When I was three I fell off a swing and broke my collarbone. That happens to a lot of children, but when they took an X-ray, they noticed a healed compression fracture in my spine. That doesn't happen to a lot of children and I think about it sometimes and wonder when it happened and how it happened. I was a colicky baby. Was it colic or pain that made me cry so much, I wonder.
The rest of my childhood was fairly uneventful. I broke my ankle falling off a horse at ten. But that could happen to any child. I went ice-skating for my sixteenth birthday and broke my wrist. I grew up in Southern California and I hadn’t ice skated before. A perfectly normal fracture, I thought. I got one of those heavy plaster casts they don’t use anymore. My friends signed it and I passed my history final by hiding a piece of paper with the answers on it in my cast. When I was seventeen I got a new bike and another cast on that same wrist. I swerved too quickly when a car came at me and fell off the bike.
I think I might be forgetting a few childhood fractures because my high school friends seem to remember me as "always getting hurt" and what I've described doesn't seem like that many.
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I’ll be fifty this July and I've been trying to remember how many times I've broken my right wrist: Ice skating, bike, karate punch, fall on ice, minor car accident, another fall on ice, I think I’m missing a few. I really should move someplace where there isn’t ice. I'm told I've broken my left wrist too, but strangely I can't remember when or how. I must have known at some point because they can't do the dexa scan for bone density on places where there have been fractures and they can't do either of my wrists. I must have told them I broke my left wrist somewhere along the line, or they must have it in their records.
I have broken most of the bones in my left foot, most of my toes, three fingers, both ankles, the right one I think three times but I may be forgetting one or two, my left patella, my left tibia, both my elbows, and most recently and dramatically three years ago I shattered my right shoulder and wound up needing a partial shoulder replacement. I don't think I'm extra clumsy compared to others. It's just that when I fall I break things, so falls most people will forget about, I am reminded of for six to eight weeks. Though as you have seen, I do forget fractures. When you’ve had enough of them, it’s hard to keep track. I have this niggling feeling there are a few I’m forgetting to mention. Probably wrist or ankle, as they happen frequently enough that it’s hard to keep track. Also, for some reason, my fractures don’t always show on x-rays. I’ve had at least three fractures that showed weeks later, on bone scans or MRI’s that I begged to get, because the pain wouldn’t stop. The elbow fractures, I’ve never bothered to get x-rayed, though I’ve been told about my right elbow when my wrist was x-rayed.
The day before I broke my shoulder I was wading on slippery rocks and I remember clinging to a friends arm for balance and feeing foolish, like I was frail old lady at forty-seven years old. The next day I tripped in my friend’s house and there went my shoulder. I can still hear the sound of it shattering; a cracking sound, like wood snapping.
I've tried hard over the years to tell myself these are just normal fractures, but I don’t know anybody else who keeps crutches around the house for just in case. My efforts to pretend it isn’t so only led to fractures I might otherwise have avoided. You heard about the karate punch. I mean really what was I doing taking karate? And don't even get me started on the horses. Ok I did dressage, which is pure flat work. But still- those broken fingers were all from horses yanking on the lead. It's hard to hold onto a lead when your finger breaks when jerked a bit. I miss the horses terribly, but I finally realized I had to give them up. Horses falling or stamping on your feet is bound to break them. Especially if you're me.
My first bone density test was at age 28. The doctor read the radiologist’s words out loud to me: "Quite profound osteoporosis." Some things you never forget. Though of course I already knew my bones broke too easily, so it shouldn’t have been a surprise. The second time I broke my foot, the orthopedist who took the x-ray said I had the foot of an eighty-six year old woman. I was twenty-one at the time.
“It” runs in my family. I say “it” in quotes, because I don’t really know what “it” is. My mother breaks too easily too, though not as badly as me. Her father broke too easily and I’ve heard her grandfather also had this problem. It’s clearly genetic. I don’t think it’s Osteogenesis Imperfecta, which is the bone breaking disease most of us have heard of. I don’t have blue sclera for one thing. It isn’t clear that my insurance would pay for the genetic test and it wouldn’t really change treatment, so I’ve never bothered. I think it’s probably related to my Common Variable Immune Deficiency, which is a B Cell defect, for those who are medically minded. I’ve seen articles linking B Cell defects and Osteoporosis. It certainly isn’t the kind of Osteoporosis most people think about when they see commercials with nice looking straight backed elderly women talking about how wonderful Fosomax is. All those medications make me nervous, though I’ve done Forteo for a couple years and I expect some form of Bisphosphonate is in my future. I’m not even post-menopausal yet.
The thing I hate most about my bones is how fragile they make me feel. I am, quite literally, breakable. I didn’t realize how I felt about this until I read a book about a girl with Osteogenesis Imperfecta and halfway into it I started sobbing and couldn’t stop. That’s when I realized the toll these bones of mine have taken on me. Mostly, when you break a bone, you just do what must be done – get to the ER or the Urgent care or the Orthopedist’s office, get the cast, figure out how to make it all work. One thing about fractures is, once they’re immobilized, they mostly stop hurting pretty quickly. Though it’s possible I’ve just learned to tune the pain out. But I was talking about my fragility and how much I hate it. See how I back away from that and start focusing on being stoic about dealing with fractures and making the pain stop? There are so many things am afraid to do, because I have to think about whether X is worth a fracture. I won’t roller blade, or ski, or ride a bike, or hike or walk where it’s slippery, or wear high heels. I live in a Cape Cod style house with a lovely furnished upstairs, but I live on the first floor only, because I don’t want my bed to be upstairs and find myself unable to get there with crutches or risk falling down the stairs. I really want to move into a one story condo and someday, I will. I gave up my standard shift car after I broke my shoulder and a good thing too, because the first long trip I took in my new automatic car, I broke my left ankle and would have been unable to drive home if I’d had the automatic. Now I don’t have to borrow or trade cars next time I break something. See, this is how I think – it isn’t if I break something. It’s next time. I prepare for it. I’m trying to think of a way to get my washer and dryer out of the basement. That was a real pain with the shoulder. I had to throw bags of clothes down the basement steps. Yesterday I went toilet shopping and I noticed one that said it was especially high. My first thought was, that could be useful if I ever break a knee again. I went with it. Someday, when I can afford my condo, I will have one of those walk in baths and a standing separate shower. Taking showers in my bathtub scares me. I’m just waiting for the day I fall and break something.
So, there you have it. Between my immune system and my bones, it’s as if I’m eighty-six years old instead of nearly fifty. Sometimes I’m afraid I won’t really live to be eighty-six and sometimes I pray to the FSM that I don’t, because it’s hard to imagine what my body will be like then, if I make it that far.