Broken Bones Change Everything
My foot is now healing. In fact, it is almost completely healed, and I'm starting to walk again. A little. Slowly.
Of course, my experience is not unique. Especially the times when I have been angry, sad, disappointed, frustrated, or afraid. To alleviate many of my reactions, I have read about others online who have had or are having the same problems as I have had. Usually, I find a mixture of some terrible and some useful information that simply reminds me that other people have gone through this and are now normal walkers again. The internet also often reminds me that I don't have it that bad - other people have bigger problems, even if it's just that they haven't healed in a year (and I'm complaining about my 4th month).
What I have realized is that some of the worst things about having a broken foot had nothing to do with the actual break. As an independent person, it was very difficult for me to accept that I needed someone to help me with everything. The best example of this is when I threw a tantrum one day because I couldn't just go upstairs and grab the clothes I needed after a bath. My husband has been unfailingly diligent, caring, and generous, but he hadn't brought me fresh clothes, and didn't realize I was finished with my bath. So I crutched into the living room naked and started ranting through sobs that everything was horrible. Not something I do, in general.
My husband and I were both confronted with sides of ourselves that we wouldn't normally have occasion to experience. Some things were very positive, because we are emerging from this time of nursing as in love as we ever have been, possibly even more dedicated. I can see how this kind of strain might put relationships in danger. I also found it very easy to become convinced that I am a problem, a burden, or that I am being punished. When I'm in a good mood, it's easy to brush off those thoughts. But the way my broken foot affected our plans made it hard to be in a good mood. I often felt like crying during the first few weeks, and it took at least a couple of months before I could hear that my foot needed more time to heal without tearing up out of complete self-pity.
We were about to fly to Norway when it happened, and our trip was delayed by four months. That is a problem. I sometimes wondered if my husband held my broken foot against me, or that he blamed me for putting him in a situation that was uncomfortable (he didn't).
Thinking about all these things is important, and voicing them may be more important. For a little while I didn't ask for things I needed, because I felt like I was always asking for too much. As soon as I spoke up about that feeling, Joshua told me not to be crazy, and things have been better. We also joke around about the difficult things in a way that allows us both to release our pent-up frustrations without causing trouble or hurting feelings.
I encourage you to go online and see what other people are saying. Don't take someone's casual advice and run with it. Someone wrote on a forum that he didn't want to stop running, and so he didn't go to the doctor, that he just dealt with the pain. He said healing was all about how much pain you can withstand, and he just lives with it. Bad advice!
But I've also read some nice posts from people who say they suffered through physical therapy and are now walking normally again. Or people who explain the advice they got from doctors, their healing time frame, or what kinds of physical therapy exercises they had to do.
Sometimes you get good information, but mostly what you'll get is a bigger picture. Overall, your experience is probably pretty individual. But pieces might be the same. An example of that would be the way that doctors don't always know exactly how long it will take for you to heal. I felt frustrated when my foot wasn't healing as fast as my doctor first said it would. But then I read online that other people have had that same frustration, and I was reminded again that nobody can know everything. Doctors are the ones with experience, but they haven't experienced you before.
Looking online might help you form questions to ask your doctor, and when your doctor says 'no, that's not what you have,' you will feel reassured. The internet is not a substitute for a doctor, ever, but it will help you understand that many people have gone through what your are going through - and also, every single situation is a little different. No two feet are the same.
When I broke my foot I had no insurance. Young? Healthy? On a break from travel insurance? It happened to me. I am lucky not to be drowning in medical debt. Of course I will talk about how that happened.
My situation will not be like most. The truth is that I didn't have to be anywhere quickly. I wanted to be in Norway as soon as possible, but I work from home, my husband works from home, and my generous father could let us live with him for a little while. We had it pretty good. For us, going with the cheaper but slower option made more sense than getting things done as fast as possible and going into medical debt. Surgery would have led to a fast healing time, but maybe that is not what we all need.
I hope that if you are reading this you don't have a broken anything, but chances are you do. It's really not any fun. Sure, being waited on hand and foot for a couple of weeks feels nice. But overall it has made me feel helpless, weak, lazy, and... broken. Incomplete. Useless. If you do have a similar problem, I hope my observations help. I'll start with advice, and probably tell the whole story from that perspective. If you are just interested in knowing what happened, please visit the fun part of the blog.
1. Your Doctor Matters
For the first few days, I did not think that my foot was broken. It was badly injured, I couldn't walk on it, but I hadn't been doing anything I had never done before (and I will do it again in the future). Dancing? Yes.
I went for an x-ray just to be sure I was okay (look for a local clinic, often they will x-ray you for less than $100). Not only was my 5th metatarsal broken, it was seriously jacked. Broken and dislocated. The doctor I saw was an MD, and he said he would refer me to someone who would know for certain, but in his opinion I would probably need surgery. He put me in a walking boot, told me not to put weight on it, and I crutched out of there in a state of shock. Surgery is expensive. My plans had to be put on hold. My husband was now married to an invalid who might put him into medical debt.
The doctor I was referred to said that surgery was the way to go. I told him that I wanted to talk to a few doctors, maybe get two out of three opinions to be the same, and he said that I would probably need five before I got a majority. He said that of course it would heal without surgery, bones are cool. However, the bone would be shorter than it had been before.
Potentially, I would always feel pain, and possibly enough pain to warrant surgery in the future. But he also said that surgery would include putting in a pin, which can also cause pain and lead to surgery again. Nobody knows for sure?
My x-rays were digital, so I could easily send them around. Which is what I did. A friend of mine is an MD at a children's hospital. She said I could let it heal, and possibly go back for surgery if it caused pain in the future, which made me consider immediate surgery again. A cousin of mine is an orthopedic surgeon in Canada, and he said it might be okay to let it heal, but he recommended an MRI in case there was some prior damage to tissue that had helped cause this break. He also said I should talk to a foot and ankle specialist. I have another friend who is a nurse in an emergency room. She kindly showed the x-ray to an attending physician who said that if it had been his foot, he wouldn't consider surgery. He'd yank on that little toe and leave it alone. A couple of my dad's friends said they'd broken their 5th metatarsals and never bothered about it - let it heal and it'll be fine.
I called around to doctor's offices, hoping someone would be willing to look at the x-ray while on the phone with me. I was willing to pay the price of an office visit. But not many doctors wanted to do that with a first-time patient.
Finally, I decided we would have to go to an office, so we called an orthopedic surgeon whose office referred us to a foot and ankle specialist. Foot and ankle specialist.
He gently pulled and pushed on my foot a bit. He asked what hurt. He was careful, but firm, checking for damage to ligaments and tendons. Then he looked at the x-ray with us. He agreed with the rest of the doctors in general; if we left it alone it would heal short, which would probably, but not certainly, be a problem. But he also had a another idea. He offered to yank on my toe (he used the word 'distract') and then let it heal. Much cheaper, less invasive, much less likely that I'd need a pin removed in the future.
I went with him. It turns out he used to be lead podiatrist for a professional sports team over 20 years ago, and has been in private practice since then. This is a man who has seen a lot of broken feet. But he also keeps up with newer procedures, advances in care. I felt like I could trust him, and of course I liked the option he gave me.
So firstly, don't be afraid to ask around. The doctor I was initially referred to was a good doctor. If I had gone to him, he would have done what is probably normal. But I would have been very insecure throughout the healing process, and afraid of needing a second surgery to remove the pin. It would have been unaffordable, which would have made me feel guiltier than I did already. Find someone you trust, someone who makes you comfortable and listens to your questions. And then ask questions. It's not only the health of your foot at stake. Surprisingly, I think you should feel good about the decisions you make.
2. The Distraction
I had my toe distracted. The doctor put amazing amounts of novocaine into my foot, via large needle, poke poke poke. My foot was swollen with novocaine. This produces an excellent feeling in your brain about 30 minutes later. It also made my foot completely numb. The needle hurt. But when he pulled on my toe and prodded my bones closer together, no pain at all. In fact, it felt really good when he pulled on my toe. Like popping a tight knuckle.
I was pain free until that night, and the medication he prescribed barely softened the pain. For about 24 hours I was in miserable pain. But after that I took high doses of ibuprofen for a day or two, and then I was pain free.
3. Paying for Medical Expenses in the US
Hopefully you are employed, and breaking a bone doesn't cause you to lose your job. I think that would be illegal. I hope that is illegal.
My husband and I are both freelancers, and although we do buy travel insurance when we are on the road, we didn't have coverage for the 10 days or so that we would be back in the US. It is possible to get temporary insurance for not much money, but we neglected to do that. You, too, can get temporary insurance, just blackle "temporary insurance". They are dying to sell it to you.
With that off the table as an option, here's what happened to me: I was at an event. Sure, you think, sue them for a bad dance floor! It turns out, it doesn't even have to be their fault. If you did something stupid or klutzy or drunk, you still might get their insurance to pay for it. Sounds lame, and unbelievable, but it's true. At official event locations, like restaurants, bars, hotels, event halls, or churches, they will have something called an 'event note'. They probably don't want you to know that, and it wasn't super easy to find out about cashing in on this, but I did it.
Try the HR department, tell them you injured yourself at an event and want to talk to their insurance company. You don't have to say it was their fault, but don't tell them it's your fault either. Not right away. The insurance adjuster who I spoke to basically sold me the event note option, what he called 'no liability', because I said I thought it had to do with a problem with the dance floor.
He explained to me that I had a choice: blame them and we go through a long legal process that costs them lots of money and time, or accept only financial help with medical costs up to $10,000. If you feel the event location is at fault, go for the long, expensive option. I don't think it would have been worth the hassle in my situation. Our only other expense, besides medical, was the cost to change our flights, which came to about $320. When you find them at fault, you can get reimbursed for that kind of cost, as well as loss of work pay and other things that I wouldn't get anyway.
The guy didn't tell me about the $10k limit, and he didn't really explain how it would work. I had to ask a lot of questions. But in the end it worked. They paid for my doctors visits, bandages and casts, whatever I bought at the drug store, including pain medication, and without any questions. I assume that they knew I still had the choice of deciding to say they were at fault.
Everything was reimbursed. I paid the doctor up front and got the check months later. I was fortunate, because we could afford the expenses as they came in and I didn't have to charge anything to a credit card that would accrue interest. If I had had surgery, it would have been very different.
I would love to use this opportunity to rant and rave about how crazy it is to receive medical care in the US, but that's not what this is about. The truth is that the insurance industry is more afraid of legal battles because they will probably lose when all they do is deny claims, so they have come up with a simple offer that ends up being cheaper for them: nobody's fault, but they'll pay up to a certain amount.
4. Healing Time and Expectations
My doctor was great. But his expectations about my healing time ended up being wrong. He said it would be six to eight weeks, more likely eight weeks of healing time. After the first 3 weeks he looked at the x-ray and said maybe we should go for surgery after all. Wow, that was annoying. Wasted 3 weeks... But he retracted, he said it wasn't healing as fast as he expected. Which made me feel like my foot was somehow bad at healing itself, which made me sad.
But he said we could see after another 3 weeks if we wanted, and that there were some signs of healing - there was no reason not to wait and see. Except that it would be faster to have surgery. There was just a little under a centimeter of space that needed to fill in. He said that for a young person (30 is still young) this is usually possible. So we waited, and three weeks later the x-rays showed signs of healing. Good healing.
It turns out that your bones don't grow towards each other, as I imagined. Your body actually grows new bone cells in the space between the two broken pieces of bone. So after 6 weeks or so, we started to see a white haze between the two pieces of bone, and the bones were moving towards each other! The small piece closer to my toe was rotating back towards the larger piece.
Human bodies are amazing.
So we made another appointment for 4 weeks later. Initially, I thought it would be two months, maybe a little more, and then physical therapy to get walking again. Not so lucky. This is one of the hardest things about healing - expecting a certain time frame and having that time frame extend and extend. It made me feel like I might have made a mistake, surgery would have been quicker. The effect on my attitude was negative, which doesn't help. Time passed slowly.
We celebrated at 10 weeks (after the distraction) when the bone was clearly healed very well and the doctor said I could take off the cast and use the walking boot. But he also didn't want me to put weight on it for another 2 weeks. We went back after those two weeks, and he said I could start walking on it with the boot and no crutches, but that I'd need another x-ray and check-up in a few more weeks.
12 weeks = 3 months. And that is 3 months after the distraction. The actual break happened about 10 days earlier. So we were closing in on 3.5 months since the dancing, and I was just starting to put weight on my foot again. As you can imagine, my foot wasn't really happy about that.
Three weeks later and I was walking with the boot without crutches. Not hiking around town for hours, but up and down stairs, back and forth to the bathroom. I could finally help in the kitchen again, wash or put away dishes, chop vegetables. I wipe counters. These are the little things that make me feel useful again. At the end of the day my foot feels tired, and I end up using one crutch to help lighten the load on my poor foot. But it is clearly getting stronger.
5. Get Some Exercise
About three weeks before the cast came off, I started exercising. Nothing fancy, and at first I was doing hardly anything. I would lie on my back, put both legs straight in the air, and then slowly lower them to the floor and lift them up again. Maybe a set of 10 at first. Then I did crunches, maybe 50. I would be on all fours and lift one leg at a time behind me. Or lie on my side and raise one leg at a time, like someone in an 80s exercise video. Really amazing stuff.
But after a month of doing these things, I was up to four rotations of the simple exercises below - and I could tell I was stronger and fit into my pants better. I even break a sweat when I do these things. And it feels really good.
25 side leg lifts on one side
25 leg lifts on my stomach, each leg
25 side leg lifts on the other side
25 times lowering legs while on my back, two rounds with both legs together, two rounds one leg at a time
I have never had a regime like this before, and I am not really into exercise just for the sake of it. I like my physical activities to be a part of the way I live my life, like cycling to work every day. But not being able to use one of my feet has driven me to drastic measures. I'm still doing these things, every day that I can. And it really helped when I started doing stretches and exercises to rehabilitate my foot, because I was already in a daily routine.
Circulation is blood moving through your body. Blood brings oxygen and nutrients and takes away toxins and waste. So it follows that the better your circulation, the more oxygen and nutrients get circulated, and toxins and waste get discarded. I figure my foot needs a lot of nutrients right now. Specifically calcium. It turns out you can over-do calcium, because if you are getting so much that your body doesn't have uses for it, you will start to stock-pile it in calcium deposits, which are painful.
My point about circulation is this: anything you can do to get your heart pumping and your circulation moving will be helping your foot to heal.
6. Learning to Walk Again
So this is another really disappointing thing. After 3.5 months of not bearing any weight, my foot looked flabby and my left calf was visibly smaller than my right calf. It was also completely soft and squishy.
Walking is hard! At first, it just hurt. Here comes the fear part: I was so afraid of re-injury that I was afraid to do anything that hurt. My doctor did say 'If it hurts, don't do it'. But the truth is that physical therapy will hurt, and putting weight on a foot that hasn't walked in 4 months will hurt, and there are different kinds of hurt. For example, my heel hurt a lot at first. Any weight and I would get a tingly pain in my heel. That pain wasn't from my broken bone, but because I hadn't walked on my heel in so long.
So I was extremely careful. And I read about other people feeling this kind of pain, and was reassured. Mostly, I slowly, slowly started bearing more weight, until the pain was minimal. And then I stopped using one crutch. Ugh, what a slow way to becoming independent.
At least with one crutch I could carry a glass of water from the kitchen to the couch. But that was about all I could do. I tried running a couple of errands with just one crutch, and it was painful and wore me right out. I came home discouraged from yet another minor attempt at independence that just made me feel worse.
And the doctor wanted me to get more x-rays before walking without crutches and the boot.
After almost five months, I can now walk with the boot on without crutches. I still only do this around the house, and by the end of the day it is sore. But I've just started walking up and down stairs without the crutches and it feels so good. Doing little strength building exercises every day is really important. Everyone will tell you that. But even beyond the strength you are gaining, it gives you the feeling that you do have some control over your healing process. And you do have some power to help yourself heal faster.
Don't forget to give yourself massages, too. Rub on your foot. Especially the parts that were not broken. It feels so good. And it's good for circulation, which is the way your foot heals.
My other favorite thing to do is to go to the pool and walk in the water. If the water is the right depth, I can walk with no pain. I float just enough. And I can stretch and move my foot the way it needs to move. My calf is gaining strength, too, which is, of course, critical to being able to walk. The 80s leg lifts really helped keep my hips from freezing up, but there is nothing like walking to help you get strong enough to walk.
As I heal, I will post more updates to this page. For now, get some inspiration for your future and take advantage of time. If not now, when?
Update: August of 2011
Well, I'm walking pain free and spent a couple of months on a bicycle tour - so I guess we can say that the foot is healed. It did take a lot of time for the pain to go away altogether. I attribute my recovery to taking it very slow, and then getting to work. In April I got a waitressing job and for about 6 weeks I was doing a lot of walking back and forth, quick turns, carrying heavy awkward objects, and not sitting for hours at a time. At first it was exhausting, both for my foot and for the rest of me. But the soreness was defintiely a muscular soreness so I took ibuprofen and got through the first hand full of days that way. Every couple of days I would try without the drugs, to see how it was feeling, and I certainly found that I was strong again quickly. And of course riding the bicycle was even easier than walking. I went on a 30 mile bike ride over massive hills before I could even walk normally. So keep at it - you'll get better!
Update: Thanksgiving 2011
It's been over a year. I didn't even think about the one year anniversary of my broken foot until I saw that it was the 1 year anniversary of the event I was at when I broke my foot. While not thinking about it as a date to remember is great, I think about my foot all the time. Not because it hurts, in fact it doesn't hurt. Sometimes, if I go on a long walk, I feel like I can feel the bones inside my foot. Not painful, but there. I am hyper aware of everything I do with my left foot, and I am cautious about putting my entire foot on each stair when going up or down stairs.
There's still this feeling in my brain that I could re-break that bone at any time. Now that I've had a broken bone, I feel like breaking a bone is an easy thing to do. It's also something I'd really like to avoid. I do try to stretch and flex my foot consciously and regularly, just to see how it's feeling. There are some things that I try to do, like flex my pinky toe away from the rest of my foot, that do hurt. But the more I do it, the easier it gets, so I guess I'm just regaining strength in a muscular motion I have not been practicing. If I put a lot of pressure, using my hand, right on the place where the bone was broken, it does hurt. So I avoid that.
But all in all, things are good. I can still summon the feelings of being totally helpless, but instead I just feel calm. I think one of the most important things I learned to do is wait. My ability to be patient through all kinds of things has increased. I can sit and entertain myself by doing nothing. Just thinking and breathing. When that is all you can do, you get good at it.
Update: May 2012
Since it looks like a lot of people are reading this, I feel like it might be worth an update. I don't worry about my foot much anymore. I can still make it hurt if I try, but things have been good.
The recent change is that I've started running - just because. Husband loves running (what?!) and we have both been pretty sedentary lately. So we bought the most expensive shoes I've ever bought, and they are the ugliest, too. Vibram Five Fingers. Barefoot running with gravel protection. So far, so good.
We're starting out really slowly. We're using the Couch to 5k app to move from not running to running - and the first day was five minutes walking, then alternating between 1 minute of running and 1.5 mins walking - for 20 minutes. We don't run on paved paths, just through the woods, down dirt roads and grassy trails.
It feels pretty good to be starting slow, and I can totally feel how I've been favoring my left foot. I haven't really been walking on the outside of my foot, which is how you're supposed to walk. Don't take it from me, learn about proper walking somewhere else. I'm taking what I've learned and trying to adjust the way I walk. Barefoot is different and it feels great.
Update: July 2012
Thanks to everyone who has visited this page! I hope you've found it helpful. We've completed the Couch to 5k app and now we're doing Couch to 10k. Week 10 of running and now we run for 15 minutes, walk for 1 minute, then run for 15 minutes again. And then 1 minutes walk and 15 more minutes of running. I cannot believe I can run like this. Still barefoot and now on some paved paths as well as cobblestones. Pretty crazy stuff. But it feels great and my feet and legs feel stronger than they have in a long time.
Keep it up! You can and will get better!