So You Have a Lisfranc Injury?

Otherwise known as “Oooooooowwwww!!!” I hope it won’t also be known as “the injury that never quits hurting.” Just over a month ago I was moderately athletic,  happily jumping around on a martial arts mat, and then, suddenly, crouching on the mat trying not to pass out. Ironically, the person who carried me off also helped me off the mat 25 years ago when I got hit in the face with an ironwood weapon. That was an accident, too. So of course, I sat on the side with ice on my foot when I could stand it, trying not to pass out (still), and finally, after about 45 minutes, came to my senses and decided to go the emergency room, where I was told that it wasn’t pretty (the medical term for “wow, you really trashed your foot”) and that the staff thought that maybe a taxi ran over it. So now I am lying on the couch with my new laptop on one leg, (on a tray) and the other leg up on two cushions and a pillow. The first month I was too blotto to write, and anyway, I couldn’t get to my computer, but I will try to remember… The moral: If you plan to mash your foot-don’t. If you must, be sure you have everything you need arranged in the living room where you can reach it. And finally, don’t under any circumstances, have a loft bed! Or live in a fifth-floor walkup.

Finally did a back roll!

Well, it isn’t fluid yet, but I finally did a back roll and was able to land with the injured foot and slowly lower my knee to the ground. It’s the first one on that side since last April. So there is hope.

A forward roll comes next!

My Big Toe

Ever since I got out of the cast, I have been working on moving my toes. I was able to move my big toe downward without moving the other toes, but I couldn’t move it upwards. Finally, last week, I decided I was approaching the problem incorrectly, so I raised all the toes and then tried to lower the four little ones. I had to touch my big toe to tell it where it was, but once I had done that, I could isolate it! I still have to touch the big toe every now and then to remind it, but I can now move my little toes down and leave my big toe up. I wonder if this means the problems are from nerve damage rather than tendon damage…

It seems like a little thing, but I still want to be able to do front and back rolls, so I can be back on the mat like a real aikidoka, and this seems to be part of getting my toe strength back.

Oops!

Well, life is what happens while you are making other plans, as it said in the card one of my friends sent me. Guess what??? I’ve got breast cancer…as tho a bum foot wasn’t enough. The good news is, it got caught early. The bad news is…it really messes up my pt for the foot! So I should add to my lists of  “don’ts” I posted way at the beginning..don’t break your foot if you have ANY chance of having another health problem at the same time.

I’ve been through two mammograms, a sonogram, a stereotactic biopsy, (with the usual insurance problems..this time a doctor who said she participated in GHI, but didn’t. I haven’t received the bills yet, even tho the first mammogram was done in August. But the hospital, Beekman Downtown, just billed me for the first time for a service provided during a hospitalization that occurred 4 years ago!), two lumpectomies (whoever invented the forced-air warming quilt is a genius! I don’t care about the health part, it feels so NICE before they put you out!), and in a week I start an radiation as part of a study that does all the treatments in a five-day period. The doctors say it won’t be that bad, a friend who knows someone who did it says it probably will.

So back to the foot, which is what this blog is about..I lost the appeal, so I am going to PT on my own. I still cannot do a forward roll on my right side, or a back roll, because I cannot push off with my toes or catch myself with my toes to finish the back roll. I am doing calf stretches and lifts to strengthen the toes, but I did too much and strained the foot, so I had to take a few days off. Every day, though I stretch the toes and do isometric strengthening exercises, pushing the toes against my hand, both up and down. I also do balancing exercises. I was doing pretty well, but seem to have regressed. As soon as the breast heals, I will go back to doing the sun salutation..downward dog to plank , then knees chest and chin is a very useful series for toe strength and mobility.

So the pt has gotten pretty boring, just the routine of everyday life. Over and over, with tiny improvements. It’s not a lot to blog about.

Now the question becomes “should I blog my radiation treatment.?” There are few blogs on lisfranc injuries, but many about breast cancer, so I am not sure it will be useful for anyone but me!

still plugging away

A lot has been happening…not all with the foot. Lost the appeal for more PT. Apparently, if you can walk you are considered fit! So I am going once or twice a month and working on my own. I wish I had gone to the new place sooner, because they work more on getting the foot to be flexible.

I can now do one-foot calf raises, so that’s an improvement. The toes still don’t have the range of motion I need.

NYU Medical Center Snafu part 2

What a mess! Now I am going to a GHI-participating therapist, but I can’t get it covered because New York University Medical Center still hasn’t fixed the insurance mess. Now they are billing both GHI and Empire Blue Cross Blue Shield for the same treatments! So GHI thinks I have used up all my therapy visits, but I don’t know if the need for pre-cert knocks them out, and I can’t get a straight answer from them because no one can believe that the hospital made such a mess of things.

To top it off, NYUMC’s “customer service” rep called me to tell me they had lost the paperwork on my refund. Since they are offering to refund only $280 of a  $300 overpayment, I asked where the last $20 went, and then she started telling me that I actually had a $130 overpayment, from which they took $20 remaining from a $50 invoice that I never received! The only time I have experienced anything like this was when I was up against a bookkeeper who was messing up the books to cover the fact that he was taking money!

I guess the moral is: Don’t trust anyone.

Meanwhile, I requested an appeal of the denial. I think the therapist sent in misleading info when she asked for more PT to be provided. She kept measuring the ankle movement, when the part that isn’t working now is the forefoot and toes.

Physical Therapy goes south!

They finally got the billing worked out! Almost…and just in time for my insurance to cut me off pending a peer-to-peer review. So here I am, left with a foot that doesn’t really work. Before I do that I am going to try a new therapist who specializes in sports injuries, and takes my other insurance..I have until Dec. 31 with that one..

I get the feeling that the insurance companies feel that as long as your foot doesn’t fall off, you are just fine!

Meanwhile, I did a front roll on one side, and a back roll, sort of, on both sides, but I cannot get up very easily, which definately puts a crimp in my style!

yippee! Did a back roll

Today at the dojo, I padded my foot (why didn’t I do that earlier?) and did a standing back roll and a full back roll very slowly, catching myself with the toes of the hurt foot. So there is hope!

Nightmare neutralized (let’s hope)

They finally worked it out. Of course, now they are questioning whether I still need PT, but at least the sessions I have had are covered!

Nerve Damage?

Had discussions with various friends over the weekend. The general opinion is that the peroneal nerve isn’t functioning properly, which is why I can’t move my toes very much. This is really debilitating. Wonderful!

I have to find a way to wake it up. Anyone got any ideas?

More with the billing

Last week, a woman who is supposed to be New York University Hospital’s “customer service representative” left a message on my home phone to call her so she could tell me what they were doing about the mess. I have called her back 4 times…she doesn’t answer her phone or return calls. Finally, I called the pt department…their insurance person told me they are going to change the billing (apparently they made the original mistake).

But today I got a statement from the company they DID bill..showing that during the entire month of September they disallowed every bill because I had run out of benefits. Now I am afraid that I will have exhausted the benefits that the company that should have been billed (and authorized the sessions) because the entire thing is out of hand.

And to think I thought I was following up on everything by riding herd on my therapist and making sure we got all the necessary authorizations!