I’m in a funk. A foot funk! I feel like a Groundhog that didn’t see the level change in the cement so now I get six more weeks of boot.
If you heard about this, you thought the foot story was done. Well, sort of; we’re about a third done. As of yesterday, since it is officially now confirmed I have the number one missed fracture by urgent care, allow me to use this as a teaching experience.
DIAGNOSIS: broken. Lisfranc fracture.
SOLUTION: surgery.
SOLUTION WHEN YOU GO UNDIAGNOSED FOR 8 WEEKS: boot. And wait and see.
The fact that this is a common sports injury still baffles me that it is also the most commonly missed. Or, if you know you have a fracture you keep missing, why doesn’t urgent care start thinking of this to get better at recognizing it?
Here ye! Here ye! IF the top and under your foot is bruised and sensitive in the middle, IF your toes are bruised purple, IF your foot seems to have widened, and IF – you cannot go up on tip-toe, you might have a lisfranc fracture. If I had known this existed, I would have fought a little harder.
I knew something was wrong. It didn’t hurt like rolling an ankle or spraining your foot. Trust me, I’ve done both. Unfortunately, in the fall for the past nine years every three years, I fart up my feet. At first I thought it was a grad school thing, but unless the dissertation channels the same energy waves, two in the PhD program is a new record! (Although…..it must power stronger waves. I’ve never had an actual break before!)
The other weird part about all of this is that I had to warning signs with the doctor and the technician. First, at urgent care, the doctor came in and said “this looks like an old fracture” and pointed to what now seems like my now permanent foot lump. At the time I was too tired and in too much pain to argue. They also gave the justification that if you’ve rolled your ankle, it can create similar looking x-rays. That I’ve done. Old fracture I haven’t. The other warning was when I went to my PCP five and a half weeks later because I needed a referral to a podiatrist because something was still wrong, when they ordered the x-rays, I pointed to the spot on my foot and said it looked like the bone was crushed. But the actual foot part of the bone looked fine – from that angle, so no: second time doctor and radiologist said it’s just really sprained. Another round of trying anti-inflammatories for a week. And then it took another two weeks to process the referral to the specialist.
The lack of diagnosis is because a lisfranc fracture can only be diagnosed with a weight bearing x-ray. Which no one did. Forcing weight on an injury isn’t really people’s style I’m guessing. But now that I know this exists! Basically your foot cracks down the line of your big toe, thus causing your foot to widen. It’s kind of cool to realize that’s even possible. If you know lisfranc exists!
At first I was told two weeks. Then I was told three days. Either way, I way missed the magic window for surgery to fix this right and fast. We will now do six weeks of boot, and then start weaning out of it. Therefore, I’m in a groundhog funk. Probably because as if I wasn’t having the time of my life with the boot, but now I get to go to NYC, Iceland, and the Blue Lagoon, all with a freaking foot boot!
So, what I’ve learned from all of this: sometimes, you need to be a little louder complaining. Two doctors and two radiologists said it wasn’t broken. I had been saying since day one it was. Sometimes you actually do know your body better than anyone else. And Doctors, including PhDs, aren’t gods. We’re human. Error is possible and ship happens. But don’t be passive. Whatever you do, stop being passive.
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