Rheumatoid Arthritis Patient Shares Lessons Learned from Breaking Leg in a Fall

My osteoporosis also proved to be influential in the outcome of my fall. I fell in my living room as I reached to arrange pillows on the sofa. I landed on plush carpeting, but as I fell, my right knee hit the rock-hard sofa frame. Immediately, I felt knife-like pain accompanied by tightness as my knee swelled to what felt like a basketball under my jeans.

X-rays revealed a comminuted displaced and angular fracture of the distal right femur, immediately inferior to the femur rod attached to my right hip arthroplasty. This type of fracture is caused by high-impact trauma as in automobile accidents, and it occurs in older people who lack normal bone density. The latter describes me perfectly.

I underwent an open reduction internal fixation (ORIF) to correct the damage to my femur. To prepare me for major orthopedic surgery, several abnormalities in my blood had to be corrected. My RA has caused me to be chronically anemic, shown by a hemoglobin at 7.1 g/dL and hematocrit of 21.3%. I received one unit of packed cells preoperatively. I have taken warfarin daily since my CVA in 1984.

My international normalized ratio (INR) was 2.5, a therapeutic level for anticoagulation, but too high to proceed with surgery. I was given three units of fresh frozen plasma to bring down my INR. Finally, I was ready for surgery.

I learned that it is an RA patient’s responsibility to discern whether the exercises prescribed are appropriate for the complex deficits many of us have. … It was my job to discuss & explore with my therapist whether the exercises prescribed safely met my needs.

Post-Op

The author uses her platform walker before going to church.

Post-operative orders specified two months of no weight bearing on my right leg—none at all. My bone density is osteopenic at the distal end of my right femur, so my orthopedic surgeon wanted the hardware he used to have ample healing time.

Being an RA patient who has a right shoulder arthroplasty in addition to weakened wrists and finger deformities, I had to use my platform walker to pivot with my left leg. Absolutely no hopping on one foot or crutches were allowed. My platform walker was an odd-looking contraption that accompanied me wherever I went. Other patients stared at it and wondered what planet I came from. Not only was it bulky, but the platforms added weight, which made it heavier for me to move.