If you're reading this - you either have been diagnosed with a Trimalleolar Fracture or know someone who has one. I'm not going to sugarcoat it - a trimalleolar isn't good. I do hope, however, that I can provide an optimistic take as I have progressed and healed faster than my surgeon and his team expected. I am going to share my approach to the injury and what I have done since it happened.
October 16, 2017
As Mondays go, this one was pretty typical. Putting out (figurative) fires in the early morning and then a regular day as a dentist and dental school administrator. As is my habit, I headed to the gym for a workout at the end of the day. As I was walking back to the rack after the final rep of the day to return my kettlebell I didn't see a wet yoga mat someone had lovingly placed on the floor. As I stepped on the mat my foot slipped, and since I was carrying the kettlebell at the same time my balance was thrown in two directions. I landed on the floor with my foot at an almost 90 degree angle to my leg. Probably still in shock, I diagnosed it as a dislocation and violently tried to jerk it back into alignment. Didn't work. At this point, a few wide-eyed, horrified looking gym patrons saw my predicament and ran to get help. The gym administrator charged with writing an incident report (Yes I knew my name, yes I knew where I was. It wasn't my head that was at 90 degrees to my body) asked if I wanted an ambulance. With as little sarcasm as I could muster, I agreed that an ambulance was indicated.
The ambulance ride was approximately 5 city blocks and it was horrible. The shock was wearing off and the pain started. The EMTs started IV morphine which didn't have the effect I had hoped. Every pothole, trolley track and red light stop sent pain jarring through my leg.
I was wheeled immediately into the Emergency Department and met a great physician and nurse. The ordered Xrays and then consulted the Orthopedic Resident on call. Below is a picture of the X-ray:
As the radiograph was developed, the orthopedic resident arrived. I asked her if she thought it was just a dislocation. She informed me that my ankle was without a doubt broken and that she was going to re-set it. I, in turn, informed her that she would be sedating me first. She was not impressed by this idea but I didn't care. At this point, my friend the ED physician returned to the room and agreed with me about the sedation even saying to her "I don't care what you think, he's my patient and that's what we're doing." I do sympathize with the resident as I too was a hospital resident for a year. It sucks to be called in after hours and then wait to get working. But patients come first (at least they did when I was a resident) and I was going to be sedated.
So my pal the ED doc told me they were going to sedate me with a cocktail that included ketamine. What a trip. Literally. The TV in the corner had "Family Guy" on, and once they onboarded the drugs, I was in the Family Guy episode with Peter and Lois, along with the resident attempting to re-set my foot. It took the resident tow attempts to re-set my foot. Small victory for me as she realized that it would not have been pleasant for me to endure teh re-setting attempt twice without sedation.
When I came out of my trip, My leg was wrapped like a cartoon misadventure:
It was at this point I realized that I wouldn't be walking for a while. The hospital staff finished with a CAT Scan, took my insurance information and told me that I could go home. I called my pal Paulie to come pick me up. Before he came into my room to drag my sorry behind to his car he asked the nurse if she could spare any Percocets. She liked him right away. I was transferred from a wheelchair to crutches and into Paulie's car.
Paulie dropped me back at my condo and I read my diagnosis on my discharge paperwork - Trimalleolar Fracture. It didn't mean much at the time as I fell asleep exhausted from the day.
