July 11-I got into a tussle with a tape dispenser and severed my extensor hallucis longus tendon. I can’t fathom the odds of injuring one’s self in this manner. The few cases I found online related more to cooks in the kitchen dropping knives on their feet. Ouch. Anyway, here’s how it happened:
I was taping the ceiling in the sunroom so I could paint the walls. Call it laziness or sheer bad luck…that I left the tape dispenser on the ladder when I climbed down to move it. As I scooted the ladder, the tape dispenser fell off and on to my foot in such a way that it severed my tendon. At first it just hurt like hell and I stepped back, into a pool of blood. I looked down thinking I must’ve stepped in paint, saw the blood and things pretty much go fuzzy after that. I understand I let out a wail of a scream and 911 was just seconds away. The hospital emergency room was full so they put me in the pediatric ER; lots of cute wallpaper.
The ER doc couldn’t fix it, but he clamped the severed end and showed me the tendon, which sort of looked like rice paper. He gave me a tetanus shot, vicodin and sutured it up. I left with a soft-cast, set of crutches, a prescription for pain meds and antibiotics, and instructions to see a foot surgeon asap. I saw Dr. D (DPM)the following day.
July 12-Dr. D has so many podiatry degrees on his walls dating back some 24 years, that I immediately felt at ease. He looked at the injury and asked me to wiggle my toes which, at first, I couldn’t. Finally, the 4 little ones came up. Dorsiflexion of the foot at the ankle was almost nonexistent. Still, he needs an MRI to confirm the injury. He re-wrapped the foot and fitted me with a walking boot in addition to the crutches.
Note on Bearing Weight (post-script): Even though I was fitted for a walking boot or “cam boot,” I was told NOT to bear weight on the injured foot. The reason for this is that tendons are stretched like rubber bands and the severed end can get drawn up into the shin making the severed end difficult for the surgeon to locate and lengthens the surgical scar. Best advice: Do not bear weight on the injury until 4-6 weeks post surgery.
Note on DPM vs Ortho Surgeon (post-script): A DPM is a doctor of podiatry medicine meaning they specialize in just feet. While ortho surgeons treat every tendon injury from shoulders to feet. Surgery requirements for EHL re attachment are among the rarest tendon injuries. Regardless of which type of doctor you chose, one of the things to keep in mind is experience, not just in their general practice but specifically how many EHL tendon repairs the doctor has done and what their success rate is. The biggest difference I’ve noticed between the two based on feedback herein is the post care or follow-up wherein suture failure results from allowing the patient to bear weight too soon after surgery resulting in the need for a 2nd surgery.
July 13-Waiting for the insurance company to approve the MRI is tiresome. Don’t they know I’m in a hurry to get well?
July 15-MRI appt. at 6:00 p.m. This was my first MRI and not an experience I’d care to repeat. It feels like a thousand particles of static electricity coursing through every part of the body. You can feel it in the air. The ominous sound of the machine firing a volley of images redolent of a WWII battle scene. It doesn’t hurt but it sure doesn’t feel good. Whatever the result, I won’t know for 3 days until the pathologist delivers his findings to Dr. D.
July 16-I suck on crutches. It’s like trying to dance with chopsticks. I’ve lost the use of my big toe. Without surgery, I’ll be unable to extend my foot upward 15 degrees toward my shin and vice versa…meaning I won’t be able to drive :-( Without special shoes I might even trip over my toe, just walking!
July 18-Took a pain pill and removed my stitches with a small pair of eyebrow shears. Washed the wound with soapy water and checked for seepage. None…so it must be good. Right? This kind of injury longs for the time when doctors rode over in horse-drawn buggies to make house calls. I suppose I could take a taxi to the clinic, but even that requires me moving about.
July 20-MRI results are in; confirming total separation of the EHL tendon. Met with Dr. D to go over surgical procedure and risks associated with surgery. Surgery scheduled for Friday, July 23, 2010 at local hospital.
July 22-Hospital called to confirm schedule for tomorrow at 12:30 p.m. I’m to arrive 3 hours early for check-in and blood work. How come everyone seems overly concerned with payments, co-pays, deductibles, etc… Do I look destitute? Basic instructions followed: No eating or drinking 12 hours before surgery, wear loose comfortable clothes, have ID, insurance card, co-pay, deductible, no jewelry, valuables, or electronic devices. Recommend leaving my walking boot at home and coming in on crutches. It’s an out-patient procedure so I’ll leave same-day approx. 3-5 hours later in a new soft cast and on same crutches. Any questions?
Fear sets in slowly. What if the anesthesiologist screws up? What if my surgeon isn’t the pillar of his profession? By nightfall, I’d worked myself into a frenzy and checked the state’s website to make sure my doctor’s license is in good standing. I’m suddenly reminded of a death-row inmate and wonder, in hindsight, if a frozen chimichanga burrito was really what I would’ve chosen if I’d known it could be my last meal.