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Also known as Roller Skating, Part II…

Well, Josh only fell once, but once was enough. After hearing the snap, crackle, pop, it was evident that our fun time at the roller rink was over. We headed to the emergency room in Jacksonville, and the kiddies were picked up by Nana. Shortly thereafter, we were called into an examination room.

If you bring your phone any closer, I'll bite you!

Josh really was in a LOT of pain, but being a bit of a photo nut, I managed to squeeze a smile out of him in the ER.

If you are ever in a situation like this, and are unsure of what exactly has happened to your leg, try to remember this: splints are your friend, even if they are made from cardboard and tape. If you can, use a wheelchair from the ER once you arrive. And even if you are smiling, rate your pain as very high or you will have to wait a long time for any pain medication.

The flimsy but effective cardboard splint is on the counter.

At the skating rink, they had also remembered to ice it! Very important! That is the only thing the ER did for a long time. Just kept ice on it. When someone came to see him, it was one of those student doctors who are hanging out in the hospital bidding their time until they can get their ‘real degree’ and get a private practice in plastic surgery or something. She was very nice, and barely even looked at Josh’s foot. It’s broken, she said, we’ll have to take X-rays.

After about another 30 minutes, the “real” doctor came in, sat down, didn’t even look at Josh’s foot, and said “Well, we’ll have to get x-rays before we know anything”. Which all boils down to finally getting x-rays and the discovery of a broken fibula. A fracture and broken mean the same thing, there are just degrees of it. Well, as it would turn out, Josh’s was clean broken in two.

Now, as it turns out, when Dr’s say, You’ve broken your ankle, that could mean one of three bones. Looking at the fancy bone picture, on the left you see the fibula, on the right, the tibia. Both of these bones make up your leg from your knee to your foot. The fancy “lateral malleoulous” bone is the ankle bone you feel on the outside of your leg, and the “medial malleclus” is the ankle bone you feel on the inside of your leg. And all this time you thought it was just on big bone with nobs on either side, eh? Well…I did. So any who. Josh had a spiral fracture right above the ‘fibular notch’. Spiral is a fancy word for his crack looked like this: \ instead of maybe like this -

On the x-ray, it was just a thin dark line that Saturday, so the ER doctor declared he wouldn’t need emergency surgery and after getting a temporary cast, we’d be free to leave and by the way, call an Orthopedic surgeon on Monday to schedule an appointment.

So we are off to a drug store to purchase pain killers. Let’s just leave it at not all pain meds are equal, and if this ever happens to you, ask for the strongest stuff they can give you right up front. Josh was prescribed a medication we had never heard of and on the pain scale of 1-10, his hovered at a 7-9 1/2 for many days.  

So on Sunday, Josh preached. He had already prepared his sermon the week before and on such short notice, we didn’t want to inconvenience anyone else. Sunday morning, with ibuprofen only, he did a great job.

On Monday, we called the Orthopedic Surgeon and miraculously got in the same day. So far, I have kept fairly calm about this whole ordeal. Then they take off the temporary cast/splint. It’s not fun to see someone you love in pain, AND knowing he was trying to put on a brave face in front of strangers. I gritted my teeth quite a lot that afternoon.  So now that the splint is off, it’s time for more x-rays! Oh JoY!

To the right is Josh’s actual x-ray. Yes, I took lots of pictures. More to come, hold tight. Anyway, in this x-ray, you can see the big tibia behind the smaller fibula which is a brighter white, then there is a long dark line (marked with the red oval) where the bone is suppose to be solid. Not only did he have a clean fracture but because of HOW it broke, from Saturday to Monday, the bone slipped farther and farther away from itself essentially leaving his foot dangling with no support, damaging tissue all over the outside of his ankle. So what does the doctor do? He immediately schedules surgery for the next day!

The shift is evident by Monday, the foot is pushed over to the right toward the broken bone.

The doctor also explained that in order for this type of break to happen, there is a ligament that gets damaged. After surgery, we find out that Josh’s ligament is shredded so there isn’t any kind of repair that can be done, other than to keep it immobile, which we are already doing for the bone.

AGH! So once again, he prescribes a different pain killer and off we go. Percoset worked better, but when your pain is very extreme, don’t expect any pain medicine to render your injury painless.

Tuesday, I get the kids off to school, and then get us ready to get to the surgery center. Lucky us, it’s bitter cold and drizzling sleet! I just lOOve to drive in bad weather! Not! So I’m stressed about the surgery, I’m stressed about the weather, I’m stressed about throwing a wrench in our childrens routine, and wouldn’t you know it, I’m stressed because I have realized that Josh will only be able to hold down one job for a while, and that means I have to get a job ASAP! No pressure or anything. NOT!

So the surgery goes well the doctor says. A titanium plate and seven screws. Six to screw the fibula to the plate, and one to screw the fibula to the tibia. More pain medicine prescriptions and away we go! Now here’s another important lesson for you if you ever have emergency surgery. If you can, stay over night because traditionally, the first night and third day are the most painful after surgery, and if your pain level is almost a 10 on a consistent level, it’s not going to improve much in the first 24 hours after surgery.

So part of my instructions for post op care are this: If his swelling is causing extreme discomfort, you can cut the gauze wrappings. So at 1 a.m. the night of the surgery, what do I do? I take off all the gauze wrapping! Hubby hurts!

That's a lot of bruising!

The next day, I call the office, and lo and behold, I was only suppose to cut up the front of the wrappings and they expect to see all the gauze and ace bandage on his leg at his two week checkup. So I did what any girl would do. I promptly get all the gauze out of the trash and call my mother in law to come over and fix my mistake! She had a career as a Physical Therapist Assistant and part of that involved wound care, so I figure she knows how to wrap stuff right!

In this photo, she is starting to wrap his foot, and of course, I have to take a picture to show the kids what Daddy’s foot looks like. The bruise you see is just part of it, the whole bruise looked like someone had crammed a horseshoe onto the back of his foot and he had bruising like above on both sides of his foot. Yikes!! The side of his leg with tape is where his incision was. A six inch long incision with lots of staples. Yippee!!

Look at where his foot is suppose to be as opposed to where it was the Monday we had it x-rayed.

Since he had to have surgery, we decided early on that the next Sunday, preaching was out of the question. Hopefully, he’d be so doped up that he couldn’t write a sermon and that is exactly what happened. He slept most of the week. I kept medicine logs and set alarms left and right for all sorts of hours to give him pain meds. It was like having a baby in the house but you knew when it would wake up and that taking medicine only took a few minutes, not half an hour like nursing.

So we get through the first week of nursing him back and everything is going fine. The second week was when I was called in to substitute at the high school as a secretary. Let me tell ya! It’s tricky getting two kids on the bus by 6:30 a.m., getting myself ready and getting an invalid all the drinks, snacks, and misc supplies by 7:15 a.m. That week of working 40 hours, I got a small glimpse of what it must be like for a single mom. The only difference was at 4:00 when the bus dropped the kids off, I didn’t have to worry about them being without an adult in the house, even if the adult was in bed elevating his leg.

Another point to ponder, if you ever break your leg, or ankle, or injure your knee severly, elevation means to get it above your heart, so flat on your back and lots of pillows. Now is not the time for the lazy boy because that simply doesn’t elevate your injury above your heart.

The second week also saw the weaning of pain meds. Josh has had med addicts in his family, and it was foremost in our minds that as soon as he could get off, he would. He wasn’t prescribed pansy pain meds, he was given three different hard core drugs that doctors can’t just call in to a pharmacy. Luckily, since the surgery, his leg has felt more secure and by mid-week, he was able to handle the pain with ibuprofen during the day, and hydrocodiene at night.

Let's get those staples out!

Also, lucky for him, his mom lives around the corner, so the first day I went to work, he stayed at her house, and the next two days, she brought him lunch. Thursday and Friday he fended on his on all day using a walker with a seat in the kitchen.

We borrowed a tall bar stool from his sister and he was able to preach the next Sunday no problem. Lord knows he had plenty of time to write a sermon while everyone was gone from the house that week!

So this past Tuesday, the 20th, we went to the two week follow up and got encouraging news. His bones are healing well, and maybe by the four week checkup he can go to using a cane! He can now take showers and start to put a little bit of weight on his leg. His swelling is going down and is able to wear a sock in his big boot.

So today is Thursday, and I’m not going to let this publish until Sunday I think. Today, Josh drove for the first time since his accident, and I can tell it did him a lot of good to feel a little independent again, and the alone time at the house certainly didn’t hurt me! This is the first time I’ve been alone except for driving so I feel refreshed.

I found out today that my orientation for Walmart is Saturday so perhaps I’ll have another blog in the corner pocket ready for next Monday?

I realize today’s blog was long, but when researching the web for information about broken fibula’s, there really wasn’t much. There is a broken leg forum that had a lot of information (and some links to really cool crutches) but I decided then and there that I wouldn’t blog about Josh’s story until we had most of the experience in a place where we could offer hope. And until you see the orthopedic doctor for your surgeries follow up, a situation like this feels hopeless. Josh is lucky that he might go to a cane in four more weeks. Some people who break their ankles are in crutches for six or nine months with lots of physical therapy. If that had been the case for us, who knows if I would be blogging about it now. So thanks for bearing with me.

I hope you at least found the pictures interesting! And remember, it’s not too late for prayers or good wishes if you are just finding out about this. They ALWAYS help!