Long climb back from ladder fallPublished 10:07am Friday, February 19, 2010
By JOHN EBY
Dowagiac Daily News
A bizarre accident last Nov. 21 shattered Angie Merrill’s heel and, for a time, her outlook on life.
Her tumble from a skidding ladder while painting also fractured two bones in her face and opened her eyes wide to the quality of medical care available in her community from Borgess-Lee Memorial Hospital Bone and Joint.
Three months later, she’s still hobbling on crutches, but the ski boot fits over the L-shaped scar around her left ankle, so the mother of two can drive and work part-time in the Union High School kitchen while overseeing her nine rental houses.
She can also see the end of her ordeal with a final surgical procedure anticipated in May when a plate and nine screws are removed.
This might have been a timely valentine to her medical team had there not been a few setbacks, such as an allergic reaction to medication which scrubbed an interview initially scheduled for Jan. 15.
Her mouth swelled up, with “red bumps” carpeting her tongue. She couldn’t taste anything and experienced trouble breathing, which “can be fatal.”
Previously, her major medical malady was a broken wrist in a cast as a kid.
She felt empathy for a friend who last year followed foot surgery two weeks later with a shoulder broken in a car crash.
“I told him, ‘I had no idea what you were going through.’ It’s horrible. You feel isolated, you’re depressed, You need people, but I’m very independent. Nobody wants to call people and say, ‘Hey, I need you to come over and get me a sandwich out of the refrigerator because it would take me a half hour to scoot over there on my butt.’ I’d go days without lunch. I needed people. My mother came over and cleaned. This knocked the life out of me. I ended up being anemic, which drains you,” and lost 15 pounds.
Brushing her teeth came to symbolize things she took for granted until she couldn’t do it without help.
Yet “I had something far beyond a wonderful experience,” she wrote in an e-mail last month. “I really want to make sure that our citizens here in Dowagiac know about the care they have at their fingertips … doctors and nurses have just gone above and beyond and I want others to know how lucky we are to have our hospital and such a caring staff that comes with a small town.”
That’s an important statement for Angie, 33, to make because it’s not what she used to believe.
Her caregivers won her over, as she explained in an interview at the Daily News Thursday afternoon.
“Dowagiac hospital was so good to me,” Merrill said – and ironically, it was her former mother-in-law who referred her after an unsatisfying experience in Kalamazoo.
Borgess-Lee Memorial Hospital Jan. 28, 2009, announced the opening of Borgess Lee Bone and Joint, an in-hospital practice specifically designed to provide patients with comprehensive, high-skilled orthopedic care without the need to travel out of town.
The former Angie Steinman’s life was already in transition before her accident.
She left her finance job at City Hall Sept. 30 and married Jason Merrill a week after that after living together four years.
“About six weeks after the wedding,” she said, “I’m looking at the living room thinking how gloomy it was. I went and bought a $300 chandelier and all the paint. I love to paint. I was painting a spot 15 feet up. It’s two levels, but it’s all open in the spot I was painting. We’ve got a big shadowbox window. The extension ladder was extended all the way. I had about two more steps. The ladder started sliding on our wood floors, down the wall. I had about half a foot before it dropped off the ledge and slammed to the floor. It wasn’t going to be sliding anymore, it was going to be free-fall, so I pushed off to the side. I landed on the floor, broke two bones in my face and had a little cut. Blood and paint were everywhere, splattered on the windows and the wood floors. The doctor said my heel was in about 30 pieces. He said it’s one of the most painful breaks you can have because it’s the most the most vascular bone in your body, which means it’s full of veins.”
Angie already knew about painful at that point.
She preferred childbirth.
You know you have good neighbors when they come over to help mop up blood.
“My neighbors came running through the woods in every direction” to her Pine Row Trail home.
But how did she hurt her heel and her head at opposite ends of her body?
“We’ve talked about this,” Angie said, “and the only thing we can think is that maybe I hit my eye on my knee. All the furniture was pulled out. It knocked the wind out of me. I remember lying on my back, trying to breathe.”
“I had a concussion on top of that,” Merrill said. “My husband was there.” In fact, he said, “Hey, Angie, hold on a minute and I’ll hold that ladder for you.”
She had watched Jason clamber up and down to hang the chandelier, but then he climbs ladders for a living building water towers.
“Normally, I do fold-up ladders – not extension ladders,” she realized too late. “It happened so fast.”
Her daughter dialed 911, but Angie “remembers nothing for three hours after I fell. Not the ambulance. I didn’t know my name, where I worked, what I was doing – and I guess I kept saying, ‘Now what was I doing up on the ladder?’ They’d tell me, then I’d go, ‘I know you just told me, but can you tell me what was I doing up on the ladder?’ I’d forget that quick,” so they transported her to Kalamazoo.
“My thought,” she said, “was ‘thank God.’ I don’t want to be in Dowagiac at this hospital. They’ll screw it up.’ You know how small towns are, where you hear all the bad. I was relieved to be going to Kalamazoo.”
It was three days before swelling subsided enough for a doctor to examine it.
When she went back, “The office was so unprofessional,” Merrill said. “After my appointment seeing him the second time, he rewrapped the injury and explained there would be another couple weeks of waiting.
“It’s a tricky injury,” Merrill explained, “because you have to have the swelling down because the skin on the side of your foot is so thin.”
As she left, an employee informed her, “By the way, we aren’t covered under your insurance.”
“I couldn’t believe they didn’t check that before I drove all the way there,” she said. “I was afraid I was going to lose my foot and they wanted me to call my insurance company and argue with them. I didn’t care for the way they handled it, telling me what to tell my insurance company, but they’re really going to charge this. They had two different rates, depending on if you had insurance. It was shady, and I shouldn’t have to be worrying about this when I’m already hurt and upset. I had a big, black eye and I was in so much pain.”
She phoned her ex-mother-in-law, Julie Cline, a nurse at the hospital, to vent and muzzle her other impulse – to thumb through the Yellow Pages until she settled on a health care provider.
“It was crazy,” Angie said. “What was I supposed to do? Who do I call? I was on all kinds of pain medication and couldn’t think. I couldn’t believe I had to come up with some sort of plan,” insult adding to her injuries.
Cline gave her succinct advice: “We have the best group here in our bone and joint clinic in Dowagiac. I’ll call them for you.” Cline ended up being the nurse who did Angie’s antibiotics infusions. “She was comforting,” Merrill said. “It was nice to have somone I knew.”
That same day Angie met Dr. Michael Maskill and nurse Katie Coburn.
“She hugs me, tissues, ‘It’s okay. You don’t worry about the insurance or any of that stuff. Sit down, sweetie. It’s okay, sweetheart.’ You know what? I needed to hear that. It felt like my grandmother was taking care of me. I felt like I didn’t have to worry anymore.
“Dr. Maskill came in and he’s so upbeat and genuinely warm. He’s got a warm persona about him. He said, ‘Hey, Angie, this is no big deal. I’ve done these surgeries within the past couple of months.’ He spent years doing clinicals around the United States with one of the top surgeons who does these surgeries.”
His calm manner immediately put her at ease.
She underwent surgery Dec. 8 with Dr. Kurt Piatkowski assisting Dr. Maskill.
Her foot was “such a mess” it was like piecing together a jigsaw puzzle.
“I don’t know how they put it all back together,” Angie admitted.
“And it was so nice to see faces I knew at my weekly appointments,” she decided. ” ‘Hi, Angie, how’s it going? How you feelin’? You gettin’ around okay? You poor thing.’ Just tons of sympathy, but it meant so much having small-town people know me and recognize. Just that attention, to feel loved.”
That night, following her surgery, the nurses overwhelmed her with compassion and caring. One spent hours at her bedside when she couldn’t sleep. “We talked about paint, her son, her husband, my husband. I was scared and here I am in the hospital and don’t know what to expect when all this pain medication wears off. All of the nurses, I can’t say enough how wonderful they all were. They genuinely care and made everything seem like not a big deal and that it was alright.”
“You’re not going to get that in Kalamazoo. They’ve got other stuff to do,” Merrill said.
Another two weeks elapsed, along with Christmas.
It was time for Dr. Maskill to examine her foot again.
One spot was slow to heal with blood pooling as she elevated her foot to avoid excruciating pain when Angie placed any weight on it.
“We’re going to flush it,” he told her. “It’s considered a surgery, but it’s no big deal and takes about 15 minutes. I’ll take about four of your stitches out.”
Merrill compared the procedure to a “power washing” to clean out the wound and guard against infection.
“Unfortunately,” she said, “I had a small infection. Every time we had a bump in the road it was like no big deal,” even though she was acutely aware being hospitalized overnight and anesthetized seemed pretty big to her.
“But it didn’t feel so big and scary,” she said.
At least until the following day when he prescribed an infectious disease doctor in Kalamazoo.
“He said, ‘Angie, I am very aggressive when it comes to surgery and my patients. If it was my wife, if it was my mother, if it was my best friend, I wouldn’t do anything different. I want you to go to someone who looks at this every day – not a Dowagiac doctor who dabbles in it.’ ”
An outcome of that visit was a line in her arm like a permanent intravenous portal. “It’s a tube that goes in your vein and down into your heart. I had to do that for six weeks. I got it out (Feb. 18).”
Now she just has to overcome her apprehension to walk without crutches.
“It’s like when you’re a kid, standing on the diving board, and your mom’s standing there, and you know nothing’s going to happen because it’s just water, but you just can’t do it. That’s how I feel. Ice and snow are no excuse in the house. But Dr. Maskill and his nurse say, ‘Don’t worry, Angie, you’re doing great.’ When you’re ready, you’ll be ready. Everything’s going to be okay.’ He only tells me what I can handle. Dr. Maskill gave me his personal cell phone number and said if I had any questions or felt scared, he didn’t care what the reason was, to call him. I called him a couple of times, like after I saw the infectious disease doctor. I called him bawling because I thought my foot was going to fall off. He called me at 7:30 on a Friday night to tell me he got my bloodwork and everything looked okay. He wanted me to have a good weekend. What doctor does that?”
As she ended six weeks of daily visits to the hospital, a half-dozen nurses on Two North gathered around and applauded Angie.
“I want everybody to know they do great things up there,” Merrill said. “I can’t walk through that hospital without at least four nurses or doctors – or the cleaning ladies” inquiring, “How we doing, Ang? How many more days? They swarm to make sure you’re comfortable.”