2009

It didn't start with Greg and Alice's wedding in Hong Kong but it felt like it did because Hong Kong was when I noticed. Hong Kong was the first time in a very long time that I didn't have a bike with me to act as a 'crutch' or a 'wheelchair'. Hong Kong was when it got so bad that it couldn't be ignored any more. Hong Kong was silently choking back tears in subway stations while my friends waited for me at the next platform as I limped from one train to the next.

After Hong Kong, the doctors visits and the emails to my lawyer started. It had been nearly 9 years since the accident that put me in Shock Trauma Intensive Care for a week. It had been 8 years since I took my first steps without crutches. I'd lost all of the wheelchair weight and gotten athletic and been biking. My leg shouldn't be hurting so much. It shouldn't. But it was.

This x-ray from February shows the fusion between the two bones in my lower leg.

The orthopedics department at the People's Hospital in Haikou had a diagnosis they were very sure of. They also refused to act on that diagnosis because my leg was put back together in part by the University of Maryland and in part by Johns Hopkins and, to paraphrase "we ain't touching that". That's probably a good thing since their diagnosis was wrong and acting on it might have made things a whole lot worse.

As there are hospitals there which can bill US insurance companies, there was an attempt to try to get me covered to go to Hong Kong or Beijing for treatment. My insurance, however, wasn't real keen on international travel and housing expenses and the hospitals there weren't sure that they could say what was wrong until they saw me in person.

So things went. Emails to my lawyer progressed from "what about trying to get them to allow me to go to Hong Kong" to "what do you think about my trying to go back to the US in August?" They continued to "I think I could try to be back by mid-July" through "It wouldn't be too much effort to schedule late June" until, in April, they eventually they hit "Dear Mr. Katz, this is to inform you I will be in Baltimore on Monday." By which point I was already on crutches and my right foot was pigeon toeing so bad it was almost impossible to believe that I hadn't acquired some kind of new bone trauma.

I'm deliberately showing off how messed up my range of motion is but, at the time, I actually couldn't turn my foot completely straight.

Over the summer in the US, I had a lot of tests—not a single one of which came up with a conclusive reason for why things were wrong other than they were very clearly wrong. Through intensive physical therapy, I slowly started to learn how to walk again. I had to look at my feet and constantly force the pigeon toe out the right way but, by the end of June, I could make it almost half a block without hurting.

And then, the PT decided one morning to assign me to his intern. We finished up my exercise session and she was going through the usual physical therapist spiel of "if I poke you here, how loudly do you scream?" where they determine how they are going to adjust your next session and she said "I think you have a short leg".

Since my injury is below the knee, this was a very easy test to perform. I didn't have to drink anything radioactive, I didn't have to use any expensive machines, I didn't need a specialist to read a report. All I had to do was lie on my stomach and bend my knees. And bam, like that you could see it. Cause it's really obvious. Really, really obvious. It's so obvious that every single doctor in two countries assumed that one of the other doctors before him had done it.
But none of them had.
Not even one.

In this picture from 2018, the weak bridge between the two bones is broken off and reabsorbed. There's also enough obvious new bone growth along the various cracks that, if necessary, I've finally reached a stage where I could probably have the support rod removed

When she went into the head PT's office to tell him, I could hear him yelling at her about medical students who think as soon as they learn something that they know it all and how "just because you have a hammer, that doesn't make everything into a nail". His body language was still angry with her when he stalked over to have me repeat her test, to show her what an idiot she was being; I don't remember if he apologized or not.

Within a week I'd seen my pain specialist, gotten a prescription to see an orthotist, caught an appointment because of a no-show, gotten prescribed custom foot wear and a temporary gigantic heel wedge in my shoe, and was walking almost completely normal. Also, by virtue of no longer having it, I also discovered that I apparently had had back pain.

When I returned to China at the beginning of September, I was actually on doctor's orders to walk as much as possible and to try to avoid biking too much. Apparently, part of how I'd managed to have my leg deteriorate all the way back to crutches, and part of how I'd done probably permanent repetitive stress injuries to my ankle, knee and hip was because biking had given me the ability to ignore the "Walking Hurts" signals until they became "Walking is Agony" signals.

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