Vacation detour to the ER

“Don’t jump!” she yelled, in Belarussian, a moment too late.  I watched as he fell from the rock to the ground below. It was at that point  that our plans to relax with friends and family at our mountain retreat quickly turned to chaos.

This first weekend in October had been planned for several months. My husband and I made the drive to the mountains of North Carolina after finishing my day of work, at the SNF (where I am completing my 711 clinical experience).  Arriving late on Friday,  we met my in-laws, who had traveled from  Florida the day before, and my parents who, along with friends from the country of Belarus, arrived a few hours earlier from New York.

After a late night of catching up and sharing the current events of our lives, we headed to bed. Saturday morning after a delicious breakfast, we decided to head to the Blue Ridge Parkway, as our friends, from Belarus, had never seen mountains before. The first overlook we stopped at was beautiful, but we explained to our friends that the view would only get more beautiful the higher up the mountain we went. After stopping for a few photos, we got back in our cars and headed to the next overlook. As promised the next overlook was even more beautiful than the first.  With magnificent rocks across the street, one of  our friends from Belarus decided to go for a small climb to pose for a picture about 5 feet up the face of the rock. Those of us that brought a camera snapped a shot or two of our friend and began crossing the overlook to look at the valley below. That’s when we heard  Belarusian words being shouted toward the rocks; the words, we would later learn translated to, “Don’t jump!”

I ran across the street not knowing what to expect. Not speaking much English, my friend (Alexander) pointed to his left knee. I looked at his knee and knew immediately something was not right; his patella was situated more proximal than it should have been.  I asked him if he had heard a click or pop and he replied that he heard a click when he landed. I gently palpated it, moving it left and right and realized it was extremely hypermobile as though it were just floating under skin; I knew he had torn something. His knee was only slightly flexed and I placed my hand on the posterior side of his  knee. I asked  him if he could push down into my hand and completely straighten his knee. He was able to do so and I could see his quadriceps contract; his quadriceps tendon seemed to be intact.

Next I had him flex his knee, and while he was able to do so, it was difficult and painful. The biggest clue however, that helped me solve his diagnosis mystery, was that his patella did not track as it should, but instead remained in the same, strange, superior position it had been in.  I knew then that he had torn his patella tendon! He wanted to try to walk, but I told him not to. I had my husband and my friend (Dema) go to each side of him and provide the support he needed to get to the car without bearing  weight on his left lower extremity.

We arrived at the hospital and while we waited in the emergency department waiting room, I looked up the patella tendon on my mother-in-laws I-Phone. I then showed Alexander what I thought had happened when he landed from his jump off the rock. When the nurse called him back to the examination room, Dema and I both went with him, as Dema spoke the most English and could translate between English and Belarusian and I was able to help translate between medical terminology and common English. The on-call orthopedic surgeon arrived within an hour and confirmed my diagnosis of a patella tendon rupture. He then informed us that surgery was the only option; that Alexander could have the surgery done immediately or wait until he got back to Belarus. The surgeon’s recommendation for the best outcome was to do the surgery as soon as possible.  Despite the fact that this was a big decision for Alexander, for he had never experienced any surgical procedure in his 47 years of life, he quickly chose to have the surgery immediately.

Within exactly 24 hours Alexander arrived at the hospital emergency department, had surgery to repair his patella tendon rupture, participated in physical therapy at the hospital and was discharged from the hospital on crutches,  wearing a knee immobilizer! Two hours following his discharge, he and his family and my parents were continuing with their travel plans and were on their way to the coast of North Carolina where our friends from Belarus would see the ocean for the very first time ever!

Despite all that happened this past Saturday,  Alexander and his family were able to enjoy their last few days in America and continue with their traveling as originally planned prior to his injury. In an attempt to look at the positive side of this event,  it was a chance for me to use what I have learned at Elon and apply it in a real life situation. While a patella tendon rupture is very straight forward and easy to diagnose, my ability to do so quickly and accurately have left quite an impression on my Belarusian friends.  My Belarusian friends have always had great respect for American medicine. They now view American physical therapists with very high regard and see Elon as an outstanding university as well.

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