I've been treating Superman this week. Well, a patient who may as well BE Superman for all the progress he's made with all the significant stuff that's happened to him.
He's a fairly young guy, in his 40s I think, and he's a Tree Person. I'm not sure what the official job title is. Basically he runs his own business and trims trees, or cuts them down etc. He's a pretty super strong guy., Very active and enjoys working out and hiking and cycling and doing crazy adventurous kind of stuff. Well, a tree fell on him. I'm not exactly sure how it happened, I'm not even sure he's exactly sure how it happened. All I know is the tree came down, somehow flipped him so he fell off his truck and then landed on his leg crushing his knee.
He literally CRUSHED his knee. Bone, arteries, joint... everything except the nerve. Which is lucky because an artery is a lot easier to put back together than a nerve, and with better results. So he needed surgery, obviously. He's got a huge external fixator in his leg. Basically instead of the screws and plates and pins being inside the leg to hold the bone together inside, they're screwed into the bones and then fixated OUTSIDE the leg for increased stability. They also needed to do what's called a fem-pop bypass. Basically what they do is bypass the arteries in the knee where the femoral and popliteal arteries meet. They graft on a harvested or artificial blood vessel to bypass the blockage, or in his case crushed and non-functioning area of artery so that blood flow can be maintained. So he's got a lot going on in his leg. It's locked straight with metal bars on the outside holding it together and he can't move it on his own for muscle weakness and also pain. So he needs a lot of help to get up. But really just for his leg He's made leaps and bounds in the ability to move everything else around the leg with just us moving and holding his leg for him. And the amount of pain I'm sure he's in.... I'd be screaming and yelling and crying and crazy and definitely NOT moving at all, but he's getting up and walking with me with a walker twice a day.
He's completely amazing. Strong, mobile, motivated, all those things. Unfortunately he can't go to rehab because his insurance doesn't cover it. So I've been training him and his wife to move around by themselves safely. His wife needed to learn how to move his leg, how to help him stand and sit, how to guard him while walking etc. It's actually a pretty involved process. He's supposed to have gone home today. I'm not working today so I don't know for sure if he went, but that was the plan.
I'm still amazed he was able to become mobile enough to get home. He's up and moving, walking, (well hopping really) getting around in a wheelchair and a walker and he's just completely amazing me every treatment. He's really going to bounce back from this without a huge problem. He's already leaps and bounds ahead of almost anyone else who this may have happened to. He is though understandably frustrated at the fact that he can't do a whole lot for himself, or do a whole lot at all. But he understands that this just takes time and given time and a couple of more surgeries and some intense Physical Therapy which I'm sure he will continue to be a model patient to the Nth degree, he's going to be back to normal.
Like I said, he's Superman. I just can't say it enough, I'm so proud of him and his motivation and all he's accomplished in a week, and I'm actually sorry to see him go home. I'm happy for him that he's getting out of the hospital, but at the same time, he was great to work with. Always pleasant and nice and willing, no matter what I asked of him. And I miss being able to follow through with a patient like I was able to in rehab. Ah well, I made him promise to come back and visit me and let me know how he's doing.
And that's my patient of the week. My multi-trauma, crushed leg Superman. It was a good week working with him. :) And definately more fun and interesting than Bilateral Total Knee Replacements. I hate those. They're SO hard to work with. But that's another story for another time.
Monday, January 30, 2006
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