Trout Leg Syndrome
or,
How to Break a Leg in Two Places in Two Easy
Steps
by Greenstick
The process is so easy, even YOU can do it. Here's how:
- Slip on some mud and fall into a hole.
- Get up and do it again.
Okay, okay... here's the whole story... (Note: See progress updates at the bottom of the story...)
It was about 1:30 p.m. Bud and I had decided to try a different spot on the Rush river. After parking, we split on sides of the road, he going a little further southward, downstream, I northward and upstream. We agreed to meet at the car at 2:30 to allow time to drive to the weigh-in at the Park-N-Ride by I-94 and Hwy 65.
Nearing the river, it was easy to tell it had recently overflowed and therefore, the banks were a bit muddy. Being careful to select an ingress spot to the river with a shallow incline, I carefully measured and tested each step for solid footing. After putting my full weight on my left foot in preparation for the next step, the ground seemed to collapse under my foot and my boot went down, toe-first, and twisted slightly to the left. <CRACCKKK> and I was down in the mud.
I instantly knew that trout fishing for me was done for the day, and after a half minute or so, decided to try to hobble back to the car and wait for my partner.
I stood up -- I had no problem getting back up on my feet -- and I tested the left ankle a bit for lateral stability and angulation. It felt like a really bad sprain and my thought was that the snapping noise I'd heard may have been the ankle popping out of position for an instant. My ankle felt weak but otherwise, not terribly uncomfortable.
I took a small step with my good, right foot and everything was fine. But when I set my left foot down again and tested the ground to see if it was solid enough to hold me up, the ground gave away, my boot again went toe-down and <CRACCKKK>, I was back in the mud. But this time my left ankle felt differently. It was initially painful, of course, but this time, it no longer felt like a bad sprain -- it quickly felt numb and disconnected. That was when I looked down at my left leg and noticed that the orientation of my knee and thigh didn't match the orientation of my foot -- not even close. I also found that I couldn't move my foot at all.
I could see the car about 175 yards away, and I started crawling across the muddy field toward it. (Love those chest waders for that!) I could crawl relatively easily on my knees and hands, and I made it over to a fence where I could use the fencepost to stand and evaluate my ankle a little further.
"A foot just just isn't supposed to point outward quite like that," I said out loud. I could turn my foot at will by bracing the toe against the fencepost and moving my leg, but my leg didn't seem at all connected to my foot. There was no lateral stability, nor could I move the foot otherwise.
Back down on my knees, I rolled under the barbed-wire fence to get closer to the road. After another 25 yards or so of crawling, an SUV pulled up along the side of the road and a man and his son stepped out. He introduced himself as Scott LeFebvre (spelling?) and said he and his son had watched from a window of their house as I was making my way on all-fours and that it looked like something was wrong. They helped me into their SUV and drove me up to the car, where I chose to sit until Bud returned from fishing. It was now about 1:45 pm; about 45 minutes before Bud would be back.
A lot can happen in only fifteen minutes but it had seemed like an hour or more. I thanked the LeFebvres for their kind help and told them I'd be fine.
So there I sat. About fifteen minutes later, the same SUV stopped by again -- this time with Mrs. LeFebvre, offering a handful of gel icepacks for comfort. I hated to turn down such a nice gesture, but I felt that the best thing for my ankle would be to keep the boots tied on since they would at least minimize swelling. Also, on the off-chance that the fracture had broken the skin, the waterproof waders would keep the mud and gunk out. But I've added some new friends to my Christmas Card list!
Let me digress a bit and discuss the size of a Dodge Durango's rear bumper. It's not wide enough to sit on and after about a half hour, your butt goes numb. Car manufacturers would do well to beef-up the bumper on SUVs and make them a little wider. Detroit, are you listening?
Believe it or not, that's actually a thought that went through my mind while I was sitting there waiting for Bud! After a while, I saw him in the distance, tromping through brush on his way back. When he got within talking distance, I asked how he did. "Got two!" he said enthusiastically. "Man, it was tough down there! How about you?" That's when he saw my ankle and he said, "Uhhhh...that doesn't look so good..." That Bud's got a sharp eye!
He cleared out some space in the back of the Durango so I could lie down; I propped my left foot against the wheel well so it wouldn't flop around. "We're going to the first hospital we find," he said. While driving up Hwy 63 to I-94 west, that would have been a hospital in Hudson. "Since Hudson is only a bit east from Minneapolis, let's just keep going -- we're only talking about a half-hour," I said. I also suggested that we swing by the Park-N-Ride to drop off our score sheet, but he wouldn't have anything to do with that idea. We were west-bound and down.
Bud called Griz on his cell to tell him why we wouldn't be at the weigh-in, and we actually read him our scorecard (actually, it was Bud's card -- I hadn't caught a thing all day). And we kept venturing through traffic, all the way to Abbot-Northwestern hospital where we arrived at about 3:30 pm.
Hospitals are universally considered to be clean places. But when they wheeled me to the ER desk, it was "shock and awe" as they viewed this unshaven, muddy creature. The ER doctor greeted me cordially and said, "Well, from the look of that foot, it doesn't look like you're having a very good day." (She and Bud must have gone to the same school of awareness). A couple minutes later, they had me on top of an exam bed in one of the rooms -- waders, boots and mud all around. They found by removing the laces from the boots, they slipped off easily so they didn't have to cut them off. They practiced on my good foot first and then worked on the problem one. And rather than cut the waders off, they decided they were loose enough to try to remove intact. After slipping them down over my butt, they got them down to my knees -- and then they discovered the left leg of my jeans was soaked with blood. A lot of faces in the room changed right then. I remember hearing somebody say, "Uh-oh..." I think it was my wife, Sue. Then it got really quiet.
Again, they practiced by removing the wader's boot-foot from the good leg, followed by the bad leg. That was when the blood ran out of the wader leg onto the table and floor. Faces changed yet again and a lot of people started scurrying all over the place. The doctor ordered non-essential people out of the room.
The doctor cut off my sock, and that's when the compound fracture became apparent -- a great big bone sticking through the flesh of my leg. A nurse quickly covered the exposed area with gauze to protect it, but I remember how gleaming, shiny ivory-colored it was.
Then she cut off my jeans. As you know, it takes a long time to get a pair of jeans "just right," and these were perfect. "Dang!" I said, "That's the worst thing so far -- losing a great pair of jeans!" Everybody got a chuckle out of it. I wanted to keep the whole thing light; after all, I wasn't in a lot of pain and people generally do better at their jobs when they're smiling and not up-tight, anyway.
Shortly thereafter they had stopped the bleeding, covered the wound with gauze and an Ace bandage to keep the pressure on it, and the staff set about the task of cleaning up the room. Somewhere during this time, Shatner (my brother-in-law) showed up and took a couple pictures with his cell phone.
They finally wheeled me into surgery around 10:30 p.m. Dr. Kempcke, my orthopedic surgeon had been on a gunshot case until then. They tell me that I was wheeled out of recovery around 2:30 a.m. Shatner had stayed the whole time to keep my wife company. (I have a really cool family -- I'm really a lucky guy!) I have a metal plate and several permanent screws in my lower left leg now, so I've got that goin' for me. While I was in recovery, I vaguely recall meeting Chips' wife, Marcia. I was pretty groggy from the anesthesia so I don't have a great recollection of what we talked about.
My wife is still angry with me for not dialing 911 with my cell phone when the accident happened. I had the phone in a zipper pocket inside my waders and I briefly considered doing just that but I dismissed the idea because there was no way I could tell someone where the heck I was! "I'm uhh....down here by the Rush river in the mud and I've broken my leg." doesn't count for much when there are tens of miles of fishable river water, poorly-marked rural highways and you're out in the boonies.
A lot of folks have asked me, "Didn't it hurt?" Well, yes it did. But let me share some perspective here about the concept of "pain." Over the past 15 years I've had both a cervical fusion and a lumbar fusion to eliminate the pain from degenerated discs in my neck and lower back, a lot of which was due to my professional golf career. If you've never experienced severe back pain, you really don't have a valid reference point for understanding, but I'll try to describe it. Back pain takes you down, right now. Literally, on the ground. You collapse. It takes even the strongest, most virulent Marine right down. You can't breathe. You can't think. You can't talk. It's incredible agony. That was my reference point. And compared to back pain, this leg thing was like a headache -- it didn't even make the chart.
So there you have it. Looking back on the whole experience, keeping the boots and waders on was exactly the right thing to do. I should have paid a lot more attention to where we were on the map -- which was not easy to do because of the poorly marked rural roads. But next year, I think I'll take a couple walkie-talkies along for our team, and I'd suggest that all Dogs do the same in case Trout Leg Syndrome attacks someone unexpectedly.
By the way, this turned out to be the most expensive fishing trip I've ever taken. Added to the waders, boots, and other new fishing equipment was a $29,461.11 hospital bill. And while they managed to save the boots and waders, I'm still a little peeved about the jeans...
Progress Update April 2, 2007 - Dr. Kempcke, the surgeon (or should it be "sturgeon" since it's a fishing injury?) checked me over after two weeks in the temporary cast. Because the wound on the inside of the leg where the bones broke through the skin isn't sealed-over yet, they can't put the permanent cast on yet, either. The outside of the leg looks good (???) and they removed all the staples on that side today. I'm in a removable cast now and we have to change the dressing on the open wound a couple times a day. Depending on what happens this next week, Dr. Kempcke says that I may not require the "hard" cast but may get by with this removable thing that has about 25 feet of Velcro fasteners holding it tight. I could live with that, to be sure! Here are some photos and a couple x-rays for you to ponder... Click on a photo to enlarge it to full size.
Progress Update April 9, 2007 - I just returned from another 4-day stint in the hospital. Because of my in
ability to walk or be very active (and actually keep my leg up and at rest), blood clots developed in my left leg. These are quite painful -- and after they diagnosed the clots (some quite large and also above the knee -- a very dangerous spot), they immediately set up an IV-drip of heparin to prevent additional clotting. A day later they started me on a coumadin regimen that thins the blood and will eventually help my body dissolve the clots -- in about 6-8 months. Now at home, I give myself injections of a drug called Lovenox, which is a substitute for heparin -- at $90/shot, twice a day. The doctors orders were to lie low, don't do any specific exercises for a week to make sure the existing clots are stabilized, and have my blood clotting speed (my "INR") checked every day. You oughta see my right arm where they've been drawing blood four times daily for the last four days. It looks like a black-and-blue pincushion. Here's a current photo (click on it for full-size)....
Progress update May 7, 2007 - No photos, but the swelling is going down a little. I was standing in front of our patio door the other day and my wife said she could see right though me -- all the blood thinners I'm taking must be working overtime. I can begin to put a little weight on the leg now -- doctor says up to 50%. That's hard to do in this protective boot because of the height differential -- the boot has a 3" heel on it! I feel like Herman Munster. Come to think of it, I probably look a lot like him, too.
Progress update June 7, 2007 - Today, the surgeon said I can start walking on the leg now, although I should be pretty careful not to twist it. No kidding. Today was my first day without crutches. Had to buy a new pair of shoes today. It's hard to find a matched pair when one foot is about 3 sizes larger than the other because of the swelling. Showed up at the Waterdogs meeting tonight and gimped-up to the dinner table. The doctor's given me the go-ahead to fish in the bass tournament next week and I'm paired with my brother-in-law! Good-bye crutches...
Progress update June 16, 2007 - Kirk and I successfully completed the two-day bass tournament. We had a chance to win after the first day but couldn't make it happen on the 2nd day. My left leg/ankle is the size of a tree stump and feels like somebody hit it with a sledge hammer. If you ever are given the choice between breaking your leg and not breaking your leg, if at all possible, go for not breaking it. You'll be a happier camper. Can't take any anti-inflammatory drugs to reduce the swelling because of the blood thinners I'm taking. Dang.
Progress update June 30, 2007 - Finally got my boat out of the garage and was able to successfully put in and pull out by myself, although I'm not very speedy at it. Leg/ankle still swells up quite a bit but not nearly as badly as only two weeks ago. I can't count the number of Tylenol I've taken in the past two weeks. Still taking the blood thinners, too, although in a recent scan of my left leg, all the earlier blood clots apparently have dissolved, so I've got that goin' for me. The whole leg from the knee down is just in a constant ache, and I can't walk normally yet because of the pain. But it's worth it to be able to go fishing again. The wound has completely healed-over, of course, and there's a huge scar/dent where the bones originally protruded through the skin. Not to worry though -- I've never been a hit at the beach, anyway. I'll get a picture up here soon...
Progress update July 15, 2007 - It's still difficult and painful to walk down a stairs, and even just to walk without pain, I have to walk slowly. If I try to walk quickly -- whoa -- Painsville, Minnesota (apologies to the folks who actually live in Paynesville...) Here's what the leg looks like now from both sides and for fun, together. See if you can tell which leg had the break... (click a photo to enlarge) There's still a screw in the leg that the surgeon wants to take out -- it's one of the long ones. Last time I saw her she said she can do that in the office -- all she needs is a scalpel to cut through the skin and a screwdriver to take it out. Geez... Hope she remembers the anesthetic and bandages... I still taking this blood thinning stuff and I might bleed all over the place again -- just like when this whole adventure started!
Progress update August 24, 2007 - A little day-surgery today as they removed one of the screws from the leg. In the x-rays above, it's the long screw that goes directly horizontal through both bones, and it was always the doctor's intention to remove that one after about 4 months. I wanted to watch the operation but they zonked me with a heavy dose of intravenous Valium -- the anesthesiologist said he'd give me enough so I wouldn't care, and he was right. I don't remember a thing after he said, "Ok, get comfortable now..." The doctor said she made about a 1" incision in the same scar line on the outside of the left leg, went in with a hex-head screwdriver and it came out really nicely. She said, "Yup, I think I got it all." They let me keep the screw, which is nice. It would make a really nice deck screw. It's stainless steel, so maybe I'll find a place in my boat where I can use it. Now there are 3 more stitches holding the incision together; I get them taken out in about 2 weeks.
Progress update September 6, 2007 - They took out the stitches today. Dr. Kempcke looked at the leg and signed off on it. saying that I should give it a year or two. I asked her about fishing this next spring in the trout tournament and she said, "Well, you'd probably be okay, but if it were me, I'd take a year off and give the bone plenty of time to heal so that it can fill in where we took out the screw. Right now, that's a weak point and likely will be for quite some time. Otherwise, there's no need to see me again -- unless you break something..."
So, it looks like the saga of Trout Leg Syndrome is a wrap. The leg is still swollen, but not nearly as much as it was in the photos above. I still have periodic pain and a little gimp walking, but that should go away after a few more months. I have better range of motion of the ankle now that that one screw was removed, and overall, I'm nearly good-as-new, which actually was never that great to begin with. I'm still on the blood-thinning medication and my primary care physician says I will be through October. But trout fishing next spring? Not sure. I had a great time this past March, but she was pretty serious when she told me to take a year off, let it heal and not put that kind of stress on it so soon. I could easily have lost the whole fishing season this year because of it, so maybe I should heed her direction. We'll see...
