Sunday, April 18, 2010

Dr. Hsu

Peace on the wall near the lake at Chang Geng Memorial Hospital in Linkou, Taiwan

I had my first appointment with the orthopedic department of Chang Geng Memorial Hospital about two weeks after my accident. The first appointment we could get was with their back specialist. Yuni had gone back to the Taoyuan Provincial Hospital and gotten a copy of my original x-ray. We showed it to the doctor, and he just snorted. He ordered a set of x-rays and put me in a splint. He didn’t try to set anything because he was not a knee specialist. He got me an appointment with their top knee surgeon, Dr. Hsu, but the first available appointment was not for two weeks. I would go back the following week for the series of x-rays, and I would see Dr. Hsu about a month after my accident. I was offered pain medication, but since I was still nursing Peace, I did not take it.

The next week, we went for the x-ray series. The technician was quite nice, but he had to manipulate my poor leg into many angles that made me tear up or scream. I was still in a lot of pain. One angle in particular was very hard for me to hold, and it took three tries and several pillows before we got that x-ray. Apparently, though, it was the most important one.

I went home and cuddled Peace for comfort. She nursed a little, and I felt better from the endorphins. All during this time period that I couldn’t work and I was in pain, little Peace enjoyed coming over and “snacking” whenever she wanted to. It was comforting, and the act of nursing did relieve the pain. Later, I would learn that this frequent nursing actually saved my knee, but all I was doing at the time was comforting myself with my baby.

Two weeks crept by, and it was time to see Dr. Hsu. He was Taiwanese, and he had practiced medicine for five years in the US and for three years in Australia. He understood, read, and wrote English quite well. He also spoke English, but his accent was so heavy that I really did not know what he was saying. I tried to get him to speak to me in Chinese, but whenever he saw my American face, he switched into his English channel. He looked at the set of x-rays and pointed to a faint shadow on the film that had taken us so many tries to take. He said: “Tibia plateau fracture, you need a bow new garaff two.” I did not know what the tibia plateau was, and I had no idea what a bow new garaff two was. I kept asking him to speak Chinese. Finally, he turned to Yuni and explained the situation to HIM in Chinese. Then I figured out that a bow new garaff two was a bone graft. That took me by surprise. I asked why the emergency room had only found a slight crack in the tibia. He said that they had not taken the x-ray at the right angle, probably due to inexperience. He said that when my motorcycle caught my leg and slammed it to the ground, it smashed the knee at just the right angle so that the rounded top of the tibia where it met the femur had been shattered. He said that the only way to prove it was with an MRI, but he was willing to bet money that the top of my tibia was not only shattered but also indented. That was why I had had so much trouble in the “walking cast” from the emergency room.

He was one of the top two knee surgeons in Taiwan, and when we communicated in writing, it was obvious that he had spent time in the US and Australia. He just had not had to polish his pronunciation. He said that since surgeries were piled up, he would schedule the MRI and the surgery immediately. He said that we would get an MRI appointment in two weeks, but it would take at least a month to get an OR for the length of time needed to complete a bow new graff two. He was worried that because I was not yet thirty, my bone was growing back and he would have to re-break or shave off the surfaces of the knee so that the graft would take. The surgery could take up to seven hours if he needed to do that. I told him what had happened with Peace and mentioned that I was very sensitive to anesthesia. He promised to consult with the anesthesiologist who had handled my case with the twins. Apparently, they knew each other well.

I went home and continued my nursing routine. I was getting bored without being able to teach or take the babies for their walk, so I began to rememorize the Three Character Classic. I learned it both orally and written. Dr. Hsu said that I would not be able to put weight on my left knee for a full six months after the surgery. By the end of the seven months, I could write the entire text from memory. The Three Character Classic is an elementary school text that began floating around in the Song Dynasty (1100s to 1200s CE). Other people updated it with each new dynasty, and I had a version from the early years of the Republic of China when a classical Chinese education was still popular. It covers all of China’s history, basic philosophy, and important works of literature in three character phrases. It really gave me a good basis for understanding Chinese culture more deeply.

When I went to get the results of the MRI one week before the surgery was scheduled, it was obvious that Dr. Hsu had known his stuff. The outer top “ball” of my tibia was completely gone, and there was indeed a hollow depression. Dr. Hsu explained that he would take bone from my right pelvis, from the part that stuck out. He said that it was easiest place to take bone on a woman. He would use that bone to rebuild the top of my left tibia. He also assured me that Dr. Ma would be my anesthesiologist again. The two of them were working out a strategy to allow me to undergo a lengthy surgery without causing me any problems. They were planning to use light general anesthesia and tons of Novocain around my knee and hip. It sounded good to me.

Of course, I had called the US to inform my relatives of the situation, and my mother was able to take time off work to come stay with me in the hospital. That way Yuni and Pa could continue to work to pay the mortgage while Ma and the unmarried sisters handled the three babies. They were not looking forward to when Peace would have to go cold turkey on the nursing, but they also knew that there was no other way. At least, she was already able to eat rice and vegetables and other solid foods (like candy from her grandpa).

And so, all the arrangements were made. During the first week of December, a full two months after my motorcycle accident, I was admitted to the hospital with my American mother in tow. We were at the branch hospital in Linkou, not far from the mountain where Yuni and I had met. The facility had beautiful grounds and a little lake. It was set up as a surgery and convalescent center. I was to be in the hospital for at least 21 days to be sure that everything was healing okay and that the bone graft “took” without infection. There was a huge food court down in the basement with all kinds of different styles of cuisine: Japanese, Chinese, American, noodles, etc. Mom learned to buy food there very quickly. She made many friends in the hospital.


Cloudia said...

What a saga, Teresa!

You are one brave biker girl/scholar.

Aloha from Waikiki my very dear friend.

Comfort Spiral

Teresa said...

I try to live life to the fullest every day. It certainly can be exciting :)

Barrie said...

I can't believe you had to wait that long for surgery. And in all that pain. You really did use the waiting time wisely--studdying and playing with the baby. Incredible!

murat11 said...

Beautiful picture of Peace on the wall. Your nursing her reminded me of Tina's nursing Walden; such a peaceful cocoon that created for them both.

What a difficult time this must have been for you; difficult to revisit too, I imagine. Bless those healing babies of yours.

Teresa said...

Barrie, I was waiting for one of the top two knee surgeons in Taiwan, and his schedule was VERY, VERY full. Knee reconstructions are time-consuming, so he couldn't do more than one a day. There are lots of motorcycle accidents in Taiwan... so lots of surgeries needing to be done. And the difference between a competent and incompetent doctor are so great that it is better to wait for the best.

Murat, this week's post was easier to write than the one about the accident. That one kind of took me by surprise. I am still mad at the driver of that car who sped off, seemingly oblivious to the mayhem he or she had created. Both families rallied round, and I have to say that I had excellent care and the babies were pampered by their grandparents and aunts beyond belief. Their baby teeth were riddled with cavities :)

Ivy and Haley said...

Oh my goodness, waiting that long for surgery sounds just terrible!