Elbow Revolt

June 16, 2008

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Late last summer my left elbow all at once began aching when I dressed and undressed or opened and closed a door.  It groaned during light exercises, throbbed as I sat with bent arms poised over the computer keyboard, and wailed in the bleak hours of night.  You can no longer deny it’s a problem, I was told; go to the sports doctor; he’s been ministering to college football and minor league hockey players for a generation.

The white-robed doctor walked in, his face a startling red, and ten seconds into my explanation said, “I know what the problem is.  We’ll give you some cortisone and clear things up right away.”

Surprisingly, I didn’t ask for his diagnosis.  I just said: “Great.”

He stuck a big needle into the left elbow and readied to rush to his next patient.

“Excuse me,” I said.  “What should I change?”

“Don’t change anything.”

“What about light shadow boxing?  Seems like that might not be good.”
“It’s fine.”

“I must’ve done something to cause this.”

“Don’t worry.  I’m sixty-two years old and run long distance and hurt all the time.” he said, clapping my shoulder.

The following night my face lit up, brighter than the doctor’s, and a rash began invading my neck.  I tried to procrastinate but as facial heat escalated I eased into my car and drove to urgent care.

After checking in, I stripped to my shorts, donned a patient’s gown, and was hooked to a heart monitor by a nurse’s assistant.  A tall stern woman, who could be cast as Ichabod Crane, appeared and announced credentials I didn’t understand.

“I’m having a severe allergic reaction to cortisone.”

“Cortisone couldn’t have caused this,” she said, and issued a series of irritating questions.

“Look,” I said, dropping the gown, “The rash is spreading down my chest to my stomach.”

“It couldn’t have been cortisone.”

“Now it’s crawling up my legs.”

Several silent seconds later, I asked: “Are you a doctor?”

“Just a minute,” she frowned, and wheeled out of the room.

The next person in, a man with a stethoscope around his neck, projected the scholarship of a physician, and acknowledged that while it’s rare, some people are allergic to cortisone, assured me I wasn’t going to die, and scribbled the name of an over the counter medication for rashes.  The following day I called the nurse of the sports doctor and she said, “Yep, it can happen.”  No apology was offered.  Must be protocol.  The rashes worsened and I went to a dermatologist who opined that cortisone didn’t cause the problem then prescribed a cream that, over a few months, controlled the outbreak.

Meanwhile, my elbow had quit hurting and felt like the smooth pivot of an eighteen-year old.  It remained that way until about a month ago, when, I assume, the cortisone began dissipating.  I returned to the ruddy sports doctor.

“I recently went to a conference back East,” he announced, “and they said if the first cortisone shot doesn’t work then we should follow with an MRI.”

Alarmed that a specialist had only weeks before adopted this apparently basic sequence, I hastened to make an appointment.  Three days later I entered a cavernous imaging facility where one by one a brigade of healthy young women, clad in uniform print blouses and white pants, checked me in at the front desk, greeted me in the waiting room, processed me in another room, questioned me another place, and instructed me to take off my pants somewhere else.  If Magnetic Resonance Imaging didn’t require specialist referral and cost more than a thousand bucks, minus insurance payments, this would be a fine place to spend Friday afternoons.  But not as a patient.  Only under medical compulsion would I again enter an MRI tube.  I’d been suspicious.  By phone and in person they several times asked if I were claustrophobic.

“I don’t think so,” I said.  “I’ve never been enclosed.  Why?”

“Some people have problems, but not many.”

They told me the open MRI was more spacious.  I selected it and was impressed by an antique-white machine indisputably large and modernistic.  A motorized gurney-like device provided the horizontal rack for my body, and once equipped with ear plugs and stretched out in an appalling position somewhere between my stomach and side, the male technician – they use men for the rough stuff – pulled my arm straight out and put it elbow down in shackles, placed a bag of sand on top, locked the shackles, shoved a pillow under my head, said don’t move for twenty, thirty, forty minutes, and pushed a button that conveyed me like bread into an oven.

With my ears plugged the whirring and popping of the machine weren’t painful but I didn’t care.  In this impossible position I felt my arm could be torn from shoulder.  And my hand soon swelled about a quarter larger than normal.  Try to be still as possible, the technician ordered from behind his fort.  I complied.  Most other patients processed with me were in their seventies and eighties.  It would’ve been undignified to complain about aching body parts.  I tried anyway, whimpering how much longer is this going to last?  Knowing he hadn’t heard, I braced myself with my right hand and burrowed my face into the pillow.  Whenever the machine stopped whirring and popping I thought the technician was preparing to pull me out but the big tube was only idling, and the process proceeded and droned I don’t know how long.

Ultimately, I was retrieved, unshackled, and taken to a recovery room where new pain ceased in minutes and the technician handed me a CD of the imaging.  I delivered it to the nearby office of the sports doctor and set an appointment two weeks later.  Ten days early, my phone rang.  It was the secretary saying, “Doctor has to change his schedule.  Can you come in tomorrow?”

“Sure.”

“Let me check to make sure the radiologist sent his results.”

“Did he give a diagnosis?”

“Yes, here it is.”

“What is it?”

“I can’t tell you.”

“I’m anxious to find out.”

“Only Doctor can discuss this with you.”

Maybe they’d noted alarming images of my left elbow.  Couldn’t they have told me something?  I’m going to be tight till I know.  It’s not heart surgery, I tell myself.  Be stoic.  No, I don’t want to.  I want to feel good and pretend I’ll forever be healthy and vigorous.  I can’t let this be the first inexorable step toward invalidism.  Two bad elbows and I’d feel like an octogenarian.  If the knees went, I’d be helpless.  Maybe they can take care of what’s wrong.  Maybe I can be almost like I was.  But what if I can’t?

Into the office I stepped Thursday afternoon, examining the secretary’s eyes.  Was she trying to conceal knowledge of my condition?

“You can tell me now, if you want.”

“You’ll know in about fifteen minutes.”

In five an assistant led me into an empty room and said, “Very soon now.” I began reading about a female golfer who shortly after joining the tour had gained sixty pounds and strained her back.  Soaring scores threatened to relegate her to a mundane job, but she counterattacked with diet, exercise, and longer blond hair – like the once corpulent, crew-cut, and frowning Jack Nicklaus – and has transformed herself into a tournament-winning, model-like star who earns millions a year and acquires stylish homes, noteworthy art, and fine wines.  I was ready to drift into this world when the ruddy doctor, whose coloring I’m adjusting to, came in and said, “That elbow’s really screwed up.”

Wonderful.  I tried to remember the medical details but can only state a tendon is damaged and needs repair along with bone underneath and nerves in the neighborhood.

“Don’t worry.  It’s an outpatient procedure.  Surgery’s only fifteen minutes.  But we’ve got to put you out.”

“Only fifteen minutes?”

“Most guys need a half hour but I’ve done so many of these.”

“How long will I be in pain?”

“It takes about six months to feel right again.”

“How long for the bad pain?”

“Oh, only a couple of days.  You could have it done on a Friday and be back at work Monday.”

“Fine, let’s set it up for June twenty-seventh.”

George Thomas Clark

George Thomas Clark is the author of Hitler Here, a biographical novel published in India and the Czech Republic as well as the United States. His commentaries for GeorgeThomasClark.com are read in more than 50 countries a month.

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