Anne Goonan

3 PTs, a Nurse & a Surgeon

On June 23, 2016 while descending stairs I sustained a life changing event, an unexpected ‘trip’ due to a broken step on the staircase. My husband Michael (P.T #1) was descending the stairs before me and prevented me from falling face down on the staircase. My right foot, unfortunately, took the brunt of the mishap though. I sustained a significant ankle injury. Michael’s worried look frightened me, but at the time, we were thankful that the only visible injury was to my right ankle. That was until we understood how significant the injury was. Michael’s professional guidance, physical and emotional support enabled me to maintain my mental stability and stamina through the injury repair and rehab.

After a trip to an emergency room to confirm bones were broken, we started our quest for repairs. The first orthopedic surgeon the next afternoon (Friday) recommended the injury be repaired by an ankle/trauma specialist. Where would we find such a surgeon on a Friday afternoon? A setback that led to a fruitful benefit. Our son Brian Goonan, DPT (P.T. #2) works at Hospital for Special Surgery (HSS) and, through colleagues, facilitated an appointment with Dr. Mark Drakos (an ankle and trauma surgeon) the following Monday morning. After assessment and examination, Dr. Drakos explained surgery was required if I wanted to walk without a limp and to minimize ankle trouble. The procedure was scheduled for the following Thursday, at Hospital for Special Surgery. On June 30th, a beautiful summer day, Dr. Drakos and I were ready. When he performed a planned arthroscope before surgery, he found cartilage damage and a torn tendon. The surgery was then expanded to include tendon repair and placement of my own stem cells to repair the cartilage damage. The surgery was then completed with insertion of 2 plates with 12 screws to put the ankle back together. All in all the “Right Open Reduction and Internal Fixation (ORIF) of my trimalleolar ankle fracture, with posterior tibial tendon repair and iliac aspirate [to obtain the stem cells for the cartilage]” was completed successfully! Dr. Drakos’ expertise and skill gave me the start I needed toward independent ambulation.

The procedure was same-day and the nursing care before, during, and after surgery was exceptional. The attention of the nursing staff was impressive, in pre op, the surgical suite and the post-operative area. I was visited by my niece Kristin Hernandez, RN, who is a nurse at HSS. At my request, she collaborated with the Recovery Room nurse, and assessed the care to be excellent. Just like the ad says: “It’s what we do”. The discharge instructions (based on the HSS nursing experience and evidence based practice) included how to manage pain when the anesthesia/block wore off at home. This tip was quite helpful because by the time the block wore off, I was home. Following the instructions helped me avoid a significantly painful experience. I must say being a nurse myself for 40+ years, I was quite impressed from start to finish.

The plan for rehabilitating the ankle was clear: non-weight bearing for a few weeks followed by physical therapy to full weight bearing/ambulation without assistive devices. The first attempts at physical therapy resulted in minimal signs of improvement from August through November. Ambulation, in spite of therapy, was painful with marginal use and function of the ankle. In addition to my personal goal of independent ambulation, another goal emerged in August 2017. Our son and his fiancé were planning their wedding for March 2017. My main goal changed from walking independently to dancing with my son at their wedding. In November 2016, this goal seemed like a dream that might not be realized.

Fate and insurance allowed me to switch to One on One Physical Therapy, Bay Ridge, a participating member of the Hospital for Special Surgery Rehabilitation Network. The 3rd PT in this story, Enrique “Rick” Garcia, DPT, completed the assessment, heard my story and pledged we would work together toward my goal to fully participate in the wedding and dance without a limp. The plan was as innovative as the care at HSS, and included manual manipulation, stretching, deep tissue massage and even cupping to facilitate movement and increase dorsiflexion. The plan also included aggressive exercises and Yoga assisted by athletic trainers to increase function and assist mobility.

On March 10th, 2017, although my rehab was not complete, I was able to dance and share in the joy of a wonderfully marvelous and happy Wedding Event! My dream of the Mother – Son dance was realized. Dancing to “Unforgettable”, my prayer for a beautiful and full married life for the newlyweds was joined with a prayer for these 3 PTs, a Nurse (and all the other nurses) and the amazing surgeon (with his surgical team) who made it all happen. Although I still continue PT to complete my rehab, I know full recovery will happen and I believe it was because of HSS I was able to get back in the game in one of my favorite roles: being a MOM!

My heart is full of gratitude… thank you all!