“Wisdom is the reward for surviving our own stupidity” – Brian Rathbone
A simple torn toe nail four days before Christmas has forced me to accept something I’ve been putting off for some time now, the reality of assisted living. The ripple effect of such a nondescript activity can put in motion a tsunami of events. I may be a little punchy over my recent hospitalization but there are certain realities we are all forced to face at some point. The first ripple was the frightening idea that a simple torn toenail could put me back in the hospital. It was on my left foot and I can’t reach my left foot due to my fused hip.
What is a “fused hip”? Well it is no longer a hip with a flexible joint. The hip doesn’t really bend. It was a surgical technique used in the early day of orthopaedic surgery with polio kids. It wasn’t exclusive to polio but we were good candidates for the trial and it fit my agenda. After all there was nothing I wanted more as a fifteen year old in the 60’s than the ability to get rid of the last of my leg braces and wear tight jeans. The crutches didn’t matter, to me the tight jeans were the epitome of normalcy.
The process was basic physics but I had cut so many physics classes I didn’t realize that. It wasn’t until much later in life that I recognized the irony of cutting so many classes in a science that would play such a big part of my life, physics.
The pin to the left was put in my left hip in 1964. You can see where the screw holes are and those were screwed into my femur. The pin extending the other direction could be set at a variety of degrees by tightening the connecting screw (my doctor choose a 3 degree bend). They then lace a thin metal wire to the femoral head to plot their next move. After x-raying it to make sure they have the right angle they line up that extension bar and with a mallet they insert it. Once that is done they shave bone chips off which they then transfer to the head of the hip joint and use that bone like a mortar that will graft onto the rest of the hip filling the joint area.
Six months in a cast from my chest to my toes and the hip is fused. They also fused my left angle and now, based on the laws of physics, I would be able to weight bare on my left leg with out the aid of braces. The combination of the two fusions would lock my knee in place. Problem solve bring on the Levi’s.
What wasn’t taken into account then was how long it would be effective. Any builder, manufacturer, mechanic, etc will tell you that when you start screwing with structural integrity maintenance has to happen on a regular basis. Why do you think chunks of bridges are falling on cars in Montreal? Lack of maintenance. How do you maintained a fused hip? You don’t, you adapt and develop work arounds. And that will work for 35 maybe 40 years but eventually the structural damage affects other parts of your body now performing actions they were never designed to do. But I wanted those jeans and it was hard enough thinking two years ahead let alone 53.
Fifty-three years later the trade off for those tight jeans is the loss of a lot of confidence. When you are no longer guaranteed you can put on a sock in the morning because you can’t reach your foot your confidence starts to erode. You know your confidence is shaken when transferring into your car causes more trepidation than excitement. You begin to realize just how shaky your confidence is when you begin to count how many times you have missed your chair on that transfer from car to wheelchair.
You know confidence is shaken when you breath a sigh of relieve because you were able to get out of bed and get back into my wheelchair without landing on the floor. When something as basic as taking a shower is a stressful activity you know the confidence is weakening. Not having a wheelchair accessible bathroom start to take its toll on confidence and all of this for tight blue jean as a teenager.
It was a difficult decision and takes a big swipe at my pride but it is time I looked into assisted living. I can’t afford the high end stuff that the 20% live in but I will look into some of the subsidized centres around the Island. To continue pretending I’m as capable of total independence is sure to result with me in some outdated medical unit surrounded by older guys awaiting extended care placement due dementia. Not a fun room to be in.
So that little ripple caused by a torn toe nail is the beginning of a light tide washing over the system of service filters Island Health has in place to access various programs. Knowing how long many of these things take I have already called Island Health (three times over the past week) and left messages. I eventually did receive a call back and after a brief discussion with the women on the phone I may just be to independent to qualify for assisted living. How twisted is that? But she did agree to have a nurse assessor come out to see me. I’ll keep you informed…