what to expect

A month ago my baby—my 6-foot 14-year-old baby—broke his size 14 left foot (his 5th metatarsal—the long bone under the pinkie toe) while playing basketball. Jonesfracture

Avery LO-O-OVES basketball, but within minutes of being told he probably wouldn’t be back on the court until June, he was back to his usual making me laugh out loud self.

“My arms are gonna get SO buff with these, Mom!” he announced excitedly after crutch training in the Emergency Room. Now he’s doing spin moves with them that make me nervous.

If he didn’t have my eyes, I would question if he really did come out of my body; I would probably just be emerging from a woe-is-me funk by now. Don’t know for sure because I’ve never broken a bone, which means I don’t really know what to tell him to expect. Couldn't tell him what it would be like to get a cast, be in a cast for weeks and weeks, or have it taken off.

We were in the children's orthopedics clinic cast room. His first cast needed to come off. I watched his eyes stretch wide and his fingers grip the gurney as the technician came toward him with that tiny saw. I had to fake reassure him that everything was going to be fine. That the tech wasn’t going to saw through the cast and a portion of his leg. I didn’t know the blade wasn’t sharp until the technician noticed Avery’s face and put it against his own finger as he smiled knowingly. Avery unclenched. I breathed a sigh of relief.

Now why couldn’t he provide this little demonstration before he started cutting Avery’s cast? I thought. I was reminded of how often we health providers, who have cut through hundreds of casts or have seen as many patients go down the same path of an illness, forget that for the patient and family in front of us, it is usually their first experience. Fear moves into that empty space in the mind when knowledge is nowhere to be found. 

But I wish it was always as easy as showing a cast saw is not sharp. Sometimes we can’t tell someone exactly what to expect because we don't know for sure. Doctors do a lot of things to patients and talk patients into doing a lot of things, most of which we’ve never experienced ourselves. Yes, in my young career as a nephrologist, I have witnessed dozens of dozens of patients on hemodialysis. But I don’t know what it feels like to have a thick serpentine blood vessel—a surgically created fistula—coursing up my arm or know what it feels like to have those two large bore needles pierce it three times a week or what it feels like to have my blood come out of my body through one needle, travel through tubing and the machine, and come back to me through the other needle in one continuous circuit for three hours at a time. Dialysis_-_arm_-_01I’ve been light-headed before, had leg cramps before, even feel tired sometimes, but I don’t dare compare them to what I see my patients endure sometimes. I can only tell people what I’ve seen. And even if I had experienced it for myself, it would just be my experience. Theirs will be theirs.

When I do talk to patients whose bodies may soon need and benefit from dialysis, I hear myself minimize the not so good aspects to try to ease their fears. Because usually the fear is worse than the reality. At least that’s what many of my patients have told me.