I walked in for an x-ray at the wonderful UCH fracture clinic last week and was met by "it's you!"
The radiologist was on duty the first time I checked into UCH at Easter time. She remembered because I was carrying my large Timbuk bag over my shoulder and Airnimal folding bike tucked under one arm. When the original x-ray popped out the machine I remember there was much gasping and then scrabbling for a wheel-chair and a generalised hurry to get me off my feet, well my right one at least. In truth I wasn't in a huge amount pain, certainly not as much as the doctors and radiologists assumed. But I had kind of suspected something was wrong as I couldn't plantar-flex that foot (i.e. go up on my toes). It wasn't pain blocking the movement, it was more that I could no longer propriocept the movement pattern.It was all written in neon if I had paused to read it. I couldn't organise the movement because the fibula was snapped in two. The x-ray above is the most recent and shows clear healing in the shaft of the fibula. it feels much better and the 5-6 weeks in the orthopedic boot have worked their magic by effectively freezing the foot in place 24 hours a day. It has served to remind me of the first principle of medicine - that the body heals itself. The role of the clinician is to put the body in a position and place where healing and rehabilitation can occur. And in that regard UCH have been incredible - checking on me every couple of weeks and taking progressive x-rays. I am now allowed to take the boot off periodically through the day, which feels amazing. I can now send the mental mapping to elevate onto my toes, but no longer have the strength to do so because I have lost 50% of my calf mass in six short weeks. Atrophy is just pitiless.
The last doctor I saw at UCH read my notes back to me - apparently I had said that I intended to continue commuting in my orthopedic boot, against their advice. I don't remember explicitly telling them this, but I do stand by it. So much so, that I think cycling (even on a static bike) in a boot or cast should be standard procedure for this kind of fracture. Maintaining riding, was almost entirely pain free in the boot and maintained blood-flow and general condition over the six lost weeks. Imagine how much muscle would have been lost if hadn't cycled through the injury? The two weeks I was on crutches was the worst, for so many reasons, but mainly I had to carry them around with me on the bike. The crutches were painful and inconvenient where the bike was functional, tranquil and largely very comfortable.
On reflection I think UCH was very happy to discharge me. For my part I am very grateful for their excellent care and advice. A truly great hospital.