Cute Titles Abound

Back Again, Grounded, Both Legs Hurt, A Matched Pair


Capt. Virgil "The Cooler King" Hilts, at it again.

I broke my left tibia on 2/9/08, while at work. For those keeping track, I previously broke my right leg on 10/28/05. The injury is nowhere near as serious as the original.

Here is a rundown of the events since the accident.


Columbia Hospital - Good Sam now occupies the site.

Sunday, 2/9/08, Good Samaritan Hospital Emergency Room (Bobby Kennedy was taken there after he was shot at the Ambassador Hotel)

I was taken by ambulance from the accident scene (Wilshire Blvd/MacArthur Park) to Good Samaritan Hospital in LA.

The ER doctor originally diagnosed my injury as a torn MCL, ACL and and/or Meniscus. After he reviewed the x-rays he changed his diagnosis to a broken tibia.

My leg was placed in an immobilizer, I was given crutches and told to stay off the leg, keep it elevated and to ice it down. I was given a prescription for vicodin and ibuprofen and told to return to Good Samaritan Health Center on Monday, 2/11/08.

Of Note: There was a vial of drawn blood (purple top) on the floor in the corner of my examination room. Definitely a violation of JCAHO standards.

Monday, 2/11/08, Good Samaritan Health Center (Intercare Medical Group, Inc)

I was seen by a general practitioner who referred me to an orthopedic surgeon ASAP. I thought I would be going home in a cast. No such luck, apparently today's appointment was so that I could make an appointment. I have no idea, why I didn't go directly from the ER doctor to an orthopedist. I was sent home with more medication and told the office would call me with an appointment time, hopefully within a few days. The doctor said it would be a miracle if they could schedule me to be seen by an orthopedic surgeon that day.

Of Note: GSHC seems to do a brisk business with workman's comp cases and pre-employment physicals for LA County. The lobby furniture was stained and the water cooler was empty. The office felt like a clearing house for workman's comp cases.

Tuesday, 2/12/08, L.A. Wilshire Orthopedic & Medical Associates (Housed within an old section of Good Sam)

After I checked in I was sent for additional x-rays. Apparently, Saturday's did not make the trip from the Good Sam ER to LA Orthopedic.

I was examined by Dr. MS, who said I would need surgery and recommended I see a specialist (Dr. TS). Looking at the X-ray, Dr. S said, "I'd say 100% of Orthopedists would operate. I'm a sports guy, you want someone who does these all the time." He said from a prognosis/recovery standpoint it would have been better if I had torn something rather than a broken my tibia as I did.

Surgery, ouch.

I was sent home with the immobilizer and crutches and given an appointment for a CAT scan later that day.

Of Note: The x-ray tech said that he often has people complain of knee pain but that he had never seen such a visible crack in the bone.

Great.

Tuesday, 2/9/08, Western Imaging (In Culver City, adjacent to Brotman Medical Center.)


CT of the right tibia and fibula, without IV contrast. The fissure in the middle and the depressed right side are the problems.

Dr. P's "Findings: The digital radiograph demonstrates extensive traumatic deformity of the distal tibia and fibula on the right. There is extensive comminution . . .

I had to look comminution up.

1. The act of reducing to a fine powder or to small particles; pulverization; the state of being comminuted.
2. (Surg.) Fracture (of a bone) into a number of pieces.

The second definition is only slightly better than the first.

. . . of the left lateral tibial plate. There is approximately 10 mm depression of the posterior lateral tibial plate. There is a large joint effusion. Axial scans demonstrate a fat fluid level, consistent with the tibial plate fracture."



Of Note: At first glance the WI building looks like an addition put onto a house for a jacuzzi or sun room. There is ample parking but no handicapped button on the door. While I was waiting to be seen an elderly couple staggered in. The husband spoke with the receptionist while the wife panted heavily. After 15 minutes they got up and left.

Friday, 2/15/08, L.A. Wilshire Orthopedic & Medical Associates

Dr. TS's Prognosis: Surgery, followed by 12 weeks of no weight bearing, followed by a month of walking with crutches, followed by 2-4 months of rehab. 25% chance of needing a knee replacement, possibly within as little as two years.

Estimated recovery time: 6-8 months

I was given a prescription for more vicodine and sent home with the immobilizer and crutches.

Of Note:

Lego: "Do you do a lot of these surgeries?"
Dr. TS: "I do a lot of the tibial fractures we see at Good Sam, but we don't see that many. At county they see a lot more of these."

I was not bowled over by the doctor's confidence or his prognosis. The paperwork he gave me said, "Orthopaedic Spine Surgery" underneath his name. I had already asked to be seen by a doctor that was closer to my home. After thinking it over for the weekend, I decided that I should go see Dr. G, the Orthopedist who fixed my right leg. Luckily, Dr. G accepts workman's comp cases. He was initially booked but my nurse case manager played the "two time looser card" and was able to get me an appointment.

Thursday, 2/21/08, Orthopedic Institute, Torrance

Dr. G's prognosis: Provided the surgery goes as planned, I'll be bearing weight in 6 weeks and although there is still the possibility of a knee replacement it would most likely be at least decade down the road.

Estimated recovery time: 3-6 months

Quotables from Dr. Gold:

"There are easier ways to see me."

"We know you're a good healer. Not everybody would have healed like that (motioned to my right leg)."

"I have a simple grading system for the fractures I deal with; B, RB & RFB; bad, real bad and . . . you're real bad."

Surgery Overview:

The depressed part of my tibia will be propped up and filled in. He mentioned using coral (yes, swim in the sea coral) for the fill. An "L" shaped plate will be screwed to the top of of my tibia to hold it together. I will be able to bend my knee right away.



Where do things stand now (ha, ha):

My leg was wrapped in an ace bandage to help prevent a blood clot and I was sent home with the immobilizer and crutches to await surgery.

The moral of the story is, always get a second opinion. While I think the first doctor I saw was trying to give me the worst case scenario, I feel much more comfortable with Dr. G, knowing that he sees a lot of tibia fractures and has previously fixed me.

BTW: I'm proud of the right side rebuild. It's been carrying all the weight since the accident and holding up fine.


I feel a bit like Dengar in the immobilizer.


Look closely, what's that innovation? Ace bandages now have built in velcro attachments.

Tuesday, 2/26/08 (Rolling Hills)

Pre-surgery screening. A doctor will draw blood samples and make sure I am healthy enough for surgery.


Wednesday, 2/27/08, Little Company of Mary Hospital (Torrance)

Surgery scheduled at 1:30PM. Dr. G will do the cutting and mending. I will be in the hospital overnight.


I'm not sure if my room will come complete with a recently expanded family or not.