My Sojurn In The Ahab Zone
January 10, 2012 7:05 AM   Subscribe

Broke my foot on New Year's Eve and am coping with the fallout. You are not my doctor -- but my questions about mobility are non-medical and anecdotal anyway.

I've perused this and gotten some great advice already; my break is less severe than that (I'm able to get around on that boot thing and a cane; don't need crutches, and I can get away with putting a little weight on the boot, even). And odds look good that I'll lose the boot in mid-February; the orthopedist said that if I don't push myself I can most likely avoid surgery. I live in a 4th floor walkup, but I'm getting myself to and from work in cars and taxis, so no subway for a while. And once I get back from work, I stay home (and am resigning myself to just having to be a hermit for the whole of January).

My questions are:

1. Some people at work were teasing me about having to scoot down the stairs on my butt if we had a fire. And that got me wondering what actually DOES happen if there's a fire in an office building, and someone's got a broken leg or something. The fire marshalls always remind us over and over that "you need to go down the stairs", but in the case of someone who can't use stairs as quickly as they probably need to, what actually DOES happen? Should I lasso someone to be my designated "carrier" if there is a fire over the next 6 weeks, or are firemen trained to look for people like me and I should stay put?...

2. I'm assuming I'll have to do some kind of physical therapy, but am not sure whether that'll be "you'll be coming to this office once a week for the next six weeks" or that'll be "here's a pamphlet with a list of foot exercises, do these once a night at home for the next six weeks". Is there any kind of rule of thumb, or is that very much a "it depends what your doctor says" kind of thing?

3. What are the odds that I'd be able to do a little dancing a month after the boot comes off?...

You are not my doctor, you are not giving me medical advice. This is all anecdotal, I know. Thanks.

(All I will say about how the break happened is that it involved a little too much champagne and a recording of "Come On Eileen.")
posted by EmpressCallipygos to Health & Fitness (22 answers total)
In the first case, don't quote me on this, but our emergency exit maps designate certain places as "handicapped rescue areas" or some such. I think that's so the fire departments can make sure they know where to go, and the people vacating the building can point to those spots as places where the disabled folks who can't easily get out of the building are congregating (and, you know, breathing a ton of smoke).
posted by Madamina at 7:14 AM on January 10, 2012

I can answer about physiotherapy. It will depend on your therapist, but probably weekly for a while with daily exercises for you to do at home. Do these exercises. Discuss goals with the physio. Insist on seeing a physio at least once. You will not regret that.
posted by jeather at 7:17 AM on January 10, 2012 [2 favorites]

jeather, you've actually given me a lot of hope (I PREFER the weekly-excercises-at-home and am a little more diligent if self-directed). Whew!
posted by EmpressCallipygos at 7:20 AM on January 10, 2012

3. What are the odds that I'd be able to do a little dancing a month after the boot comes off?...

Seriously, avoid any unnecessary strain on your foot for at least a few weeks after the boot comes off. Ease back into regular life. A little dancing is not worth the risk of exacerbating an injury that is not yet fully healed and winding up in the boot for another eight weeks.
posted by qxntpqbbbqxl at 7:29 AM on January 10, 2012 [1 favorite]

Oh hey, join the club EC, I broke my foot in five places on Xmas Day! My ortho reckons I'll need some physiotherapy for a sore ankle when the plaster comes off because it will have weakened over the six weeks of plastering. But he reckons only a few visits and an at-home regime for a little while after. I have to use crutches - my ortho said a boot puts too much pressure on bones in the foot which spread to accommodate body weight. So, keep it elevated as much as possible. He reckons if I keep it elevated, don't put weight on it, I should be back on form very soon after the plaster is removed.

And I've been worrying like crazy about emergency situations, so I'm glad for your question here. At my college they had a convening point for disabled folk on each floor level marked on the fire exits sheet that's stuck on each room's door. And I guess [hope like crazy] that handsome firefighting dudes throw you over their burly shoulders and carry you down the stairs. Actually, during a fire at the college in '98 that's exactly what happened to a gal in a wheelchair who was on the fourth floor.
posted by honey-barbara at 7:30 AM on January 10, 2012 [1 favorite]

For your first question, the answer is this: evacuation chairs.

High rise office buildings should have these or something comparable. I don't think it's a regulation, but hey, pretty cool, huh?
posted by clockbound at 7:36 AM on January 10, 2012

If it were me, in a fire or an emergency, I go down those stairs in the boot and worry about the ramifications later.
posted by JohnnyGunn at 7:36 AM on January 10, 2012 [2 favorites]

1. In my office we have people who are trained to be "Life Safety Officers". They have received first-aid training and are instructed on evacuation processes for the building. If you have any such individuals, I'd ask them first. For our 15 storey building, there is something called an Evacu-Trac for people with limited mobility. Admin staff are usually a wealth of knowledge and if nothing else they may have some idea as to which people (if any) have received safety training.

If you can walk with a cane and the boot, you will have some mobility during an emergency.

2. I broke my 4th and 5th metatarsal bones but did not need surgery. I was on crutches for two and a half months before transitioning to the RoboCop boot and gradually started walking. I had to go to physiotherapy twice a week for six weeks. Generally I would just walk on a treadmill for 10 minutes and she would observe my gait to ensure I wasn't favouring the bad foot. After each session, I would receive a series of exercises to work on at home. My physiotherapist gave me a Thera-Band exercise band, I did calf raises, and I had to practice standing on bad foot first with support and then unsupported. I was also instructed to do a series of stretches at my desk during the day.

3. I would agree with qxntpqbbbqxl who mentioned that you might want to ease back into your regular life. Something I am having a hard time with is sensible shoes. I went on vacation and took something with heels and REALLY regret that. My strong foot was fine but my bad foot let me know it was consistently unimpressed with my footwear choice.

I'd try to avoid re-injury at all possible costs. Sacrificing a bit of dancing a month after the boot comes off will be worth it so you can get your pain-free boogey on in the future. If you have any influence over the dance party, promote a Saved By the Bell Theme and do the Sprain.
posted by nathaole at 7:45 AM on January 10, 2012 [1 favorite]

For escape in case of fire: usually the handicapped rescue areas are on landings in the fire stairs. In a large and/or public building there should be someone designated to check these areas on their way out of the building and alert emergency personnel that they need to go up and grab the person - I know this was one of my responsibilities when I worked in a museum, and I took it very seriously though I never had to evacuate anyone who couldn't use the stairs (I think maybe there was a phone in the stairwell, too).

In your case, though, you're probably best off just making your way down the stairs the same as you make your way down the stairs of your apartment building. You'll be slow, but evacuating a high-rise is actually pretty slow in general.
posted by mskyle at 7:48 AM on January 10, 2012

I can answer about physiotherapy. It will depend on your therapist, but probably weekly for a while with daily exercises for you to do at home. Do these exercises. Discuss goals with the physio. Insist on seeing a physio at least once. You will not regret that.

Seconded. When I broke my knee, they had someone come round the house to lead me through a few routines. They did help, even if they hurt more than the original injury.

Stick with it. It'll be a huge literal and metaphorical pain, but stick with it. involved a little too much champagne and a recording of "Come On Eileen."

I was gardening. The injury is one thing, having to repeat your tale of stupidity over and over? Mmnyeah...

Good luck.

posted by Capt. Renault at 8:01 AM on January 10, 2012

At least some of the firefighters have the rescue chairs clockbound pointed to in their firetrucks. When I saw one in use (US/New England), each handle was grabbed by a fire fighter and they brought a person down the stairs that way, which is why the handles in front are below the ones behind. It gave me yet another appreciation for them.
posted by jwells at 8:05 AM on January 10, 2012

I'm not sure if you're a high-heel wearer, but after I broke metatarsals many, many years ago I was unable comfortably to wear high heels again because the heel put all the weight onto the break spot and it always hurt.

Re the fire evaculation, in my building there is a separate elevator, away from the main elevator shaft on the other side of the building, which is used only for evacuating the disabled during a fire (drill and false alarms so far, no real fire). It runs off a separate power supply. I have no idea what would happen if the fire is around the area of that elevator.
posted by essexjan at 8:08 AM on January 10, 2012

I am fortunately not a high-heel wearer; I never liked them and they make my back hurt. All I own are sensible shoes and the occasional cute flat.

Okay, I'll cope with the going easy on it for a while after; as long as I'll be able to walk up and down stairs really soon without the Clunky Boot that'll be good. (That way I can start taking the SUBWAY home, which we'll all be happy about.)

For those of you who had the RoboCop boot (I am SO stealing that nickname, thanks), I have a couple of follow-up questions about that which I forgot to ask:

1. they gave me some socks to wear with it, but they only gave me TWO. Do I need to only wear those super-special socks, or can I just wear any sock that's long enough? (Everyone around me would probably appreciate it if I changed socks more than just once over the next six weeks, I'm sure, and I hate to be doing hand-washing of a single sock every night.)

2. Those of you who specifically used the Aircast kind, which has a couple of inflatable cells inside that are supposed to help customize the fit around the ankle: I find is that rather than stabilizing my ankle, over the course of a couple hours those inflatable things are gradually pushing my whole foot FORWARD inside the boot. The site of the break is unaffected, all this means is that over time my toes start edging out of the front of the boot, and the front of my ankle starts getting uncomfortably pinched. But I've tried not inflating them so much, and that just makes it feel loose (I have REALLY narrow feet). If you used the Airboot, did you have this problem, and how did you hack it?
posted by EmpressCallipygos at 8:28 AM on January 10, 2012

Oh, hey, that was my post! It seems so long ago. I do not miss wearing Das Boot. (That wedding was about five weeks after the break, and I didn't dance. I did have a ridiculous time in the airport on the way there.) No advice on the AirBoot as I didn't have one.

For my physical therapy, after a few weeks, my orthopedist referred me to a physical therapist. I saw her twice a week for about two months, and did exercises at home. I was kind or a weird case as I had some issues with losing almost all flexibility in my Achilles, which caused a lot of pain and an ER visit for suspected blood clots. My physical therapy was then really necessary for pain reduction. I also lost a lot of hip strength and stabilization. I maxed out my insurance for PT but ended up okay.

Random tip: I am a dedicated flats-wearer, but I found it easier if I wore a very low heel on my non-booted foot to stabilize myself. Like essexjan, I had trouble with heels for a while, and also trouble with impact sports, but got back to normal well enough.
posted by quadrilaterals at 8:39 AM on January 10, 2012 [1 favorite]

Hey, quad! I think I first found your post when I did the search for "fifth metatarsal" after I initially got the x-ray. I got REALLY lucky, I think; the x-ray guy thought it was a Jones fracture, but the orthopedist said "actually, not quite" -- it's more like an avulsion fracture with an extra crack. But no dislocation -- all the bones were in all the right place even though I'd been hobbling around on it for a couple days thinking "it's just a sprain". Did you have a Jones fracture, or what happened?
posted by EmpressCallipygos at 8:52 AM on January 10, 2012

I have an avulsion fracture of the 5th metatarsal, sustained playing squash the week before Christmas. They sent me away with crutches only from A&E, but the consultant at the fracture clinic appointment a week later told me that I didn't have to use them if I didn't need them to cope with the pain (I don't), that it would almost certainly heal well and not to bother going back if I felt 'ok' after 4 weeks. Absolutely no physiotherapy mentioned at any point.

3 weeks later and I'm walking normally, no limp, no boot, no cast, no crutches - a little twinge now and then but no real pain.

This is NHS treatment in the UK, so might be that the advice is bad. :)
posted by bifter at 11:02 AM on January 10, 2012

Empress, didn't see this till now, but as to your first question: I used to have a girlfriend who had MS, which sometimes confined her to a wheelchair. One time when they had a fire alarm in the building she worked in, she got carried down the fire stairs on the arms of two fireys.
posted by Logophiliac at 11:09 AM on January 10, 2012

A long sock should be fine. I've had friends in various corrective casts and some used short socks with leg warmers, some long socks, etc.

Additionally, adjust it for comfort during the day. your leg will swell and get uncomfortable as the day goes on, letting a little air in and out as needed without affecting the break significantly in my second-hand experience has been fine.

I am not a doctor, medic, psychic, or physio; I've done this with injured but not proven broken feet and watched/assisted friends. If I were in your sitch I'd check with the nurse in the office on adjusting.

Agreed with those who noted the emergency procedures - been co-captain of my floor and folks who aren't fully able bodied have buddies and other checks to ensure their evacuation.
posted by tilde at 1:04 PM on January 10, 2012

I broke my foot fighting robot ninjas* a few years back. I was in the dreaded stormtrooper boot for about two months, but I ended up not needing surgery. I wore men's socks with mine because they were loose and easy to slip over my ridiculously swollen and painful foot.

My injury may have been different than yours because it was pretty clear my foot was broken immediately, but I'm sorry to say I definitely didn't feel like dancing a month out of the boot. Once I was cleared to stop wearing the boot my doc told me just to use pain as my guide for what activities I could and could not do.

*that's my story and I'm sticking to it
posted by missmerrymack at 6:04 PM on January 10, 2012

Sorry, meant to include that I had that aircast as well. I inflated it more if I knew I was going to be up and about and left it looser when I was at my desk or at home and could have my foot up. Much more comfortable.
posted by missmerrymack at 6:07 PM on January 10, 2012

Can I warn against being too careful? I broke my ankle in two places a year ago, and sprained it. The whole thing has been really irritating and very painful. Before this Christmas, I went to the doctor for the 9th time because the pain never stopped, and he told me to try to put more pressure on it, directly contrary to the physiotherapist's advice. Since then, relief has been rapid.
Obviously, you need to take care in the beginning, and do your daily exercises at home religiously. (Get a balance board). But you also need to push yourself a bit as soon as the fracture has healed up. I understand now....
posted by mumimor at 2:20 PM on January 11, 2012

Got an answer on the fire-evacuation front -- if I'd been thinking more clearly, I'd have gone to the security desk in our building and asked them this rather than coming here. So am posting "ask the security desk in your office building what the policy is, they'll at least refer you to the right guy who knows" as the answer. (In the particular: this is my floor's fire warden's problem. Fortunately the fire warden is also one of my best buddies in this office and has already told me he's got my back.)

As for the physical therapy and the activity Post Boot, it sounds like the answer is a big and resounding "it depends". I'll hit up my male friends for any unmatched athletic socks they may want to donate me, and I'll keep playing with the fit of the boot (my new problem - pressure bruises, but I think I've already got a fix for that). I'm marking this "resolved," but please feel free to hit me with any more random coping tips and "hey this is what I wish someone had told me" kinds of things. Thanks.
posted by EmpressCallipygos at 8:05 AM on January 12, 2012

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