1 in 55,000

What exactly is a LisFranc injury?  Thanks to the internet, I found lots of scary things to trigger my anxiety.  I found out that my injury is pretty rare.

"The incidence of Lisfranc joint fracture dislocations is approximately 1 in 55,000 persons each year.  Thus, these injuries account for fewer than 1 percent of all fractures."

Yay, I'm special?  I got the pleasure of experiencing this rare gem of an injury.

I also learned a lot about foot anatomy.

The midfoot consists of five bones that form the arches of the foot (the cuboid, navicular, and three cuneiform bones) and their articulations with the bases of the five metatarsal bones. Lisfranc injuries are caused when excessive kinetic energy is applied either directly or indirectly to the midfoot and are often seen in traffic collisions or industrial accidents.^[4]

Direct Lisfranc injuries are usually caused by a crush injury, such as a heavy object falling onto the midfoot, or the foot being run over by a car or truck, or someone landing on the foot after a fall from a significant height.

A significant height.  That was me.

The first thing I did on Monday was call the Orthopedic surgeon that my ER doctor recommended.  He wasn't able to even meet with me for a consult until next week.  I called around to several specialists recommended by family and friends, and simply due to the 4th of July holiday, most schedules were completely booked.  The soonest I could be seen was next week.  For a consult.  I knew nothing about this injury, it's prognosis, recovery time, surgery, etc.  I could not sit around waiting almost 2 weeks just to talk to a doctor.  I went into full blown meltdown mode.  The thought of being completely dependent on my husband for simple tasks: going to the bathroom, bathing/showering, carrying anything to and from any point in the house to the other, getting in and out of the house (we have stairs at all entrances) was a terrifying, horrible, and frustrating thought. The last thing I wanted to be was a burden on other people.

The hospital had given me crutches.  They were really, really hard to get around on, and I was still SO sore from doing the Spartan race, that it was painful to move even just a few feet on the crutches, let alone trying to travel all the way down the hall to go to the bathroom, or navigate the 2 steps we have in the garage.  My husband, to the rescue again, called a medical supply store downtown and arranged for me to rent one of those wheely, knee scooters.  I tried it out, and was SO relieved at how much more mobility it offered me.  The tears had stopped, for now, at least, and I enjoyed riding around on my scooter outside.

 Of course, boys will be boys, and Nate just had to take a test drive.  He is not injured.

My amazing husband also called the TOSH Orthopedic Specialty Hospital and convinced the receptionist to slot me in for an appointment with a foot and ankle specialist on Thursday.  THIS week!  She'd said that the doctor would be double booked, and we'd most likely be in the waiting room for a couple of hours, but he'd see me.  I didn't care.  I'd be seeing Dr. Drew Van Boerum in THREE days.  Hooray!

For now, I am binge watching anything I can get my eyes on.

The Initial Diagnosis

After the race, we went home, and my husband helped me out of the car, up the steps to our garage and into our house.  I crawled awkwardly through the kitchen to the bathroom, leaving a trail of mud behind me.  I needed to go to the ER, but I also needed to clean off the gallon of mud that had started to cake on my skin.  I flopped into the bathtub somehow, and laid down to shower, completely exhausted.  I managed to get myself dressed and somewhat presentable for an ER visit.

With the help of my husband again, we drove down the street to the Riverton Hospital Emergency Room.  Just my luck, they were extremely busy, and I waited over 2 hours to see a doctor.  They x-rayed my foot in a various number of positions.  My foot was numb; I couldn't flex or wiggle my toes.  I had a tough time complying with the radiologists requests so that they could get all the pictures they needed of my little piggy bones.  The radiologist noticed my husband wearing his Spartan Finisher shirt, and asked if we had done the race.  To which he replied, "Yep.... that's kind of why we are here."

Eventually, I saw the doctor.  She examined my foot for the obvious injuries, and up my leg to find any that may have been missed in the x-rays.  The doctor then sent a PA in, who fitted me for a splint and a dose of ibuprofen.  He said the doctor would be by soon to answer any questions and I'd soon be on my way home.  I'd never broken a bone in my life, I had no idea what it felt like, but it couldn't be that bad of an injury if they were sending me home with a splint and a couple advil.  Nate and I watched the World Cup and joked about Canadian food while we were waiting for her to return.    I wasn't really worried about anything at all at this point, and just wanted to get home to my cats and my sweet dog.

Then the doctor came back to crush all of my dreams.  She casually mentioned that I had a few broken bones in my foot.  And there was one that was shattered into several different pieces.  Oh, and I'd need surgery next week, and she given me the name of an orthopedic surgeon that I needed to contact on Monday.  Recovery would be more like months, not weeks.  She wasn't a specialist, so she'd called the on-call Foot and Ankle surgeon, and mentioned something about fixing a LisFranc injury.  What?  I was given strict instructions to not bear ANY weight at all on my right foot until I saw the surgeon.  She then handed me some Lortab and told me I'd need something much stronger than Advil.

Wait.  What?

Ground Zero - The Injury

When I saw mile marker 8, my adrenaline kicked in.  Less than a mile to go to the finish line.  I'd already given this brutal course 4 hours, and every muscle in my body had been pushed to their limits.  Utah was in the middle of a 100 degree plus heatwave this week.  But, I'd trained for this.  I'd trained months for this. And it was all going to pay off soon.

I was running the Utah Super Spartan Race, an 8+ mile obstacle course nestled in the sweet little mountain town of Heber, UT, filled with rope climbs, walls, and mudpits.  As I crawled through about 100 yards of mud under a barbed wire fence, I could see the finish line, just one more obstacle to go, the Stairway to Sparta.  

On the other side, the infamous fire pit and my much earned Finisher medal.  I began the climb of the 16 foot wall/ladder combination, covered in mud from the barbed wire crawl.  I climbed over the top, smiled and waved to my mother at the finish line, who was there capturing photos of our event.  My husband, who was running the race with me, asked me if I was OK.  "Yes! I'm fine!" I said as I began my climb down the other side.

But, then something tragic happened.  I lost my footing, and the combination of the slippery mud, muscle fatigue, and heat exhaustion, I slipped and fell, about 9 feet, onto the rocky terrain below.  I landed full force on my right foot.  I laid there stunned for a second, not sure what had happened, and the next thing I saw was my husband's worried face as he cradled my head.

I assessed my body.  Nothing major was hurting.  Head and back were both fine.  I moved my extremities.  My foot kind of hurt.  Sprained, probably.  I went to stand up, being a mere 10 feet or so from that sweet, sweet, finish line.  A fellow racer stopped to check on me and told me to stay still.  He was an EMT.  I told him my foot was hurting and he started to examine it while the Spartan race staff summoned the medical team.  I just wanted to get up and cross that finish line.  My mom blew through the barricades, nothing would stop her from attending to her injured daughter.   A small fan club started to gather around me and give me words of encouragement. I ended up being in multiple racers' finish line photos.  I was a celebrity, kind of.  The girl in this photo is not me.  I am the mud covered blob laying on the ground behind her.

The medical team assessed nothing critical, wrapped my foot, and called a cart to take me to the medical tent for aid.  My husband told me it was time to cross that finish line, and I agreed.  He and a few other racers helped me to my feet.  I tried to bear weight on my right foot.  It felt like a million shards of glass piercing every part of my foot.  Something was not right.  It was a really bad sprain, I thought.  I hobbled with the support of my husband and an unknown mystery Spartan across the finish line, got my medal and was carted off to the medical tent.

My foot looked like a giant deformed softball.  I was given some ice and salted gatorade (yum!) to help with muscle cramps from the heat.  In the medical tent, I had a few friends.  A girl was getting her finger stitched, another was suffering from heat exhaustion.  There was a man with his arm in a sling and on a stretcher, a dislocated shoulder.  At least it could be worse.  The medical staff didn't have an x-ray machine.  They sent me home and recommended that I get that foot looked at.

My husband then drove us over an hour back home down the windy Provo Canyon, caked in mud and happy to be alive.  It could have been so much worse.  So much worse.