Tuesday, November 8, 2011

It’s Just Never Easy

Ten days now since our fall at Moab. So here's the update on how everybody's doing.

Hoss looks pretty good. He still has a tiny bit of swelling around his left fetlock and pastern. I palpate him every day, but so far he's just annoyed that I keep fussing. He gives me no pain response at all. There's no heat and the swelling feels mushy for want of a better word. I'm beginning to suspect there's something going on with his foot. Again, no heat, but the swelling is of the variety that would make me suspect an abscess or other hoof injury. I haven't done anything about digging into his feet, because my hip hurts an awful lot.

After nine days and I wasn't any less crippled, I decided I'd better get checked out. I called my doctor's office and was told she couldn't see me for three weeks! I didn't think that was quite soon enough. This is more than a little frustrating. How long in advance to I need to know I'll have a problem in order to get in? She does have a triage procedure which I have used in the past. It's a little hit-or-miss. Without being physically seen, the nurse has to go by my description of my symptoms. If I miss something or I'm wrong, well, I get the wrong treatment. More than once I've gotten the wrong diagnosis based on the phone interview thing.

Based on the realization that either way I'd be driving into town for xrays at the least, I decided to forgo the triage process and went to Balboa hospital instead. I'd considered hitting an urgent care closer by, but realized the hospital was a better choice. The urgent care doesn't have an xray machine, so I'd have to be referred to another facility. It would likely result in me driving all over the place to get a diagnosis. At least at the hospital, it's one-stop "shopping," as it were. Any diagnostics could be done right on site.

Mondays are evidently a rather busy day for the emergency room at Naval Medical Center San Diego. There were so many patients a woman who was sent in by her doctor after discovering a dangerously high blood sugar level had to sit in the waiting room. There simply was no place for her in the back. They drew blood on her and plopped her back in the waiting room.

I knew I'd be "fast-tracked." Balboa used to have an urgent care, but due to remodeling, it's not in operation. Now everybody goes to the ER, and anybody who should be in urgent care is sent to fast track. Obviously I wasn't in any immediate danger. I was in the ER waiting room for a few hours before a bed opened up in fast track and I was called over there.

The student Physician's Assistant came in and did the exam and background. Her first comment was "So you got kicked by a horse." Um, no, not kicked. My horse did not kick me. He was slipping. He had no control. He slid right into me. I told the PA I wanted it officially noted the horse did nothing wrong. I'm beginning to feel the statistics about horse-related injuries are skewed because ER personnel don't get what the patients are telling them. I mean, someone looking at the report for my injury would assume Hoss had kicked me!

Once I got the whole kicked/fell thing straightened out, the PA decided based on my description to get xrays taken of my hip. There was a bit of a wait, but I had a book with me so it wasn't bad. Getting the xrays taken was not fun. First the tech had me put my toes together with my heels apart. Wow, that was uncomfortable. Worse was when he had me bend my knee and drop it to the outside. Holy crap that hurt!

Back over at fast track I lay down and waited for the results. It seemed like a long time passed before the young PA came in. What she told me was more than a little frightening. She told me they saw what looked like an avulsion fracture in my hip.

I know what an avulsion fracture is, so this was not good news. An avulsion fracture occurs when the attachment of a ligament or tendon to the bone pulls part of the bone away. This type of fracture can be significant and require surgery. From her description, I knew it wasn't of the surgery variety. Still, it would take a long time to heal and involved soft tissue damage, which just takes even longer to heal. They were waiting on the radiologist to confirm the diagnosis.

I spent a rather tense time waiting for the final word. Ultimately the radiologist determined what they had seen was calcification in my hip joint. My right hip has been a problem for a very long time, so it doesn't surprise me they're seeing arthritic changes. I did get the chance to see the xrays myself. I do have some experience reading xrays, even if it has been horse films. To my eye it could go either way. I wouldn't be at all surprised if it was misdiagnosed and I do have a fracture. Fortunately if it is misdiagnosed the fracture is mild enough as to make no difference in treatment.

The last couple of days Hoss has been giving indication that he's getting rather bored with the standing around and doing nothing. He has figured out how to remove the T-post caps on his pasture fence. He had the fence down enough he could have left, but was standing quietly in his pasture. I think he was expressing his desire to get out. I'll probably start taking him along on morning walks just to break up the monotony.

As to the remainder of our ride season, I'm not hopeful. At this point I am leaning heavily toward not going to Arizona for Lead, Follow, or Get Out of My Way on the 19th. My pain level at this point is simply too daunting to make me feel comfortable with committing to another ride. I'm thinking our ride season is over. I have two more days to make a final decision, so while I'm pretty sure we're done for the season, I'm leaving the door cracked for the possibility.

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