When I came home from the ER I was pretty sure I didn't have a broken patella. The pain was no where near severe enough. A chipped patella, which is what the ER resident was talking about as one of the two possibilities would be a real painful event. The other possibility he allowed was a severe bruise.
That's what I thought I managed. I've done other less than bright things and that's what happened. I have a real heavy bone structure, and it takes some serious effort to break something. My past has pretty clearly shown that. I also have a real high tolerance for that sort of pain. Again, experience.
So the next morning, when I called into my lead at the IRS, Bernadette Harris, I described my result as a bone bruise and that I'd probably be out a few days, but in sometime next week.
I really believed that. Obviously I was really wrong.
Did DCMH have an ER orthopod on call? They must have. What would happen if someone came in with a really bad fracture. The ER resident couldn't reduce a compound fracture. Do the ambulances not deliver that sort of case, but take them to a real trauma center? How do i find out that sort of information?
If there was an orthopod on call, why didn't I get referred right there on Thursday night? Why the instruction to see my own doctor as soon as possible.
As far as I can tell there never was any consideration of ligament or tendon damage. I know that I mentioned I couldn't move my lower leg, and any sort of cursory examination would have and must have shown that. That doesn't relate point to a bone problem, but to a ligament or tendon problem. Did I really see a resident or just an intern. I think the doctor was a resident, but I can't swear to that.
Ligament and even more so tendon problems have the best prognosis if the corrective surgery occurs within 24 to 48 hours. The example of pro athletes is instructive here, When they ligament and tendon problems they have surgery with 24 hours, period.
In my case the diagnosis came 20 DAYS after the injury and surgery did not happen until day 26. Did the 6 day wait between diagnosis and surgery make any difference? Probably not. I was so far out the optimal window that 6 days made not a bit of difference. A more relevant question is whether my back problem was intensified by the fall on the 15th or by the operation on day 26. If the former, would earlier intervention helped? If the latter, the timing makes no difference.
Summing up: I thought I was looking at a quick recovery and for the first 20 days I had no reason to believe otherwise. That was so wrong. 12/19
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