Chapter 15

The alarm clock fought its way through my unconsciousness, and I rolled over to slap the snooze button and silence it. Then I rolled over a little more and started to push myself into a sitting position so I could start the day.

Halfway to a sitting position, I decided it was probably cold and damp outside, because my back was killing me.

Many people with dwarfism develop back problems in childhood, as I did. I ultimately had a large part of my spine fused, but my doctor fused a little bit less than he really wanted to, because I was still young and fairly active, and he didn’t want to take away too much of my mobility.

What I didn’t learn until later is that he was concerned about my lower back not being able to bear the resulting additional burden. Unfortunately, he turned out to be correct, and over the previous couple of years, my lumbar spine had essentially begun collapsing in on itself. The treatment included physical therapy to strengthen my core and to support my spine, as well as prescription-strength pain medication to permit me to function despite the damage that had already been done. One of my little secrets was that I often took a double dose of it shortly before a race to improve my chances of being able to finish without collapsing in pain along the way.

Some days, though, the medication and the physical therapy simply aren’t enough. This morning was clearly going to be one of those days.

Although I am able to walk on my residual limb – because I had what is called a Syme’s amputation, my stump is the heel of the foot I used to have – I knew better than to try that morning. Instead, I lowered myself to the floor and crawled on all fours to the bathroom. I maneuvered myself into the shower, turning the water on a little hotter than usual. Sometimes this will help to relax the muscles in the back and alleviate the pain.

On that morning, however, it was not to be.

I managed to get myself back to my bedroom, get myself dressed, and move to at least a standing position, although I was walking slightly hunched over.

During a normal day at work, I try to make a point of walking a circuit around the office a couple of times every hour so that my back doesn’t tighten up from sitting all day. On this day, though, I didn’t move from the chair at all if it wasn’t absolutely necessary. I also made sure to write down the time when I took my pain medication, because on a day when I am on the upper reaches of the pain scale, it would be very easy to accidentally overdose.

I managed to make it through the day and, as I left work, I texted Lisa to beg off of going to the gym tonight, telling her my back was bothering me. She texted me back and asked if I’d like to come for dinner instead. I was willing to accept a two-for-one deal: time with her, and I didn’t have to cook.

After a very nice dinner of chicken Parmesan ... and a very nice make-out session on her couch ... I retired to my apartment for the evening, hoping that maybe a good night’s sleep would help.

As soon as my alarm sounded again the following morning, though, I realized it was not to be. If anything, the pain was worse.

Still walking in a slightly stooped position ... and now intermittently grabbing onto the walls ... I forced myself through the workday. I was relieved when Lisa sent me a text telling me she had to work late, obviating the need to come up with another excuse for not working out. I ordered dinner from GrubHub instead.

The third morning was when I finally called Dr. Milstein.

Dr. Bruce Milstein is a doctor I found when I was Googling the doctor who did all the work on me when I was younger, Dr. Emmett Wall.

Although Dr. Wall’s reputation in the orthopedic community is as a singular spine surgeon, that was not how I first came to be under his care.

When I was born, the most visible manifestation of my dwarfism was in my right leg. Where most people have two bones in their lower leg – the tibia and the fibula – I was born without a fibula, and the tibia in my right leg was shorter than the one in my left leg. As well, the leg had a club foot.

I was initially treated by a surgeon who made several attempts to “fix” my leg to make everything look normal, culminating in an early version of what is now called an “extended limb lengthening” procedure. In layman’s terms, the plan was to break the tibia, hold the two pieces several centimeters apart with a metal plate, and wait for the ends to grow together.

Not only did the procedure not work, it nearly shattered the tibia beyond repair. At that point, a friend of my mother used her connections to arrange for Dr. Wall to examine me. After his evaluation, he matter-of-factly presented my parents with two options.