Thursday, June 8, 2017

On Falling

Every time I visit the doctor -- lately several times a month -- I'm asked whether I've fallen in the last 90 days, and I've always said "No". Next time I will have to say "Yes," because the day before yesterday, I had a bad fall, and this morning, I can barely walk (though I think that's a consequence of an RA flare coming on as well as any lingering effects of the fall itself.)

It happened this way: Ms. Ché and I were talking the afternoon away in the house when I thunderstorm came up the way they've been doing almost every afternoon for weeks now. No big deal. Ms Ché got up to let a cat in and casually remarked, "Oh look, it's hailing!."

I said "Oh shit!" and got up. "The tomatoes!" We needed to cover them fast or they could be destroyed. One year, the hail pretty much destroyed everyone's tomatoes in the area. Our friend across the highway had a wonderful crop on the way; the hail not only destroyed her plants, it ruined all but a few of the tomatoes on the plants.

That year our plants were damaged but survived. The crop was minuscule, but at least there were a few.

This year's plants are still very young and quite fragile. They'e Cherokee Purple grown from seed, and we have way more plants than I thought would come through the various disasters of trying to grow tomatoes from seed at this altitude. Close to 100 plants at the moment are in various stages  of growth, and some have been transplanted to containers scattered around the place and are growing well.

Hail, though, could mean the end of many of them. So we raced to get as many as we could under cover. As we did, the hail came down stronger and stronger, and as I headed back to the house get more covering, I tripped on a wire -- actually a section of chicken wire laid on the ground to keep the cats from using a patch of lawn as a toilet.

BAM! I fell hard on the gravel -- the rough gravel we use for some pathways -- on my knees, and the pain was amazing. I thought I had broken both knees. Ms Ché saw me down and hollering in pain, while the hail storm intensified. Oh doG, what to do now?

I asked her if she could help me get up, but that didn't work, so I sat there in pain while the hail pelted the both of us and we became soaked to the skin. I couldn't get up on my own, and I was pretty much convinced that at least one knee was shot, if not broken. After sitting there for a while, I asked Ms. Ché to bring over a couple of milk crates that we use to transport things around the place. She did, and with some effort, I was able to hoist my bottom onto the crates, and once there, I was able to slowly and gingerly get myself into an upright position -- with the help of a walker that Ms Ché brought from the studio.

Now what? Could I walk? I didn't know. But I tried one foot in front of the other and sure  enough I was able to shuffle through the hail to the back door and make it up the steps and into the house. Whoo-hoo!

The pain in my knees was pretty bad, though, and slowly, I peeled out of my soaked duds. Both legs were pretty banged up from knee to ankle, the left one much more so than the right one. The left knee was quite bloody, and it looked like I'd done more than scrape the skin. I asked Ms Ché if she had any Bactine, and by golly she did. We sprayed it on the wounds.

And I sat for twenty minutes or so in my damp underwear, catching my breath and trying not to get overwrought.

Not a pretty picture.

Ms Ché was soaked, too, of course, but she tried to take it all in stride. I said, "Get into some dry things, I'll be all right." She went off to find something dry to put on while I continued to sit and contemplate my wounds. Apart from the scrapes and what looked like a broad puncture from a piece of gravel, it didn't look too bad, and because I could still bend my knees -- carefully -- I figured nothing was broken. I got up and...walked... ha ha... to the bedroom to find some dry clothes, and Ms Ché and I chatted about what had happened as she re-dressed in dry things. Well, you know, it was just one of those things.

She was worried that I shouldn't be walking, but I said I better figure out how lame I was, and see if we could deal with the wounds as best we could. Some Neosporin and bandages should be enough.

So over the next hour or so, we sorted out our various conditions. Ms Ché wasn't injured in the incident, but she's dealing with leg and foot issues of her own thanks to diabetes and an outbreak of psoriasis that makes her have difficulty with her own mobility. The stress of this incident didn't help at all, but she's developed some remarkable strategies to get and keep going no matter what.

I'm not nearly as good at it, but nevertheless, I didn't want to make too much of falling, but I wanted to make the best of it, no matter.

After an hour or so, I was pretty well bandaged up and recovered enough to go out and check the tomatoes. The hail had stopped and it was barely raining.

We only got the plants in the side yard covered. Those on the north side of the house were on their own.

I noted there was a bit of damage here and there, but nothing too serious. It looked like most of the plants would pull through just fine. Whew!

And I could walk. Pain was still pretty bad, but I could walk and get myself up and down steps, so that was good.

By bedtime I was afraid I wouldn't be able to sleep because of the pain. I'd taken a couple of Aleve, though, and the pain was fading. I slept fine. Got up the next morning and was nearly pain free. Wow.

Took it easy yesterday just the same.

But last night when I headed to bed, I felt more pain in my knees, and this morning, I woke up in severe pain -- both knees and ankles. I could barely walk at all. Oh.

I attribute most of it to a developing RA flare. It's been more than two weeks since the Rituxan infusion, and I've had no joint pain or flare. Doctor says, however, I most likely will continue to have flares for at least another month. I took a couple of Aleve which has moderated some of the pain, so I suspect that not all of what I'm feeling is RA related.

We'll see. Today we were planning an expedition to Santa Fe to explore the "Counterculture" exhibit at the history museum. I think we'll have to pass.

So it goes...

UPDATE: By yesterday afternoon, all of the pain was gone, and I could walk without difficulty, though both legs were still stiff and sore from the fall.

I emailed my rheumatologist about it asking whether the absence of pain after what seemed like the start of an RA flare was a sign that the Rituxan was starting to work. It's been a month since the first infusion and she's said that it generally takes six weeks to two months for Rituxan to have measurable effects on RA.

No word back yet.


Got word from my rheumatatologist that it's possible for Rituxan to work within a month though it is rare. The situation as I reported it suggests that in fact the infusions may be working. I need to keep monitoring symptoms and response. And not fall down!

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