The drive from Dr. Leemoore’s office to Bay Orthotics had been a short one, only taking about 10 minutes of so, Larry had skillfully maneuvered the van around two traffic jams on the freeway and had safely gotten Beth to her appointment 10 minutes early.
Larry had jumped out as soon as the van was parked and came around to open the door and help Beth out of the Van.
"Well, here we are maim, Bay Orthotics is right through that door, I will wait for you here"
"Thank you Larry, but this could take a little while, why don’t you get something to eat and come back"
"No thank you maim, I will wait for you here" Larry smiled as he held the door open that led into Bay Orthotics
"OK, well I’ll see you in a while"
An older woman behind the reception desk greeted Beth as she entered the office.
"Good afternoon, can I help you" replied the smiling face
"Yes, my name is Beth O’Connell and I’m here for my 2:00 appointment"
The woman quickly flipped trough the pages of her appointment book
"Lets see, oh yes, here it is, cervical orthosis fitting with Andrea, 2:00. Please have a seat Mrs. O’Connell and I’ll let her know you are here" the receptionist looked up from her appointment book and smiled, her short Grey hair almost perfectly matching the clear gray frames of her glasses.
10 Minutes had passed before the door leading to the back rooms opened and out came a woman wearing a white lab coat, khaki slacks and white Nike tennis shoes. Her curly red hair was pulled back in a ponytail, exposing her milky white skin and ruby red lips. She stood 5"11 with perfect posture.
"Hello, you must be Beth" Beth looked up from the magazine she was reading and smiled
"Yes, and your ........"
"Andrea, Andrea Murphy, I’ll be doing your fitting this afternoon, why don’t you come on back"
Beth followed Andrea as they walked through what looked liked Santa Workshop for the handicapped. There were laths, sewing machines, metal bending machines, plastic molding equipment, saws, grinders and sanders all surrounded by a variety of artificial legs, arms and different types of braces. The whole area had a scent of melting plastic and adhesives.
"Lets use this fitting room" Andrea held open the door leading to a small fitting room adjacent to the workshop
"Oh, thank you" replied Beth as she walked through the door past Andrea
"Please, have a seat up on the fitting table" Andrea said as she closed the door behind her
"So I understand you enjoy riding horses" Andrea asked looking down at her clip board
"It’s my passion, unfortunately that’s how I ended up here" Beth smiled and put her hand to the Philadelphia Collar encasing her neck.
"Horses are beautiful, but they can be dangerous, I do a lot of braces for people who have fallen or have been thrown off a horse". Andrea looked up from her clipboard, now wearing a pair of round, tortoise shell glasses, which were positioned mid way down the bridge of her nose.
"Yes, believe me, I know they can be dangerous, I’ve have had a couple of girlfriends at the equestrian club injured in riding accidents"
"So, it looks like you did quite a number on your neck here, at C5 and C6". Andrea said as she looked at the set of x-rays hanging from an illuminated screen to the right of the fitting table.
"Dr. Leemoore said they were pretty minor breaks and should heal fairly quickly" replied Beth in a confident tone.
Andrea carefully studied the x-rays as she slid her pointer down below the area where the neck injury was. Stopping midway down the spine, she looked closely at the x-ray and began writing something down on her clipboard.
"Is everything OK?" asked Beth as Andrea pulled down the x-ray and examined it further
"Well, it looks to me like you might also have a hairline fracture at T5 & T6, that’s down near the middle of your back" Andrea gently pushed on the approximate spot where she thought the injury was and Beth winced in pain.
"It is a bit tender there, but Dr. Leemoore didn’t mention anything to me about that" replied Beth with a puzzled look on her face.
"Well, maybe he missed it, it looks like it might be a very minor fracture, hardly noticeable unless you look very closely" Andrea held up the x-rays to the light and pointed to what looked liked a small imperfection in the x-ray
"Wow, I can’t see anything" replied Beth, "Of course, I don’t even know what I am looking for"
"Why don’t you relax for a few minutes and I’ll call Dr. Leemoore and see what he thinks about this"
After Andrea had left the fitting room, Beth could feel her eyes beginning to well up with tears again, what else could possibly go wrong today, she thought to herself. The morning had started out fine until that dreaded phone call, requesting she come down to the Dr’s office right away. After that, the bad news of the cervical fracture and then more bad news about having to spend the next 2 - 3 months in a neck brace even more restrictive than the collar she was already wearing. And now this, another possible fracture found in the middle of her back.
What would this mean, more time in bed? more time in the brace? how would Jim react?, how would she explain it to him?, surely he would not buy the "rolling bladeing accident" story after he learned of the new injuries. Beth begin to quietly cry as she waited for Andrea to return, hopping that this was all one big mistake and that the x-rays belonged to someone else, but knowing in her heart that they were in fact hers and that the news Andrea had would not be good.
Andrea returned 30 minutes later, wearing a fresh coat of ruby lipstick and carrying a small brown box under her left arm and a larger white box under her right.
"Sorry to keep you waiting but I was on the phone with your Doctor for almost 20 minutes" Andrea set the boxes down on the counter directly behind her and began scanning her clipboard.
"After reviewing the x-rays again, Dr. Leemoore confirmed that you do in fact have a hairline fracture of T5 & T6. Apparently he missed it this morning because one of the lights in his x-ray table is out, and he was not able to clearly see that portion of your x-rays" Andrea looked up from her clipboard and careingly smiled at Beth, trying to ease her concern.
"So what’s this all mean, more bed rest, hospitalization or..."
"Well, not really, its a very minor fracture and should heal without any problems, the only difference is that we had to change the prescription on your brace slightly. Dr. Leemore had originally prescribed a brace known as a SOMI for you". Andrea turned around and opened the larger white box now sitting on the counter next to the brown box.
"This is what a SOMI Cervical Brace looks like." Andrea pulled out a white "Y" shaped chest piece made out aluminum with metal shoulder supports and two dangling straps, a head piece with two aluminum supports and a chin piece that was supported by one bar in the middle and two side straps. Beth watched intently as Andrea took off her white lab coat and her purple silk blouse, revealing only a nude colored bra cradling her size 36 C breasts. Andrea placed the "Y" portion of the SOMI Brace over her shoulders and on to her chest. She then reached around her back and found the two dangling straps, which she tightly connected around her torso into two metal buckles attached at the bottom of the chest piece, just beneath her breast line.
"I hope I’m not offending you but I like all my patients to understand why we prescribe the type of braces they will be wearing, how they work, and what there function is. The best way to do this is to show you the brace fitted on me."
Beth smiled slightly; intensely staring at Andrea and the SOMI Brace that was now firmly strapped to her torso.
"The piece I have on now is called the chest piece, its main function is to support the head and the chin piece." Andrea now had the headpiece in her hands and was attaching it into two metal brackets mounted to the front of the brace. She then took the chin piece off the table and slid it under her chin, adjusting the height so it held her head in a perfectly upright, neutral position. Finally, Andrea attached the two leather side straps connecting the headpiece to the chin piece.
"There, I think I’ve got it now, as you can see, the SOMI Brace is keeping my neck and head in a straight line, limiting rotation and transferring the weight of my head on to my shoulders, relieving the weight on my neck." Andrea slowly turned, showing Beth the front and back of the brace that now held her head and neck in an upright and very rigid position.
"What it is not doing is keeping me from rotating my spine below where the brace ends" Andrea put her hand on the bottom of the brace, midway down her torso and twisted.
"Since this brace only limits movement down the torso to about T3, and your second injury is at T5 & T6, we need to use a brace that extends further down the torso." Beth sat in silence as Andrea removed the SOMI from her body and put her blouse and white lab coat back on.
"Do you have any questions on the SOMI or why we can’t use it in you situation" Andrea was now fully clothed and writing down some notes on her clipboard
"No, I don’t think so, I’m just a little nervous about the new brace the Doctor prescribed. The SOMI you just showed me looked scary enough"
"I know it looks scary at first, but believe it or not, it is actually a very comfortable brace, I do about one to two SOMI fittings a week and most of my patients, after the initial shock, find it fairly comfortable." Andrea looked up and smiled.
"So what type of brace has the good doctor prescribed for me now?" Asked Beth, her voice slightly cracking.
"Well, Dr. Leemoore and I have discussed your situation and we both feel that a CTLSO would be the most effective in restricting the movement of your cervical and thoracic regions of your spine. I’m sorry I wont be able to show you how this one works, at least not on myself, its quite a bit more complicated than the SOMI I just showed you and it has to be custom made."
Andrea turned and pulled a book off the shelf behind her entitled "Modern Orthotics" and laid it on the table next to where Beth was sitting.
"Let’s see, CTLSO – CTLSO --- ok, page 874 –875. Here it is" Andrea turned the open book toward Beth so she could see the title "Cervical Thoracic Lumbosacral Orthosis" or "CTLSO" and the two pictures below.
"This is similar to what you will be wearing." Replied Andrea as she pointed to the two illustrations.
"It is designed to keep your entire spine immobile from your chin to your hips. As you can see, this brace goes much further down the torso than the SOMI. It’s really more like the Milwaukee Brace, used to treat Scoliosis, but it has a complete chin pad and headpiece, instead of the low profile throat mold, used on the Milwaukee. It also has a complete body jacket or "Clamshell", which will be custom molded to your body. It will completely enclose your torso, hips and extend partially down your bottom. Also, unlike the SOMI, which has flexible leather straps connecting the head and chin piece, this brace uses rigid steel connector bars, which totally eliminate any movement between the two. "
Beth could now feel her heart rate race faster than ever as she looked down at the pictures of this other brace called the "CTLSO".
"Andrea, are you serious, is this really the brace I will have to wear?" Her dark brown eyes looking for a glimmer of hope in Andrea’s face.
"I’m afraid so Beth, but trust me, it’s not as bad as it looks. Once we get it all put together and properly fitted to your body, you’ll hardly even know you have it on. Besides, almost all of the brace will be covered buy you’re clothing, so most of it really won’t even be noticeable." Andrea looked at Beth and smiled, trying her hardest to comfort her.
Beth’s mind was now was racing a mile a minute as she thought of a million questions to ask Andrea but could only come up with a few.
"How high will the "Clamshell" portion of the brace come up on my torso?" asked Beth with a lump in her throat.
"Well, your brace will be a little different than the brace shown in the book, but basically the bodyjacket will start at your hips and continue up the torso to just under you arms" answered Andrea
"Does that mean that it will cover my chest as well?"
"Yes, It will go up over your breasts and stop at the base of your neck. It is imperative that the plastic shell of the brace extend up to your sternum." Responded Andrea
"Why can’t I have the shell stop just below my breasts with the little "T" type pad extending up from there, like you showed me in the book?
"Well, that works on women with smaller breasts but someone your size, the "T" bar, as we call it, just will not work. What tends to happen with larger breasted women is that a rash begins to develop underneath the breasts from the top of the clamshell rubbing against the skin. From my experience, it is much better to enclose them within the body jacket than to use the "T" Bar." Replied Andrea, with a very authoritative tone.
"I think these boobs of mine have caused me more heartache in my life than pleasure" replied Beth as she put her hands to her chest.
"With all the comments from the boys when I was young, to back aches and now this, they really can be a pain sometimes! Well, I’d better inform Jim that he better enjoy them now because this time next week they will be hermetically sealed in a plastic shell for a while"
Andrea smiled and laughed a little as she looked at Beth with compassion in her eyes, knowing full well that wearing a CTLSO for any length of time was NOT a fun experience, especially for a woman as attractive and well endowed as Beth.
"I am sure there are a lot of women out there that would gladly trade you their chest for yours but as they say, "the grass always looks greener on the other side of the fence" replied Andrea
"So Andrea, how many CTLSO’s do you do in a week?" asked Beth, hopping she would tell her she does a lot.
"Well, I guess the question should really be "how many CTLSO’s do I do in a year" because they are really pretty rare. I think in my 4 year career as an orthodist, I have done 3, not including yours"
"Well, that’s reassuring, I was hoping you would tell me you do one a week, I guess misery love company" replied Beth
"Actually, I have had extensive experience with the CTLSO, in fact, in Orthotics school, it was my specialty. Every student in the program was required to have a certain brace or prosthetic they specialized in and mine was the CTLSO so actually I guess I really have done more than 50 since 1995. Just 3 on "real" patients, the rest on other student volunteers and my boyfriend at the time, as kind of a homework project, but that’s another story.
"Wow, it sounds like you really do have some very extensive experience, I guess I am in good hands!"
"Well, not to sound too full of myself, but for spinal orthotics, especially the CTLSO, I am one of the best, and if you are going to have to wear a CTLSO, you want the brace, the fit and your orthodist to be the best, you’ll see. Now lets get to work so we can get you home before 6:00 PM. I’ve got a lot of measurements that need to be taken and we will need to cast you from your chin to your pelvis so that we can make a positive mold for the body jacket.
Beth smiled and tried her best to be positive, but she knew inside that she was in for a long and difficult road to recovery.
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