Sunday, November 6, 2011

Update on the Ankle

So - I went to the doctor and the doctor said, "no more monkey's jumping on the bed."

Sorry - whenever I start with "went to the doctor and the doctor said" - the child's song goes through my  head.

So - I went to the doctor and he said...

According to the Ottawa Ankle Bone Injury Rules...of which I had never heard...doctors have decided that if a basketball player can walk off the court, there will be no x-ray and, by not doing this x-ray, they have cut the cost of such treatments by 54%.

So, as the likelihood is that it is not broken...why waste funds doing the x-ray? So, my doctor did not feel an x-ray was necessary - I was able to walk/hobble.

I stayed off it as much as possible, favored the left leg, and avoided steps...which are agony.

The doctor said I could even drive, though I pointed out that I really did not feel that I could. He suggested that if I wanted to be over-cautious, that was fine but I really don't think I was being over-cautious...or even cautious. I am still not sure that I have the ability to press the gas, never mind the break, adequately enough not to make a nuisance of myself, or worse. No, I do not have full mobility of my ankle but it is getting better.

Now, several days later, much of the sides of the foot are black and blue (the ankle is yellowish) and I am able to walk upstairs like a normal person and not a 2-year-old. I still feel pressure when my leg is not elevated, but I have again mastered general walking and going upstairs.

Downstairs, well that's another day and another story but the hobble is now definitely a walk and I'm pretty sure I'd be in a lot more pain if the ankle were broken.

No, I'm not impressed with Ottawa - because the goal of medical care should be to do what is best for the patient. Had the results indicated a 54% cut in radiation, I might have been sold on the idea of waiting but the source I found focused on the monetary benefits and not the medical ones.

Should I have had an x-ray? I guess Ottawa won out and I didn't need one.


ProphetJoe said...

Hopes and prayers that you are back to 100% soon!

ProphetJoe said...

Hopes and prayers that you are back to 100% soon!

weekilter said...

I had my own bit with a twisted ankle as a result of wet weather and a slipper aisle on the bus. It's taken all of three weeks to have it back somewhat to normal. The first couple of days were horrid and I could barely walk on it. I could only sleep because I had some heavy-dutey pain killer that I had from a previous incident. I hope your ankle heals quickly.

Findalis said...

The yellow, black and blue is from breaking blood vessels when you twisted it. I know this from experience. I have a tendency of twisting my ankle at least once a year.

Stay off your feet (a good time to be pampered), and don't walk too much.

I do hope you will be feeling a lot better soon. I am praying for your complete recovery.

Anonymous said...

I broke my ankle once by slipping down some marble stairs. My foot hung at a strange ankle and I couldn't put any weight on it at all. My doctor sent me straight to the emergency without an X-ray, it was so obvious that it was broken.
I know every case is different, but I think that if you can walk and the pain is getting better, it probably isn't broken :)

Anonymous said...

The goal of any good doctor is to do what is best for the patient. Every decision doctors make is a cost/risk versus benefit way up. Sometimes it is simply money, other times it's comparing the probability of adverse outcomes to the probability of beneficial outcomes. In this case, research has found that if the patient can walk (or even hobble) away following their injury, the chances are no bone has been broken. And yes, you could always take an X-ray just to confirm, but the benefits of confirming something that is already very probable are less than the losses from all the extra X-rays that would need to be taken. In your eyes you are just one, but if it were policy to always take an X-ray, that would mean 100 000's more X-rays every year. Except, medical staff run on an EXTREMELY limited budget(they're not protesting for nothing). For more funds to be directed in one direction they would need to be coming out of something else. And in the bigger picture of all the conditions and diseases doctors face on a daily basis, broken ankles are somewhere near the bottom (sorry).

As well, even a simple X-ray has risks for you - you are being exposed to levels of radiation above normal. Yes, the levels are monitored and as low as possible, but still, the risks of being exposed to radiation to simply confirm what is already most probably known, well, the risks out way the benefit and so it is not worth carrying out the X-ray.

The doctor was not being lazy and he was doing what was in your best interest.

I can appreciate your frustration, while at the same time am able to see the bigger picture. I can imagine the pain is excruciating at times and I hope the painkillers are doing their job. I wish you a Refuah Shlaimah!

Oh, and by the way, I am a medical student :)

MommaMindy said...

I'm sorry for your pain, but the "no more monkeys jumping on the bed" made me smile. Love that crazy book cuz I love monkeys. May you heal quickly.

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