Thursday, July 28, 2016

All Worried Out- and crowding sourcing some help?

I'm a worrier.

Make that a Worrier.


I always have been. I am a champ in the worrying game. When I was young my mother would randomly knock on things mid-conversation mid- my ranting and yell "who is that... oh it's trouble?.. Someone was asking for you? ....It was Lizzy!!" Which is kind of funny in retrospect, but I hated it as a kid.

I like to game through all scenarios- the worst case tends to take up more mental energy. That only stands to reason, the worst case has the most ramifications, right? An example: here (remember while all these crazy thoughts were happening, Suyra-Scott was in the freezer!).

Currently I am a Stress Mess. I can keep a lot on my plate, but eventually even I tap out. This is mostly just venting, the last paragraph is me summarizing the situation and asking for help if anyone has also been in the situation of a potentially fractured metatarsal with no x ray evidence. Feel free to skip:


Work- Still no answer on my work. At least now if it's a negative outcome, I'm only risking 4 months income rather than the 7 I was looking at in the beginning. Another day, another dollar.... and another patient suffering, but that's a whole different worry ball.

Mom- My mom has crappy joints (as do I, Thanks Mom!). She recently had been experiencing knee and leg pain. On Sunday, something gave and she ended up in the ER. Suspected hamstring rupture. They are dragging their feet in a firm diagnosis, but finally an MRI was done and it is looking like answers soon.

Me- Baby is still breech (I think). I really hate when people whine about baby's sex and method of birth. If you and your kid are alive and healthy you won. But I am sad at the thought of a c-section. I had a wonderful birth with Kins and think about it fondly often. I'm sad at the prospect of losing that. Though if Surya-Scott ends up here and healthy, I'm not going to throw a pity party.

Hub- Ugh I hate having hub on my list. I feel like I did a lifetime of worry during the military years. Can’t I be exempt? This real worry is coming at a lousy time mentally for me, there was a tragedy within my social circle and a friend lost her husband. I've been anxious and panicky since (as well as obviously devastated for the loss and for our friend).

Basically, I'm a wreck in general and then hub starts limping a few weeks ago. This isn't unusual (Army years= plenty of minor, nagging injuries/issues) but became concerning as it 1. continued and 2. became really painful. Hub is a traditional stoic solider (in this way only: he's also way liberal and a feminist so..) seeing him limp, wince, take (gasp) pain pills and just generally baby his foot was unsettling for me. I told him to go to the doc- he refused. You know, normal married stuff. Then on Sunday his foot was swollen, there were times he couldn't put weight on it. On Monday we had a conversation about our work weeks (as we also do, we're work-a-holics). He mentioned a new client and needing to tour their site and commented he really didn't want to have to walk around long enough to do it. This worried me and I told him to call the doc.. and he did. Which worried me even more. Apparently the doc was worried, since he was seen less than 24 hours later. 

At the appointment, the doc initially was thinking sprain but when he pressed along the top of the foot found significant point tenderness. The doc did a few more manual maneuvers and said he believed it is a fracture of the 5th metatarsal. He was concerned that this has been an issue that has come and gone over that last 8 or 9 years. He said likely it is a stress fracture, which will need surgery. Other options may be a non-weight bearing cast or boot. On his driving foot. UGH. He went for x-rays and...

They were negative. Huh. The nurse who called with the results was apparently like "yay! no fracture. Bye!" and hub was like “wait.. what's wrong with me?” Then she asked if he wants PT. His response was, “I don't know, will it help?” The nurse went to talk to the doc and he was going to call.. but no word ever came. Business day ends. So I google scholar and apparently it is very common to have these types of fractures NOT show up on x-ray when they are new and only show when they start to heal. Most of what I have read says he really needs to be non-weight bearing for 6-8 weeks to have a chance at natural reunion of the bones otherwise surgery. There are a range of stories though, and I can’t find anything about what to do in the time before the fracture becomes apparent on x ray. I am continuing to freak out. 

Last night, hub and I had a talk about what to do. I’m a planner and he’s much more worried about it than he usually lets on. This allowed much better conversation than we usually have when I’m worrying about things. Overall, we’re both very concerned about the idea of delaying treatment until the stress fracture is visible (if this is the issue) and making the situation worse in the meantime. This could easily lead to having him being in a non-weight bearing cast while I am recovering from a C-section or getting surgery right before or after baby is born (again I focus on the worst…). It very well could be “nothing”, a little injury that needs RICE and a bit of care. We decided on the following course of action: Call doc, ask what he should be doing/ not doing on the foot. I think it was assumed that he needed surgery so didn’t give suggestions for care. Also, call the PT place he was referred to and see what their opinion is (may be they have additional information?). Take it easy. This is the big one. He is a very proud guy, I know he won’t use non-prescribed crutches at class or work. I doubt unless he was missing a leg, or his leg was casted in a way that made walking without them actually impossible he’d use crutches in front of people at all. But he will work from home most of the day and promised to use them in the house. Next week, he’s going to work from home 100%. We’re going to at least ace wrap the foot, if not prescribed something more restrictive. Stay off it whenever possible, to include not driving and using the crutches. It wasn’t too hard of a sell. There are things that make him visibly wince- stairs, pivoting, getting up from sitting and occasionally just an average step. I think his pride is getting in the way of using the crutches, but me suggesting, insisting, demanding he use them swayed him .  

So, this morning hub makes the calls to the Doc- not in the office. He went over to the PT place to discuss with them. They were very confused that he was sent to them, since they had no treatment plan either from hub (obvi) or from the doc’s office. Basically they were like “we’d love to help… when we know what we’re helping!”. So called the doc again and get the nurse from yesterday. She was confused that hub felt unsupported since she was under the impression he was going to PT. He explained he felt he had no guidance on care, activity level or even a diagnosis. The nurse was like “Doc didn’t say anything about orthotics or restrictions, but PT for chronic foot pain.” Only, the pain isn’t really chronic. Yes, it’s happened before, but it completely goes away and this is past the level than it has been in the past. So he is like, I really think I need to see someone and figure this out since I called the PT and they said they need more info AND I’m in pain and would like a diagnosis. So she says they will send him to a podiatrist they have.. but he’s only in on Tuesdays and out next week, so it will be August 9th. Byeeeeeee

Ummm what? They are having him walk around- no boot, ace bandage, crutches or restrictions at ALL for two full weeks after initial complaint? And again, there is plenty of information online that a fracture wouldn’t necessarily show on an x ray this soon after injury. The doc went so far at hub’s first appointment to tell him that surgery could be scheduled once x-rays were in and they usually get people in within a week. That leads me to believe there is a really good chance (swelling, point tenderness, history of similar pain in same place after high risk activity) that this is broken. And broken in a place that mandates surgery or complete immobilization toes to mid-calf in a non-weight bearing plaster cast for 6-8 weeks. But you’re just going to have him limp around? For 2 weeks?

Anyone with a history of this injury? Called a shaft fracture or march injury to the 5th metatarsal. Stories? Thoughts? Help?

1 comment:

  1. OH my gosh! WHAT?! I'm so sorry to hear about his foot. I would see if you can see another doctor in the practice or switch practices altogether. A once a week doctor is a no-go in my opinion. I have no advice on the actual injury though. It sounds awful. :(