My Story

When I was thirteen, I sustained an injury that resulted in two broken legs. One of them healed quickly and properly while the other did neither of these things. What follows is the story of my broken leg and the aftermath of almost a decades worth of chronic osteomyelitis.

On February 22nd, 2006 I broke both of my legs. I fell about seventeen feet onto the hard asphalt below. Unfortunately for me, there were no bushes or grassy areas to soften the fall. I had a compound fracture of my right tibia and fibula, which are the bones in my lower leg, and also broke my left ankle. A compound fracture refers to a broken bone that has pierced through the skin. That same night I had surgery to wash out any dirt that had entered my leg when it broke. This was done in order to prevent an infection. I later learned that compound fractures have a relatively high risk for developing osteomyelitis, something that I would later be diagnosed with.

My left leg was in a short fiberglass cast (from my toes to just under my knee) for six weeks. After that it was in something called a walking boot or cam boot for three weeks. This was to prevent the ankle from re-breaking once I was allowed to use crutches - my newly healed ankle would be taking all my body weight as my right leg was still broken. This was the leg that healed quickly and properly.

Meanwhile, my right leg was placed in a heavy plaster full leg cast (toes to hip). The goal was to let things heal normal, which would take about three months, and to avoid needing surgery. A week after the accident, I had x-rays taken to make sure everything was properly aligned. Unfortunately this was not the case and I required the bones to be manually manipulated back into place. This was done while I was awake without any form of pain relief - I screamed a lot. After that my leg was placed in a long fiber glass glass for the following six week. After that I had a series of short leg casts.

As previously mentioned, the right leg was supposed to heal within three months. Unfortunately, this did not happen. I had something called a non-union, which means that the bone has failed to heal. In order to determine why my leg was not getting better I had a series of scans done. I had a white blood cell scan (WBC), which is used to find sources of infection, and a bone scan, which looks for metabolic activity in the bone. These scans could have indicated that there was an underlying infection. The results, however, were ignored because they were inconclusive and by the time we got them my leg had healed. Yay! By this time it was the start of September and I was ready to walk again! Bu it was not to be. My leg has healed at a seventeen degree angle. When bone heals in a non-optimal manner, this is called a malunion. My surgeon explained that I could walk on my leg if I wanted to, but doing so would lead to arthritis at some point in the future. The only option was to re-break the bone. I had surgery a month later to re-break the bone (osteotomy), re-align it, and fix everything in place with a metal plate and screws (hardware). Following surgery I was in a cast for a month, followed by a walking boot for another month. My best Christmas present that year was being able to ditch the crutches.

Sadly, this was not the end of my broken leg journey. Over the following years I experienced many signs of infection, including pain, redness, and swelling. More concerning were the sores that would develop on my right shin and the pus and/or fluid that would drain out of them. Despite going back to my doctor and surgeon numerous times, they didn't think that anything was wrong with me.

It became evident that something was wrong in the spring of 2008. I had tired out for the school's soccer team and wound up with a hard egg-sized lump in the middle of my shin. My leg was red, hot and extremely painful. The lump oozed a bit and my leg would throb whenever I would lower it below my heart. My surgeon ordered another bone scan and WBC scan. These were done in May or June. My surgeon went on holiday over the summer so we didn't get the results back until the middle of August. Based on the results, which were inconclusive like the ones I had done in 2006, my surgeon didn't think anything was wrong but said he could take the hardware out because that could have been causing the pain I was experiencing. No x-rays had been taken at this point.

The surgery to remove the hardware was at the start of September. What was supposed to be a relatively simple procedure resulted in an incision that was twenty-three centimeters long. The bone in my leg had grown over the hardware, what we later learned is a sign of the body trying to reject the hardware. It had to be chiseled away before the hardware could be taken out. We would have been aware of this going into the surgery if my surgeon had ordered x-rays. The swab samples taken by my surgeon from the area directly around my bone during the operation came back positive for two types of bacteria: staph. aureus and negative coagulase. My surgeon called several days after surgery to tell us this - he still didn't believe that anything was wrong, saying the samples had been contaminated, but gave me a prescription for a months worth of antibiotics just in case. Meanwhile, my leg was red, hot, and swollen and my incision was draining pus.

I saw my surgeon at the start of 2009 due to pain in my leg and tenderness around the area that had ballooned up back in 2008. He told me that everything was find and that I wasn't his problem anymore and shouldn't come back again. Over the next few year, however, the symptoms I had been experiencing continued. In 2010 I became increasingly tired. I put it down to working hard to get good grades in my final year of high school so that I could apply for university. The fatigue continued throughout the summer but I put it down to taking an extra high school course to boost the scholarship I had been given to the highest level (different amounts were given based on overall average). When the fatigue continued into the fall, my first semester of university, I dismissed it as the results of the heavy course load and adjusting to university.

By 2011 I was sleeping at least twelve hours, if not more, per day. I was going to class and getting my school work done but nothing else - there was never any energy left for other things. That February I had a series of sores open on my shin. One of them became quite large and a sliver of bone ended up coming out of it. This, naturally, was quite disturbing so my mum and I went to the family doctor. He wanted us to believe that it was fiberglass. We, of course, didn't believe this - how on earth could fiberglass have gotten into my leg? We did convince him to send me for another set of scans - both bone and WBC. We also convinced him to send us on to a specialist if the results were abnormal or inconclusive,the latter of which they turned about it be.

I met with my infectious disease specialist for the first time in June 2011. By this time I was sleeping a solid sixteen hours a day. There are no infectious disease specialists were I live, so we were referred to her in Hamilton. This is probably the single most important thing that has happened because it meant that I would be getting better care. I was being seen at a teaching hospital, which meant doctors had to be at the top of their game and act professionally. There was a huge difference compared to the hospital where I live - one that is known for it's bad reputation.

The first appointment I had with my infectious disease specialist lasted at least an hour. She wanted to hear my entire medical history and intently listened to every word, writing it all down. From what I had told her, she believed that I did have chronic osteomyelits, or a chronic bone infection. She explained that this type of infection waxes and wanes, and that it can lie dormant for many years which is why all the scans were inconclusive. She also said that open fractures are usually treated with six weeks of oral antibiotics, something that I never received but could easily have prevented the infection and years of pain all together.

I had an MRI scan in June 2011 to confirm that I did have chronic osteomyelitis. I got this news on July 12th at my next appointment with the infectious disease specialist. The diagnosis was followed by fifteen months of oral antibiotics, mid-July 2011 to mid-October 2012. I was referred to a new orthopedics surgeon, the one I am still seeing today and has now performed four surgeries on me. I had surgery in April 2012 to scrape away the dead/infected bone from my tibia. This was followed by two months of IV antibiotics which required a PICC line (long term IV).

The oral antibiotics were stopped in October 2012. I had an MRI scan a month later to see if the infection returned once I was no longer taking the medication I was on. I didn't get the results for some time - my ID specialist said she would call with the results but she never did. I made an appointment at the start of 2013 to get the results of the MRI. They showed something concerning so I had yet another round of bone and WBC scans. The bone scan showed increased activity within the bone but this was attributed to my bone still healing. The WBC scan showed no signs of infection. I was relieved! It took some time to stop seeing my self as the sick girl and to stop worrying that the infection could come back, but I got on with life.

That summer I got a job as a cashier. My leg ached occasionally and I did consider the infection after the first few shifts, but eventually I attributed it to the long hours and the inevitable swelling due to all the damage in my leg.

In 2014 I gradated from university. This was incredibly important to me because I had been so sick during the first two years of university (even after I was declared infection free at the start of 2013, it took a really long time to gain energy and endurance back and to bounce back from all the antibiotics - I think I caught every cold that went round campus that winter).

During the following summer I experienced some odd pains in my leg and had a few tiny sores pop up. The thoughts of infection crept into the back of my head, but I ignored them, hoping for the best. Soon the spots went away and the aches subsided. In the early fall, however,the pain returned. In October I became seriously concerned and shared my thoughts with my mum. Later in the month I developed an odd rash on my shin that wouldn't heal. I made an appointment with my infectious disease specialist and saw her in November. She said it was probably nothing but said it was odd that it was always the same spot that caused issues. She ordered an MRI scan which took place two days before Christmas. The MRI staff compered the scan from 2012 to the one I was having at the time and said it looked like things hadn't healed very much since late 2012. They wouldn't say much more, but I had this deep feeling that something was wrong.

I got the MRI results on January 15th, 2015. I had moved out several weeks earlier and was two weeks into the nursing program I was accepted into. My ID specialist said she strongly expected that an infection was still smouldering away. She ordered another WBC scan and bone scan. Based on these results, which I got in early February, she believed that there was nothing to worry about. She said to call if I had any problems and to come back in ten months just to make sure everything was okay. Meanwhile, I was still exhausted and my leg still ached. Despite this and that little nagging voice that says that everything is okay I felt relieved and wanted to get on with life.

Several days later I ended up in the ER with sores all over my shin. I was advised to make an appointment with my orthopedic surgeon. I saw him on February 13th, which happened to be Friday the thirteenth - somehow fitting seeing the news that I got. My surgeon took one look at my MRI scan and said "What the... what the hell is that?" I'm not kidding. Those were the exact words he said. He believed that the infection was still there and that was why the bone hadn't healed from the surgery in 2012. He proposed to cut out the infected section of bone, leave it be for several months while I was pumped full of antibiotics, and come back after that to do a bone graft from my hip to fill in the missing section of bone. Compared to everything else I had been through, this was pretty hard core stuff. The plan was to wait two years to do this until I had graduated and gotten a good nursing job. Unfortunately, this is not how things played out.

Over the next months I began to feel worse and continued to have spots form on my shin. At the end of May it was confirmed that I would have the first surgery once the semester ended, requiring me to take eight months off of school. By the middle of June I was exhausted and often in pain. By July I was getting spacey - I could lie on my bed for twelve hours just starring at the ceiling. After an ER trip and contacting my infectious disease specialist, it was decided that I would get my PICC line to start IV antibiotics early. The goal was to start this around the time of surgery. Instead it happened at the start of July. I was placed on IV vancomycin.

Surgery, my fourth one, was performed on August 26th, 2015. My surgeon cut out 6.5 cm of my infected tibia and filled the gap with bone cement. Due to the amount of bone that was cut out, I was no longer eligible for a bone graft, the upper limits for which are 4-4.5cm. Instead, I would be getting an external fixator to re-grow the bone through a process called distraction osteogenesis. I had a short leg cast for the first month and a half after surgery. My PICC line was pulled out at the start of September as a result of side effects caused by the vacomycin. I continued to take oral antibiotics until the start of October and then began the waiting game to see if the infection would come back. Fortunately it did not!

On November 5th I had surgery to have an IM nail placed in my tibia and to get my external fixator. My scar is now 25 cm long - the same one has been used for all of my surgeries so that my leg does not look like a cutting board. I started doing "the turns" to regrow my bone on December 3rd, and I have been doing them ever since.

During an appointment at the fracture clinic on March 4th, my surgeon found something called a heterotopic ossification on my latest set of x-rays. A heterotopic ossification is  bone growing in the soft tissue. It was impeding the movement of my fixator. As a result, I required surgery to remove it. This surgery was performed on March 11th. I started adjusting my fixator again the same day. And that is where I am at right now, still doing "the turns" and waiting for my bone to be re-grown.

And there you have it! This is the aftermath of a decades worth of chronic osteomyelitis, something that could have so easily been prevented with a simple prescription for antibiotics. A simple broken leg turned into years of pain, a chronic bone infection, six surgeries and one external fixator.

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"If you told me when it first happened that I would still be dealing with the aftermath of a broken leg ten years later, I would have called you crazy."

I don't know how many times I have said that over the years. Countless nurses, doctors, surgeons and specialists - they have all heard this phrase at some point or another. The story that follows is always the same and it always boils down to the same point: my leg hasn't healed. The only thing that ever changes is the length of the story. That and the number of years that have passed, followed by how many surgeries I have had. It's not like a legend or a fisher man's story. The details don't change based on who I am talking about or who I want to impress. It is neither a story I tell with enthusiasm nor one that brings back fond memories. It is always just the cold hard facts. It has to be the facts and the facts alone because thinking about everything I have been through and I how much I have lost, how much it has changed me, is overwhelming. I have had to re-tell is so may times that is has become repetitive and annoying. Sadly, every time something happens to my leg the story gets even longer and I often have to tell it twice just so a doctor can get all the details.

In the mean time, I have tried to keep things together. I completed high school and moved onto university. I got my first job as a cashier at a supermarket. I graduated from university, earning a B.A. in History with honors, after which I completely shifted gears and enrolled in a practical nursing program in college. I have taken up hobbies like blogging and cross stitching. More importantly, however, I discovered who I am - compassionate, a bit too self-conscious, an introvert who paradoxically wants to work in a very people oriented field.

As it is for many young adults, my teenage and early adult years helped shape who I am - school, work, hanging out with friends, and so forth. Unfortunately, these years have also been shaped by that single day over a decade ago. What simply started as a broken leg has thrust me into the harsh, sterile medical world, filled with doctors, hospitals, a new set of ever expanding medical terminology, and surgeries. There is the fear and worry, the lack of faith in my own body and the feeling that it betrays me. Not to mention missing out on all the things my peers got to do, not being as carefree as they are, having to do and think about things they won't have to for another forty or fifty years. There is realizing that you are not invincible and coming to terms with your own mortality much sooner than anyone else your age will. It sets you apart, makes it difficult to hang out with your friends and take part in what now seem trivial thing after all you have been through. It changes how you look at life and what you want from the future.

Ten years of medical problems has had a profound affect on me. It has changes who I am; in some ways good and other ways bad. There is worry and fear, anxiety before x-rays and scans, surgery, hospital appointments, undesirable news - these are unpleasant and undesirable things. I have experienced frustration and loss, grieving for what I have missed out on, jealousy as I watched others live a normal healthy life. On the other hand, I now see how precious life and good health are, I try to live a simpler life and to always take pleasure in the little things; I am more patient and definitely more empathetic to others. So however horrible the medical side of things was and how much it robbed me of, there were also good aspects of it. The good aspects are things I wouldn't change no matter what. Ironic, isn't it, since they come from something so bad and wish that never happened.