Tag Archives: lisfranc diagnosis

Short Outing during LisFranc recovery

Since my surgeon has cleared me for short outings, my husband and I decided to attend a dear friend’s surprise birthday party today.One of the challenges of not being able to walk stairs in our multi level home is how to transport me from our lower level up to our driveway.  My husband devised a plan where I would maneuver onto his John Deere tractor by climbing on board from my knee scooter.  I then sit in the drivers seat with my legs spread, dangling my injured right foot over the side.  My husband, standing in-between my legs (with his butt in my face) operates the steering wheel, speed and direction.

I had a girlfriend be the guinea pig on the first attempt, while her husband shouted for my husband to get his butt out of his wife’s face.   We all laughed so hard, I thought it would never work, but it has been HUGE success.

I have to say, the first few times were very scary and I was convinced we would topple over and my foot would be re-injured.  But now, I look forward to my rare outings and the ride on the tractor. I am working on getting a picture so that you can see how we manage the John Deere transportation.

So today I took my tractor ride and my husband loaded my knee scooter into the trunk.  We arrived at the restaurant and I scootered in.  Immediately I felt very conspicuous and in the way.  People kept bumping into my injured foot and I was glad to have my bedazzled cast on my foot.

The party was fun, but I was shocked how tired out I became.  Eventually I sat down with my foot resting on my knee scooter.  But after a while, even that was painful.  I knew it was time to go home, ice and elevate.

It was wonderful to get out and see how beautiful the landscape has become this spring, even if the view is only from the window in the back seat of our car.

I am surprised, though, how cozy it is to be back in my chair with my foot in an iced air cast while it is elevated on two king sized pillows.  It has been an exhausting, but fun day.

Today marks 3 weeks after my LisFranc surgery and is also the halfway mark in my non weight bearing period.

The first week post surgery is a blur of pain and narcotics.

 Last week (week 2) was spent adjusting to being completely dependent upon my husband, family, friends and neighbors.  It was also the week I had my 2 week post op appointment.  My cast was removed, my stitches were extricated and my surgeon announced I had little to no swelling which is a really good sign.

Yes, that is pink nail polish you see on my foot.  My surgeon gave me permission to keep it on during my surgery.  He said the titanium plates and screws he put in my foot were blue, though, and not pink.

I was given permission to go on short outings as long as I remembered I was non weight bearing and when moving around, I had to promise to wear “the boot.”

Memorial Day visiting graves on my knee scooter.  Note the pink sneaker.

Of course, pink was not a color option for my boot.  Being married to a grey boot was depressing. so a friend of mine came over and we bejeweled the boot.  I have decided to have everyone who comes over to “babysit” me sign my boot.

And now I have completed week 3 and I am sitting like a hopeful dog whose nose is pressed against the window, longing to be outside. I am completely dependent upon my husband to get me to the car, as I cannot do steps yet.  I am reclining in a room that is mostly windows, with my foot on 2 pillows and an ice/air cast wrapped around my foot.  And I watch the leaves grow.

Day 11

I think it is the isolation that is the worst part. Before my surgery, I planned on not being very mobile and set up our lower level with a TV, DVD player, stocked our little kitchenette with water, diet coke and plenty of fruit.  I moved all my clothes into our guest room and had plenty of e-books and hard cover books available.  I made the bathroom completely handicap accessible for a person who can only put weight on one foot. Crutches, knee scooter and walker all stand at the ready to help me live as normal a life as possible.  But never once, did I contemplate how alone I would really feel.The first week after my surgery is still a complete blur of pain and narcotics, and an exhausting revolving door of friends and family bringing flowers, food and company.  Switching to OTC meds really helped with the exhaustion and when all the attention died down, I realized I was alone, really alone for the first time.Being alone sounds so wonderful when the world is spinning out of control, but when you are forced into isolation, it really isn’t all I thought it was going to be.  I was going to get caught up on all my reading, watch movies and maybe even start that novel I have been planning on writing.  But instead, I am sitting here watching the rain drip down in silent drops…drip…drip..drip.

I have my 2 week post op appointment on Thursday and all sorts of things flicker through my thoughts…why is my big toe numb?  Why does my foot hurt so much on some days and not at all on others?  Did I do damage to the surgical repair when I fell off the knee scooter on one of my sleepy days? Will I get the splint/cast off finally???  What will the next 6 weeks be like if I am already tired of the forced sedentary life?

The days stretch on endlessly as I try and think positive healing thoughts…

I am now 3 weeks post surgery and have been curious about the plate my surgeon put into my foot since most of the lisfranc surgery pictures on the web didn’t look at all like mine. Most of the pictures  I could find were of various horizontal plates and elongated screws placed at different angles.  I didn’t find any pictures with a square plate like mine. I also noted that  several lisfranc surgery pictures showed more than one incision on top of the foot.

Yesterday I found a manufacturer of the square plates and discovered this is a newer concept in lisfranc surgery.  Here is the the website in case you want to check it out:

I have only one incision on top of my foot and the plate my surgeon inserted will never have to be removed, so there will be no need for a second operation. I am very fortunate to not only have found my surgeon, but that he is on the cutting edge of lisfranc surgery.

A lisfranc diagnosis is rare and often missed……

I wish my lisfranc story was more exciting.  Wouldn’t it be more fun to tell people I sustained my lisfranc injury while skydiving in Brazil or snowboarding in Aspen?  But my story is much less dramatic. I was celebrating the grand opening of a new restaurant with friends and we were on our way out when we saw some of my son’s friends sitting in the bar.  I went over to collect my hugs and turned to leave, and missed the step down, falling off my 3 inch heels.  I was mortified  that I fell off my perch and tried to stand up right away, but my right foot was so unstable that I fell again. (I was hoping none of my sons friends were taking a video and that would end up on youtube the next day. )I took off my shoes, thinking the heels were the stability problem and my husband helped me hobble painfully to the car.  I remember thinking how weird my right foot felt when I tried to walk on it.  My foot felt wobbly and I didn’t trust it to hold my weight.

Lisfranc injury is indicated with severe bruising on the bottom of the foot

I was in a lot of pain that night and in the morning my husband took me to urgent care.  The doctor took an x-ray (non weight bearing) and said I had not broken  anything and that it was a bad sprain.  I asked how to take care of it and he said Advil, elevation and rest.  I asked for some crutches since It was too painful to put any weight on my right foot at all.  I wish I had taken pictures, but I had the classic bruising of a lisfranc injury where even the bottom of my foot was severely bruised.

The Urgent care discharge instructions said that if I wasn’t better in 10 days, to seek additional medical attention.  I waited the 10 days, and not only did my foot not get better, the pain and bruising got even worse.  So I sought out my Podiatrist who had helped me in the past with plantar fasciitis.   I brought a copy of my x-ray from urgent care and he agreed that it was not broken.  Informing me that bad sprains take time to heal, he put me in a walking cast, the kind that goes up to your knee, and said to use that and crutches to get around.

Weight bearing x-rays are essential for accurate lisfranc diagnosis

I waited another 10 days and my  foot was still not better.  The bruising was still there and my pain was hovering at about a level 4.  I decided to seek a 3rd opinion from a well known orthopedic center in Minneapolis.  The doctor who had time to see me immediately was a surgical podiatrist.  He looked at my x-ray and said he wanted to take one of his own as he suspected a lisfranc injury.  This was the first time I heard the word lisfranc.  I was brought into his x-ray room, where the technician had me stand on my injured foot for the x-ray.  My new doctor than gave me the tragic news.  We viewed the new x-ray together which showed a large separation between my first two metatarsals.  He asked how the x-ray was taken at urgent care and I told him laying down.  Lisfranc injuries are often missed because lisfranc injuries are seen easier on weight bearing x-rays where weight is on the mid foot area.

My new doctor then told me I was a few days outside of the optimum surgery window for a favorable outcome and that he would still be willing to do the surgery but it had to be done immediately on an emergency basis.  If I didn’t have the surgery, I may never walk again and would have pain the rest of my life.  I felt tears leaking from my eyes as he delivered this news.  He went on to say that he would come in on Good Friday (2 days away) and do the surgery for me.  That is how strongly he felt I needed immediate attention. He told me he would be putting  a combination of plates and screws in my foot and would make up to 3 incisions and as he was talking, his voice started to fade in my mind.  I was having a hard time accepting what he was saying. Next he explained that I would have to be non weight bearing and in a cast for 3 months, I felt my life completely collapse.  I told him my husband and I were going to Israel with our church group and he said I had to cancel the trip.  The trip we had looked forward to, planned for was gone!

The next few hours were a blur.  I was seen by another physician in his group for my pre-op physical, I was given instructions for surgery prep.  I was scheduled for my surgery plus 3 more post surgery follow up doctor appointments.  I was given a packet on what to expect after surgery.  A knee scooter was put on order for me and then an appointment was set up for me for a CT scan.

I walked to the parking lot and sat in my car and cried.  I couldn’t believe this was happening to me!  I wondered how I would ever tell my husband, not only about the surgery and the after care that it would involve, but that we had to cancel our trip to Israel.  After I calmed myself down, I decided to drive to my husband’s office and tell him in person.  He met me in the parking lot and I broke the news to him while sitting in my car.  He was astonished, disappointed but was glad I had something that was fixable.  It really bothered him, though, that this all was on such short notice.  We both knew that for a major surgery we really should be seeking a 2nd opinion, but I was told I didn’t have time.  Not if I wanted to walk again.

My husband decided he was going to find a 2nd opinion and find it fast.  We both knew that would be a long shot since all the top orthopedic surgeons are booked weeks in advanced.  He started by calling his primary care physician and asked who the top foot specialist in the twin cities was and was told the name of a doctor who works out of Twin Cities Orthopedics and that this surgeon was a “doctor’s doctor.”  AND he took care of the Minnesota Vikings players feet.  Well my husband left 3 messages with the surgeon’s assistant that he wanted the surgeon just to take a look at my x-ray and tell us if it really was a lisfranc mid foot fracture and if emergency surgery was indicated.  We didn’t hear back from the assistant, so my husband decided to hand deliver the x-ray to this surgeon.  Meanwhile, a dear friend of ours, who co-owns the building Twin Cities Orthopedics offices in, called in a huge favor and had one of the owners of Twin Cities Orthopedics call the surgeon and ask him to take a look at my x-ray.

The next thing I knew, the surgeon called me on my cell.  He said that after looking at the x-ray, he didn’t think lisfranc surgery was indicated.  I was stunned!  I told him what the first doctor had said and that I was scheduled for surgery in the morning and he said that it was not true that this was an emergency and that I would not walk properly again if I didn’t have surgery right away.  I asked him if he would like to see my CT scan and he said yes and could I bring it to him right away.

Lisfranc surgery is elective surgery

When I arrived at Twin Cities Orthopedics, I felt like a celebrity.  There were sticky notes with my name on them saying not to let me leave before seeing the surgeon.  I was ushered into a room and waited.  Shortly afterward the surgeon walked in smiling and commented that I had friends in high places.  I liked him immediately and felt calm settle over me.  His aura was one of quiet confidence.  He pulled up my CT scan and showed me various pictures of my foot.  He said with this new information he would have to reverse his opinion and that I did indeed have a lisfranc mid foot fracture with ligature rupture and joint displacement.  Surgery, however, was not an emergency, but rather a choice.

Choose your surgeon carefully and inquire about their recovery protocol

I explained to him about our trip to Israel and how disappointed I was to have to cancel but that walking properly again was more important to me.  I also asked him if he was taking new patients.  He said “apparently I am.” and smiled.  He then told me to go ahead and go to Israel.  I was stunned!  He said his surgery schedule was 6 weeks out anyway, so he would put me in a walking boot and if I wanted to go, I could. I had to promise him that I would “listen to my foot” and not push myself if it hurt.  And then he promised me that he would be able to fix my foot and that I would be able to walk without pain again. I felt tears of happiness slipping down my cheeks as he delivered this news.  As he stood up to leave the consult room, he turned to me and said “you will cancel the surgery for tomorrow, yes?”  And I said absolutely.

So my husband and I loaded up with Advil, instant ice and my walking boot and and headed to Israel for a life changing marriage changing experience.

When I returned I had an appointment with my new surgeon who took another x-ray and confirmed that I still needed to have the surgery.  This time, I knew I had the right surgeon operating on me.


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