I became a prisoner of Workers Compensation, something I knew nothing about. If I had thought about it at all, I would have assumed that the best hospital in the city would provide me, one of their best employees, with the best medical care available. <huge sigh> The surgeon on call that night from the orthopedic group chosen by the hospital to treat WC injuries turned out to be an excellent ... pediatric surgeon. She's just who you'd want if your baby was born with a clubfoot. A complex, multi-focal fracture of a mature leg? Not so much. She gets partial credit; she did diagnose two of four fractures. The broken tibia and fibula were hideously apparent on x-ray, no doubt distracting her attention from my broken ankle and foot. At no point did she (or anyone else) assess me for other injuries.

After surgery to place a rod inside my tibia and a night in the ICU, I stayed in the hospital two more days so I could transition to oral pain meds and learn how to walk with crutches. It wasn't until I was home, off the morphine drip, that I began to notice my back. I was taking Oxycontin every twelve hours plus percocet for break-through pain, and yet my back woke me up every night. One of my clearest memories of those first weeks is of waking up every night with searing back pain, fumbling around for my crutches, and floating in a tub of hot water. Nothing else touched the pain.

When my staples were removed, new x-rays were taken. I could see that the fractured ends of my tibia didn't approximate well, i.e., there was a gap between them. My gut started talking to me, the same gut we all have and we've all been told to listen to, but I let the surgeon convince me it was fine. She was NOT able to convince me my ankle was fine. By then my ankle and foot were black and hugely swollen, so she ordered a CT scan ... and found the other fractures. "I'm so sorry, Kelley. It never occurred to me to look for fractures in your foot and ankle because the force of that kind of fall always goes up." Right. It did go up, but it started in the foot. I realized I was involved in a clusterfuck.

I insisted my case be handled by someone else. This second surgeon noted I had a non-union of the tibia, an unstable fracture, and intractable pain. If I grasped my leg below the knee and gave it a gentle shake, my foot and lower leg would rotate around the fracture site. In spite of this, his treatment plan included progressive weightbearing and physical therapy, combined with insults and a complete lack of compassion. His idiotic plan resulted in my tibia being "cored out" by movement of the rod. By the time six months had passed and I was fortunate enough to make my way to Denver to the Center for Limb Preservation, my tibia was almost translucent on x-ray. Clusterfuck.

It took four years and five surgeries, but my leg works fine today. There were many dark nights when I thought I would lose it. I was non-weightbearing on crutches for a good two years ... and blew out both of my shoulders. During surgery to fix the first shoulder, the anesthesiologist knocked a chunk out of the bony structure behind my bottom teeth, using unsterile procedure, and gave me sepsis. Six weeks later, during surgery to repair the second shoulder, someone moving me in the OR grabbed my arm and pulled, tearing two tendons in my healing shoulder. Clusterfuck. It took a gifted lawyer to get me away from that insane situation and into the care of a shoulder surgeon in a different practice. He did a third shoulder surgery to repair the torn tendons. Did a nice job.

As I said earlier, my back hurt from the get-go. "Of course your back hurts. You're on crutches. Here - go see this chiropractor." I didn't have an MRI of my back until sixteen months after the initial injury. It showed three herniated discs. The specialist who ordered the MRI had frightening prescribing habits: Oxycontin - lots of it. Percocet. Sleeping pills. Muscle relaxants. Antidepressants. Injections of steroids into my spine and sacroiliac joints every three months. He also had a massive ego, a preference for yelling at his patients, and an unfortunate tendency to make inappropriate sexual remarks. When I declined antidepressants (I wasn't depressed, I was pissed off and scared) I thought he was going to hit me. Meanwhile, the problems with my back got increasingly worse, to the point that I have permanent nerve damage in my "good" ankle and foot. Clusterfuck.

A surgical consult recommended fusing four vertebrae together, which would leave me with so little spinal flexibility I might not be able to live by myself and, oh, by the way, I might not feel any better afterwards. A second consult, arranged by my lawyer, agreed that would be the right procedure ... IF I was going to have a procedure, but he thought I should leave it alone. I never did have back surgery and, with a lot of hard-won wisdom I'll share in a future diary, I have an arsenal of non-pharmaceutical pain management techniques that allow me to live fairly comfortably (most of the time), if not work.

When I wasn't having surgery, I was in rehab. I had physical therapy for my leg (five times), for both shoulders (several times) and for my back (most of the time). I spent hours with massage therapists and acupuncturists. In all, I had nine gatekeeper physicians, five orthopedic surgeons, one allergist, two internists, one chiropractor, two podiatrists, two dentists, two oral surgeons, one endodontist, one psychologist, five physical therapists, one massage therapist, three acupuncturists, and eleven home health aides.

I wore four bone stimulators at different times. I had a total of eight surgeries, fifteen steroid injections, eight doses of IV Ancef, thirteen rounds of oral antibiotics, three MRI's, one CT scan, one white blood cell scan, and one arthrogram.

It was a clusterfuck. The hospital fired me when I couldn't return to work in three months. I couldn't afford COBRA premiums on the disability they were paying me, and Social Security initially denied my application for benefits. The WC director at the hospital was rude, threatening, unhelpful and a daily source of stress. (My lovely lawyer, once retained, saw to it I never spoke with her again.) It took six years to settle everything, six years when I didn't know if I would be sleeping in a bus station and eating cat food, or if I'd be okay. The disabled plates on my car came at the price of my health and my profession ... but I am happy to report the hospital paid for the car itself. The hospital also pays my mortgage every month. There's a trust fund that pays for all medical expenses related to said clusterfuck, and Medicare takes care of my other health needs.

Once we get something done about healthcare, we must not forget about our fellow citizens who are in Workers Comp hell. If this could happen to me, an educated, articulate, and assertive RN, imagine the same situation with someone who barely speaks English, who has little education, and/or who has no experience with either the healthcare system or the legal system.