Orthopaedics

Samuel's Story

Samuel B.

Name: Samuel B.
Occupation: Dartmouth Medical School MD/PhD student
Age: 24

A bad tackle

Last summer I was playing soccer and was close to the goal. I scored the goal and, as I was scoring, I was running sideways. The goal keeper of the other team went down on the ground to grab the ball but in fact he missed. He somehow grabbed my foot and the momentum of my body sort of twisted my knee sideways. I could hear two loud cracks.

I couldn't get up at all for about a day or so. My friends had to help me get home from the game and I was on crutches for about two weeks. In the meantime I got diagnosed with an ACL (anterior cruciate ligament) tear at DHMC going through Dick's House [Dartmouth College student health services].

Fast service

My first experience was through x-ray [DHMC Radiology services] and it was great because I didn't have to wait. They were really nice and set me up very fast. I think the same day or the next day, they communicated their report to the Dick's House physician, who then communicated it to me.

It's interesting because my small fracture wasn't something that would impede me from walking but it was characteristic of an ACL tear. It's one of those rare cases where a fracture diagnosis is what happens in the soft tissue, according to the radiologist. I was then referred to have an MRI at the hospital and my MRI was done four or five days after my x-rays. I lived in Canada before and I think for something like this I might have had to wait for a month or more.

Making an informed decision at DHMC

Two days following my MRI, I met Dr. Sparks, my orthopaedic surgeon. He had everything on record when we met. I had three extensive meetings with Dr. Sparks. I was hoping I didn't have an ACL tear since I was able to somewhat stand on my leg, but during the first meeting, he told me I had torn my ACL, and my meniscus as well. That was a little hard to hear since this was the first serious injury I've had in my life.

Dr. Sparks involved me in making decision from step one—whether or not to have surgery. During the next two meetings, Dr. Sparks answered my questions and explained my options for the treatment and the types of surgery. He listened to me and I was very reassured by the end of the third visit that most of my questions were answered and that the surgery would be beneficial.

Pain relief for surgery

The morning of the surgery, I went to the hospital and was immediately admitted.. That's when I got anesthesia and had my first interaction was with the nursing staff. They were comforting and made sure I was in a calm state of mind.

I had the ultrasound-guided nerve block and that was really helpful because this surgery is extremely painful. I think just having regular pain killers is not very efficient in the first twelve hours of the surgery. There are screws in the knees and holes in the bones, so the nerve block helps to numb much of the pain for the first period. It basically consists of an injection to the side of the hip that reaches all the way to the nerves. I thought that procedure would be very painful but it wasn't, because they injected me with a pain killer before then so it was a very seamless procedure.

Getting back to my active life

I lead a pretty active life, especially in the summer. I like to play a lot of sports like soccer. Two months after surgery, I now have to work on building the muscle strength in my leg because muscles tend to shrink quite a lot. I can't run for another two months because the ACL graph is not strong enough to sustain all the running and it could actually stretch. I must allow time for the graft to vascularize so the body uses its own vessels to feed that graft. Once that happens, the graft becomes much stronger and then I can run. So in two months I'll be able to play soccer again. In any case, I'm happy because now I can walk without my leg or knee giving out.

DHMC set me up with a physical therapist right after surgery. I believe there are different schools of thought about this: some doctors let the patients wait about a week before they start their physical therapy program, but I started the day after my surgery. The physical therapist was absolutely wonderful – he spent time teaching me how to do the exercises and compared my recovery rate to the average trend he's seen. It's reassuring to have this information and it was very helpful to start physical therapy right away.

Leading an active life is important to me, especially being in medical school. I feel like I need to do something besides academic work. It's critical to keep a balance between physical activity and other things in life.