Skin, checked: all clear

The month of March was "Melanoma March" in some circles; the month to raise awareness about skin cancer and melanoma. I was involved in producing a filmed interview of a woman who had survived stage 4 melanoma and hearing her story gave me just the nudge I needed to speak to my GP about a skin check.

I'd never had a skin check, despite having reasonably fair skin and growing up in the sun. I'm now very aware and careful of the sun and wear sunscreen daily. I'd watched family members deal with various kinds of skin cancers (not melanoma) and still had not done anything.

I'm not a very "moley" person. I don't have that many, but I'd noticed a couple of new ones lately and also had one on my arm that was small, but it was raised; I could feel it when I ran my finger over that part of my arm.

My GP checked and said that she thought they were okay but referred me to a dermatologist for a more thorough check. Her concern about the moles was that they were new. I learnt that new moles after the age of about 30 need to be watched. Then she asked me what the bump on the side of my nose was.

"I don't know. Just a bump. Isn't it from wearing glasses?"

She looked at me like I had an IQ of 25 and said she wanted to take a sample. I then had the choice of just watching the other two and making a decision later, or having them off all together now. I opted to get rid of them.

The worst part of the procedures was the injection of the local anaesthetic - especially the one at the top of my nose, right near my eye.

The dressing was worse than the biopsy.
© 2014 divacultura

"I don't know how doctors can do injections like that," I said, trying to make conversation to distract from the horrible sting and pain I was feeling.

"I don't know how you write scripts and produce films," she replied.

Fair enough. Good answer! It didn't make the pain go away.

About 8 minutes later I had a big dressing on the side of my nose and waterproof dressings on my arm. The samples were housed in their own separate jar of liquid and looked innocuous.

Today I received the official letter telling me everything about these three specks of skin. It contains words like "ectactic", "fibroblasts", "dysplastic" and "lentiginous".  The word "malignancy" appeared several times. Thankfully it was preceded by "no evidence of". I couldn't quite relax until I saw the stamp added by my dermatologist. It said "NO SKIN CANCER, RESULT CHECKED BY DR (My Dermatologist).

Thank goodness for that little rubber stamp.

I'm pleased that I took action. I'd rather have things cut off and samples be taken and discover that everything was okay, than do nothing and then later discover a melanoma or other nasty.

Have you had a skin check? Do you wear sunscreen?

Power dynamics and patient feedback

This morning I was working with one of the health sciences schools at a Melbourne university. I happened to be working with the same student I had a couple of weeks ago when my character was one day post-operative. I remembered the student, but I think he became confused as he wondered whether he was supposed to remember me (even though I was playing the same character). Sometimes what happens within a simulation takes on a life of its own.

The student who was working with me was professionally polite, but a little cold and formal. He needed to relax a little to build better rapport with my character who was gung-ho and very motivated to get on with her rehabilitation. In the feedback afterwards, I gave him a quick refresher on rapport building and he looked like he'd heard it all before.

The main thing I talked to him about though, was quite personal and is an example of why feedback from simulated patients is so powerful. The student had a cold and was sniffling and fighting nasal congestion throughout our consultation. On several occasions he apologised for his cold, which I noted as a sign that he was aware of what I might be noticing. Great. What wasn't so great was when he wiped his nose with his hand and then moved in to touch me as part of my treatment. I considered saying something during the consultation, but it didn't really fit with my character, so I suffered through the hand-to-nose-to-knee sequence several times, silently giving thanks that he wasn't my dentist.

When I gave the feedback he looked shocked and was very apologetic. He told me he wasn't aware that he'd been doing that. I know that hand hygiene receives heavy attention throughout health education and continues into the workplace, so I was surprised to see this behaviour. I suppose it highlights why there are signs everywhere with instructions about how to wash your hands or use hand sanitiser properly. (Don't forget to do the back of the hands too!)

I know that it would be rare for a real patient to tell their allied health professional to wash their hands after they wiped their nose. This is because of the power dynamics and powerful protocols in play, as we align to playing our designated roles.

How's your hand hygiene? Would you stop someone from treating you if they had wiped their nose just before touching you? 

Rural health care - or the mysterious tale of the spider bite

Last week I experienced what it's like to go to a GP in a rural town. A large red swelling had appeared on my right leg On New Year's Day. It was hot and had a hard centre. It was painful to walk and seemed to be growing larger by the hour. I tried a few remedies over the course of the day but when I awoke the next day to a bigger, redder, angrier swelling, I decided that I needed to see a doctor.

Firstly, I discovered that one must call in the morning to make an appointment for that day. It is not possible to book ahead. Therefore, making an appointment is like trying to win a competition on a radio station - you just have to keep hitting redial until you succeed in getting through. By the time we spoke to one of the receptionists, only late afternoon appointments were available. In the time taken to give my first name, the slot we thought we were booking for had been snapped up and I was in to see a different doctor at 3:45pm.

I arrived a few minutes early to complete paperwork. It was very hot, so I asked the receptionist where I could refill my water bottle.

She looked at me, puzzled.

"Where can I refill my water bottle?" I repeated.

"We don't do that here," came her mean reply.

"Wow. Really?" was the best that I could do.

I took a seat in the expansive waiting room. I took in the meagre pile of sticky magazines, children's toys spread all over the floor, the blaring television and the miserable looking people and imagined the difference a supply of cool water would make.

Before long a very large man came and sat right beside me. There were so many seats and available places to sit, but he sat right beside me and proceeded to sneeze and cough. I moved. I didn't want to leave the doctor sicker than when I went in!

I  was called in to see the doctor only ten minutes after my appointed time. He took me through and immediately took a past medical history. He didn't say hello and he didn't introduce himself. He asked a lot of questions about my past medical history that had nothing to do with my current problem. It was probably about ten minutes before he stopped typing on the computer, turned to face me and asked what my problem was today! I was appalled. (I know that all my work teaching doctors about empathy and communication probably makes me a tough audience, but really, this was sub-standard.)

I showed him my leg. The expression on his face changed (shock? distaste? fascination?) and he donned some gloves. He pressed and touched and then declared that I had been bitten by a spider. He asked me if I wanted some antibiotics to treat the secondary infection that had resulted and suggested that I take some antihistamines. I reminded him that I take antihistamines daily.

Seconds later I was out the door with a prescription for an antibiotic in my hand and a bill for $70.

By contrast, when I collected my prescription from the pharmacy, the pharmacist wanted to confirm that the tablets were for a skin infection. I showed her the bite. She nodded vigourously and said that she'd seen about five others just like this.

I've been sleeping with an icepack to take the heat out and the antibiotics have reduced the swelling and the red ring of poison. I now have a hard, dark, sore lump on my leg.

It's unlikely to be a Red Back Spider that bit me (I'd be really sick). The consensus is that it's probably a White Tail spider that feasted on me. Avoid this if you can!

Have you ever been bitten by a spider? What's the worst thing you've ever been bitten by? Did you bite it back?

Being a patient - for real this time.

This time last week I was recovering from general anaesthetic. Hence my absence from writing. Beforehand I was a little anxious and just didn't have the headspace to write.  Afterwards, I was recovering, sleeping and thinking and just needed space.

Thanks for bearing with me.  Thanks also for the love and support sent my way at this time.

While I'm very experienced in being a patient interacting with the health care system, I'm not usually sick. Everything feels completely different when you're confronting surgery. From the moment of walking in the front door of the hospital (if you're lucky enough to be able to walk in), doing paperwork and making payments, to following instructions and having observations taken, the power relationship shifts. Suddenly I went from being an independent woman who acts on my own behalf and decides whether or not to follow rules and obey instructions, to being completely passive and following all instructions without question or comment.

Luckily I had a solid and trusted person with me who helped me keep perspective and stop me from worrying myself into a puddle on the floor.

Waking from a general anaesthetic is surreal.  One minute you're listening to the friendly and soothing chat from the anaesthetist as whatever marvellous stuff he has given you starts to loosen your hold on consciousness; you're noticing a mask being placed over your face.  Next thing you're hearing your name, you're somewhere else and you're in pain.

Pain was attended to swiftly and with gentle concern. Even as I shook uncontrollably for what seemed like ages, I was aware of the care and attention I was receiving. When the shaking didn't stop, I started to become distressed and tears started to flow. It seemed like a biological reaction which I was observing from afar. Unpleasant. It took a long time to make it out of the first stage of recovery. I kept falling asleep and my oxygen saturation was low. An alarm kept sounding and I was being reminded to breathe. I would and the alarm would stop.

I was relieved to be moved to another area and see my friend arrive. God knows what we talked about. I can't really remember. I hope I wasn't rude and didn't reveal any secrets.  A different nurse took over. She  didn't introduce herself and I felt she was very matter of fact and not very empathetic. My friend said she was doing a fine job from his perspective and I should appreciate that. I did. I've spent so much time thinking about and teaching empathy to health care professionals that I really notice when it's not there.

We arrived home after 8pm and my friends changed shift. My friend who stayed the night had a quiet night of it. The next morning I thanked her for staying and apologised for there being no middle-of-the-night emergency. We both have an appreciation for drama and she said she was a little bit let down she hadn't been required to play the scene requiring her to drive me somewhere, in my car. The kicker is that it would have been her first driving practice in about 20 years.

We both understood that we were joking.

On Friday, I had a half day of simulated patient work. I was back in a hospital gown and lying on a trolley. While the case was very different from my own circumstances, I felt that my recent surgical experience was adding to my authenticity in the role. Several students checked to see whether I would be okay as they finished their exam station. (Now that's empathy!)

Monday, I was back in shapeless blue piece of material, hopefully (ironically?) referred to as a "gown" as I went to have an MRI on my knee. (This is the one I fell on back in August.) The procedure was straightforward and painless and required me to follow one simple instruction: lie perfectly still.  Suddenly, this was an impossible task. My right arm was at a funny angle. Could I move it? Only it? Surely if I just shifted it a little, it wouldn't move my right knee?  Would it? I can't breathe! Oh, yes I can, but am I moving too much when I breathe? Or maybe I'm not breathing enough? Is that why my left big toe is suddenly incredibly ITCHY? I've got pins and needles in my left hand! Just lie still! Just lie still! Only 17 more minutes to go. I hear the machine go quiet. The technician reads my mind and just as I think I can move, her voice instructs me through the headphones to "keep lying still...only five more minutes to go...you're doing really well!" Look how much my chest moves when I breathe! How deeply can I breathe without moving my whole body? Wow, suddenly I'm aware of my earlobes...

And so it went for the whole 20 minutes.

I was told I'd been very still and given a well done as I carried my basket of clothes back to a cubicle to extricate myself from what I hope will be the last gown I'll wear for real for a while.

Quitting sugar - FAQ

Yesterday's post about the impact of a year without sugar raised some questions amongst readers.  I'm happy to answer them all.

Lots of people wanted to know about the affect, apart from the lab results.  I've dropped a dress size.  I don't have cravings. My appetite is more stable. I eat less. My skin is clear.

I've really noticed the 3pm sugar run that people in the office have. There's a line to the biscuit tin, the chocolate box and the lolly jar. It's so great to be free from that kind of slavery.

The other question I received was about whether I eat fruit. The answer is: "rarely". I now eat fruit when I'm at an event and the only other food on offer is sugar laden cakes and biscuits. I will also choose the fruit carefully and pick high fibre or berries, ie avoid watermelon and dates and choose the pineapple, pear (skin on) or banana. I never have juice. Juicing the fruit turns it into almost pure fructose when the the fibre is removed. I also avoid dried fruit because the fructose becomes concentrated.

Some of you also wanted to know about my porridge. Breakfast was actually the meal that I had to change the most.  I used to be a yoghurt, fruit and muesli girl. That had to go. I discovered Vita Brits, just with milk. As my palate adjusted I discovered a natural sweetness in many foods that I would not have previously identified as being sweet. Porridge is my new favourite breakfast during the week. Oats are also recommended for lowering cholesterol. I buy rolled spelt and mix it with rolled oats, cook it on the stove top with some added chia seeds and then serve with milk and a sprinkle of seeds and cinnamon. You can sprinkle the chia seeds on top instead of cooking them in if you prefer. This is a long way from brown sugar and maple syrup that I used to love.

If the supermarket has other rolled grains available I buy them and mix them in too.  I cook two thirds of a cup of grains with twice the amount of water and find the stirring at the stove with my myrtle spurtle a quiet moment of morning meditation. This keeps me going until lunchtime. Ground cinnamon is an easy ingredient to sprinkle over if you need a little sweetening. With time, I've discovered that there is a natural sweetness in the oats and it's not needed. I haven't gone down the Scottish path of adding salt.

Anything else you'd like to know? Just ask me.  Thanks for your interest.

Quitting sugar - it paid off!

It's been almost a year since I quit sugar.  I did it at the suggestion of my doctor when my blood results showed an elevation in liver enzymes and cholesterol going in the wrong direction.  That day, I read Sarah Wilson's I Quit Sugar and I started immediately.  I viewed food with sugar as not being food.

So today, I want to tell you a good news story.  I received my latest blood results today and I can tell you that I've never been so excited.

Those liver enzyme markers were back to normal.  All the cholesterol and fat markers are back where they should be. Everything is looking great!

Here's the interesting thing - all I have done is cut out sugar (fructose).  I eat a balanced diet but you should know: I eat cheese; I use butter; I eat red meat, sometimes with the fat on. I eat the skin on chicken. I do not eat fructose. I also eat multi grain porridge (oats, spelt, barley etc) sprinkled with chia seeds.

This is what all the books say will happen.  The science around fructose is that the body processes it into fat through the liver and causes issues with cholesterol, appetite regulation and so on.

I was a bit nervous as I waited for my doctor to explain the results.  I really hoped that the early struggle and now my mindset had paid off with positive health results.  It did!

What's your view on sugar? When my doctor asked me that a year ago my answer was, "I love it!"

My favourite gig OR why I was being paid to lie in bed and wear pyjamas.

"I can't believe that you don't have a brain injury!" Ordinarily these words might be an insult or cause for concern; today they were the best compliment I received all day. Today I was being a simulated patient in a ward with three others and a mannequin.

The patient had fallen off a ladder and now had a brain injury. Such a simple thing and suddenly this woman is confronting a completely changed life. Her walking, eating and cognitive function is affected. After my recent mishaps (the bag falling on my head and my knee injury) I have new perspective on the fragility of being okay and fully functioning in the world.

Be careful on ladders!

This week I've been working with different groups of students across the full spectrum of healthcare. Saturday and Sunday was the gynaecologists and obstetricians; Monday and Tuesday it was mental health nursing; Wednesday I was working with orthoptics students; today was nursing, physiotherapy, occupational therapy, social work, nursing and medicine and tomorrow, international medical graduates. It's such a privilege working with these students as they develop their skills and identity within their chosen field. Mostly they are excellent - really interested in people and ready to help; occasionally I notice that they've already lost their empathy.  I think it's because they focus on skills and knowledge and forget there's a person at the centre of it.

Yesterday was the first time I've worked with orthoptists. They come with a lot of equipment and have spent their time practising their technical and clinical skills on each other.  I noticed that many of them didn't explain what they were going to do before they approached the simulated patient. They would just lean over and peel the simulated patient's eyelids back and wonder why there was  a reaction. The were great with equipment and not so great with the people. I asked if any of them had ever suffered the complaint that the simulated patient had (double vision).  None of them had. I asked if they had considered what it would be like to have double vision. None of them had. I asked them who drove to university that day. Sadly most of them had. I asked them how they would have made their way to university if they had double vision. They started to think about life from the patient's perspective. Here was the "ah-ha" moment.

A few of the nursing students today had already developed what I call "nurse tone". There's a particular brand of condescension - talking overly loudly, slowly and using terms like "we" when they mean "you". I really hate that.

Working as a simulated patient has made me a better real patient. Talking to my GP the other day about a referral to a specialist, she asked me what kind of doctor I wanted. "A good one" was my response. She asked me if I was okay with someone who is very direct. Initially I said yes, but then I pictured myself in conversation about my particular issue with a very direct person. I realised exactly what I wanted AND what I didn't want: "I want to be a person, not a [insert body part here]." My GP selected a different doctor for referral.

I'm not sure I would have had the awareness of being a body part, or an illness before working as a simulated patient.  Many times I turn up to play a role and am not referred to by my own name, let alone my character's name.  Instead we gather to cries of "Lungs in here!", "Cancer in room three!" and "Depression follow me to the basement!". So the rot has started to set in as administrators and educators strip the person from the situation and turn us all into cases.

I push back, not moving until I'm referred to by one of my names. I correct people who say they've been happy to "use me" as a simulated patient, suggesting instead, it's a been a pleasure to work with them.

It's wonderful that health care education now gives students the opportunity to work with simulated patients as a proxy for real patients.

Spending the afternoon lying in bed, wearing pyjamas and talking to enthusiastic young people is a gig I love!

My favourite things - this week

1. You may remember meeting Rose Wintergreen right here on divacultura.  Rose crowd-funded her album and I was very happy, willing and privileged to be able to contribute.  My favourite moment of week was reading about the release of her single, Feet in the Sand. You can read more and listen over on her blog.  What do you think?  I LOVE it!  If you like it too, pass it on!

2. This morning I set aside time to write a first draft of a book chapter that I'm collaborating with several other people on.  I'd had a few false starts in actually putting words down, but the ideas had been whirling around in my head for a while. I knew it was just a case of having a block of time and no distractions.  I put Bach's cello suites played by Yo-Yo Ma on the stereo and pretty soon I had exceeded the word requirement. I know that it's a first draft and now the task of editing and blending with my collaborators has to occur, but it is always thrilling to see ideas come to life on the screen/page. There's the additional excitement of discovering new insights as fresh connections are made.

3. I managed to get tickets for Sunday's AFL final match between my team, Richmond, and Carlton. Technically my friend got the tickets and they came with the news that we would need to hire a sherpa, take oxygen and leave now to get to our seats at the Melbourne Cricket Ground in time to watch the match.  I don't care!  I'm so excited.  Richmond hasn't played in the finals since 2001 and I've never been to a finals match at the MCG.  I figure you just have to do it!  As a consequence of actually going to the footy, I have had to put a hold on my lack of love for the colour yellow.  Richmond's colours are yellow and black and I just can't go without sporting my team colours.  I managed to snag the last ball of yarn in the perfect shade of yellow and figure I can knit a yellow and black beanie in time for Sunday's match.

4. My physio's declaration that it is possible for my knee to fully recover was definitely a good moment..  This made me very happy after struggling to zip my boots this morning.  (The angles were all wrong.)  Apparently my PCL (posterior cruciate ligament) has been stretched so far that it hasn't sprung back.  It's like an elastic band that has stretched too far.  Despite this, my physio is confident that with exercise and treatment it will regain its elasticity.  (My physio contributed another favourite moment when we were discussing the soreness in my left arm which had probably resulted from the fall that injured my knee.  The muscle I've hurt is called the "supraspinatus".  I heard her tell me I'd hurt my "super bananas". I felt lucky.  Imagine if it was my ordinary bananas!)

5.Waiting on platform 9 at Flinders Street Station today, I watched people on platform 10 running for the train.  Human beings move in some mysterious way:. the squat woman, struggling with several bags, her body engaged in multi-directional undulation; the neat Asian man wearing a backpack shuffling, Cliff Young style - not very fast but certainly tidy;  the confidence of the long-legged lunge of a besuited, bespectacled, bebearded man;  the weirdly stiff-legged gait of the man in too-skinny jeans; the small pointless steps of the woman in stilettos running for her life to catch that train; the hopeful striving of the wannabe medalist, slowing and slumping as hope fades that he can make it before the doors shut.

What was your favourite thing this week?

The road to recovery

The knee injury is healing slowly.  There's only pain if I try to bend too far, twist or roll over in bed.  Putting a shoe on my right foot is becoming less of a production too.  It will be one week since I fell over and I'm at about 85% capacity.

Every night as I watch the television news I look at the footballers and the injuries they sustain and wonder how on earth they can go back on and play with torn and broken bits.  Firstly I do know that I do not have the same level of fitness as an elite athlete so my recovery will take longer, but even considering that, bodies work in generally the same way.

My issue with walking properly is not really pain, but a lack of ability to fully bend and extend my leg.  As the physio said yesterday, it's like a rusty hinge which has to be worked and worked and worked until the rust is gone and the hinge moves freely.  As a result of my altered gait, I now have a sore lower back and hip on the other side.  It's actually more painful than the knee.

Physiotherapists are miracle workers.  I always approach them with trepidation.  I know that they are probably going to cause me pain but that I will be much improved the next day.  It must be a hard job to do where you know that you will be causing someone pain but that it needs to happen if they are to feel better.

I've recently discovered the television program "Embarrassing Bodies".  After previously writing it off as voyeurism I stumbled upon it a couple of weeks ago and found it to be informative and interesting.  Last night one of the segments featured a baby girl born with talipes (club foot).  The baby was being treated with plasters and boots to straighten the foot.  In between plasters, which were applied weekly, a physiotherapist worked on her tiny foot.  The physiotherapist looked gentle and kind and seemed to be handling the baby's foot carefully.  The baby was screaming and the mother was crying.  The physio continued her work and then reassured the mother that she wasn't hurting the baby and explained exactly what she was doing.  It turned out that the baby was hungry, but it was intense watching this scene and I wondered at the focus and commitment to healing that a physiotherapist needs to have in order to help their patient.

Yesterday's visit was my first encounter with this particular physiotherapist.  From my point of view, the first visit is all about trust and rapport.  Am I confident that they'll work with me?  Do I trust that they won't hurt me?  Are they listening to me?  I'm happy to say that the answer to all of these questions was "yes".

The rusty hinge is squeaking away and the initial treatment made a world of difference.  I'm heading back tomorrow and expect that I'll be nearly right as long as I keep up my exercises and take  my own share of responsibility.   Perhaps this is the key to athletes' recovery - physiotherapists and doctors on tap from the moment of injury.  I hope it's that and not "performance enhancing" drugs.

My performance in the Global Corporate Challenge has taken a severe hit too. My daily average steps has now slipped below 9000 steps per day and I'm annoyed that I can't be active.  It's been interesting to notice the steady increase in daily activity as the days since injury.  I was barely reaching 1000 steps per day over the weekend and yesterday almost made 6000.  Can't wait to crack 10000 again.  No performance enhancing drugs for me!

How are you going?

Spectacular trip and I'm off to hospital

Regular interaction with the health system is a feature of my working life, but usually I'm a simulated patient, rather than a real one.  Today I experienced the emergency department of one of Melbourne's main hospitals from the perspective of a real patient.

Following my usual routine, I had enjoyed the walk from Flinders Street station to the office South Melbourne.  There's something refreshing about a brisk walk in the cold air.  I arrived at the office just after 9am and entered the foyer.  I took one step, felt my left ankle slip, I corrected and over-balanced the other way, landing on my right knee as I went for a spectacular slide on the ground.  I lay on my face for a moment (elegant!), gathered myself together and sat up.  Several people walked past and then a woman stopped to help me up and ask if I was okay.  It was then a few steps into the office.  I sat in reception, burst into tears and announced that I had just had a fall.  

An icepack was brought immediately and a team of people sprang into action.  I had been able to walk, but bending the knee was causing a nasty twinge at the back/side.  I peeled back my leggings and discovered a nasty bruise and some swelling.  We quickly decided that I should head to an emergency department for xrays and assessment.

I arrived with a work colleague at 10:10am and could immediately see that it was busy.  My colleague joined the queue for me while I sat and waited for the three people ahead of her to be seen by the triage nurse.  She was lovely but had an unusual definition of pace and urgency.  I was thankful that I had someone with me and that I wasn't really, really sick or injured.  Several people in the queue looked terrible and there was no one to go to for help except the slow moving triage nurse.  

After about 30 minutes I made the front of the queue.  I gave my name, date of birth, address and gave a description of what had happened and a rating for the pain.  I was directed to take a seat and wait to be called by the administration clerk.  After a further fifteen minutes, I was seated in front of the administration clerk and asked exactly the same questions again as well as details of my Medicare card and employer.  These two people were sitting a metre from each other and using computers, so it seems incredible that my information hadn't been passed on.  Several times when I was trying to respond to questions, the administration clerk turned to talk to other people or answer the phone.  

Soon a very friendly physiotherapist came to see me.  She did a quick examination and then took me for an xray which was done quickly and I was back on a bed.  It was good news: nothing broken or torn, but some local bruising, likely deep bone bruising and soreness.  I discovered that one part of my knee is very sore to touch normally.  I nearly jumped out of my skin when she pressed somewhere that I hadn't realised was sore.  When she checked the other knee in the same spot I had the same reaction.  Apparently I just have sensitive knees.

Two hours and ten minutes later I was in a taxi on my way home, wearing a sexy compression bandage with a list of instructions for regular application of an ice pack.  

When I came back to the waiting area, there were more people and people who had been there before me were still waiting.  None of them looked happy or comfortable.  All the seats are upright and there wasn't even any way that I could sit with my leg elevated while I was waiting.  

I put my brother down as next of kin and called him to tell him what was going on.  He's a veterinarian and immediately performed a lameness exam over the phone and promptly ordered a full body cast while laughing maniacally.  I started to reconsider my decision to have him as next of kin.  After I had been seen and was waiting for the paperwork to take with me I called him again.  He obviously still thought the whole thing was hilarious and asked me what  he should say if he got a call that said I was unconscious and they needed to know whether or not to amputate.  My response was "wake me up and ask me!"

My final instructions to him were that he wasn't to plug me in or unplug me.  Nothing like a sympathetic little brother to lighten the mood.

A weekend of lying in bed reading or lying on the couch watching TV with hourly trips to the freezer to retrieve the icepack stretches before me.  And I don't have to feel guilty!  I'm pleased that I haven't sustained a serious injury  and can't imagine how much pain I'd be in if I had!