Wednesday, February 20, 2013

Dual diagnoses.





Whelp. I broke down and saw Emory Sports Medicine today about my 'flicted ankle. Yes. One full week of rest and still moderately 'flicted.

Sigh.

Here's a glimpse into my visit. (I mean, in case you were really wondering exactly what happened when I saw Ortho today.)

Orthopod: "So what'd you do?"

Me:  "I've been training for a half marathon. Running a lot. Increasing my mileage."

Orthopod:  "Hmm. Okay. Did you roll your ankle?"

Me:  "Nope."

Orthopod:  "Okay. How many days per week were you running?"

Me: "Like five."

Orthopod:  "Five?"

Me:  "Errrr. . . . five-ish."

Me:  "I started having pain after running some hills. Then I rested it for a few days and ran again. It hurt worse. Then I rested it for almost a whole week. And I got some shmancy shoes."

Orthopod:  "Were you still having pain after that week?"

Me: "Un poquito."

Orthopod: "Un poquito?"

Me: "Un poqui-tito. Which is even smaller."

Orthopod:  "Umm. . . okay. So you ran."

Me:  "Yup."

Orthopod:  "And now you're here."

Me:  "Claro que si."

Orthopod:  "Do you speak Spanish?"

Me:  "In my dreams, I do. Fluently, actually."

Orthopod:  "Excuse me?"

Me:  "Uhh, nevermind. So my ankle. What do you think?"

Orthopod:  "Just point tenderness when you run or bear weight? Right here on the lateral malleolus?"

Me: "Regrettably."

Orthopod: "Excuse me?"

Me:  "Yes."

Orthopod:  "Okay."  Starts manipulating foot every which-a-way. Has me jump (ouch!) and walk and stand on my tippy-toes. Pushes on outer ankle bone once more.

Me:  "Owie."

Orthopod:  "Owie?"

Me:  "I mean, that hurts."

Orthopod:  "You mean when I do this?"  Pushes again.

Me:  "Dude."

Orthopod:  "Oh, I'm sorry."

Me:  "So what's the deal? Is it serious or am I just, like, 'flicted?"

Orthopod:  "What was that last thing you said?"

Me:  "I said 'flicted."

Orthopod:  "I'm not sure I'm familiar with that term."

Me:  "I think that, as an Orthopedic surgeon, you should familiarize yourself with that term. Because I'm sure you see lots of folks that are 'flicted."

Orthopod:  "Did you say. . . 'flicted?"

Me:  "Yep. As in AF-flicted. But never say the 'A' part. Just say 'flicted."

Orthopod:  (laughs.)

Me:  "It's when something used to work but doesn't now. It isn't limited to humans either. Cars, computers, all sorts of things can be 'flicted."

Orthopod:  "Got it."

Me:  "So am I just 'flicted?"

Orthopod:  "Hmmm. I'm thinking this is a dual diagnosis. Everything put together suggests something that isn't ligamentous. It seems most consistent with a stress fracture or a tibial stress syndrome. Those can lead to stress fractures."

Me:  "So why the dual diagnosis?"

Orthopod:  "Also -- how did you say it? Afflicted?"

Me:  (laughing out loud)  "No! It's 'flicted."

Orthopod:  "Okay. So that and a stress fracture."

Me:  "Dang. Well that sucks."

Orthopod:  "Not completely. You can still cross train and things like that. But no running for 4 - 6 weeks."

Me:  "So no running for 4 whole weeks?"

Orthopod:  "To six."

Me:  "What if I feel good at 4 weeks and I'm no longer 'flicted?"

Orthopod:  "Then you can try a gentle run."

Me:  "Okay."

Orthopod: "What's that word again?"

Me:  "'flicted."

Orthopod:  "'flicted! Yes, that's it."

Me:  "Best when paired with 'old.' As in 'old and 'flicted'. But I don't think there's an ICD-9 code for it, though."

Orthopod:  "ICD-9 code? Hold up -- are you . . . a physician?"

Me:  *coughing*

Orthopod:  "You're a doctor?"

Me:  "Uhh, me? Yeah. But, like, not an orthopod like you."

Orthopod:  "Ha ha. . . Let me guess--you must be an internist."

Me:  "Huh? Why do you say that?"

Orthopod:  "Because you guys are the main ones that always call us 'orthopods.'"

Me:  "Oh. My bad. But it's because the whole 'orthoPEdics/PAEdics' spelling is confusing."

Orthopod:  "That's funny."

Me:  "What's up with that random, fancy 'A' in OrthopAEdics anyway? What's that all about?"

Orthopod:  (now with hand on the door)  "Ha ha . . . that's the British spelling, I suppose."

Me:  "Uuhhh, okay."

Orthopod:  "Four weeks for follow up."

Me:  "Gotcha."

Later in the hallway as I was exiting.

Resident:  "HEY!!! Dr. Manning!!! I haven't seen you in forever!!"

Orthopod:  "You know her?"

Resident:  "Do I know Dr. Manning? She taught me in medical school AND she was my program director during my first year!"

Orthopod:  (looks at me with eyes raised.) "You're faculty?"

Me: "Claro que si."

Resident:  "It's so good to see you Dr. M!"

((hug))

Me:  "You, too.  . . .hey, did I ever teach you what 'flicted means?"

Resident:  "Hmm . . . 'flicted? I don't think so."

Me:  "Okay. Well ask your attending here. He knows all about it."

Flashed a big smile.

*ting*

And with that, I chucked them a deuce and hobbled on out. Still wearing my heels.

Mmmm hmmm.



See? Isn't my life super exciting? What's up with y'all?

***
Happy Wednesday.


26 comments:

  1. Praying for a speedy healing...even speedier than 4 weeks! Godspeed! ~Millicent

    ReplyDelete
  2. I believe you schooled the orthopod. :)
    Poor doc probably didn't know what he was dealing with. Thanks for the smile tonight and wow, a stress fracture, really? I'm hearing about a lot of those in young and oldish runners. What's up with that? Is is the shoes, calcium, repetition, or that we're not designed to run on asphalt and concrete?
    Anyway. Hope you're back in business soon.

    ReplyDelete
    Replies
    1. Girrrrrl, I hope so, too. I'm sure that guy is having dinner with his wife telling her about this crazy lady he met today that happens to be -- wait for it -- faculty. Ha!

      Delete
    2. LOL,that would be "FACULTY"!

      Delete
    3. oh my, I was logged on as my daughter, oops!

      Delete
  3. Hahahaha what an experience you had. Well today I had to sit in lectures all about orthopedics and gait. Oh what a time; and we are currently learning PM&R maneuvers, all of which are pretty interesting.

    4-6 weeks will go by before you know it and you'll be back to training. Good luck and happy healing!

    ReplyDelete
  4. What's up with me? Nada, chica.
    Seriously, I'm glad you got a diagnosis that doesn't require surgery or anything gnarly. I know, I know- you want to get out there and run but in the scheme of things, a month off isn't the worst thing that could happen.

    ReplyDelete
    Replies
    1. I know. That's what I've been telling myself. The doctor told me that it would be much worse if I had a bad ligament tear or something. These usually improve with rest for a month or so. Thank goodness!

      Delete
  5. Mmm...let me see. I went to see cardiologist #3 this morning. I'm set up for a bunch more tests. Fun city! Got back to the office in time to be 15 minutes late to the the webinar. The webinar ran overtime so I was late to the manditory meeting that followed. That meeting got out just in time to see the cafeteria close the lunch line...sigh...good times.

    So if you were in Midtown and the orthopod's last name began with G, I know just who you are talking about. When my son explained that he tore his meniscus by trying to do a hand stand while wearing a Chuck-E-Cheese costume, he asked who Chuck-E-Cheese was. Guy seriously has no life. But he is an excellent orthopod. When my son tore the other one up playing soccer, we headed straight back to him.

    Feel better soon.

    ReplyDelete
    Replies
    1. Wow, sounds like you had some good times indeed!

      Nope, not the orthopod you speak of, but I'd probably not admit it if it were. But it wasn't. ;) Glad your son got good care by an Emory physician. Keeps us all in business so I try to support our own.

      Delete
  6. Now, be honest...don't you feel a little guilty talking to an orthopod that way? It's getting into a battle of wits with someone who's utterly unarmed. When talking to orthopods, you have to channel your inner caveman: "Ugh. Ankle hurt. Very sad. Grog fix? No hammers!"

    (Kidding...mostly. But not entirely.)

    ReplyDelete
    Replies
    1. Awww dang, PJ! That's cold blooded! Ha ha ha!

      Seriously, though, this guy was on his game other than being confused by my random Spanglish. And as for Ortho people, I always tell myself that their board scores were an average of 50 points higher than me or any of my friends so I give them mad props for that. ;)

      Delete
  7. I knew you were "setting up" this poor doc when you started speaking spanish, LOL!! Poor fella, ROTFL!!! NOT!

    ReplyDelete
  8. And get well soon! I had to wear tennis shoes which I HATE, for 6 STRAIGHT months because I was being hard headed after a foot injury!

    ReplyDelete
    Replies
    1. Oooooh, glad I didn't have that. I'm still in my heels thank goodness!

      Delete
  9. As a physician who had "the worst ankle sprain" my lady orthopedic had ever seen, I had to endure 6 weeks of crutches and air cast. I "borrowed" a walker one weekend when visiting my dad at his nursing home. Nothing cuter than having one of the residents tell me, "You look like one of us now." Lol

    I just finished PT last week and am headed to Disney World with 26,000 other Princesses for my first half marathon, with my physical therapist's blessing! If I can do a half, anybody can!

    Can't believe you left without an X-ray. I was sprayed before I even saw the MD!

    Rest for 4 weeks, at least!

    ReplyDelete
    Replies
    1. He wanted to do an MRI since plain films often miss small stress fractures. I asked him (being the nerdy internist I am) "How will this change the management?" And he said, "It won't. Either way it's no running for 4 - 6 weeks to rest it and let it heal. Stress syndromes need rest, too." So this is how I ended up not getting imaged. The main thing I needed was for someone to ix-nay my running for a few weeks in an official capacity. We nerdy internists are minimalists when it comes to imaging. I want an image if and only if it will change the next step in management. He was super surprised that I didn't push the issue!

      Have a great race! I hear that half is totally amazing. My friend Jen did it last year. Enjoy, Princess!

      Delete
  10. Hahahahahah-I love that you were schooling ortho on myriad levels ! Now-follow his orders and allow that tibia to heal! I know how we as physicians can be -ahem-misguided in self assessment of ability to work through being 'flicted.

    Maria, fellow Meharrian

    ReplyDelete
  11. Gal this is/you are high-larious y muy divertido. =o))) Do take him seriously and rest that leg, though. x0 N2

    ReplyDelete
  12. I love that I know exactly which orthopod you saw. I can totally see this happening. I can't believe you spoke spanish to him...haha.

    ReplyDelete
  13. So funny that he didn't know you were faculty until the end. I can match your pouting face with my own, since I have to have an MRI on my dominant arm's elbow this coming Thursday and it's 90% out of commission at the moment. 'flicted.

    ReplyDelete

"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan

Related Posts with Thumbnails