Just got back from the doctor, now three and a half months after breaking my fifth metatarsal in my right foot. Handed in the crutches, and the doc says that so long as I favor the injured area, I can walk more or less normally. For me, the problem will more likely be that I’ll be so used to favoring the whole foot, I’ll limp more out of habit than out of necessity.

With this whole thing coming to a close, I thought I might write about the experience from start to finish.

This started on December 3rd, as I was walking out my door. I was invited to a party with people from work, and I had spent the day before shopping for party food and learning the route (it was a long way away, three train transfers and two bus rides). I made sure I had everything, locked my door, and headed for the stairs. To get to the stairs, I have to take a u-turn from my front door. The concrete floor at the point of the turn is not only smooth, but also (as I discovered by observing later) is slightly inclined so as to allow rain run to a gutter. Add in the centrifugal force of the turn and that I was going a bit faster than usual on the foot-pivot, and the result is that I slipped and fell. My foot, however, remained level as it slipped, while my leg and body fell at an angle. That led to too much strain on the outside of the foot, and I heard a loud “snap” as the bone broke.

My first decision was whether or not to have surgery. As you can see on the original x-ray, the broken bone halves had separated quite a bit. I was shocked to hear the emergency room doctor suggest that simply leaving it to heal naturally would be an option. After talking to the doc and my immediate family, I decided to go with surgery to have pins put in. However, the decision was a bit complex.

The injury happened just ten days before I was scheduled to fly back home to stay with my folks, so flying back was one factor. And though I didn’t know it at the time, it is said that if you have surgery, then the chance of a thrombosis (a blood clot you can get from sitting in an airline seat for too long) increases dangerously. Then there’s the wound left by surgery, which could become infected, and I’d have to do it again later to have the pins removed. But my biggest worry was whether or not the break could heal properly. At last, a somewhat distant family relative in orthopedics got back with the advice not to have surgery. Knowing that it was possible for the bones to heal without help, going through all the extra hassle (and expense–at least $1000, with insurance picking up the other 70%) for the bones to heal a few weeks faster would not have been worth it.

So I traveled with crutches instead. Though the foot swelled up quite a bit when traveling to the U.S. (ten days after the break), my trip was otherwise pretty successful. Wheelchairs were provided at Shinjuku Station, Narita Airport Station, and at the airline check-in counter on the Japan side, and at the door of the plane upon arrival at SFO (my travel agent handled the airport wheelchairs, I arranged the JR help). The wheelchairs came with staff to push me and drag luggage (JR provided 2-3 people each time, the airlines one apiece), and I got taken through the crew/diplomatic lines, very short and fast. And of course, I got early boarding. So long as you arrange everything in advance, you can get some very good assistance to make everything breeze through.

Not everything went smoothly; the transfer from Keio to JR lines at Shinjuku Station was a nightmare, with an ignorant ticket gate staff sending me on a very long, unnecessary uphill hike with crutches. And the seating on the airplane on the trip out was disastrous–the bulkhead seating I had to fight the airline to get turned out to be the worst on the whole plane, with a regular economy seat near the back being more spacious. That’s partly how the foot got swollen; not only could I not elevate it, but I couldn’t even rest it comfortably.

Here’s a thought. They only allow physically fit people to sit in the exit rows of planes. The reasoning is that these people will be the ones to help others out. If you ask me, that reasoning sucks. I was seated about 8 rows back from an exit. Had there been some emergency and the plane caught on fire, I would be screwed. It would be hard enough for anyone to get out of the plane, but me, with a broken foot and my crutches stowed? Forget about it, it’d be hopeless. And why do the “helpers” have to sit right next to the door? Why all three people sitting near an exit? Seems reasonable to me to put the people with infirmities near the door so you can grab them and throw them down the escape slide. If you seat them everywhere else, they’ll be stuck and cause a traffic jam. Not to mention that the infirmed need that extra leg space, far more than anyone else. Someone should re-think that whole policy.

The trip back was better, partially because I got “Economy Plus” (i.e., a regular economy seat rather than a sardine-can “Economy Minus” seat like I got on the way out), but probably more because my foot was more healed by that time.

The timing of my injury was both good and bad. Bad because it zapped me just when vacation was upon me, forcing me to fly with a broken foot, and miss out on a lot of fun. Also bad because the best birdwatching season is December to February, the exact time I was out with the injury (and I had started birdwatching the previous February, just as that season was ending). The timing was good, on the other hand, because I had just finished my last class of the semester the day before. Final exams and the graduation ceremony I was able to sit out (I monitored the exams from home while others subbed for me). That’s good because it meant I missed the least amount of work possible. Work started again a month and a week later, by which time I could get around enough to come in to work. But then fortune struck again: by unusual chance, I happened to have a schedule that brought me in to work on Tuesdays and Thursdays only, meaning I could recuperate more and crutch around town less. In that sense, the timing was just about perfect.

Driving a scooter also helped immensely. If I were to use public transportation, it would mean crutching down a hill for ten minutes to a bus stop, and waiting for the bus. Then crutching through train stations, worst of all Shinjuku–the transfer from my train line to my work’s train line included a walk across the length of the station, which would probably take 15 minutes, with stairs along the way (ever tried climbing/descending stairs on crutches in a busy train station?). Then there would be the trip from the station to work. And at every juncture, I’d have to take elevators, which are often placed inconveniently. Then the same in reverse on the way back (ending in an uphill 10-minute climb). Had I had a 5-day-a-week schedule, I’d have to do that ten times each week. God, what a nightmare that would have been.

Instead, I had my scooter, thank God. Door-to-door transportation, sitting all the way. For short trips, I could just put the crutches on the floor board between my arms, leaning against my shoulder. For longer trips, the crutches went upside-down on my back, between my back and my backpack, like those samurai flicks where the guy has his hilt on his back, and reaches over a shoulder to draw his sword. A lot of people commented that it seemed dangerous to drive with an injured foot, but so long as I could place weight on the heel, there was no problem.

I also learned a bit about how handicapped people are treated. While sometimes people would give preference to me in public, all too often they did not. When I was going to the airport, after my seemingly endless hike at Shinjuku Station, I had to buy a ticket at a JR ticket shop. I was sweating like crazy, my arms and good foot in obvious pain–I was a wreck on crutches, and yet no one offered me to get ahead in line. When I first tried to go shopping at the supermarket, I tried to use a cart, which was extremely difficult–I’d have to crutch and then push the cart every step, alternating where my hands went–and people in traffic around me kept shoving in front of me, making it harder, not easier. Once, when I was entering a Subway Sandwich shop, I opened the door, only to have some guy try to shove past me and get ahead of me in line to be served. Not a lot of consideration sometimes, I’m afraid.

Then there’s the design of my apartment and the building it’s in. Japanese apartments are not good for disabled people, as they tend to be narrow. Fortunately, I had an old, small, armless office chair on wheels which I used a lot to roll back and forth from one place to another. But my bath/laundry area is elevated up a step, making navigation more difficult there, as is the toilet room, making it hard to access, especially when I was starting out.

But worst is the general staircase design outside my apartment. My building has an elevator, but the idiot who designed the building made it so the elevator stops at the half-floor, not on every floor’s level. Which means you have to walk up or down half a flight of stairs to go between your front door and the elevator. Stupidest design I’ve ever seen, and completely unnecessary to the building’s function. The only purpose I can see it having is to keep the elderly and handicapped from renting there.

The healing process in my case was slow. The doc originally said 6-8 weeks. But the x-rays taken every two weeks kept showing little improvement, and “another four weeks” was a recurring diagnosis every two weeks. Even now, with my crutches no longer needed, the x-rays don’t show the rebuilt bone every much–you have to work hard to see anything in the gap. But the doc insists it’s there. And the bone parts seem to be pulling closer together. I can still feel the jagged edge of one part sticking out a bit, which the doc says will be subsumed within a few years.

The foot still hurts some, but feels better all the time. The remaining pain is mostly in the non-injured parts of the foot, from atrophy and strain from hobbling. Hopefully that’ll decrease as time goes on. Who knows, maybe in three weeks, when spring break comes up, I’ll be good enough to start birdwatching seriously again. Maybe by May or June, I’ll be well enough to birdwatch up Mt. Takao. We’ll have to see. This was my first broken bone, and it was educational. Let’s hope I won’t have another such chance to learn ever again.