Fractura

When the urine slipping, wall kicking incident happened two Saturdays ago, I thought for sure I had broken my toe. I almost cried. But by the end of the day I had stuffed my bruised and swollen foot (even though only my pinky toe made contact with the concrete wall, the swelling and bruising extended down into the outer part of my foot) into a shoe to kick around a soccer ball. Such is my competitive nature.

The following Monday one of the trainers for the men’s soccer team had a look at my toe. After quite a bit of time poking, prodding, pulling, and pinching, he determined that it was not broken reasoning that no one would be able to put up with the pain of that treatment with a broken bone. Although it wasn’t the most scientific of methods, I was pleased with the diagnosis, so I didn’t question it. I was cleared to play.

And play I did. But a week of sports with the kiddies, four soccer games, and a basketball game later (4 Ws and a tie), it turns out that I really do have a broken toe. Damn.

I actually would still be playing had not the head coach of the men’s team taken a look at my toe this past Monday and insisted that I get an x-ray. The trainer was trying to massage out the swelling, but the coach noted there shouldn’t even be that much swelling 10 days after the fact.

So Tuesday morning Peace Corps sent me to Galeno, the private hospital in Cobán, to have the toe checked out. I waited nearly two hours for the doctor to take one look at my toe and then send me to get an x-ray. Now in the states getting an x-ray would simply involve being escorted to another floor or room, but of course it is not that quick and easy in Guatemala. I was given a slip of paper with the name and address of a radiologist some seven blocks away from the hospital with the instructions to go there, get an x-ray, and return with the results…on foot…with a possible broken toe. Okay.

Despite its close proximity, I don’t spend a lot of time in Cobán so I needed a bit of help to make sure I was heading in the right direction to get to the radiologist. I stopped to ask a guard outside a bank but he had no clue where I trying to go (surprisingly he told me as much; usually people here will give you directions regardless if they know where the place is or not), so he sent me inside to consult with two other guards.

“I’m looking for this clinic, and I just need to know if 6th avenue is that way.” I showed the two men my slip of paper.

Guard 1: “Ah. This is the place where they give ultrasounds.”

“Actually it’s my toe. I think…”

Guard 2: “Yes, it is. You can get an ultrasound there.”

“I kicked a wall. It might be broken.”

Guard 1: “To get to the ultrasound place, you need to go…”

The guards proceeded to give me directions to where I could get an ultrasound, I mean x-ray of my toe. Ironically enough I might never need an ultrasound since the technician didn’t bother to cover up my lady parts during the x-ray. Or I might have a child with three arms.

The technician was also rather confused as to why I would bother to have a toe x-rayed.

“You want an x-ray of your little toe?”

“Yes, that is correct.”

“Just a toe?”

“Yes, just a toe.”

I guess he couldn’t understand why I would waste $20 getting an x-ray of my toe when nothing could be done for it even if it were broken. But for me the results of that toe x-ray were to be the deciding factor of whether I should continue to play through the pain or stay off my right foot. It looks like I am going to be sidelined for a while.

The doctor was very concerned that after 11 days there was absolutely no sign of any healing taking place. Hmm, I bet I know why. Here is his diagnosis:

Edema de tejido blando a nivel del dedo chiquito del pie derecho. Lo anterior es secundario a fractura oblicua y alineada del vértice externo y distal de la falange proximal del dedo chiquito, la cual tiene componente intrarticular.

Roughly translated as:

Edema of the soft tissue of the little toe of the right foot. The preceding is secondary to an oblique fracture that is aligned from the external apex and distal of the proximal phalange of the little toe, which has an intra-articular component.

And further translated and paraphrased as:

I have an abnormal accumulation of fluid in the soft tissue of my pinky toe on my right foot caused by a fracture that cuts across the first bone of the toe and extends into the joint where the first bone meets the second.

So not only do I have a broken toe, I have the kind of fracture that meets a joint (intra-articular), which frequently causes long-term posttraumatic arthritis. I am currently on 2400 mg of ibuprofen a day to reduce the swelling and edema and staying off my foot and keeping it elevated whenever possible. If the swelling and edema don’t subside within the next couple of days, I’ll be making a trip to the capital to see a foot specialist.

And all this pain and suffering because I didn’t see a pool of dog urine.