I Was MAFO'ed

Do you recognize this script?

Mr. McQuire: Ben.
Ben: Mr. McQuire.
Mr. McQuire: Come on with me for a minute. I want to talk to you.
A woman: Excuses, John.

(Mr McQuire and Ben step away from the crowded room).

Mr. McQuire: I just want to say one word to you, just one word.
Ben: Yes, sir.
Mr. McQuire: Are you listening?
Ben: Yes I am.
Mr. McQuire: Plastics.
Ben: Exactly how do you mean?
Mr. McQuire: There is a great future in plastics. Think about it. Will you think about it?
Ben: Yes, I will.

The 1967 script was from a scene in "The Graduate" starring Anne Bancroft and Dustin Hoffman (no relation). I love that movie because it's about "coming of age" and, of course, you-know-what. That movie made me think of the MAFO.

What does MAFO stand for? You have three guesses. Is it a) Muslim-Americans for Obama, b) Midwest Association of Farmworker Organizations, or c) Molded Ankle-Foot Orthotic? Of course, you know! I gave you a great hint with that script. Plus, as is this is neither a political or farming blog, it must be "c"--Molded Ankle-Foot Orthotic. But some of you don't know what an "orthotic" is. That's why I'm here, to explain it to you. For those of you who do know, bear with me. We've come to background time.

A MAFO, generally known as an ankle-foot "orthotic," is a molded, plastic, supportive aid to the upper or lower limb that makes improved movement do-able. People who make orthotics are called orthotists. Orthotics, coming the Greek word to straighten or align, is a specialty within the medical field concerned with the creation, manufacture, and application of the aids. The acronyms started in the 70s to define in which sub-specialties the orthotist functioned, like MAFO, TLSO that stands for thoracolumbosacral orthotics for conditions like scoliosis, and WHO which represents wrist-hand orthotics, just to name a few.

Foot drop (dropped foot and foot drop are interchangeable terms), what I have, is a symptom of the greater problem, not a disease in itself, characterized by the inability, or sometimes difficulty, in moving the ankle and toes upward. The dropped foot can range from a temporary loss to a permanent condition, all depending on the muscle weakness or, at worst, paralysis. Foot drop can be caused by spinal nerve trauma, an anatomy anomaly, toxins like lead or mercury poisoning, disease, or nerve damage.

My foot drop was caused by the nerve damage when I had the stroke, specifically to the peroneal nerve, the one that broadcasts to the muscles to lift the foot, and that nerve wasn't working. The classic foot drop is characterized by dragging one's toes along the ground. To accommodate patients whereby they lift their foot higher than usual to avoid dragging, they should wear a MAFO, which raises the foot high enough to prevent the toes from dragging.

Functional electrical stimulation (FES) using electrical currents to activate the nerve is an option for some, depending to what degree the nerve damage is. But if the nerve is dead, like in many stroke patients, a MAFO is the best and only bet. Wearing a MAFO causes a person to lift the foot in a process called dorsiflexion. A cuff is placed around the patient's ankle, and another one higher up under the knee, causing the patient to lift up the shoe when walking.

Ten weeks after my stroke, I had a MAFO, and still do. And now begins the MAFO story.

When I came home from the four nursing places I had been, I was wearing the MAFO. Some people asked me if I took it off, once in a while during the day, but they didn't know what you know now, that I couldn't take it off. Foot drop is foot drop. There's no way around it barring a miracle. Miracles are hard to come by. Winning a lottery is easier.

When I got home from the nursing fiasco, I noticed some red marks on my foot, even though the MAFO has to be worn with a high sock, high enough to cover the brace. Being the A-type that I am, I saved the orthotist's card when I met him at Rehab Y and called him to make me a new MAFO, or adjust the old one. He came to the house, wearing a suit (he was a proper kind of guy) and got to work with his apprentice. The two of them were using saws, sanders, and pliers (at least they resembled them) on my MAFO in the kitchen, and when they were finished, I was good to go.

But my foot was swollen after I came home from Rehab Y (I must have been retaining fluids), and in three months, the MAFO was too loose for my foot, risking a fall. So the orthotist came back again and fit a new one while I waited in the living room. This time, to my epic dismay, he decorated it with flowers on the whole back side of the MAFO. It was really silly and child-like. Why would he decorate the MAFO? I mean, why? So I asked him.

"What's with the flowers? I use the MAFO because I have to. If it was for a small kid...."

"I know. I know. I thought you'd like the flowers." I saw his jaw twitch, but he didn't say anything nasty. He was too dignified. He twitched his jaw again. "I can't remove them because the flowers were put on with permanent markers. So keep this MAFO and I'll have to make you a new one--plain, this time."

He returned a week later with the plain one, and since he had measurements from the second one, the MAFO was already prepared.

It was now Fall. I went through the seasons and Summer came, but the MAFO got too hot in the sun, even with the socks. I felt like a wet noodle. I called the orthotist back, but I didn't want a new one since the MAFO fit fine.

"The MAFO is unbearable. It's just too friggin' hot." The orthotist was so distinguished so I cut him a break by not using the "f" word. Even so, the jaw twitching was still there.

"I have an idea which I've never done before. I'll drill a series of pinholes over the whole thing so it can release the heat somewhat. Let's try it. It can't hurt," said the orthotist.

And so he did, and when I put it on and went outside, I was cooler after he drilled the holes. I started to feel rotten about the flower decorations that he applied with good intentions but great about the pinholes. And great about molded plastic. Mr. McQuire was right on. There was a great future in plastics.

The Top Ten Things You Should Never Say or Do to a Stroke Patient

People are funny, and I don't mean in a ha-ha sort of way. They could be neurotic, bi-polar, obsessive-compulsive, anxious, or agoraphobic, just to name a few types. Some of the ones who came to visit me had their own type: dysfunctional-when-meeting-a-stroke-patient.

Even though they had good intentions, in all fairness to me, some of them said and did things that were downright insulting, if I took the comments and body language personally. But I didn't ever, for those people who took the time and came to visit me.

In all fairness to them, how could they know the right responses from the wrong? What it really comes down to is this: How do you speak to a stroke patient whose had her life turned around in a 180-degree spin?

I made a list of the top ten things you should never say or do to a stroke patient, and I, too, have been guilty of most of them before having my stroke when I visited stroke patients. So having set the record straight, here goes.

Saying good girl, good boy, good job

Those are phrases you should say to your pets when they are being rewarded with a "Pup-Peroni" or Doritos' chips. If you say them to me, I am not really being a good "anything." I'm just sayin'. IT'S SORT OF CONDESCENDING.

Talking loudly

People have a habit of speaking loudly to foreigners and the sick. Just because they are from somewhere else, speaking loudly to a foreigner will not help get your point across. There is no hearing problem involved. The same thing applies to me. HOW DOES SHOUTING HELP?

Talking slowly

Talking slowly to a foreigner might be an asset. But talking slowly to me makes me feel mentally disabled. How would YOU like it if someone said, "How -- are -- you -- feeling -- today?" If I could, (and I wasn't able to then), I would have talked quickly in response, possibly making them change their way of speaking. I REPEAT--HOW WOULD YOU LIKE IT?

Making faces at me

Stroke patients are difficult to understand at times, but please don't squint, or turn your mouth to one side, or wrinkle your nose at me. Just ask me to repeat my statement, and if you still can't understand, ask the question in a different way. After all, you're the one with a full brain! SO USE IT!

Talking over me

I mostly listen, but when I get up the courage to speak, let me do it. Don't interrupt me in the middle. In other words, LET ME FINISH!

Completing your sentence

Some people find the right word choice instantly, but it takes me a few seconds more. So please stop trying to fill in the blank. WAIT! I'LL GET IT!

Giving me lists of things to do

If you give me a list five or more things to do, I'll may miss one. My brain is going, but the parts that are dead...well, simple died and there's no hope of getting them back. Did you ever hear that heavy drinkers lose brain cells and the cells won't be replaced? Same thing. YOU HEAR THAT, HEAVY DRINKERS?

Ignoring me as if I'm invisible

Once in a while, at Rehab Y, I would see doctors on the outside. If I'm waiting at a new doctor's office, for example, staring right at some person who's in charge, the person invariably stares at my friend to find out what my friend wants, forcing me to shout and look like an idiot--which I am not. I shouted several times in person but even more on the phone. Some of the people just don't listen and say their "shpiel" regardless if I object. Covered in the previous post The First Phone Call, aka What Should We Do About Outsourcing?, "FOR CHRISTSAKE, I HAD A F***ING STROKE. GIMME A BREAK!" (Sorry to all in the PC crowd).   

Saying I'm not moving fast enough

Once in a while, people will say something to the effect, "Could I get by you?" and start moving before they even hear the answer. Their rhetorical question, because that's what it really is, a few times cost me my balance. WHY ARE PEOPLE IN SUCH A HURRY IN THE NURSING HOME?

Hanging up on me

A lot of operators hang up on me. They are nameless and they take advantage of that fact. But it doesn't help me. WHY WON'T THEY WAIT?

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Now that I've off-handedly offended most of you, remember--I said or did the same things myself to stroke patients because I never "walked in their shoes." So now, do you feel better?