12 May 2009

Cast away

Cast

Today was my day for a review. Last Monday, I slipt over at the service station, breaking my fall with my outstretched wrist. The next day I had it x-rayed, confirmed as a break (though not a major one), given a sling and a temporary cast, and told to return in a week.

The temporary cast was sturdy enough, but basically just a moulded plaster slab along the underside of my forearm, held on with tightly wrapped gauze. I had to keep it dry, and it allowed a certain limited amount of movement, which although I tried to keep it down, was painful.

After battling my way around the hospital this morning - such an amazing rabbit warren of a place - I filled out various forms and got my wrist x-rayed afresh. Again, I barely had time to sit down and read a page of the book I brought along, so smoothly and efficiently were things going on.

Doctor called me in, showd me the images, and explained that the break wasn't serious enough for surgery - they probably wouldn't be able to fix it any better than was going to happen anyway - and I was to be put in a solid cast for four weeks. No driving - I asked specifically - and I would have a greater susceptibility to arthritis as I got older.

Then they put me in the comfy chair, rested my elbow on a little rubber cushion, and a pretty young nurse cut away the old cast. "You could probably unwind the gauze," I pointed out.

"Quicker this way!" she said, snapping open a set of mean-looking shears. She chomped them through the material and my arm was exposed to view for the first time in a week.

"You might want to give it a wash now," nurse said, directing me to a nearby sink and indicating the controls for the water flow. Wave your hand in front of the sensor and the tap runs.

I gave it a quick wash and patted it dry with paper towels. Swelling had gone down, mostly, and when I looked close, there was a fading pastel yellow purple bruise. I had a better one on my backside - really spectacular - but happily no photographs of that ever got taken.

At this point my nurse was called away, and I got a good look at the bloke in the next chair, who had either had some bad compound fracture, or had been given internal fixation of some sort. There was a long wound in his forearm, sutured shut, and I figured I'd gotten off lightly, considering. I averted my gaze when his nurse unwrapped something really sharp and began unstitching him.

First step in my new cast was a sort of sticky white bubblewrap underlay, wrapped around my arm to layer the skin against the cast. Nurse took some care with this, and I admired her professionalism. This had to guard against chafing for a month, and she wrapped me up carefully, cutting out bits around my thumb to allow finger movement.

Then she stuck on two blue strips of heavier tape, one each side. I raised an eyebrow.

"When we cut off the cast, this will stop the saw giving you friction burns."

Right. Hadn't thought that far ahead.

"You've done this before, haven't you?"

She smiled.

"Can I take a picture?" I pulled out my iPhone when she nodded yes.

Undercast

"Good idea!" the bloke next to me said, and he whipt out his phone to capture his rather more gruesome forearm for family consumption.

"You've got a choice of colours," my nurse said, showing me several swatches. "Anything but white."

Two shades of blue, black, white, and a dark pink. I indicated the pink. "That's more my colour."

She smiled at that. "We've actually got white - I just won't let you have it!"

Then she drew on some purple rubber gloves, dipt a roll of the pink material in water, and carefully wrapped my arm up. Three layers, just slightly inside the white underlayer. I could feel the thing growing warm. Some chemical reaction, triggered by the water, turning the flexible material into rock.

"We've got maybe five minutes before it hardens, so there's only a small window," nurse said, deftly cutting away curves for my thumb, working quickly and efficiently.

She smoothed in a few curves around the palm, giving me a bit of finger movement, and the thing was done. She handed me a sheet with some tips for care, and a card for an appointment in four weeks time for removal.

And that was it. It had all been very quick, efficient and friendly. Smiles all round, and I was outside, waiting for a ride home, texting the cab owner to let him know I was out of action for a month.

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