Mitsugirly's Foot Journey a journal of my struggles
August 14, 2019: Injury day
I just wanted a place to journal my injury and struggles after that so that I could keep track of things somewhere. I figured what better place than on my website. I have a lot of people ask me about it: what happened, how are you doing, any improvements and so on. This is just a place for me to keep it all together as I go along.
So....here's my story...I'm an idiot. This injury occurred a few days after I returned from my NCL Breakaway cruise and my first day back to work after vacation.
I was at the gas station getting gas, in between seeing my patients, and I had put the nozzle in the truck and decided while I was filling it up to go to the door and clean out my trash from the front seat. Well, obviously I went about it the wrong way and decided to step over the gas hose and my foot got caught. I did a few hops on my other leg, trying to get my balance and catch myself...because at that point I knew I was going down...but it didn't work. I flipped over the hose and tried to put my foot down and CRACK. The sound was terrible. I knew it was broke instantly. I keep playing the scenario over and over in my head and hearing that sound and it's driving me insane. How could I be so stupid to do this? What made me think it was ok? Ugh!
Down I went and was really afraid to look, but when I did...my bone was sticking out and my foot was twisted almost backwards. Yes, I'm actually laying on my back here...
Thank goodness there were 2 other people there getting gas and I screamed over and over (they didn't see it happen) and they came to my rescue. They called the squad and said everything they could to keep me calm. One went and got a windshield wiper fluid bottle to rest my head on so was wasn't laying on the concrete and another went and bought me some water. They took the hose out of my tank for me and stopped the pump. They got my cell phone out of my truck so I could call my husband while we waited on the squad. They stayed with me the entire time. I'm so grateful for them!
The squad arrived and one of the good samaritans took my keys and moved my truck so they could get over with a stretcher. The hubby flew there (I honestly don't know how he managed to make it there that quickly because he was across town but made the comment "the supercharger did it's job lol),
I have a very high tolerance for pain and everyone kept saying I can't believe it. In the squad they laughed (They happened to know me from working at the hospital) because they said nurses are usually the worse patients but I was really amazing and I told them my rated pain level was about 6-7. 😲 I opted to go to the hospital I used to work at (they built a new one and it was a little further away than some of the local hospitals in the area) and with all the freeway construction, they decided to take the back roads. They told me it was going to be a very long and bumpy ride with a lot of turns and I told them I was up for it. I got them to agree to not strap my legs in because I had to keep moving the broken one from laying flat to raising it up on my other knee for comfort. I held on for dear life and away we went.
Arriving at the hospital, everyone was so great and I got one of my favorite doctors that I worked with at the hospital and he remembered me. He's such a down to earth guy and he'd ride his Harley or bike to work and he's just "one of the guys" you'd see on the street and not stuffy or uppity. You'd never guess he was a doctor outside of the hospital. Just an all around good guy. He told me he was riding his bike and was hit by a car not too long ago and went through the same thing I was going through. I asked if he was riding his bike on the way to work and he said "yep". LOL
Little did I know just how bad it was at the time. They came in and took x-rays and I would move my foot up and place it on the Xray and any way they wanted. They were so shocked I could do all these things and I wasn't your typical patient screaming and telling them not to touch it. I received so many nice compliments about how well I was taking this and doing much better than they've ever seen someone come in with something like this. I was very calm and proud of myself mentally working my way through the pain.
After x-rays they informed me of a tibia and fibula break, my ankle bone was "chopped off" and of course I was going to require surgery.
This is the upper part of my leg, close to my knee. They said they would not be repairing it and once they aligned my leg below, this should pop back into place and heal on it's own.
And my ankle bone that had chipped off.
Now came the bad part....the doctor was going to have to do a reduction on my foot to get it aligned more so they could splint it and wrap it prior to going up to my room. UGH! Now that was painful! I'm pretty sure I let out a yelp and a very long UGGGGHHHH while gritting my teeth and clinching my fist. I'm sure I left indents on the gurney.
They finally got me up to my room, where I would stay the night (due to my heart issues and so they could obtain an echocardiogram on me before surgery to make sure I wouldn't have any problems during surgery). My kids and my neighbors came to visit and that's when the pain kicked in and I'm talking KICKED IN! It was unbearable! Like seriously. I hated that my kids were seeing me like this and it took forever for them to get me any meds approved. They said the ER orders didn't "follow me" to the room and they weren't sure why so they had to get a new approval from the doctor and pharmacy. I tell ya the pain was way worse than when I had first done it. Whoa!
It would be a VERY rough night for me with a lot of pain, not being able to get comfortable and very little sleep.
August 15, 2019: Surgery Day
I was NPO after midnight of course and ice chips had never tasted so good the following day. Then I was informed my surgery was not scheduled until 3:40pm. Ugh! I was already starving. It was the longest day ever!!!!!! Go on a cruise and eat any time you want and all day long and come home to not being able to eat. Not fun. lol
I ended up having a nurse (on surgery day) that grew up and graduated with my older kids. Their mom actually used to be my babysitter for Kenny and Kendra until they got older. So we were always really close to them. I was so happy to see her as my nurse.
They called me back to preop around 1:45 and told me that the plans were to put 2 plates in (on both sides). They would repair the tibia and ankle and insert plate and screws in and then they would have to put a plate in on the other side to align the bones so that the fibula would align up on it's own and repair. Since the fibula is not a weight bearing bone, the fib fracture should be able to heal on it's own. Plus I had some ligament damage from the twisting on the fibula side and by placing a plate in, it would help realign those ligaments and they could repair them. They decided to go ahead and take me back to surgery at 2pm. I opted to do the popliteal nerve block on my leg because they said it would last for 18-24 hours post surgical and that would be a critical time for me to have a lot of pain. Well....here it is....22 hours post block and I'm still just as numb as ever. I'm not sure if this is a good thing or not because although it's numb and I'm not having any pain, the numbness and tingling is still very annoying. LOL You win some you lose some. **I just ask Billy, Kendra's fiance when his went away and he said 2 days***
Post surgical and back in my room. They said the surgery went well and it took about an hour.
Since my nurse was a long time family friend...I immediately started ordering food. LOL I couldn't wait to eat! Once my belly was full, I ask when I'd be going home. She told me I could opt to stay another night for monitoring if I felt it was needed or she could discharge me whenever I felt like. Well, I could lay there in the bed or lay at home in bed...hmm, not a hard decision. I opted to go home and as soon as possible. Her words were...I'll get your discharge papers done within the next 30 minutes" and that she did. I guess it pays to have "contacts" lol.
Now I'm at home, living on my first floor and sleeping on the couch I have 2 nursing aides to help me out (Sakari and the hubby) and all I'm missing is a little bell to ring for service. LOL The hubby went out and bought me a bedside commode and ordered me a wheelchair to use this morning. Kendra's fiance Billy (who just went through this from a fall back in January) gave me his knee scooter to use during recovery and the neighbor (who just went through this last summer) gave me his crutches to use. My oldest son Kenny will be coming over to make me a wheelchair ramp. Now all I gotta figure out is how to take a shower. I told the hubby I'm going to have to get some body wash and go out on the deck and him hose me down. LOL
The hubby brought my computer downstairs and he has me all set up at the kitchen table with the chairs to prop my leg up and my computer chair to roll around in to get things until the wheelchair comes. That way I'll have something to do and can do my review since I'll be down with no walking for at least 8 weeks. I'm told that it will take around 7-9 months to heal and I know the neighbor and Billy wasn't actually able to walk on theirs for about 5-7 months. It's going to be a LONG recovery and I'm not even sure when I'll be able to return back to work. I'm hoping, at this point, I'll have a job to return to. 😞 What really sucks is this is going to put me out of the cruise scene for awhile....I mean lets talk about the important things. LOL
Sakari starts school next week and I never got to go school shopping for her and the night of my fall, was her open house and picking up her schedule. The hubby is trying to do as much as he can but it's not going to be easy. He said last night "in sickness and in health and we will get through this". He's taking it like a champ and slept on the love seat last night. We'll see how he feels about this months from now. LOL Kendra just texted me offering to take Sakari school shopping so hopefully I'll get that accomplished. Her new art school she will be attending has a dress code and it's not easy finding what they are required to wear. Blah
My boys did come over and help the hubby bring down our bed to the living room, so now I officially have a bed to sleep on instead of the couch. We have made our living room as wheelchair and handicapped friendly as possible because it looks like I'll be staying in here for awhile now.
August 21, 2019: Ortho Visit...Removal of Dressing
I had my follow-up appointment this morning.
They removed the dressing...to reveal this ugly looking leg now...
The right side of my leg...plate with screws to stabilize the bone so that the bone that is broken higher up on my leg will heal and also I had ligament damage down that side and the plate would help the ligament stay in place and heal as well.
The white spot is from the blood draining down my leg and pooling on my heel. It has been bothering me and very numb...but not your "fell asleep" type of numb, more like the feeling your feet gets when they've been in wet shoes for awhile and wrinkled up and turned white type of numb. Now it all makes sense to me why it was feeling this way.
On the left side of my leg is another plate and screws to repair the ankle and fractures on that side. There was also extensive ligament damage for the ligament that runs up between the tib and fib and they had to screw through the bones to stabilize them together.
As you can see I have a fracture blister. This can happen over areas of a break where there is very little subcutaneous tissue between the bone and skin.
The black mark on my leg is where the break was protruding right under my skin (from the previous pictures when I first did it). The doctor said he was shocked that it was not an open fracture and sometimes you get these broken skin area's where the bone is sitting just under the surface of the skin but for some reason it did not break the skin...but might as well have done it. He said the deadening of skin at that area is normal under these circumstances.
Xray of my new internals I'm sporting...
This is the xray and the red lines are where the ligaments were torn and mangled. The one ligament goes up between the tib and fib in the middle, therefore the screws(2 of them) were placed (longways in the picture) to stabilize that area for the ligaments to heal and stay put.
The line on the right side of the picture was another ligament that was torn and mangled out of place and they used a plate and this U shaped plate holder to pull the ligament to where it supposed to be at and hold in place (you can see the little curve at the bottom on the right with a screw into the bone and it goes up the tibia. This was the area that my ankle was "chopped" in previous xrays.
Now in 4 months, I will require another surgery to remove the 2 screws in the middle, holding the tib and fib together and stabilizing the ligament down the middle of them and also remove the plate on the fibula.
As for now, I am in a cast for the next week to continue to allow for healing.
They had such a variety of cast colors and I picked: purple, pink or orange out of all of them. I allowed Sakari to decide which one out of those 3 colors. She decided on.....
So I'm now the owner of a bright neon pink can-see-you-a-mile-away cast announcing to the world I made an idiot mistake. Thanks Sakari for that notification to everyone that comes in contact with me. LOL
This cast will stay on until next week and then it will be removed and the stitches taken out. I believe he said a walking boot after that...but of course no walking involved with the walking boot...for at least 2 months for now.
My family made sure to put their "mark" on my cast and of course Sakari couldn't wait to put her artistic touch on it as well.
August 28, 2019: Ortho Visit...Removal of Cast
I did my follow-up with my ortho doctor today. The cast was removed...whew! (They commented on "there must be an artist in the family"....Sakari did me up good with palm trees, dolphins and so on while the hubby drew me a stick figure with a mangeled leg saying "ouch". LOL ) There's a lot of swelling, but I have to say it LQQKS a lot better I think. The fracture blister has reduced in size and I could tell by the burning every so often that it was "leaking" fluid. There seems to be a pocket that looks to be full of blood hanging in it still. They said to just let it continue to drain on its own.
They removed my stitches and then applied a walking boot. No walking or pressure on it for the next 6 weeks. At that time, they will take xrays and start PT and apply a little walking here and there.
At the 4 month mark, I will have outpatient surgery to remove the plate on my exterior right side (that was only applied to pull my upper bone back into place for the fib fracture and align everything up so that they could repair the ligaments torn on that side to heal) and they will remove the 2 screws holding the tib and fib together as well. They will not be removing the interior left side plate where the ankle, leg and ligament was severely mangled.
Tomorrow I go for an ultrasound due to concerns of a possible blood clot with some pain and feeling I've been having in the back of my leg calf area. So I'm hoping for the best and hoping it's just due to the extreme swelling of my leg. My leg has swollen so much that it has caused bruising, in a round circle, around the top of where the cast was at all the way to the back of my posterior knee area.
So for now...just more rest. I hate this feeling. I feel like my leg and foot are going to pop. My skin is so taut and the edema is the entire lower leg and foot. I tried icing it today and despite having it on for 20 minutes and feeling like my skin was frozen solid, it still felt warm to the touch. But, no signs of infection. I can't even use my knee scooter yet because I'm unable to bend my leg at a 90 degree angle to put it on the scooter. 😕 Lots of time and healing in my future.
On a better note, my work was excited when I asked if there was any work I could possibly do from home while I'm not able to see my patients....TONS AND TONS of work. So, at least I'll be able to keep myself occupied.
Excitement builds...
Pregnant seahorse...I guess it's a boy...(this picture doesn't look half as bad as what it really is in person)
Stitches out...
Fracture blister has blood in it now and hanging
Momma got a new pair of shoes...well, not exactly a "pair"....
Rest and ice...but still really bruised
August 29, 2019: ER visit and Ultrasound
Headed to Mt Carmel (the hospital) to get my ultrasound today for what I'm pretty sure is a blood clot in my leg. I'm hoping for the best, but feel deep down inside I already know the answer.
Once the Ultrasound was complete, of course they told me they had to have the doctor read the results...and time went by so slowly waiting for the result.
When they returned, they gave me that dreaded news...I had 3 blood clots. Two in my calf and one behind the knee. 😭 I just knew it...😔 I just keep running into road blocks and it's very hard to stay positive.
I was immediately sent to the emergency room for "treatment". They prescribed me some blood thinners for treatment and off to the pharmacy we went....scared to death at this point.
Then the pharmacy tells me that my medication is going to be $760!!! How do they expect someone to afford that (and that's only a 21 day supply). I'm told I'll be on it for 6-12 months!!! They want people to have to take out a second mortgage on the house to pay for prescriptions or what? geesh There's no telling how long it will take my body to absorb the clots so it's just a waiting game and I'm hoping the blood thinners do their job and help keep from getting more or the current ones growing.
The problem is that Xarelto and Eliquis are fairly new drugs and there's no generic for them yet. So, people are forced to pay the expensive prices. These drugs are different from the regular Warfarin or Heparin because there are no diet restrictions or monitoring your blood. I did immediately inquire about switching, once I found out the price, and since the ER doc prescribed it, I was unable to switch. I will have to contact my PCP, who is who they say will have to monitor me while I'm on it, to discuss switching it. The ortho doctor said they do not monitor the patient with blood thinners and only have the "ortho" side of things...even though that is what caused this.
After weighing my options, switching to one of the other medications would probably end up costing the same, if not more, because of having to go in to be tested every 2-3 days (charges for doctors visit, lab draw, lab reading) and so on.
The pharmacy did have me searching for coupons online and we did use GoodRx and found a coupon, which brought the price from $760 down to $662. 😕 I felt bad for the pharmacists that had to endure my long list of codes I found online and tried every one of them to get the best deal (I brought in about 7 of them). I did find a "free trial 30 day sample" code that worked and got it for free this time around. It just sucks that the free sample was for 30 days and my prescription was only for 21 days...so I wasted 7 days using it. :(
I'm trying to hang in there and stay strong, especially in front of my family. But, I don't think a night has went by since I did this that I haven't cried in the middle of the night when no one is around. It's a very hard pill for me to swallow.
Just some information on blood thinners for knowledge: being on blood thinners doesn't make the clot go away. The blood thinners helps "try" to keep the clots from getting bigger or "try" to prevent more from forming. The clots will eventually (hopefully) dissolve on their own. Your body naturally dissolves it when it's ready and usually once an injury heals. My problem is...the 3 blood clots are preventing blood flow to and from my foot (since they are above that area), which is hindering healing, which means my body knows it isn't healed, therefore not absorbing. 😕 The more medical term for it is once the body is healed, we have plasmin in our system in the clot. Plasmin is there the whole time and what is needed for it to dissolve. However, it's just laying dormant and waiting for the body to heal before it "turns on" and does it's job of breaking down the mesh structure that forms the clot. It can take weeks to months.
August 31, 2019: Lots of Dressing Changes
September 6, 2019: Blood thinners & issues
Things only seem to be declining. Blood in urine today and an ortho that won't manage it or the blood thinners I was put on and a PCP that won't take workers comp (even if I pay for it and ask BWC to reimburse). So now I'm stuck trying to find someone to manage my "other" condition caused by the break. :( When will it ever end???
September 11, 2019: A visit to the doctor for follow-up
It not only rains and pours here, but I'm expecting a tornado any day now. Things don't seem to be getting any better and the pain is only getting worse. :( My foot looks like it's ready to explode and no blood return is causing it.
I'm now wrapped up with daily dressing changes. At least I'm able to keep a good eye on it now and see if anything goes wrong.
For the most part, it was scabbing up, but there were some open wounds still. My fracture blister had finally popped and was now just an empty piece of skin there that had now hardened.
Things have not been improving. There have been no changes other than the pain and swelling are increasing. It's almost to an unbearable stage that I had to call the ortho doctor yesterday to make an emergency appointment. I couldn't wait another 4 weeks for a check up.
All my problems explained to the ortho PA: increased pain and swelling to the point I'm in tears on a daily basis also only getting 2 hours of sleep at night before waking up in so much pain I can't sleep. Solution: they took me off the pain meds and put me on Tylenol and Gabapentin. 😫
Increased swelling in my foot: due to 3 blood clots in my legs and the blood is having problems returning and pooling in my foot. Solution: massage the foot in upward motion to get the blood to go up. So, this works...while you are doing it, but once you stop, it comes back! Ice and elevation does NOT work at all and makes my entire leg to my buttocks fall asleep. So, I have to go up and down with my leg constantly.
Incisions aren't healing and still leaking fluids which causes some skin to peel off every dressing change. Solution: stop using the emulsion dressing and go to a dry dressing to help create a scab that will stop the leaking.
Since being on the blood thinners, I am constantly freezing to the point I'm shivering but no temp. My house is between 80-83 daily and I'm covered in 3 comforters not being able to get warmed up. Per everything I have read, being cold is not a side effect and the PA wasn't sure. However, multiple searches revealed many people with this symptom.
Increased urine output: up every 2 hours at night and 1-2x every hour during the day. Once again, PA couldn't explain.
Blood in urine: It has subsided now and I'm keeping my fingers crossed it doesn't come back.
Pain in patella that has been there since the fall with no bruising and I can't put my knee down on anything, such as a knee scooter, because of the pain. They x-rayed it and said no breaks so solution is to start rubbing it to desensitize the pain. Also do the same with my incisions...rub to desensitize an decrease the pain. 😭
I'm sure I'm missing things...but I did once again inquire about them saying I will start walking on it in 4 more weeks. I think they are crazy! They keep telling me that my leg was a pretty bad break, 4 places, plus the plates and screws on both sides, plus the screws mobilizing both the tib and fib together, and I'll start walking in 4 more weeks? 😲 I can't even feel my swollen foot that is asleep most of the time! Both my neighbor and son in law had the breaks in the same area, but only 1 break and 1 plate and screws and they weren't walking until 5 months and still trying to walk normal at 7 months.
I haven't been able to get a return phone call about finding a new PCP that accepts BWC to monitor and prescribe my blood thinners. So, that's a work in progress and I just keep calling and leaving messages to the places they gave me.
Life is grand at the moment to say the least....🙄 I'm just dealing with so much...and so much going on with poor Sakari and her school transportation. She's now riding 2 1/2 hours on the bus to get home and I've been fighting them about that. It's just a mess.
My knee had been hurting and it wasn't addressed at the time of the fall so today I went to my ortho doctor and they did an x-ray on it. Thank goodness there was no fracture. My instructions today was to stop using the dressing and use just the gauze only. Put compression on foot to move blood and no work for now. All they can say to me is "you really took a bad fall and was pretty mangled and it is to be expected". They say that all the swelling is making the pain worse but nothing can be done about that at this time because the swelling is being caused by the blockage in my legs. Blockage=swelling due to no blood return=added pain + blood thinners=slower healing process=additional pain. 😞
This has been VERY hard for me. I'm a multitasker and always on the move. Being confined to a bed with my leg propped up for 90% of the day is just depressing. My oldest daughter and youngest son comes over a lot of visit to keep me company and help me out with things around the house. She actually took me grocery shopping yesterday (it was a 4 hour ordeal from start to finish) and I was in so much pain at the end of it, but at least I have food in the house now and don't have to depend on someone to bring me my meals or make them. LOL She also set me up with her Netflix so I have now found some tv series to watch and have been entertaining myself with that all week. haha
September 12, 2019: A few updated pictures
Things are starting to get dry and icky looking. I'm not sure if this is "normal" during the healing process, but it's very uncomfortable and the swelling and pain is just too much to handle at times.
I'm still struggling with trying to find my blood thinner medications for a reasonable price. I was emailed with a list of resources (only 1 pharmacy in my area) and several National resources (places like GoodRx, which I have to say I have already tried a lot of these including GoodRx, which was suggested by my pharmacy and the price of my meds went from $760 to $660 so it didn't help much).
September 18, 2019: More set backs
Well, I'm sorry to say that things have gotten even worse than before. When I last updated, I had went for an emergency appointment for the increased pain and the PA took me off the pain meds and gave me Tylenol and Gabapentin. I had discussed my concern about a possible infection (that could lead to sepsis) and she mentioned doing blood work, but never gave me an order for that.
Forward to this week. Pain got so bad I just couldn't stand it anymore. Then on Wednesday morning, it was very apparent to me that (my bad side) incision had an infection. This is the side with the black skin where my bone was laying against without breaking the skin. I just knew it was going to give me issues. There was pus coming out of it and it was really red in the entire area and it looked pretty nasty. I immediately called the ortho doctor and they told me to get there right away. This time the actual surgeon took a look at me and whew...he was trying to push on the area to squeeze some out and move my foot back and forth. He's lucky I didn't have a leg/foot spasm and him end up with a swift kick in the gut. It hurt so bad!!! He was definitely concerned about the infection and also about me not having my foot in a flat position to be able to walk when it's time. Well, I could move it to that position prior to this infection but now it hurts to move it.
He ordered blood work to test my white count (a high reading would mean inflammation), sedimentation rate (reveals inflammatory activity), and reactive protein test (which measures levels to see if there is inflammation). He changed my gauze dressing back to a non-stick dressing to keep from pulling the scabs off and creating irritation (which it's still sticking with the oozing and pus but better), and put me on 2 antibiotics (amoxicillin and cirpo) for the next week. He also put me back on my pain meds and took me off the acetaminophen (but I can still take the gabapentin).
I am to follow up with him next week where he will see if there's any improvement and order another blood test to determine if the levels have changed. IF there is not improvement, he will try to IV antibiotics treatment, which would be more aggressive. He did mention admitting me...but then also said something about putting in an IV and doing the meds at home (which of course I can do on my own).
He wants me to monitor my temp during the day and keep a record. Anything over 100.2, call him. Anything over 102, go directly to the ER and he is to be called and he will come in.
IF that doesn't work....:( He will have to open me back up, put in a wound vac, and stated that I would remain open (all the way to the hardware) until they can clear this up. He really don't want to have to do this because having an open wound just makes you more susceptible to additional infections and I'm freaking out at this point. It really upsets me that I came in the prior week complaining of the increased pain (no reduction of swelling) and asked about a blood test back then to the PA and nothing was done. This could have possibly prevented it from getting this bad had I been placed on antibiotics at that time!
Good news is...the other side is healing nicely and no pain. It's just a little dry and scaly but looking really good (and this is the side they will open up again in December...ugh).
Other good news is...my blood thinners (which would cost $880 for a 30 day supply) has been decreased to only taking them 1x a day and the mg was upped. This resulted in my meds only costing $465 for the month (with a $79 off coupon the pharmacy was so gracious to get for me) and I was a bit relieved.
I still don't have anyone to manage my blood thinners...so this is an ongoing issue as well.
Other good news: I haven't had anymore blood in my urine since those 2 days and everything is cleared up...thank goodness.
Here's a pic from Saturday (healing and drying up somewhat nicely I guess) then 4 days later, the infection and puss settles in (or should I say out) and you can tell that whole area turned red.
It hasn't felt right since the surgery. The pain is unbearable at times and I can feel the "jiggle" of the fluid in my foot and ankles. It usually numb and tingling non-stop like needles being put in it. Definitely not my foot. 😕
I honestly don't know what the future holds for me at this point. Everything is up in the air.
September 25, 2019: More set backs
Well here I am again with an update...of course not a positive one because that would just be too easy for a person like me. 😕
Last week I was put on 2 antibiotics to try to clear the infection and my ortho doctor ordered lab work. I had a visit this morning with him and he is very concerned about my white blood count being 17.5µl. The normal range should be between 4,000-11,000µl. This high WBC indicates a serious bacterial infection. He said with the surgery and also the blood clots, he would expect this number to be elevated, but not to this extent.
He can feel, what he thinks might be, pus pockets deep inside. The continued swelling and redness and areas that haven't healed on that side indicates that the infection is deep down and possibly even attached itself to the hardware. He states I could stay on the antibiotics and it might go away but chances are that the minute I stop them, it would return and continue to return as long as I am not on them. This presents a problem with MRSA and he stated that the hardware might need to come back out in 3 months (he just couldn't do it at this point since the bones are not completely healed and fragile).
So off to surgery I go tomorrow and an inpatient stay for monitoring. He will open me back up, clean out the infection, get a culture to see what strand of infection it is and then treat with IV antibiotics. I will be sent home on IV antibiotics as well and I will have to administer them for awhile. Then I will have a follow up with him next Wednesday. And of course he threw in the "you'll be walking in another 2 weeks" on me again. 🙄
I know everyone says I'm strong, but this is really breaking me down. I sat in the doctors office and just cried. The thought of opening me back up, in an area that is so painful and sensitive, is not sitting well with me. So many things are racing in my head and I feel like I'm going to have a nervous breakdown. 😭
The hospital called with orders for me to be at the hospital at 8am in the morning. It's going to be a restless night.
September 26, 2019: Surgery Day
I just wanted to give an update.
Surgery went well according to my ortho surgeon.
He scraped out the infection and said that there wasn't a whole lot, which is good. He took a tissue sample and sent it off to the lab. We will have results in the next 2 days and will determine if I will need a picc line with IV antibiotics. The last time I looked at the clock in the operating room was 11:20am and I woke up in recovery at 12.
After surgery was the worse. They decided not to do a nerve block and I woke up to the worse pain I have experienced to date. I think I cried for 40 whole minutes while they administered morphine, dilaudid, morphine, dilaudid, morphine, dilaudid....etc. etc. I lost count...then finally relief! Whew!
I was in recovery for about 1 1/2 hours...I think they were just trying to get the pain under control before moving me back to my room. I insisted on the ortho doctor coming in to talk to me (because they go out and talk to my husband and daughter once surgery is over to give a report of how things went...but my husband manages to get things a little twisted at times. For instance when the pharmacists came in to go over my medications she asked me "Nothing to eat or drink right?" and the hubby heard "Would you like something to drink?" LOL Um, no, that's not at all what she said.). The doc popped in real quick, gave me the update, which I "think" I heard him right...but then again, I was under the influence so maybe giving report to my family might have been a little better after all. LOL
He did tell me that since I'm struggling with my whole "insurance/BWC" thing that he would give me the option to go home and monitor myself, returning if there are any complications, increased pain, fever, and so on, instead of staying in the hospital for a day or two because the charges for an over night visit could run in the thousands each night. Of course I was relieved to hear that I was going to be able to go home. They decided to give me a Vicodin for the road...which put me over the edge. I hate that feeling of lost control and trying to function. Ugh.
I had a long ride home with trying to keep my head up in the car was challenging and getting into the house was even more challenging. Since I hadn't had anything to eat but the flavorful mouth watering Saltines after surgery 🙄 the hubby picked me up a Subway sub, which I split with Sakari and it probably took me over an hour to get that down. What happened to that appetite I had earlier? Then off to bed I went.
They said the most painful time after surgery is 24-48 hours and I'm not looking forward to what tomorrow brings...at all. But, I'll continue to deal with it. New antibiotics were prescribed and hopefully it will bring a new experience and outlook on things.
October 2, 2019: Removing the dressing
After last Thursdays surgery, I decided to spend "most" of my time laying in bed to keep the swelling down to a minimum. This works out well...until I have to get up to go potty or eat or whatever...then I instantly swell up like a balloon. The only option is to stay laying in bed. Swelling increases the pain...and the pain is bad. However, reduce pain = I'm going insane. I'm mentally and emotionally drained at this point.
Like they said, 24-48 hours after the surgery is the worse...and it was. The pain was bad, the swelling was bad, but I mentally talked my way through it and I have watched almost every tv series and movie known to man now (Netflix and our neighbors personal server with Plex). Coming from someone who never watches tv....this has been painful in itself. I'm bored out of my skull and some days I just open the blinds and stare outside...hoping for any action at all...the most action has consisted of a few birds, deer, and a fox.
Fast forward to a few days after surgery....just when you think no more could be thrown at me...I develop a yeast infection from all the antibiotics I've been on. 🙄 I had to wait until Monday to call the ortho office to ask them to call me in a prescription of Fluconazole.
So today was my ortho follow up. They removed the dressing to reveal a rather icky looking sutured wound that appears like if they cut the blackened dead area off and a slight hole remains now. I guess the positive of this all is I'm now seeing ONLY the ortho surgeon instead of his PA since all of this infection part has started...which I let him know how I had made that one emergency appointment because of the increased pain, swelling, redness and PUS coming out of my wound the week before I seen him and expressed my concerns with the PA and she did nothing about it and possibly could have prevented all this had she did the blood work and put me on antibiotics at that point. I guess that sunk into his head and he's been the one seeing me since then...even if an emergency appointment (which is usually given to the PA).
The ortho doctor said that he did not find a pus pocket during surgery, which is a good thing, but did remove what pus he did see under the surface. He also stated that sometimes the bacteria can adhere itself to the hardware, which was his concern. He didn't see anything to alarm him and it looks like the antibiotics are working. He told me the type of bacteria strand I had from the tissue sample they took, and for the life of me, I couldn't remember the name of it 5 minutes after he told me, but I know it started with a M and I know he said Staphylococcus aureus and can only come to the conclusion that what he said was Methicillin-resistant Staphylococcus aureus, otherwise known as MRSA! Had he just said MRSA, I would have known and that would have stuck with me because I'm accustomed to hearing it called that instead. But, he said since the combination of Bactrim and Cipro seems to be working, he will keep me on those in hopes of continued improvement (instead of switching up the antibiotics or doing a PICC line with IV antibiotics). Needless to say, I'm good with that at this time.
He said my stitches would remain in until next week (my 8 week appointment) he would remove them and he still insists that I will start PT next week with applying pressure to learn to walk again. I expressed my concerns about trying to walk on a foot that is so swollen that I can't put my foot flat on the ground because it is not only swollen on the top, but also on the bottom and pushing up against my toes. This is very painful and the thought of putting my foot down and applying pressure...I'm pretty sure it will be equivalent to someone sticking a needle in a water balloon and popping it. LOL I also told him about my continued non-stop numbness and tingling. It doesn't stop....like ever. It's not numb that I can't feel it (no, that would be too easy for me) it's the constant needles being jabbed into your foot, tingling sensation you get when your foot has fallen asleep and you "wake it up" feeling. I mean could you walk on that? He says the continued swelling is, of course, caused by the blood clots blocking the flow, which I know, and it's going to be a long process of recovery with me, but I will get there. He mentioned the possibility of sending me to a vascular specialist (which I wanted to begin with but this whole insurance thing prevented it) and seeing if there is a possibility of nerve damage (which he doesn't believe because he was no where near the nerves during surgery-explaining where they are located versus where the surgery was).
Physical Therapy: He wants me to start applying pressure (in my boot of course), improving my range of motion, and moving around a lot more. I do understand that moving around increases circulation and promotes healing quicker, I just don't know how it's going to apply to someone like me...who isn't your "normal" recovering patient with the blood clots, swelling, and numbness. None-the-less, he wrote an order for PT 2x weekly starting next week. We'll see how this goes. He upped my mg of Gabapentin in order to "reduce" my "dependence" of Norco. First off, I will never get addicted to any type of meds like that..I absolutely hate them. Second of all, I ONLY take them when I just can't stand it anymore and the Gabapentin isn't helping. Third...does he not realize that you can become addicted to Gabapentin just like an Opioid and to tell you the truth, the Gabapentin makes me high as a kite.
So, that's pretty much what I have to report on now. My next appointment will be next Wednesday and I'll report back after that visit.
Meanwhile....the other side is looking good.
October 6, 2019: Post surgery
Pic from today's dressing change:
October 9, 2019: Removing stitches
Alrighty now...it was ortho doctor day today.
So, they removed my stitches today and man was that painful in certain areas and before and after the removal....they cleaned it with alcohol 😲😭😤 OUCHIE! Several places started to bleed during removal, but after she cleaned it again, the bleeding subsided. These techs/aides/Medical Assistants...whatever they are, along with the doctor and PA are so rough with everyone. I actually asked every staff member that has came in to whoop my leg/ankle around and bending and applying dressings, applying the boot or anything, "Have you ever had this done before?" and out of everyone, no one has been through this except one said they broke their arm. Well, if you haven't been through this, you have no idea the pain I'm in and especially with this non-healing side and 2 surgeries....try to be a little more gentle with your patients!!! That's one thing I have always done...put myself in their shoes and imagine the pain someone is in...especially when I worked in the ER and did wound care or applied casts to people. JUST BE A LITTLE MORE CARING AND GENTLE!!! GEESH! The only staff members that have been extremely gentle with me there in the office is the x-ray techs.
Right after removal of the stitches
So after me fanning the heck out of my ankle and waiting on the doctor to come in, the burning subsided and I could relax again. My doctor has been very concerned that my foot may be too plantar flexed (think pointed foot and toes out) but didn't think it was to the point that it has become a significant contracture and it was due to the pain. I AM able to bend my foot (at the ankle) back and forth (it's just painful due to the swelling and the open wound and not the actual surgery or in the ankle area). I pulled my foot up in the position (flat) that he has been wanting and painfully held it there until he came so that when he walked in, he would see this isn't a problem for me...it just hurts.
The doctor came in and said everything was looking good. It is still somewhat swollen, bruised, red, and oozing. He wants me to stop using the Adaptec dressing and start just doing nonstick pads. If the drainage or pain gets worse, I am to call him. I let them know I was off the pain meds and only taking Gabapentin at this time. He stated because of the redness and oozing, he was going to prescribe me another 2 weeks of antibiotics (for a total of 4 weeks on them). He also told me I DIDN'T have MRSA. I had MSSA (Methicillin-sensitive Staphylococcus aureus) which is great and treatable with regular antibiotics, which is why he didn't do IV antibiotics. I was so relieved that I heard him wrong.
So now...he says my actual fractures are healed. No worries about walking on it. He said for me to start applying pressure of about 25% today, using crutches, and increase daily and within 5 days he wants me walking in the boot WITHOUT the crutches. I informed him he may be doing another ankle surgery because I am just terrible on the crutches and so off balance that I can just imagine applying weight to my ankle AND trying to keep my balance on crutches is going to go. Trust me, I've tried the crutches off and on. But, here we go.....I got home and I've been using the crutches and trying to apply some weight...OUCH!!!! It hurts across the top of my foot like always. I just think it's so stiff and I can't bend it past that and it has nothing to do with the hardware. This is where PT is going to help. I let him know I have an appointment for assessment next week and he was glad.
I guess the other problem is with taking the blood thinners, I have developed several of the side effects from the meds. Pain in the arms and legs, including muscle pain: I have noticed (when using crutches) my arms get pain and feel very weak.I can't go very far without them hurting. My affected leg aches with pain from the bottom up to my hip and that's when I'm just laying there. Dizziness and Weakness: Yep, that about sums it up for me. I feel so weak all the time and dizzy at times as well. This provides a few complications when trying to walk and balance myself as well.
But, I feel like I have hope now. I'm honestly looking forward to this PT. I know it's going to hurt and it's going to be a long road to recovery. This appointment brought new hope to me as much as I was dreading it, I'm feeling good! I'm feeling like this is the start of my next process in recovery and I kinda see the light at the end of the tunnel. I haven't felt this excited since this whole process.
Tomorrow is a new day and I have an appointment with my PCP to evaluate the blood thinners and we'll see where that is. I have no idea what they do to evaluate me being on them. I don't know if she'll do blood work or schedule another ultrasound to see if they are still there or what.
My healed side (there is an area that still continues to hurt...which is the bumpy area you can see where it looks somewhat bruised and I feel like I can feel the hardware sticking out there).
October 10, 2019: PCP appointment follow-up
A whole lotta not good news today with my PCP doctor. She’s running tests, sending me to hematologist, ultrasound to compare blood clots, and then ran a EKG that determined anterior infarct and she’s concerned I’m currently having a heart attack or I have a blood clot on the heart or a blockage. Currently on the way to the hospital ER for evaluation. I Just Can’t Win! 😭😭😭
Hours later....
Ok, back to being good news....Sorry for the scare. I've never been so scared in my life.
Went to PCP today for my blood thinners check up/monitoring. She was really being an advocate for me and wanted to "check all the boxes" with everything that was going on.
1) Because of all of the complications I have experienced, she wants to send me to a hematologist that she's good friends with and states he is really good. She wants him to do a complete assessment including blood work to determine my clotting factor and if I might be predisposed to getting clots and predict if it could happen again or if this is only because of the surgery. Also to determine how long I might need to be on the blood thinners (with the possibility of having to be on them the rest of my life). Also, another ultrasound.
2) However, she decided she wanted to know right now and ordered an ultrasound to see if the blood clots are still there, if any have dissolved, if more are there and so on. She wants a comparison from the last one to see where we are at and said either she will do another in a few months or the hematologist will have one done.
3) She was very concerned about the pain. She said she understands that a concern with dependency is always a factor but stated that I have been through so much and it wasn't like I just had surgery and have been recovering nicely. There's a lot of factors that have prohibited an easy recovery and she wanted to prescribe me meds. She ask what all I have taken lately, the last time I had any pain meds and what they were and asks if I was willing to do a urine drop. Of course I would...and did right then and there. I did inform her the last time I took any pain meds (either Vicodin or percocet) and I told her it had been about 1 1/2 weeks when he told me to only take the gabapentin and acetaminophen. She ask what else within the last 30 days...😮 Um well, surgery 2 weeks ago a whole sh*t ton that I can't even begin to answer but I do know fentanyl and dilaudid was over and over during recovery. Everything must have showed up ok because she prescribed me meds for 30 days and 60 pills. She had me sign multiple forms stating that she would be monitoring me on the meds and I have to return every 30 days for refills over the next 90 days and the normal "I won't sell them" "I won't take more than prescribed" "I won't stop taking them until told" kinda stuff. She's gonna be a lifesaver. However, I'm a little concerned with the "take as prescribed" part because I only take pain meds when I HAVE to and can't take the pain. I will also have to drop urine each time I visit. But, she said "How can you be expected to walk now when you are in so much pain and if you take some pain meds, it might help you feel less discomfo