Nalukataaq injuries continue, my wife arrives, and snowmobiles on the water


If there is pressure inside of a cast,

It must be bivalved, I mean fast.

    The noise and the sputter

    Of our deluxe cast cutter

Brought relief to the patient at last.

I’m still taking care of Nalukataaq injuries.  A patient (who gave permission to relate this much information) fractured an ankle during the blanket toss, requiring a trip to Anchorage for surgery.  Weeks later, the patient came in with pressure sensation at the ankle bones and the heel.

Pressure on living tissue inside a closed space like a cast prevents blood entering and leaving; a person can lose a limb that way and I can remember getting out the cast cutter on a snowy night in Navajoland when transport down the Interstate was impossible.

I had the nurse move the patient to exam room 5 where we keep the orthopedic equipment while I went back to my apartment to get my hearing protection.

In my short career as a (failing) rock musician I lost hearing and my ears are still ringing.  Loud noises don’t just annoy, they inflict pain.  Like many baby boomers I suffer from tinnitus. 

We cannot undo the mistakes of the past, but we can keep from making the same mistakes in the future.  Bethany bought me a nice set of noise cancelling headphones a while ago, with the intention that I’d use them on plane trips. I also keep a set of foam ear plugs in the case, and if I anticipate severe noise I use plugs and muffs at the same time.

I rolled the foam plugs and inserted them into my ear canals, then I put on the muffs. 

The circular blade of a cast saw vibrates at right angles to the plane of the blade and cannot cut skin, muscle or tendon though it can tickle like crazy.  While the patient watched, I touched the blade to my palm. 

To relieve pressure inside a cast, one has to make a cut up each side of the cast, turning something conceptually like a tube to something conceptually like a clamshell without the connection between the halves.  In the fissure made in the fiberglass, I inserted a specialized instrument called a spreader, applied pressure on the handles and the jaws spread, forcing the two pieces of cast apart.

The relief  spread over the patient’s face when I started to cut the cast padding with scissors.

***

Bethany flew in last night and I borrowed a truck to pick her up.  She wasn’t prepared for the chaos of carousel-free baggage claim.  We took our time on the way to the hospital, we drove around town for fifteen minutes.  We stopped at the guitarist’s house for carry out Thai and live Irish music. 

Much racket of two-stroke engines awakened us as we were falling asleep.  Bethany thought there were jet skis on the lagoon; we watched snowmobiles making circuits on the water in the midnight sun.

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