Let’s just skip past the tedious, excruciating and slightly embarrassing details of my injury and begin just after I’d limped into the orthopedic exam room in 2012. My right ankle has never been an ally, but while I didn’t expect a pat on the shoulder, I had hopes of a solution I could live with. When the surgeon finally appeared with an intern in tow, he opened with, “You aren’t going to like this.”

Mind reader. Yes, none of it was good. Holes in bones, messed up ligaments. No wonder I was experiencing “discomfort.”

“Your running days are over,” he stated before outlining his “fix,” ankle fusion, which frankly, sounded less like a solution than it did a life sentence.

“Won’t walking with a frozen ankle hurt my hip?”

It wasn’t a long drop to “bottom.” From that desolate place —a future with no running, limited hiking, flat uninspired footwear, a potential limp and accelerated arthritis in proximate joints —I had to get a grip. To allow this life limiting, permanent repair, I would have to be certain it was truly my only option.

It wasn’t. While ankle fusion was considered “standard treatment” for my injury and relative youth, there were at least two immediately obvious alternate routes. I enlisted my aunt, and, together, we Googled new technologies, clinical trials, medical papers, forums and conference notes. I phoned and emailed doctors and nurses throughout the US and abroad. I sought out former patients —even speaking with a professional football player who kindly phoned me on his way to training practice. When attempting to get my insurance company to cover out-of-network surgery in New York as an in-network event proved fruitless —“You can’t seek medical authorization of your own surgery! I can’t believe no one caught this before now!”— and the Ohio Department of Insurance confirmed no successful appeals, I moved on and researched my in-network options again. By now, I was fairly knowledgeable of both my injuries and treatment alternatives. Finally some five months after that initial appointment, I scheduled surgery with another highly qualified surgeon whom I had grown to trust.His solution involved, in very simple terms, two bone grafts and a ligament graft. His aim was to repair my ankle and restore missing cartilage without shutting the door on future medical advancements.

What I Learned:
1) Your doctor is a problem solver seeking to fix your problem from his own personal set of tools. Don’t assume he has researched the latest solutions for your particular issue or that he will have time to seek out alternate ideas from respected colleagues. His aim is to repair your injury in a manner your insurance company is likely to cover.

Always, always, always seek a second or third opinion for major medical decisions. Yes, it may cost you a few co-pays, but pro-rate that money over the years ahead. You’re paying for information that will impact the rest of your life, so price it accordingly.

2) He’s intelligent, but he doesn’t have all the answers because the answers change all the time. Good doctors never stop learning, but they also have to treat enough patients to cover their exorbitant malpractice insurance.

Researchers and scientists progress our understanding of medical possibilities daily. Pair that with lightning fast advancements in technology, and no matter how committed a doctor may be it’s almost impossible for him to keep completely current while also working a medical practice.

3) It is unlikely you will be given all your options, so you will have to do your own homework. Get the correct medical terminology as well as the more patient-friendly terms for your issue(s), and surf the Internet using keywords for your condition or injury. Search for both standard and “alternative” treatments. Check for long-term results with each potential treatment. Will committing to one treatment now limit your options if it should fail? What options are likely to be available in two years, five years…? Look for both positive and negative outcomes other patients have experienced, and seek to understand worst case and best case scenarios so that you can properly evaluate your risks and likely longterm ramifications. Most importantly, investigate potential surgeons. Who is actively learning, teaching or researching your condition and surgical procedure (s)? Does your surgeon attend seminars—or lead them?

4) You may offend a doctor —or two, if you’re me— but that’s OK. It’s your life. Would you politely stand by while a helpful bystander attempted to swat a mosquito off your head with a hammer? Of course not. Be respectful. Be appreciative —your doctor has put in years of study and experience. But own it. Ultimately, you are in charge of what is done to your body. You get to take it home and live with the results. It’s OK to say “no” or “I need to think about this” or “I’d like to get a third opinion.” Ask about success rates, probably outcomes, and if there is anything you personally can do to enhance your recovery.

Sometimes it won’t work out. Bad chemistry happens in business and in dating. It also occurs with medical professionals. Be kind and courteous, but don’t sacrifice your health for the sake of social niceties.

5) Be prepared to wait on your best option because a “quick fix” may be costly. The first time I underwent ankle surgery ten years earlier, I had three young children and scheduled surgery with the first recommended surgeon. I’ll never know if I might have had better results because in my hurry to reach a solution, I failed to investigate all available methods (and surgeons) to achieve it. Aim for a non-emotional decision over an emotional response.

There are true emergency situations where your only choice is immediate medical action. But most of the time, you have time. See if there is a way to stabilize your situation while you investigate your choices. During the weeks prior to my surgery, I used crutches and even my old surgical walking boot as needed. I wore a sturdy ankle brace for a Colorado hiking trip with my kids, stepping carefully through the snow fields —What was I going to do? Mess up my ankle? When I was finally comfortable that I’d found the right solution for me, I scheduled surgery for the first available date after my kids’ fall sports seasons ended.

No, there is never a convenient time for a single self-employed mom to have surgery, but there are times that are less horrible. For each of us. Do your homework, and aim for one of those.

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For more strategies and inspiration, download “Stuffing Sandwiches Down My Shirt!” Yep, I did that…


“…Ms. Dugan uses her upbeat humor to share her own thoughts and creative solutions to the very real challenges encountered during recovery from surgery. She also shows how one can take ownership of their recovery and stay active in the recovery but in safe and practical manner. As a surgeon, I will strongly recommend my patients to read this perspective BEFORE their procedure when possible so they can be as knowledgable and proactive as possible…”

“”Sandwiches…” is all about attitude with a capital ‘A’. Attitude makes the difference between ‘waiting-for-it-to-be-over’ and meeting the post-surgery challenge creatively ‘armed’ and with gusto… “Sandwiches…” is more than a DIY manual – it’s as if Heather becomes your personal mentor urging you to adopt your own “yes, I can” attitude…”

Download on Amazon, Barnes and Noble or at the iBookstore, and watch for the paperback edition, available soon.