Page 36 of Inherited Light
“You know her alarm hadn’t gone off, which tells me they weren’t there to rob the place. I think it was her ex-boyfriend giving me a warning because he’s still in love with her. What I can’t figure out is why he would hurt her when he claims to love her.”
He cocked his head to the left. “It does seem odd. You better be extremely careful around the guy. If he does anything weird, make sure you report him to the police.”
“Agreed. Now, about Cat,” I said and he turned his attention to his computer.
“Yes, about Cat. She complained of pain in her ankle and back, so I did imaging studies of both,” he explained, showing me her ankle x-ray on the screen. “Her legs are tiny and the massive amount of swelling made it difficult to see anything on x-ray. Do you see this line?” he asked, running his stylus under it for me to see. “It’s a possible crack in the bone, but I can’t be sure until we get the swelling down.” He clicked a few times with the stylus. “This is a CT scan of her ankle, do you see these white spots here and here?” he asked and I nodded, feeling like the dumbest guy on earth for having no idea what I was staring at. “Those are torn tendons. You can see all the other soft tissue swelling around here.” He motioned around the rest of the scan with his stylus. “Best case scenario she stays in a boot for a few weeks and everything heals well.”
“What’s the worst-case scenario?” I asked, awaiting his answer.
“She doesn’t heal and an orthopedic surgeon has to repair the torn tendons. I’m not worried about the possible hairline fracture, it will heal on its own and we don’t have to worry about weightbearing restrictions since she doesn’t walk. I will prescribe an increased dose of calcium until we see resolution of this line, though. If those tendons don’t heal back together right they will be a problem she may need to address.”
I held my hand up to stop him. “But she can’t walk. Why does it matter if the tendons are repaired properly when she doesn’t use them anyway?”
“It matters because the tendons hold the bone structure of her foot and ankle together. If they don’t heal right, eventually the bones in her arch and heel will fall down and make her flat footed. While you’re right and she doesn’t walk, it’s still painful, even for someone who doesn’t bear weight on their legs. I don’t know how much sensation she has in the foot, but it would be my recommendation you follow up with an orthopedic surgeon to go over options. I can recommend a few who deal specifically with people who have neurological conditions. The two I have in mind are excellent in their field.”
I swallowed hard, not knowing what to say, but finally nodded. “I appreciate it, thank you. I’m sure she will be happy to have the names, once she’s able to think clearly.”
“I’ll include them as part of her discharge instructions. I’ll also email the doctors and let them know I’m sending them a patient. She can decide which one and call to make an appointment. She will need to be seen in three days at the latest. It’s also important she ices and keeps the leg elevated for the next seventy-two hours until some of the swelling goes down.”
“Okay, no problem. What else should I be doing?” I asked, anxious to finish our discussion so I could see Cat.
“Her back,” he answered, hitting something else on the screen with his pen. He leaned forward so I could see the scan he had up on the computer. “This is the area she says is painful. Do you see this?” he asked, pointing to a space between two white areas.
“What am I looking at? Are those her bones?” I asked, fascinated but confused at the same time.
“Those are her vertebrae. This one is starting to degenerate,” he explained. “She complained of back pain when they did the initial assessment, so I ordered the CT. She’ll need to have an MRI scan to better assess the degree of degeneration.”
“She said her back hurt when we got in the car after her gallery showing tonight. She thought it had flared up from being in her wheelchair all day. I didn’t think too much of it as she seemed sure it would resolve with rest.”
“Neither did she, since this is the part of her back the transverse myelitis affected.”
I forced my face to remain unchanged, even though I wanted to scream, ‘What is transverse myelitis?’
Instead, I pointed at the screen and asked, “She has back pain all the time, do you think it’s from this or the…” my brain stopped working and I had to snap my fingers to get the name back.
“The transverse myelitis?” he asked and I nodded.
“I don’t quite understand all of what happened when she was younger,” I lied. The truth is I don’t understand any of it because I don’t know what transverse myelitis is or what it does, but I wasn’t going to admit it.
He called up the x-ray of her spine on the computer and pointed to a lower portion of the spine near the hips. “This is where we see the arthritis in the vertebrae. It’s jagged and inflamed according to the CT scan. We can settle the pain and inflammation down with some anti-inflammatories and maybe a cortisone injection. Here,” he said moving his pointer up to the middle of her spine, “is where children and young adults usually are affected when the virus attacks their spinal cord. Unfortunately for Catalina, her lower spine was affected, which is why she has persistent paralysis. I’m not surprised to see arthritis in those vertebrae. She sits all the time and hasn’t walked for almost fifteen years. Those two factors alone would cause pain and degeneration in the spine.”
“Do you think if you treat the arthritis she will or won’t need surgery?” I asked, a little bit less confused, but still trying to glean as much information as possible from him. Whatever he didn’t tell me I would have to convince her to share and I didn’t think it would be easy.
“The changes are early yet and I think we can get her feeling much better with some lifestyle changes and medication.”
“What kind of lifestyle changes? She has an excellent wheelchair.”
“I know, but I also know she doesn’t have a custom made cushion or back on it. With the use of those and physical therapy she should be feeling better in no time.”
I nodded. “Good, she doesn’t like being down for long. I’ll make sure we get the chair updated immediately.”
He leaned back in his chair and addressed me from under his eyebrow. “I’m sure she doesn’t like being down, no one does. She has a unique case and it will require certain treatments and medications due to the scarring left in her spinal cord.”
I swallowed hard and made eye contact with him. “I’m aware, sir.”
“Are you? Do you know what will be required as she gets older?”
“What are you trying to get at here, doctor?” I asked, trying not to sound angry.
