My Lisfranc Injuy: The Story

I haven't walked in 94 days.

3 months.

It seems like such a long time to me, but in the grand scheme of things I suppose it really isn't.

The story:

In February, I was playing volleyball and tried to change directions so another player wouldn't plow into me. In the process, I landed, with all my weight, on my inverted right foot. I knew immediately something was wrong.

Day 1: Feb 12

I was able to hobble off the court, but as soon as I got off I was unable to put any weight on my foot. I iced it on the sidelines while the first match of the volleyball game was finished and then had to be carried to my car by a guy I had only met 30 minutes earlier. *hiiiiiii.*

I got in my car. I started it and tried to put my foot on the brake pedal. I couldn't. This is when I started crying. "Shit, I can't even drive." I've played sports since I can remember. I've had a ton of injuries. I've sprained my ankle a number of times, but I was always able to at least hobble around. I couldn't even put my foot on a pedal.

I tried to call Patrick (my bf), but he didn't answer. I didn't know what else to do, so I drove home with my left foot and cried the whole way home.

The next day, I had to go to PALS (Pediatric Advance LifeSupport) class so that my certification would be up to date. Unfortunately, I was unable to move my class. It was the last class before my expiration date. If I missed it, I would be taken off my schedule in ED and also lose some dollars ($$$).

I picked up some crutches on my way in to work and my manager, who was in the class with me, brought me a walking boot. I didn't have time to adjust the crutches much before getting to the hospital. They definitely were not at the right height and I almost wiped out in the middle of the ED waiting room. I ended up having to get security to wheel me up to the 6th floor. 🤦

I had an x-ray done that day at the clinic. The radiologist didn't see anything abnormal. I went to work the next day and showed my xray to one of the physicians. He mentioned that he didn't see anything on the xray, but that based on the mechanism of injury and where my pain was that it could be a lisfranc injury.

Feb 17: Weight Bearing xray

I had never heard of a lisfranc injury. I had to look it up. It involves a ligament in your foot, between your 1st and 2nd metarsals that essentially keeps your foot from separating (this is a simplified explanation).

Patrick was also standing there when a lisfranc injury was suggested. He started looking more into lisfrancs. They had me go back to the clinic a few days later for a non-weight bearing xray and a weight bearing xray and also put in a referral to orthopedics. The clinic ended up not being able to do my weight-bearing and I had to go to the hospital to get that one done--and almost fell over in the process. :D

Feb 19

Again, the radiologist didn't pick up on anything. The ED docs did though! I had two of our providers look at my xray and tell me that I had a widening in between bones of my foot, suggestive of a lisfranc. They even saw a fracture (typical with a lisfranc injury) that the radiologist had missed. They mentioned surgery and that this was a very complex and serious injury.

Several days had passed and I hadn't heard from ortho. I called the office and they told me that the referral hadn't been looked at yet and I would get a call back.

When they finally called back, they said my appt would be in 3 weeks. I asked them if there was anyway this could be moved up. *I was told this was a complex and serious injury, usually requiring surgery. They want me to wait 3 more weeks?* Based on my xray, Dr. G had determined I didn't need to be seen earlier. *Is my injury not as bad as we thought? Did he even look for the lisfranc? He had to right, he's in ortho...* All of these thoughts and more went through my head.

The week of my appointment approaches and I get a call moving my appointment. They wanted me to wait another week. I call back and ask to speak to the nurse. I informed the nurse that I had been non-weight bearing for 4 weeks now and that I'd been told I had a lisfrance injury. I asked why I was being moved and if I could at least get some information on what I should be doing for my injury. The nurse said, "We haven't seen you, so if you are concerned about care, you should go back to your primary care or just do what they told you.... and who told you that you had a lisfranc?." I informed the nurse that multiple ED providers had looked at my xrays and thought it was a lisfranc. Nurse informed me there was nothing in my xray or notes suggesting a lisfranc and that they would see me in another week.

I got a call an hour later telling me they had moved up my appt to the next day.

Mar 12: Limited Mov't

When I got to my appt and Dr. G came to exam my foot, I mentioned a lisfranc. He also asked, "Who told you that?" He then looked at my xray in the room and measured. "Oh, I guess you do have a little bit of widening. Let's get an MRI to get a better look. If you have a lisfranc, I won't be able to see you."

I had my MRI. I found out the results a day later (from someone outside of the ortho clinic). I did in fact have a lisfranc injury with a fracture.

Almost a week later, I still hadn't gotten a call from the ortho clinic with results and information on getting a referral to a doctor who dealt with lisfranc injuries. I had already called and left a message with a nurse and 2 days later still hadn't been called back. I had to call the clinic manager who informed me that they were just waiting for another doctor to come back from vacation to look at my xray.

How hard is it to call someone and tell someone that? Why do I have to call multiple people to find that out? That doctor they were waiting on isn't even a foot and ankle specialist. It was a waste of time. I asked them to put in a referral to a foot and ankle specialist in a city about 2 hours away.

Note: Our area didn't have any foot and ankle specialist in the hospital network. My insurance would have made me pay out of pocket if I had gone to one out of network.

I got into the specialist within a week.

My appt was 6 weeks out from my injury. He looked over my MRI and xrays. He said that a lisfranc was always a bad injury--mine was on the mild end of the scale. He originally said that he didn't think surgery would be benefical at 6 weeks. Scar tissue would have formed at the site of injury and to make much of an impact it would have to be removed. He wanted a CT to make sure there was only horizontal separation and not any vertical instability.

I had the CT on a Friday. Monday morning he called me personally. He wanted to put me under anesthesia and stress my foot under fluoro (It's an in real time xray. It's like watching live tv). He would stress the foot and put screws in at that time, if it was needed. The plan was to do it that Thursday.

I let my boss know. We decide not to go on FMLA. There was a chance that they would stress my foot and I wouldn't need the screws. If that was the case, I'd be walking in 2 weeks.

Ap 4: Post Internal Fixation

Turns out it was more unstable than expected and I got 2 screws and started my non-weight bearing countdown over. 12 weeks of non-weight bearing until screws are removed and then will be able to start walking.

I had to go on medical leave (I'll probably go into this in more detail later. The whole process has been a mess).

I just hit 6 weeks post-surgery. I've been non-weight bearing for 13 weeks. I have 6 weeks to go.

I was unable to work for 1.5 months and still have 1.5 before I can go back to my regular position.

This has definitely been an experience.

Until next time...

Ap 5: Big-Ass Splint