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It was early Thursday morning as I walked into the office and was met by a security guard at the entrance to the lobby. I'm sorry sir he began to explain, but the company has gone bankrupt and will not be reopening again. I will allow you into your office but only to gather your personal belongings and then I will have to ask you to leave the premises.
Wow! How could this be happening to me? First my wife divorces me and takes my house and half my savings and now I lose my job. I knew that the company was doing badly but had no idea that they were going under. If it weren't for bad luck I'd have no luck at all. Then it hit me. Maybe this wasn't such a bad thing after all. A close friend of mine (Bill) had referred me to an out of state orthotics laboratory a few months ago. It seems that he had dated the owner and said she had once tried to talk him into being put into a cast for some fun. Well it didn't seem appealing to Bill and he later stopped seeing her because he said she was always talking about how great it would be if he became one of her patients as well as her date. He later introduced us at a party and she made several remarks to me that night indicating how she was really into her work.
She kept teasing me by telling me how nice I would look in a special neck brace called a SOMI. Just thinking about the possibilities instantly excited and aroused me. We never officially dated but I ran into her several times at different functions and she would always smile and ask me if I had considered her offer. I never was truly sure if she was kidding and I was always afraid to take her up on the offer. I later called her about designing a custom back brace for me and she was reluctant to talk about it over the phone. She said I would have to make an appointment to discuss it with her in person. Maybe now would be a good time to get on the phone and try to get an appointment and maybe even a fitting time scheduled. After all I wouldn't be working again for a while and I have a pretty big savings account, no home or responsibilities and it's only a three hour trip from here. So I cleaned out my desk and took the card with her number on it from the rolodex on my desk before being escorted off the property.
When I got home I called and asked to talk with Terrie. At first she acted as if she didn't remember me and asked if I had a prescription from my doctor and also the diagnosis for my condition. I started to stutter a bit and then said I was sorry and was not aware that a prescription was required. I thanked her for her time and quickly started to hang up the receiver. Just as I was about to hang up I heard her say hold on just a minute. I lifted the receiver and listened without talking to see if it was me or someone else that she was talking to.
After a short pause she asked "Are you still there?"
"Yes," I replied, "I'm still here."
I guess I didn't understand what you were talking about when you first called." she said. "I would be happy to set up an appointment with you if you would like to discuss this further."
"Yes" I replied, I just lost my full time job today and thought this would be a good time to get this done before I started looking for a new job. How soon could you work me in?" I asked.
"How about tomorrow afternoon, say 4:30 at my office?" she replied.
I happily made the appointment and quickly said good-bye before I changed my mind.
I awoke Friday morning feeling a little nervous about my upcoming appointment. Is it really going to happen this time? Will I finally be able to realize my lifelong dream of wearing a custom CTLSO. My heart began to race with the anticipation. I could hardly wait for the morning to end so that I could start the drive. I left the house at 1:00 PM with a full tank of gas and a vivid imagination of the upcoming event. As I pulled into the parking lot I felt a sudden surge of anxiety and almost turned around and drove away but I knew that I must go through with it. After all being so close, it would be ridiculous to stop now.
I walked into the office and was greeted by the receptionist at the window. She handed me a medical history form and asked me to have a seat. I completed the form and wondered if she may have misunderstood my request and would soon be refusing to treat me due to my lack of a real medical condition. A few minutes later I was called back and placed in a small exam room and asked to undress completely and put on a hospital gown. The wait seemed eternal as I sat looking at the four bare walls of the tiny room. Then in walked Terrie wearing a white full length lab coat and carrying a small medical bag in her hand.
"Sorry about the wait," she said with a smile. "We just finished seeing our last patient for the day and it took a little longer than I had anticipated. Now if I understood our phone conversation yesterday you are looking for a custom CTLSO but you have no physical need for such a device, is that right?"
"Yes." I replied, "I have always had an interest in recreational orthopedics and understand you may be willing to help me satisfy my needs."
"Well, she said, we can definitely be of assistance to you and have helped many people with similar interests in the past primarily due to my sharing the same interest as well. Don't you remember my proposition the night of the party?"
"Yes I remember it but I never really thought you were being serious and didn't want to let on that I was really turned on when you said it."
"Well it will take us several hours for the fitting and that's why I scheduled you for an after hour appointment today. We won't have the finished product made for at least 24 to 48 hours though and we have made arrangements for a place for you to stay until its completed."
"It's not as if I have anywhere else to be for awhile I said, I just lost my job yesterday and may wait a while before actively looking for another. Since my divorce was final I have been staying in a cheap motel and I just signed out this morning figuring I would look for an apartment."
"That's very good news." she said with a smile, "Well lets get started then. I'll need to take you to the fitting room down the hall and before you know it we'll be well on our way to making your dreams a reality."
As I walked into the room I was amazed at the equipment and gadgets available. I was asked to lay on a frame type bed in the middle of the room. It resembled a torture rack from medieval times. Once on the bed she began to explain that she would be placing my upper torso in a plaster cast in order to get an exact negative mold to make a positive casting of my body's shape. A certain amount of traction would also have to be applied to my neck and pelvic area in order to correct any deformity that existed prior to applying the plaster. That's the reason for the special frame you are laying on she said.
She informed me that the procedure may be a little uncomfortable and there may even be some pain as the plaster sets. Many people often have a problem with anxiety from being immobile for so long as well she added. Then she really floored me when she informed me that she would like to start an IV so that I could receive some medication to help me relax during the application of the cast. I was very reluctant at first and she quickly stated that it was not necessary but she usually offers it in order to avoid any unnecessary problems after they begin. I decided to let her start the IV before we began, but asked her to hold off on the medication unless I felt that I needed it. She then proceeded to place an IV into the back of my left hand which she attached to a bag of fluid already hanging from a pole next to the bed.
She then began by removing my gown and pulling a large tubular piece of stockinet over my upper body from my knees to my armpits. I was then placed in pelvic traction and a cervical head halter was fastened around my neck and chin. Soon weights were added to ropes and pulleys at the head and foot of the bed that exerted a great deal of traction pulling against my cervical and lumbar spine. She then applied two soft leather cuffs to each of my ankles, and adjusted the position of my legs using pulleys so they were suspended from the top bar of the bed frame.
As I lay there virtually suspended in the frame, I kept grabbing the side rails of the bed to stop myself from swinging back and fourth. Terrie then informed me that I would need to let go of the frame and allow myself to completely relax before beginning the cast. She gently took my arms one at a time and wrapped each of them in thick cotton cast padding from my shoulder to my hands. Then each arm was fastened to the side rails with a leather wrist cuff followed by an elastic bandage which was wrapped around my arms and the side rail to support the weight of each arm. This Terrie said was so I would no longer have to struggle to hold on. I was then encouraged again to try and relax while she prepared the casting material
I will be needing an assistant to help me in the application of the cast Terrie informed me. I hope you don't mind because I surely couldn't do this alone. My assistant's name is Tammie and she has worked with me since I opened my clinic and she also shares our common interest. Just then Tammie walked into the room. She was pushing a large cart with several drawers and she parked it just out of my sight at the head of the bed. She placed her hand on my shoulder and introduced herself to me with a gentle smile. Then turning to Terrie, she said "I see he has an IV started, this must be the one we have been talking about."
"You seem surprised that I have an IV I said to Tammie. Why is that?" I asked.
Tammie then paused a moment and before answering was interrupted by Terrie. I think we should begin quickly because I haven't finished telling him about our other clinic and his new brace design just yet and we wouldn't want to scare him off with our real plans.
Suddenly I felt a strong surge of adrenaline rush through me. What do you mean a new brace design? And what the hell is this new clinic? You basically have me tied up and suspended to this frame and want me to relax, and now your really starting to scare me. If this is some kind of a joke, please tell me right now because I'm beginning to get a little nervous. Just then Tammie pushed the cart into view. She quickly picked up a clear oxygen type mask with a self inflating bag, and connected it to a pair of hoses coming from the cart. Terrie took the mask from her and placed it securely over my mouth and nose. I started to struggle against the restraints but couldn't free my hands.
My heart raced faster as I began to yell as loud as I could for them to let me go. They placed two wide straps around my head to hold the mask in place. After tightening them, Terrie let go of the mask and stood over me smiling at me without saying a word. Then Tammie handed her a syringe and a large vial of medicine and told me that it was useless for me to yell and to struggle. She reached over to the cart and turned a few knobs and I suddenly heard the hissing sound of gas coming from the mask. Terrie began to slowly squeeze the bag attached to the mask each time I began to take a breath.
"You will relax and settle down," she informed me, "If not because you want to, then at least because we want you to."
And then Terrie raised the syringe to the IV tubing and slowly injected a milky looking fluid into the tubing. She again leaned directly over me and smiled as she said "You remember how I said it would take at least 24 to 48 hours for your brace to be ready?"
"Yes" I replied in a muffled voice through the mask.
"And that we had made arrangements for a place that you could stay?"
Again I answered yes.
"Well you'll soon be visiting that very place. And by the way, you don't have to worry about the prescription anymore. You see Tammie is not just my assistant, she's an orthopedic surgeon and now I know exactly what the doctor has ordered for you. Now each of our dreams is going to become a reality. Yours for getting the immobilization you have always only dreamed of, and ours for being able to control you and satisfy your needs as our patient. But for now you'll just have to dream a little longer. Good night my dear patient. Goodnight!"
I awoke to silence with a bright light shining in my eyes. I was sitting upright in some type of a chair and felt a burning sensation in my forehead. I squinted at the light and attempted to focus my eyes. My neck was being held rigidly straight and my arms and legs were still being held down by restraints. I struggled hard to break the bonds holding me to the chair. I could see although quite blurry the casting table directly in front of me and knew I was still in the same room. I decided to yell as loud as I could to attract some attention and took a deep breath in through my nose. I tried to yell with all the strength I could gather and could not produce a sound other than the moving of air from my chest. How could this be I wondered. Suddenly standing in front of me were my two captors. Tammie turned down the lights and I began to reorient to my surroundings.
"Don't try to talk," she said, "there is a tube inserted through your nose and into your lungs that is allowing you to breathe but will not permit you to talk. If you cooperate with us the tube will be removed later and although it's uncomfortable to you right now you'll soon get used to the way it feels. We are going to have to move you soon and if you can relax and remain quiet we will allow you to stay awake for the trip. I will try to explain everything we are going to do tonight before it happens but you have to remain calm and be patient. Terrie is going to bring you a large mirror so that you can observe for yourself your current state of immobilization. This is only temporary and will become much more involved once we get you back to our clinic." she said, "I will try to explain what you are seeing in the mirror as you look."
Terrie then placed a large mirror directly in front of me. I was covered in a fiberglass body cast from my pelvis to my shoulders. Extending up from the cast were four upright stainless steel posts connected to a ring that encircled my forehead.
"We have placed you in a halo cast / brace." explained Tammie, "It was put on you after the plaster cast was removed and while you were still asleep. Its now 3am and you have been tolerating the effects of our treatment and the drugs well. You'll probably remain drowsy for several more hours even if we don't have to give you more sedation. You can use your fingers to answer to yes and no questions while the tube is in place. Lifting one finger for yes and two fingers for no, do you understand me and are you experiencing any pain right now?"
I replied to her question by lifting a single finger.
"Is the pain in your forehead and the back of your head?"
I again lifted a single finger.
"There are several small incisions through your scalp just above the hairline. This is where we have placed stainless steel pins through your scalp and into your skull to attach the stainless steel ring you're seeing to the upright posts. This too will become less painful to you as time passes. You should not have any additional pain other than maybe a minor throat irritation which can be lessened if you try not to talk while the tube is in place. The breathing tube is connected to a small ventilator that will assist your breathing by giving an occasional pressurized breath to insure your lungs are being fully inflated in order to prevent pneumonia. The cast is very restrictive and you will have a tendency to breath more shallow on your own without occasional mechanical support. The wheel chair you're sitting in is equipped to carry the ventilator and it's batteries along with an oxygen and nitrous oxide cylinder should we need them. That will be all for now," Tammie said, "we need to load the van with some equipment and we will return for you in a few minutes."
As they walked away I could not help but notice that just looking at myself in this helpless state was actually very stimulating. Terrie returned a short time later and wheeled me back through the office to the front door. Outside there was a brand new van with a wheelchair lift lowered to the ground on the passenger side. My car was the only other vehicle in the lot at this late hour and I wondered what they planned to do with it as well as what they planned on doing with me. I was taken to the van and the chair was locked into place in the back.
Terrie climbed in with a small bag and produced a roll of white adhesive tape and several eye pads. she then pulled down the lower lids of my eyes and squirted a thick gel into each one before covering them with the soft pads. "This is called lacrilube and will protect your eyes while they're covered and prevent abrasions to your corneas." she said.
After taping them in place she said "we told you that you could remain awake but never said that we would let you know where we are taking you." With that she reclined the back of the wheel chair into a semi sitting position and the van began to move. After only a short while in the van I became intensely nauseated and came very close to vomiting. Terrie managed to instinctively notice my discomfort and stop the van. I heard the side door open as Terrie again climbed next to me. I'm sorry she said but I'm going to have to put you back to sleep or you'll never make it to the clinic without becoming very ill. Don't be afraid my dear she whispered. We will take good care of our sweet patient. The ventilator then began to increase the rate of my breathing. It was as if I had no control over when I inhaled and exhaled. With each breath I was beginning to feel increasingly tired. Finally I heard a strong ringing in my ears and once again lost consciousness.
Awaking once more but this time in complete darkness I try to get my bearings. I am supine and very comfortable but feel a constant pull against each of my arms and shoulders. I can feel that my hands are in front of me and my elbows are bent at 90 degrees. My arms can move slightly so I know that they are not in a cast. My eyes are still covered when the lights come on in the room.
Tammy came to my side and carefully removed the eye pads. She then asked me if I was in any pain and I quickly responded by lifting two fingers to indicate my lack of discomfort. Tomorrow morning we may be able to remove the breathing tube if all things go as planned. I can hardly wait to get your response to your treatment once you can talk again. By then I can safely say that you will have undoubtedly achieved you ultimate goal. Today I will be finishing your upper body and later this evening we will complete your treatment and then let you rest until your brace is ready. The next step in your immobilization is to encase both of your arms in fiberglass casts from your hands to your shoulders and incorporate them into the body portion of the cast. You will then be immobilized from the top of your head to your waist.
(To be continued)
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