 7 through 9, etc. and so on. The slice is still there, but its connections to the events surrounding it are essentially severed. Would that my brain was more like Doctor Who in its timey-wimey-ness and often blatant disregard for canon…
All spin, no sit
I quite literally cannot sit still. It's very likely my "new normal", that for the rest of my life I quite literally cannot, in the sense that I should not, sit, anywhere, for very long, and especially at any one time. The partially incomplete healing and recovery in my right knee from 5 years ago, as well as my continued recovery in my left leg means that both of my legs, but especially my knees, get stiff after sitting for too long, regardless of position or elevation.
Any standing and walking, after having sat for too long, is very uncomfortable, if not actually painful, which interferes with my already shaky sense of balance, etc., which is still recovering, and so on. I say "new" normal because even if I can get past what remains of the inflammation, etc., as a result of the fracture in my left leg, the cartilage in my left knee has thinned over the past year and a bit. Tibial plateau fractures in general carry an increased risk of early onset osteoarthritis of the knee joint. The plates and screws that helped me heal contributed majorly to that, and while they also contributed greatly to my getting an infection, their removal to fix that infection doesn't diminish the risk of early-onset osteoarthritis much, if at all.
In a way it's fortuitous that I can't sit still because:
Non-redundant Assless Chap
My ass atrophied, you could even say it ass-trophied
I'm serious, I literally have an atrophied ass
It's almost like I used to have an ass, but it fell off somewhere, and I couldn't find it anywhere
Despite any melodic pleadings to the contrary, even Juvenile himself will be truly disappointed and discouraged should I ever be called upon by his electronic sirens to perform his most sacred of duties
In all seriousness, to explain further: the much longer period of immobility and recovery, which meant I wasn't using my gluteal muscles very much, in addition to losing a lot of weight, means that I've developed a kind of "Princess and the Pea" syndrome, meaning that anything I sit on quickly becomes uncomfortable if not also painful, if it's even the slightest bit less cushioned than our foam mattress. My continued mobility, and further physical fitness should help with this, but it wouldn't be an exaggeration to say that this possibility wasn't anywhere on my list of things to look out or plan for. Not that as a typical, American, white, nominally middle class, cisgendered male of my relative generational cohort that I had much to spare in that area to begin with…
The End Is the Beginning Is the End
Overall, though, I'm feeling pretty good and looking forward to getting on with my life, again, as I attempt to embrace understanding that there isn't a "normal" to get back to, only forward, with an aim towards progress… between my own hopefully concluded orthopedic misadventures to waves at everything going on in the world I'm convinced that "normal" is not only impossible, but I severely doubt it ever existed to begin with.
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*apologies to Hedwig & the Angry Inch - "Exquisite Corpse"
