Step Two

With my medical records in hand and the hope for a quick return back to work, I headed to another ortho (I’m calling this one Dr. P). As far as orthopedists go, he enjoyed the same torture as just about any ortho and most certainly every physical therapist I have ever encountered.

When he was through with his exam, we talked about the latest MRI as well as some additional issues he discovered which were related to the ‘tingling’ on my foot. He noted some weakness in my left foot/ankle. He first wanted to have an EMG & NCS performed. He discussed the possibility of a back/spine issue. I had a back issue many years ago from toting suitcases, beach items, medical equipment, a toddler and a child in a wheelchair through the airport. This didn’t feel anything like that.

I was sent straight over for my EMG/NCS. I had an EMG once before so I thought I knew what it would feel like. I was so wrong! Although I do not remember (and most likely would never admit) screaming like that during childbirth, I screamed. And screamed. And cried. It was incredibly painful! Don’t let the google fool you…painful.

My return to Dr. P for the results was pretty straight forward. He recommended surgery for the meniscus tear with physical therapy to start the following day. I informed him I would, in no uncertain terms, NOT put myself through more physical therapy without pain medication. I was done with that nonsense. He obliged and began discussing the EMG/NCS results. I was not prepared for what he would reveal. I had nerve damage. Real nerve damage. He was ‘on the fence’ about referring me to a neurosurgeon for treatment/surgery. He was uncertain whether this damage would be permanent. This aspect would be a ‘wait & see’. Meanwhile, how about we schedule some knee surgery?

At the nurse/checkout desk, we discussed surgery dates and insurance coverage. (I should probably back up here…)      

While on my medical leave of absence from my job, I took my vacation time in short increments to allow my insurance premiums to be covered. By this time, my vacation time was long used up and I was paying out of pocket for my premiums at active employee rates. So we schedule surgery and I am on my merry way.

Unfortunately, someone at ADP made a mistake with my insurance payments. They included ALL the time I was on leave without deducting the payments made from my vacation time. In the eyes of this snafu, my insurance premium was not up to date, paid in full, so they cancelled it. Three days before my surgery. Somewhere, someone saw the steam coming out of my ears! I was hopping mad! Many, many, many phone calls between my employer, ADP, the insurance company and the surgery center over the next 3 days and all was resolved. So I thought. On the way to my surgery, I called the surgery center to verify. They were unable to verify coverage that one day before I was informed (by the insurance company AND ADP) had been reinstated and my surgery would be covered. Due to this, I was told I needed to pay $3800 PRIOR to my surgery in a few hours. How about “No” Charlie. I called Dr. P’s office to inform them and we turned around to go home. My surgery was not able to be scheduled for 3 more weeks.

Surgery went as planned the end of April 2014, a mere 7 months after my fall.

                 

I started physical therapy, as Dr. P. ordered, the following day. Torture. Pure torture. Thank goodness I had pain medication. Finally.

My therapy center was in the same neighborhood that we lived in, so at least it was close. My therapy sessions were scheduled around my youngest daughter’s school schedule or my son & oldest daughter’s work schedules. Most often it was around my youngest daughter’s school schedule. I hated that. I hated that I was unable to drive myself. I hated that I had to continue to depend on someone else. I hated the direction my life was headed. How could I stop it?

I had to think about ME first. Only, I had never done that. I was a people pleaser with passive-aggressive communication. I only spoke up for myself when I was already battered and on the ground. If only I spoke up sooner. Certainly that would make a difference. It did when I spoke out for someone else…it had to for me too.

My first attempt at ‘me thinking’ was my therapy. I became verbal about the pain I was experiencing during my therapy sessions and at home. This translated into inconsistent pain/ability. Only it really, truly was inconsistent. Some days I was golden. Some days I rarely got out of bed. Some days I was golden and then couldn't get out of bed (or vice versa). What was I doing wrong?

It all starts with one step.

Brace yourself

As with every fracture, there is immobilization. Even if you've been walking around on it for a month. So I was fitted for a brace and put on “No Weight Baring” status. Being the independent person I am, I asked if I could at least hobble to/from the potty palace. Doc agreed “Touchdown” weight baring would be okay. With that, I was ‘good to go’! Isn't it pretty??

It started pretty soon after…the cold, the tingling, the ‘my foot is asleep’. So I called the ortho office who wanted me to come in for an adjustment. I’m not sure if it was the adjustment or simply the removal of the brace for a few minutes but whatever it was seemed to help. Until it didn't. Which happened to be the next day. So, I called again. Went for an adjustment again. Okay, good. Nope. I ended up calling the office again the next day. I was then told the only thing they could do was switch me to an immobilizer temporarily and when I was ready for weight baring, I would have to return to the brace. The brace cost $185 (the insurance paid an additional $700) and I wasn't working so I was not very interested in paying for another system that would more than likely have the same results. I had a bit of experience with the immobilizers with my son. A LOT of experience actually.

My solution was simple: stay off my leg by staying in bed where I could keep it straight. Apparently the ortho didn't like that as he noted me to be ‘non-compliant’ in my chart. This was my advocate for ME start that I wouldn't realize the importance of for a few months.

I did wear the brace when I was unable to stay in the bed and used my crutches. Then later, when I was taken off non-weight baring.

I started physical therapy and discovered my knee was simply ‘not right’. Sure, the fracture was healing/healed but there was something more there. I don’t think I mentioned it but when it first happened, I thought I simply had a meniscus tear. I had one of those before and worked for several months before having surgery. This pain was more, a LOT more.

My physical therapist and I both insisted to my ortho to order a repeat MRI. Funny, a different radiologist read it and now there WAS more going on. Or was that all there to start with? Clearly a meniscus tear was present and ortho suggested injections. Or he could do surgery as a last resort. I told him “I am okay with ANYTHING as long as I am not in pain anymore!” This ortho who determined my issues with the brace equated ‘non-compliance’ then noted in my chart that I “did not want surgery”. Say what???

See, I had a meniscus tear and partial meniscectomy before. On that same knee. I knew after all the research on my first one the meniscus does not have a good blood supply and does not heal well on its own. Unless – it’s a small tear. This new one was not a small tear. It also was not in a good location to promote self-healing. I knew when the ortho was pushing for injections, I needed a second opinion. 

This was my true beginning of advocating for me. I obtained copies of my medical records and started researching other orthos. I already had some difficulties with another ortho group; when I went in for surgery, they had the WRONG KNEE on all the paperwork! Ummmm....no.

It all starts with one step.

One Step

What steps do you take when you can’t walk? My family struggled with how to help me meet my needs. My physical needs obviously came first.
                              Keep the path clear from the bed to the potty palace.
                              Make sure there’s something to drink within reach.
                              Always have a phone nearby.

The basics.

We struggled for a bit with all of those things. Sure, I had crutches. I had a mini-fridge in my room. I had a cell phone/charger. I had a laptop. What I didn't have was the ability to advocate for me. That is where my journey truly begins.

My youngest daughter was/is my biggest assist. I fondly referred to her as ‘my legs’. She would ensure I had drinks next to me before she left for school in the morning. She carried my debit card so she could stop at the store if I needed something. She texted me from school to make sure I was okay. She was my legs when I needed anything. There was some disagreement regarding meals though. (Remember, I have a self-advocate problem)

When my daughter would get home from school, she would come and check on me. She would get new sodas. She would empty garbage, bring me the mail and help me to the bathroom. She would ask if I wanted anything. I didn't. Not because I really didn't but because she already did so much for me. I couldn't ask her for anything even when she asked if I needed anything. Food? If she or my son was making something, I would say I wanted some. If they were picking something up, I would ‘place my order’. If I was hungry without either of those scenarios, I stayed hungry. I could be no more of a burden than I already was.

My path needed to change. I needed to alter my path. Changing the path started with re-arranging my room. We put the mini-fridge on the side of the bed I now was forced to use because I was unable to get into bed on ‘my’ side. My daughter no longer needed to come in to my room before she left for school. This was good. This was progress on a different path.

I decided I would take this forced time off of work to finish the RN I started in 1991 and had to withdraw from in 1993. Only 20 years in the making. I love life’s little curves. In doing this, I needed to find a way to read and take notes. My kids had purchased an amazing little overbed table when I had my hysterectomy in 2000 but I gave it up when we moved from IL to TN. Damn. We tried to fashion one out of a shoe shelf. Close. It would work. Sort of.

That solved, I needed to address the food issue. Because I was dealing with pain, immobility and no pain medication, I turned to comfort foods. You know the ones…candy, doughnuts, anything with some sweet. I had begun to gain a few pounds…eww. So, some fruits & veggies for my fridge. I could munch and mind my intake. Perfect.

Now to address the medical path. I was new to this side of the chart. This was a road I was unfamiliar with. Sharp turns ahead.

It all starts with one step.

Step One

It started as a simple sociology experiment for my high school senior. We discussed several options and decided on "behavior inappropriate for a 17 year old". At a grocery store. She, her sister and I were the only ones aware of the experiment details.

Once in the store, my 17 year old climbed into the back of the grocery cart. Of course, we made her strong older brother push her. As soon as we started "shopping", she started bouncing around in the cart. Then the "I want that!" started. Her poor brother was left helpless as her sister and I had to walk away stifling the giggles.

We turned into the freezer aisle when that one step happened. My 17 year old said "Go faster!!", so my son gave the cart a little push and let go. Since she was facing the front of the cart, she had no idea she was being pushed into a pole! At that moment, her sister and I busted up laughing as we walked away! I turned over my shoulder to catch the look on her face, turned back around and BAM! I was suddenly in terrible pain lying face down on the floor. I suppose it didn't help that it was a concrete floor. My oldest daughter was against the coolers and there was water on the floor. Did I slip? Did I trip? Did I break anything?

The store staff was very helpful collecting an ice pack, bottle of water, ibuprofen and a wheelchair. My oldest filled out an incident report while my son took me to the car and my 17 year old finished the quick list.

Off we went to the emergency room a few blocks away. X-rays and some pain medication later, I went home with a 'sprain' and instructions to follow up with an orthopedic specialist.

Ortho wanted an MRI. It took about a month to get scheduled. In that time period, I worked approximately 250 hours...most of which spent walking &/or on my feet.

What 12+ hours looked like

Once the MRI was done, the results were in - non-displaced patella fracture. Great. I was walking around on a broken kneecap for a month. Walking a LOT. To be fair, I did use crutches frequently to go between the 2nd floor on the AL side to the ground floor REM side of the building. (Picture a building in a sideways 'H'...AL located at one end of the '-', REM on the other). I was told to get off my leg ASAP and a follow up with the ortho for brace fitting.

It all starts with one step.