Doug Paul injured in a back-country ski accident

[DougPaul]

Dude - I feel for you. I know what you are going though. With the exception of 3 weeks, I have not used my right leg in 9 months. The body says, "I haen't used it, so I don't need it, so I will get rid of it". I now have "severe" osteoperosis in my right leg. All of the bones have degenerated into swiss cheese. I've gone to Boston and the docs say that I need to do PT and exercise to get the bones to regenerate. The problem is that my fibula is still fractured. So I get to do PT on a fractured leg. The surgeon said "prepare yourself, it is going to hurt like hell, but you have to do it." Usually, doctors say "this won't hurt, just a little prick." Sigh. This doc was right.

I feel for you. The waiting is much worse than the pain.

Best of luck,

Thanks.

Sounds like you are between a rock and a hard place...

It is often the details that get you. I was in good shape when I came home from the hospital (80+ deg of knee flex). But now I'm having problems with fluid accumulation in the knee joint capsule, probably due to tissue damage from overactive PT. About 20 deg flex and pain whenever I move it.

Perhaps the next addition to VFTT should be a forum for the injured to share advice, commiserations, and war stories. , actually,

Good luck with beating it. I've been between a rock and a hard place before and managed to escape--hopefully you can too.

Doug

 

[DougPaul]

Doug: do what I did. Rest in bed (with friends) and drink plenty of fluids (Doctor)

Sounds like good advice to me...

Doug

 

[DougPaul]

Status update

Sat Mar 3.

When I was released from the hospital on Fri Feb 16, I seemed to be in fairly good shape (considering...). The fracture in the femoral neck was stabilized with two screws, the femoral distal fracture (just above the knee) was stabilized with a pin in the femur (80+ deg of flex in the knee), and the wrist fracture was cast with a "watch and see" status. I was generally comfortable.

The knee joint swelled up fairly suddenly, flexibility went way down, and pain increased. 40 ml of fluid was aspirated from it and it seemed to be getting better. Then a day later a bump appeared at the side of the knee and the pain returned with flexibility down to about 20 deg. Turned out a screw securing the pin was woriking its way out, eventually sticking out 1/4 to 3/8 inches above the surface. The screw was removed (during the wrist operation described below) and comfort with ~60 deg of rotation returned. I will need more work to fix the pin.

The wrist fracture continued to shift and a few days ago, a plate was installed to stabilize it in the correct position.

I'm currently comfortable, mobile (within my house) with a modified walker, and awaiting the next step.

Thanks again for the support that you have given me on this journey.

Doug

PS. Typing with one hand is still slow...

 

[jjo]

Doug, sorry to hear of your recent complications. I went through 4-6 months of in bed therapy several years ago when I injured my back. More recently, the knee issue 99% of the time responds well to rest. So please take it easy and REST. Let your body Heal...I will pray for you...Jerry

 

[DougPaul]

Doug, sorry to hear of your recent complications. I went through 4-6 months of in bed therapy several years ago when I injured my back. More recently, the knee issue 99% of the time responds well to rest. So please take it easy and REST. Let your body Heal...I will pray for you...Jerry

Jerry,

Thanks. Things are going ok--just a bump or two on the road. The plate should take care of the wrist and once the pin is fixed, it should mostly just be time and PT. And if more bumps appear, we will take care of them. The overall prognosis looks good.

The hip seems to be quietly healing without incident. One out of three isn't too bad...

Doug

 

[DougPaul]

Status update #2

April 2

Several people have asked me how things are going, so I am posting another update in case anyone else might be interested.

And since I don't expect anyone to remember the sequence of events, here is a quick log:
* Day 0: Injuries: femoral neck fracture, distal femur fracture (just above the knee), wrist fracture, all on the left side.
* Day 0: transported to Speare Memorial Hospital in Plymouth, NH
* Day 1: operation (1) on femoral neck (stabilized with 2 screws)
* Day 1: operation (2) on distal femur (pin placed in femur)
* Day 4: wrist cast
* Day 5: released to my home in fairly good shape
* Day 10: knee starts swelling, painful, limited flexibility. Eventually a bump forms on the side...
* Day 16: Cause of knee problem found--a screw securing the pin is backing itself out
* Day 17: operation (3) on wrist to install plate
* Day 17: errant screw removed from knee during wrist operation
* Day 24: operation (4): Pin in femur replaced
* Day 28: released
* Day 38: staples securing leg incision removed
* Day 43: brace removed from wrist

The last update was on day 20. Today is day 50.

The operation on day 24 was a long one--5 hours to pull the old pin, replace it, pull the 1st replacement, and install a 2nd replacement. It also left the leg very weak and with very limited knee flexibility. On day 38, the staples securing the incision were removed and PT began in earnest. The leg is now somewhat stronger, but the knee flexibility is still rather limited (~70 deg). I am not allowed to support weight on the leg--this may change at my next appointment in 4 weeks. Improvement is slow, but will hopfully continue--clearly more knee flexibility and leg strength will be required before I can walk, hike, or ski again.

The femoral neck fracture has been very quiet--hopefully the original repair is working and it is simply healing without complaint.

The wrist is weak and has limited flexibility, but currently supports low force activity (including 2-handed typing! Yea!). PT will begin shortly.

Of course, I shouldn't fail to mention Darren's surprise party on day 41 (running into 42...). Thanks to SherpaKroto and others for giving me a chance to escape for a few hours.

Thanks again to all who have given me a hand, a get well wish, or even a get well thought.

Doug

 

[bikehikeskifish]

* Day 17: errant screw removed from knee during wrist operation

I both saw the x-rays and handled said screw. Very impressive set of injuries, Doug.

We will get to hike something together by the end of this year. I insist.

Tim

 

[jjo]

Doug, an amazing summary of events you posted. Not boring is it? Take it slow and let it heal. You'll be back on the trails soon. I'll continue to pray for you...

 

[SAR-EMT40]

* Day 10: knee starts swelling, painful, limited flexibility. Eventually a bump forms on the side...
* Day 16: Cause of knee problem found--a screw securing the pin is backing itself out

Doug

What the heck Doug. Haven't your docs heard of Loctite?

Seriously though, sorry to hear about the extra pain and suffering. Still wishing you a speedy and as painless as possible recovery. Thanks for the update.

Keith

 

[Seeker]

Thanks for the update. GREAT to see pics of you at Darren's party! Positive healing thoughts to you!

 

[DougPaul]

What the heck Doug. Haven't your docs heard of Loctite?

Yeah. Grrrrrrrrrr!!!!!!!!!!!!!

There was no visible provision to lock the screw. (I have the screw--it is a 3in long self-tapping screw.) When I asked how often it happens, all I get is "It happens"... It seems to me that if it happens at all the manufacturer would do something about it, if only to prevent lawsuits and the surgeons would choose locking models to avoid unhappy patients and the cost of the additional operations. (As an engineer, I consider it a sloppy design.)

Seriously though, sorry to hear about the extra pain and suffering.

Thanks--I was comfortable with good knee flexibility until the screw screwed up. A major setback--rehab will be much harder and more painful. Don't know if it is because the second operation used a different entry route (under the kneecap, the first came in through the lateral side of the knee) or just the cumulative damage. In any case, I'm not pleased, but there is nothing I can do but work with what is there. It feels like a band around the front of the joint which tightens when I bend the knee--the PT said it is scar tissue which needs to be stretched (much harder to do than stretching muscle or tendon).

The doc said that the new pin is excellent, but he was looking at the X-rays, not the soft-tissues...

FWIW, the new pin is secured with 4 screws--I hope this means that it is more secure rather than there are just more screws to come out... (I think.) It certainly meant more access incisions.

Still wishing you a speedy and as painless as possible recovery.

Thanks. I plan to keep plugging and hope for the best. Only time will tell if that will be good enough. (Yet another operation is a possibility to break up the scar tissue.)

Doug

 

[bikehikeskifish]

(Yet another operation is a possibility to break up the scar tissue.)

Don't they do this with ultrasound?

Tim

 

[DougPaul]

Don't they do this with ultrasound?

I had the same thought and asked--not near metal. I presume that it might damage the bone-metal bond.

I presume any surgery to deal with the scar tissue would be arthroscopic and less damaging than the previous surgeries.

Doug

 

[SAR-EMT40]

Thanks--I was comfortable with good knee flexibility until the screw screwed up. A major setback--rehab will be much harder and more painful. Don't know if it is because the second operation used a different entry route (under the kneecap, the first came in through the lateral side of the knee) or just the cumulative damage. In any case, I'm not pleased, but there is nothing I can do but work with what is there. It feels like a band around the front of the joint which tightens when I bend the knee--the PT said it is scar tissue which needs to be stretched (much harder to do than stretching muscle or tendon).

The doc said that the new pin is excellent, but he was looking at the X-rays, not the soft-tissues...

FWIW, the new pin is secured with 4 screws--I hope this means that it is more secure rather than there are just more screws to come out... (I think.) It certainly meant more access incisions.


Thanks. I plan to keep plugging and hope for the best. Only time will tell if that will be good enough. (Yet another operation is a possibility to break up the scar tissue.)

Doug

Your making me pucker. And I don't mean my lips.

I also tend to agree with your assesment of the screw backing out. Cmon guys. I can keep the damn screw on my car for 40 years and 250,000 miles but we can't figure out how to do it on a human. WTH?

I'll keep wishing the best for you buddy.

Keith

 

[DougPaul]

I also tend to agree with your assesment of the screw backing out. Cmon guys. I can keep the damn screw on my car for 40 years and 250,000 miles but we can't figure out how to do it on a human. WTH?

Yeah--last I knew, keeping a screw in place wasn't rocket science. (I will grant that it has to be removable and the solution has to survive inside a body (a rather nasty chemical environment).)

That screwhead was sticking out 1/4--3/8 inch from the lateral side of my knee just before it was pulled. I was mighty happy to have it gone...

I'll keep wishing the best for you buddy.

Thanks.

BTW, I got an email this morning from a friend who has been through 5-6 knee surgeries and said that the stiff scar tissue can be worked out or delt with by arthroscopic surgery--no biggie. Sounds good to me. Come to think of it, last time I saw him we did some XC skiing together...

Doug

 

[darren]

Do you have a bird feeder set up yet???????

Good luck. It is a long row to hoe, but there is an end.

- darren

 

[SherpaKroto]

Just to make it back to back to back gimps on this thread .

Doug, you sound like me: the healing is worse than the accident! I remember how I felt after 50 days: 2 days home, lots of drugs and sleeping. I hope that you are fending a lot better. Look at the bright side: you can form a new love for the Red Sox, and a new hate for the Y*nkees! Now THAT's a double header!

Sending good thoughts your way!
EDIT: to clean up the Y*nkees word.

 

[DougPaul]

Just to make it back to back to back gimps on this thread .

Doug, you sound like me: the healing is worse than the accident! I remember how I felt after 50 days: 2 days home, lots of drugs and sleeping. I hope that you are fending a lot better.

The accident only took a few seconds and didn't hurt. (It was so unmemorable that I only remember a few details...) The recovery is taking a long time, is a lot of work, is often boring and/or frustrating, hurts, and has a lot of unknowns.

Look at the bright side: you can form a new love for the Red Sox, and a new hate for the Yankees! Now THAT's a double header!

Sorry, I grew up in the NY area--I'm with Frodo on this one...

Sending good thoughts your way!

Thanks--the recovery will end some day...

Doug

PS: Now its 4 gimps--your move.

 

[darren]

5 gimp posts in a row....

Yah, the recovery will end someday. Well, I don't really know that from personal experience, but sherpa keeps telling me that anyway...

- darren

 

[WhiteMTHike]

Doug,

Best wishes to you on your recovery. I will always be thankful to you for your posts giving me advice when I first bought my GPS, you a true expert with that device. I hope you are back on the trails ASAP.