To give you a snippet into who Dr. Mehta is and why I’d highly recommend him to anyone, here is something he shared with me when I told him I was going to share my story and if he wanted to describe why he decided to operate on me when other surgeons may have deemed I was inoperable and this thought process when in the operating room.

 

    “When I met you, i realized I had a person with a Type A personality who had no idea how much his life had just dramatically changed. Calcaneus fractures have a disproportionate impact on quality of life measures. And you had two of them. I also recognized the tremendous support system that you had.

 

Deep breath - where do we go from here?  Even in the best of hands calcaneus fractures do "just okay" and this guy has two of them. All right, well maybe it won't be as bad as I think ... maybe they are non operative or maybe not too badly broken.

 

Then I looked at the CT - sanders III / IV on the right heel and Sanders IV on the left heel -  not good.

 

Okay time to role up sleeves and let's do this.

 

In the OR, it was as bad as I expected. After having done this for a few years you realize that the CT underestimates the amount of injury present. So, when I got in there, no real surprise. Had a plan in terms of how I was going to fix it - like putting a puzzle together and starting with the corner pieces and working you're way in. There were A LOT of pieces. During the surgery, all I could think about was "gotta get this perfect" to give this guy a fighting chance.”

 

Even today reading this brings me to tears.  All I wanted was someone to do exactly what his quotes portray and it’s exactly what I got from Dr. Mehta.  

 

Feedback after surgeries from a friend who was actually in the operating room was that I already knew how committed Dr. Mehta was to giving me a fighting chance at getting back to a normal life even if the damage was worse than images portrayed.  I don’t even know what the devastation would have felt like if I were opened up just to be deemed nothing surgically could be done to fix my heels.  I’d be lying to you if I said my desire to recover as well as I have wasn’t partially fueled as a thank you for giving it everything Dr. Mehta had and taking it as much time as needed to quote Dr. Mehta - “To give this guy a fighting chance”.

 

Looking back I also find myself incredibly fortunate based on my life leading up to my injury / surgery.  I vividly recall when meeting the Neurosurgeon for the first time his first response to me after looking at images of spinal fractures was:

 

    “I can’t believe you are alive let alone no paralysis”.

 

I actually had to ask him to go over the images with me but luckily was determined no surgery was required.  The surgeon informed me that if just a sliver of bone had went into my spinal chord paralysis would have resulted.  I soon found I did loose some movement in my big toe of right foot (can’t curl the toe) but no idea if that was a result of spinal fractures, something getting crushed from the injury, nerve damage or something severed during surgery.  Luckily this doesn’t affect me getting around.  

 

I’m also very fortunate to have never smoked cigarettes in my life - not even one drag of a cigarette.  My parents both smoked for about the first 10 years of my life and I grew a distaste for it.  During my initial consultation with Dr. Mehta one of his first questions to me was if I smoked as it has a detrimental impact on the healing of the incision and more susceptible to infection.  He even went so far as to say I’d be in-operable if I were a smoker.  It’s things like this that happen in your life that really makes the saying “everything happens for a reason” hit home and is a surreal feeling.  

 

I also work very hard to eat healthy.  If I ate as much as I wanted I’d be obese.  I avoid sugar and any non-healthy carbohydrates wherever possible and have never really been overweight.  At the time of my injury I was probably in the best shape of my life prior to leaving for Pennsylvania State University in 2001.  I put on some weight during college and hurt my lower back working physical labor type jobs in the summer so I didn’t have to work throughout the school year and afford to drive and do what I enjoyed.  I was raised to work hard for what you want and not expect anything from anyone.  My back injury ultimately led me to the chiropractors office from not using proper posture when bending over or lifting things.  Being fed up with the back pain and costs of visits on one of my last visits I asked the chiropractor what can I do to never see him again.  He mentioned to use proper posture, increase your core strength and maintain a healthy weight.  Hearing this I immediately became more strict to my diet, inserted 10 minutes of abdominal work at the end of each workout (which I still do) and did my best to sit with proper posture and lift / bend over with proper form.  It wasn’t quick, but over the next year I lost about 20 pounds and developed abdominal muscles.  I only mention this because I sometimes wonder would my injuries / outcome been different if I was 20 pounds heavier at the time of my injury?  Would I be alive?  Would I be paralyzed?  Would I have had fractures in other areas of my body?  Will never know but luckily life up to my injury seems to have some sort of impact on the severity of my injury and even impact being actually able to be operated on.

Back to walking I quickly found out I was doing too much.  I remember only being able to tolerate 4 steps at a time without extreme pain.  With the ‘no pain no gain’ mindset I powered through as much pain as I could tolerate but I had no other choice.  After walking toe-to-heel vs. heel-to-toe I developed Achilles tendinitis in my right foot where pain was so bad it forced be back to being immobile for 3 or 4 days.  Having waited 3 months to walk again this was hard to endure but it forced me to walk on my feet properly so as much as it sucked it seemed to help.

 

My next follow up visit with Dr. Mehta was about6-8 weeks after I walked again.  The goal I set for myself was to walk into Penn Medicine without a limp with the appearance I never shattered my heels.  To this day I still walk flat footed every morning as my ankles significantly stiffen overnight but loosen up after being on my feet for about a minute or so.  Back then they took a lot longer to loosen up on top of the fact that I was still working to get full range of motion back in my ankles (which I still don’t have) but I made sure I was up and walking around before I was called back to see Dr. Mehta so I could at least appear I no longer walked with a limp.  

 

Results of that checkup was that X-Rays looked good and was cleared to run!!!  Prior to my injury I ran 15 - 18 miles a week so getting back to doing what I normally did was  always a goal of mine especially from a mental perspective.  My next follow up was three (3) months later and I set a goal of running 3 miles again (only distance I ever ran) by the next follow up.  During my next physical therapy session my PT agreed to let me attempt to run but was deemed my achilles tendon was still to tight from being immobile for so long so even though I was cleared to run from a fracture perspective my ligaments were still to tight so I had to focus my attention on range of motion, strengthening my lower extremities and loosening up ligaments in my ankles that were still way to tight for running.  

 

By April, 2015 I was cleared to start running again by my Physical Therapist.  This was monumental to me because I was told when initially injured that I may never walk again let alone run and was proud of what I have accomplished in my recovery so far but was far from satisfied based on goals I had set for myself.  At this point I was seeing Dr. Mehta every three (3) months to see how I was progressing and was determined to run three (3) miles before my next visit late July / Early August.

 

Running was not easy.  I remember starting my running around the block to start and the discomfort I felt and had to listen to my body.  You don’t break plateaus in any recovery without enduring pain and need to be cognizant of when you are taking it a step too far.  There was pain and discomfort after running but once I tried to walk again after resting the pain was so bad that it was almost impossible to walk for any distance.  This was hard to endure but didn’t come as a shock.  Dr. Mehta informed me from the start that it’s going to take a while for your ankles to adjust to all the weight being bared on them again and being dormant for so long and can only imagine the impact of running on them but in my opinion there was no way my ankles would get used to that pounding unless they experienced it so I continued to power through and deal with the pain.  

 

Up to this point in time my mentality was I wouldn’t be satisfied with my recovery until I was doing everything I did prior to my injury.  About 2 weeks before my next scheduled follow up with Dr. Mehta I was up to running 2.5 miles with with my goal of 3 miles in sight and attainable.  On a run when my goal was to run 3 miles I noticed a sharp, excruciating pain in my 4th metatarsal of my right foot.  So much pain that ironically I could only bare weight on my heel.  After consulting with my physical therapist and Dr. Mehta’s staff I was diagnosed with a stress fracture.  Searching for answers why this happened I was informed it could be several factors.  The first explanation was that I was just going too hard too fast and running that much may not have been wise as my feet weren’t ready for it after so much time spent non-weight bearing.  The second explanation was that I was not walking on my right foot properly and putting too much stress on the side of my foot.  Based on the soles of my sneakers before I don’t necessarily think I ever walked on my right foot properly but can only imagine my injury made this worse but other factors could have been involved.  

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Getting the stress fracture in my foot was devastating.  Instantly I realized that no matter how hard I wanted to work I don’t have full control over getting back to who I was before.  The realization of this and the fact that dealing with constant pain and discomfort took me into a dark place.  With depression comes medicine which, in my opinion, no one should be ashamed to take.  Slowly I started to accept the ‘new me’ and never realized how much of a mental challenge it is to recover from a traumatic injury especially when you can’t do the things that used to come so easily.  Looking back the physically recovery was easy and the mental recovery never really ends.  After future discussions with all my medical staff I made the decision to give up on running for a variety of reasons.    

 

1. I’m still alive.

2. I have medical clearance to run / walk after being initially told both were a long shot.

3. It’s a safe assumption at some point in my life I’ll develop arthritis in my ankles based on cartilage damage and I’d prefer to delay the inevitable.  My mother believes I already do based on daily pain but it isn’t something I worry about anymore.  I live one day at a time and only think positively.  I used to be a negative person and one of the best outcomes of my injury is my new outlook on life in my opinion.

 

During this time my days of physical therapy went slowly from 4 days a week to 1 day where eventually insurance no longer would cover additional physical therapy sessions and I was luckily physically ready to get back to my ‘new’ ‘normal’ life. 

 

Not having the time commitment that came along with physical therapy was great but I was still getting used to daily aches and pains.  I have got back into my normal weight training routine and have modified how I workout to accommodate for the lack of cardio and started wearing flat foot shoes (Vans) more often to force myself to need to use more of my ankles to gain more range of motion or dorsiflexion. I also gave more attention to weight training my lower body because the atrophy that did occur from being immobile in my legs was still fairly evident.  This did result in greater range of motion, so much so that I started to feel the plates in each heel that seemingly prevented me from gaining more.  

 

Still being committed to my recovery I reached out to Dr. Mehta about having the hardware removed.  I thought it would be amazing to have it done 2 years from the day I walked again (10/7/2014).  Based on our conversations it was decided we would do 1 foot at a time so I was still able to get around with surgeries scheduled for 10/3/16 and 10/17/16.  The month of October was a tough one, living solo on 1 foot, but I managed to get through it based on the fact I signed up for these surgeries.  In hindsight I didn’t give enough thought into the amount of pain that I would be in after not using each foot for 2 weeks but it was a goal I set and glad it’s behind me.  I also got to keep all the hardware which was also part of why I wanted it removed.  I can’t say I have noticed a huge difference in my heels since it has been removed but I do know they needed to chip away bone to get one plate off so if you ever have aspirations of having your hardware removed consult with your surgeon about that scenario. 

 

Say what you will but when people ask me of my recovery and my thoughts about it my best way of describing it is the person who I was before my injury died on 7/7/14 and was reborn to a very much different person.  My work ethic, drive and passion without question helped in my physical recovery but the battle of depression, the level of effort and pain endured it takes to overcome plateaus, the dealing with the peaks and valleys of recovery and the mental challenge has had a profound effect on me and changed me forever.  I’ve always been an independent person and hate being reliant on anyone for anything but I can’t discount the importance the support of family, friends and medical staff had in my recovery.  Unfortunately some loved ones, that I still very much care about, were hurt along the way and is a burden I will always bear.  I truly believe I’m a better person today.  Constantly positive, worrying only about the things I can control, using brain over brawn and being humble are just few traits that I believe describe the new me and if I had a chance to go back to being who I was before 7/7/14 I whole heartedly would say absolutely not.  I have no idea what it is in store for my ankles in the future but all I can do is live life and work to be a better every day both physically and mentally.  Some days are absolutely harder than others regardless of what new pain in my ankles I may encounter or what mental challenge arises but I’m still alive and able to get around and that’s all I need.  The recovery is constant and as soon as you become complacent you regress.  

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