Remember that fancy hospital I was talking about the other day? The one downtown Heidelberg that looked like some government building? This was the next stop in my journey. This was where I learned about Kienbock's disease.
So Atos Klinikum is a rather small hospital in comparison with American or university hospitals. I mean, there's this hospital called Theresiankrankenhaus (literal translation: Theresa's sick house) in downtown Mannheim that takes up a whole stinking block. Also, I'd been to the famous Army hospital in Landstuhl down by Rammstein for a GI appointment and some scope work the year before. That is also a huge hospital. You even have to go through security to get in.
I'm a little off track here. So, we park in the underground parking garage, and take the elevator to the main floor. We're looking around and this place is like a 5 star hotel with a Pharmacy that looks like it belongs in Donald Trump's house, and a restaurant with affordable and delicious local fare, and finally a gift shop and in-patient center. The floors and columns are all marble, and there's a grand foyer section where the middle of the entire building is open up to the greenhouse roofed ceiling. You can see all the way up to the top floors, and they can look down on you. The elevators are completely glass all the way around, and you can see all this artwork in between floors while you're going up ... and we did because we went to the second floor. Or, in Germany, what is called the second floor but is really the 3rd floor because they don't count the ground floor as one level, but as "Erdgeschoss", literal translation: earthen level. We learned this moving into our house because we lived in a 4 story home and had to tell them 2Nd level for the top floor, even though in America, it's the 3rd floor. Okay, again, off topic.
So we go up to the floor where the orthopedic clinic is, and we enter the office to find it's rather normal - more like an American office than the other orthopedic clinic we went to. It has a small waiting room enclosed in glass dividers with a closing door so the doctors and nurses don't get distracted. The counter is right when you walk in, so I tell them in my best German that I'm Mrs. Cushman (you always refer to yourself formally when dealing with strangers in an office setting - name tags always say Herr and Frau instead of first names). I tell them I'm to see Dr. P. They check their lists, and then have me fill out some paperwork. All over the wall when you come in, opposite the check-in desk, are these (what we Americans would think) grotesque pictures of foot and hand injuries. This office strictly deals with feet and hands. The doctors here are preeminent specialists in Germany.
We waited quite a while to see Dr. P. Mostly because the clinic was jammed with people waiting to be seen. This was obviously a very busy hospital. My husband and I always bring something to do with us, so of course I whipped out my school books and started reading, and my husband tried to sleep. When I was called back to a room, the girl asked how well I spoke German and I told her I can speak well conversationally, but not medically. She told me not to worry, everyone that works at that hospital is required to know 3 languages, 2 besides German and most all of them can speak English. This is because in Germany, unlike America, English is a requirement that is begun in the 4Th or 5Th grade and is continued, usually, for 7 to 10 years depending on the length of schooling and type of school.
So, Dr. P. waltzes in shortly after, and speaks perfect English. He's better than the immigrant doctors commonly employed by the U.S. military (often spouses of military members) who speak English every day with every patient. Anyway, he takes my disc of X-rays and prints out the pictures. He's not happy with what he sees, so he sends me downstairs to get an MRI. Now, usually, you have to schedule MRIs at a hospital. At Atos Klinikum, they do them on the spot, and results are immediate. I spent no more than 20 minutes down in the MRI. I didn't have to take any clothes, jewelry or even my belt off. Just my shoes. The woman running the MRI said she couldn't speak English, which really means she can but is fearful of her abilities and will only speak English when she completely can't understand you. So, she spoke German to me the entire time - which I'm used to but not in a medical setting. However, I've had many MRIs so I know what she's saying. Don't move. Squeeze this sensor thing in your hand if you need to stop or there is an emergency. Don't move. Don't move. I can talk to you through this headset. Don't move. You know that kind of stuff.
After 20 minutes, she sends me back upstairs to the radiology clinic to get my results. Again, I wait maybe 5 minutes and a guy comes out and takes me back to a computer. He speaks perfect English too. He shows me my results, talks to me a little bit, and then sends me back to Dr.P.
Dr. P. is floored. We have a lengthy conversation about my fracture. He tells me this is called an avascular necrosis of the lunate and a significant radial difference. Rough translation into laymen terms: There are these tiny bones in your hands. One of them in the middle of the bottom row of bones is lunar shaped, and thus called the lunate bone. This bone, which is critical to movement of the wrist, has died. There is no blood supply (hence the avascular). Because it is completely dead and fractured, it is going to, at some point, decompose and break down in to tiny bits. They cannot restore blood supply to this bone because of the extensive damage. This is an extremely uncommon disease. There isn't much known about this disease because of its rarity. Additionally, my case is even rarer than normal because I have a radial difference. This means that the radius bone (the inner arm bone) is longer than my ulna (the outer arm bone). This difference is likely what caused the bone to die as it pushed and crushed the bones in my wrist as it grew.
Dr. P. starts telling me the different stages of the disease. He has listened and exclaimed over my entire medical history with this issue since 2001. He is horrified that no one ever took an X-ray, that no one ever found out what was wrong, and that they lied to me for years and years. His expert medical opinion based on my symptoms, my X-rays and now my MRI results, and a light physical examination, is that I am in stage 3-A. There are 4 stages of the Kienbock's disease. 3-A is pretty bad, but not as bad as 3-B or 4. I'll get more into the actual disease soon, but Dr. P. says he recommends a radial shortening considering my stage and condition.
We tell him we'll think about it, and that we will call when we make our decision. I made the decision that weekend this HAD to be taken care of, but waited a full two weeks to call the office and schedule surgery.
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