Miss G: Double Amputee

My phone has been reminding me for about a week that four years ago I was recovering from another amputation, one I don’t think I’ve mentioned here before:

I had my first rib amputated.

(One of these things is not like the other… Which side is missing a rib?)

In case you’re wondering what that feels like, I described it for posterity’s sake then:

When they amputate ribs, you can totally tell they’re not there anymore especially when you cough, sneeze, hiccup, vomit, move, or breathe.

Now I would add “when the weather changes, you sleep on your side, push a wheelchair, use crutches, or carry a fabulous handbag” to that list.

Six years ago I had that car accident that resulted in my rib being jammed underneath my collarbone where it stayed for two years, wearing a groove into the collarbone. It was the immediate cause of a blood clot that quite literally extended from my fingers into my neck although it would be almost two years before the clot, called Paget Schroetter disease (effort induced thrombosis), was diagnosed as a sequela of venous thoracic outlet syndrome (the compression of the nerve bundle) as being caused by the rib and collarbone being stuck together.

One day in the middle of a math lesson with my 4th graders my arm turned royal blue and swelled like the little girl in Charlie and the Chocolate Factory who ate the dinner flavored bubblegum and turned into a blueberry. The urgent care doctor was able to push his thumb down behind the collarbone to pop out the rib a little and relieve pressure, allowing my arm enough bloodflow to change back to a normal shade and decrease swelling, but I was sent for an ultrasound anyway. Radiology techs are not supposed to tell you what they see and are not supposed to share a diagnosis, that’s the job of the radiologist, but my tech’s exact words when she started the ultrasound on my left side (beginning in my neck) were,

“Oh. My. God! There it is! I’ve never seen anything like this before!”

She followed the clot until she couldn’t follow it anymore, taking all the images she needed, and running out of the room to find a doctor to confirm the findings before even wiping the cold goop off me. Inside 5 minutes I was getting a call from my primary care doctor who gave me a choice: hospitalization or giving myself Lovenox shots and seeing him in the morning. All y’all know me by now. What did I choose?

If you guessed Lovenox shots and sleeping in my own bed, give yourself a gold star!

I began anticoagulation immediately but for two years, that rib compressed the nerves and blood vessels leading to my arm without ever being addressed or formally diagnosed. Despite constant anticoagulation, I continued to deal with clots and swelling in the arm. For two years my left arm and hand were swollen and various shades of blue everyday before someone finally ordered scans and a surgery was scheduled to remove what seemed to be the cause of all my pain. The vascular damage caused by those two years of compression, swelling, and clotting is so complete that on particularly hot days or when I’m exercising I have to wear medical grade compression. I don’t mind though.

My sleeves look like lace. They’re actually pretty fabulous.

Despite the lasting damage that injury caused and the barometer my shoulder has become, I’m actually thankful for the injury and the amputation it necessitated. Without them, I don’t know when anyone would have eventually decided to test my blood. It was only after the obvious physical cause of clotting and swelling in the arm was removed that someone wondered why I continued to have swelling and symptoms of clotting. When the tests were completed, I finally had a diagnosis.

The diagnosis of my blood disease put me on a long path of learning, pain, and discovery that led to where I am now. Without that diagnosis, the continuous clotting, the pain, the dying tissue, and everything else that came with it, I would never have learned that my clotting has been extensive and a part of my life since childhood. Nearly every other medical condition I deal with was either caused or exacerbated by clotting. Now that the clotting is in control, everything else is healing.

It’s amazing to think that one amputation led to the other and to discovering a treatment that is making all the other problems improve as well.