Monday, April 29, 2013

Waiting - updated

I still haven't heard from my Dr.
I have an appointment tomorrow with an in-network physician who prescribes the Exogen bone stimulator.  According to the guidelines, I meet the 4 criteria for prescription:  a non-union fracture less than 1cm, more than 3 months from injury where clinically significant healing has not occured.  I hope to get this devise as recommended by Dr. Rod and others.
I'm ok with missing this track season  ... if that's what it takes to avoid surgery and heal completely.

As my friend James Chinn said, I need to take the long view.  (James is having a great season, posting 200m times at age 54 faster than he's run in 3 yrs).

I'm waiting for the Dr. to give me instructions on what I can do.   He is under the assumption I want to run ASAP.  I wish I could talk with him again.  I don't NEED to run anytime soon.

Dr. Rod, a triathlete and orthopedic surgeon looked at my xrays and told me he thinks it will probably heal without surgery and NOT form a non-union.   Thanks Rod for your input!  He also suggested what many have already suggested:  using an Exogen ultrasound bone stimulator.

WHY hasn't my Dr. suggested this?  I left a message on his voicemail requesting a prescription for this devise.

I checked with Cigna and they cover it.   In their recently updated policy on such devises, they cover it specifically for 5th metatarsal fractures.

I just have to be careful.  I've not worked out in a week.  Maybe I should go tonight.

Will update as soon as I hear from Dr. Willers.

This injury is bad but not career ending.  I still may be able to sprint forever.


  1. It may be because "uncomplicated fracture healing is repairing at a rate that is near optimal".

    Read on..

    “concluded that, after an intensive review
    of literature, none of the studies involving the manipulation of biomechanical factors could show that the experimental as able to reach the healed state more rapidly than the normal control without adverse conditions.
    He further emphasized that many factors may improve the Early and mid-phases of fracture healing, but none seems Able to shorten the time required for the healed bone to
    Recover its normal mechanical strength.

    “The same statement may apply to all forms of biophysical stimulation in that most of the enhancing effects seem to exist only in early phases of fracture repair. This observation may relate to the fact that the late stage of bone
    remodeling is the longest period of fracture repair, which requires mechanical loading under the physiological frequency, magnitude and direction dictated by the musculoskeletal function. Such a process may not be entirely replaced by other means of enhancement without risking undesirable secondary effects. Therefore, the normal biologic
    response suggests that uncomplicated fracture healing is repairing at a rate that is near optimal. Enhancement of fracture healing, regardless of the type of intervention, would
    be indicated when the normal repairing mechanism is significantly


  2. "Enhancement of fracture healing, regardless of type of intervention, would be indicated when the normal repairing mechanism is significantly compromised.”

    I think Billy's current fracture condition caused principally by his post injury behavior. puts him in 'patient category' which meets the criteria above.... Therefore, an "Exogen" candidate at this point.