Current State Summary of Injuries and Next Steps
Updated as of 3/7/25
Injury History:
Face:
10/16/22: facial laceration, laceration of oral cavity, LeFort fractures at level I/II/III, bilateral orbit fractures, mandible fracture, in the surgeons words there was a "separation of face from skull" and fractures were "in such comminuted pieces it was hard to tell what bone came from where"
1/19/23: evidence of midface collapse, elongated middle facial third, concave midface deformity
11/27/23: saddle nose deformity with depressed nasal dorsum, scarring of left ala with asymmetric alar base. broad scar on nasal dorsum.
10/11/24: exposed plate in nose - “vertical buttress plate attaching at the maxillary left lateral incisor, which is slightly more angulated, now protrudes into the left nasal cavity” - removed 12/6/24
Right eye:
10/16/22: scar tissue pulling down lower lid, causing eye not to close
10/27/23 eyelid closes but there is severe ectropion eyelid
4/5/24 eyelid closes but continued severe ectropion
ectropion improved post 4/5/24 surgery
Mouth:
10/16/22: maxillary hypoplasia, apertognathia
11/27/23 still has malocclusion in the form of a crossbite
Right leg:
10/16/22: open FEMUR fracture, right ANKLE syndomosis repair with tightrope fixation, laceration of ANKLE
11/7/22: Heterotopic ossification (HO) near femur fx site (bone forms abnormally in soft tissue)
8/2/24: HIP: subtle tear of the anterior superior labrum, partial intra-muscular tear of gluteus Maximus
8/2/24: KNEE: fibrosis of Hoffa’s fat
Left leg:
10/16/22: open FEMUR fracture, ANKLE: open fracture of proximal end of L tibia (plafond fx/pilon fx)
8/2/24: KNEE: fibrosis of Hoffa’s fat, early signs of arthritis
Arm/hand:
10/16/22: open fracture of shaft of left ulna, laceration of hand, central slip of left ring finger, traumatic arthrotomy of proximal interphalangeal joint of the left ring finger, ulnar digital nerve laceration left long finger
6/5/23: non-union ulnar fracture
10/16/22: Acute respiratory failure following trauma and surgery, bilateral pulmonary contusion, postprocedural pneumothorax
10/16/22: Acute blood loss anemia and thrombocytopenia
Surgery History (16 total):
10/16/22 (2 at the same time) - facial reconstruction #1 (12 hours!), bilateral femur and ankle stabilization
10/17/22 - L ulna and middle/ring finger repair (ulnar digital nerve and joint damage)
10/18/22 - facial reconstruction #2
10/19/22 - bilateral femur repair with rods, R ankle tightrope fixation
10/24/22 - L ankle tibial pilon fracture repair
1/19/23 - mouth hardware removal and exposed plate assessment
6/6/23 (2 at the same time) - removal of two plates and additional screws from upper left mandible; repair of left non-union ulna with longer plate
10/27/23 - R lower eyelid surgery to correct malposition (spacer graft in middle lamella)
11/27/23 - segmental lefort with extensive bone grafting
4/5/24: R lower eyelid surgery to correct malposition (skin graft in outer lamella, canthal suspension)
11/26/24: removal of L ulna hardware
12/6/24: removal of exposed plate in nose on left side of face
12/12/24: removal of L ankle plates
2/27/25: tooth extraction and bone grafting
Current therapies and providers:
Taos PT every week
Home movement practice 3-4x/week for ~1 hour
Goal to include regular walks, stationary bike, yoga, pilates, and swimming into my routine
1x/day home scar treatments for eyelid, back of ear (skin graft donor site), left ankle, left forearm
Taos PCP for medication management and guidance
ketamine therapy for PTSD (started 7/19/24)
Taos Pain Injection Specialist for trigger point injections and prolotherapy every few weeks
Taos Chiropractor/myofascial pain specialist weekly-ish
Albuquerque Atlas Orthogonal Chiropractor as needed
Taos Massage and Structural Integration weekly-ish
Taos Naturopath trained in Ayurveda, Escogue postural alignment, energy work including core synchronism and craniosacral, and movement therapy including pilates and gyrokinesis, weekly-ish
Behavioral Health, with somatics and trauma release, weekly-ish
Albuquerque Oral Surgeons as needed
Albuquerque Orthodontist every 3-4 weeks
Angel Fire Dentist every 3 months
Co Springs Face surgeon to continue to monitor facial healing progress and guide next steps
Albuquerque Oculoplastic surgeon/opthalmologist to correct eyelid malposition and monitor eye dryness
Taos regular eye dr
CO Springs Neuro-ophthalmologist
Boulder Hip Preservation Specialist
Taos Orthopedic Surgeon for both legs/ankles, right hip
Albuquerque Orthopedic Surgeon for left arm and hand
Santa Fe Rheumatologist
Albuquerque Neurologist
Taos Dermatologist
Current state of injuries and next steps:
Face:
Facial fractures are healing well, though there is some evidence of midface collapse and fibrous union (scar tissue instead of bone); my facial scarring is healing very well
Continue to experience regular dull/aching pain from cheekbones down and most of face is also numb; regular shooting pain, burning sensations, and itching that can't be scratched into eye sockets, ears, nose, and upper lip
12/6/24: Surgery to remove the exposed plate in my nose, no complications. Bone seems stable, sinus smell is gone so no need to further evaluate sinuses.
coming up: 3/17/25 cosmetic plastic surgery
1) to create more symmetry by fat grafting and scar excision on the left side of my face. This will hopefully round out my cheek, remove/soften some of the scarring, and allow the left side of my mouth to come up more when I smile.
2) to add more shape to my nose via filler injections.
Eye:
Vision challenges: extreme light and reflection sensitivity since 10/27/23 that is likely a neuro-ophthalmology issue.
Anisocoria: every once in a while my right pupil dilates way more than the left, causing me to feel disoriented. This is also likely a neuro-ophthalmology issue.
Eye dryness: I am still experiencing a lot of dryness and continue to use eyedrops all day long and gel at night.
The first right lower eyelid surgery on 10/27/23 to insert a spacer graft in the middle lamella was successful, though the outer lamella also needed to be repaired. The second surgery to do a skin graft on the outer layer and canthal suspension on 4/5 was also successful and the surgeon dismissed me as of 7/10/24.
Now it’s up to me to continue with scar massage and gel to keep it healing in the right direction.
It is possible that I will continue needing surgeries on this eyelid for the rest of my life as it will continue to revert to pulling down and exposing more of the eyeball than is ideal. I will follow up with the oculoplastic surgeon if needed.
My skin graft site (skin from behind my ear to under my right eye) has started growing long hairs (yipes!), so I will explore electrolysis when I have time.
Next steps:
Waiting for MRI (still to be approved by insurance and then scheduled) to discuss with neurologist
Appointment with CO neuro-ophthalmologist on 3/13/25
electrolysis for hair removal
Mouth
I am under the care of an ABQ oral surgery team who are working closely with my ABQ orthodontist and other specialists as needed.
Jaw surgery was 11/27/24 and successfully leveled out my maxilla, which we are now working with orthodontics to fix occlusion (cross bite) and to determine what to do about the gap between two teeth on the upper left (I lost a tooth in the accident). If orthodontics can't fix occlusion, another surgery might be necessary on my mandible. It is also still likely that I'll need at least one implant.
Now that 'I’m able to chew again, I realize I’m having issues with salivation and swallowing. My orthodontist suggested chewing gum to help get my salivary glands working and to retrain my mouth/cheeks.
Now seeing a wonderful dentist in Angel Fire to monitor tooth viability and work on breathing and swallowing. So far all of my teeth remain healthy!
As of 1/8/25, my upper left bicuspid (tooth #12) appears to be failing and needs to be removed. I had surgery on 2/27/25 to remove the tooth and add more bone grafts. It is healing very well and was an easy procedure with no surprises!
My Orthodontist is basically finished with her adjustments and we’re just waiting to see how I heal and stabilize after my recent oral surgery. I may be done with braces in the next few months!
My dentist, orthodontist, and oral surgeon have worked together on a plan for post-orthodontic care which will include a bridge where my upper left bicuspid was removed, crowns and splinting on the three front teeth on each side. Now to work on getting insurance to cover the $14,000 bill!
Next appointments:
3/12, 4/2 with Orthodontist
TBD with Angel Fire Dentist
Left arm and hand:
6/6/24 surgery to repair my non-union ulna fracture worked! As of 8/4, I no longer have to wear a splint, can basically resume normal activity with a 15 lb weight limit for ~6 weeks, progressing as pain tolerates.
Left ring and middle finger continue to have pain, stiffness/restricted movement, and numbness, as well as pain in my wrist, forearm, and elbow…
The OT/Certified Hand Specialist has been helping me with scar tissue and nerve mobilization, as well as exercises to improve hand and forearm function. I continue to experience pain and stiffness on and off and have nearly exhausted all she can do for me. I am considering seeing the surgeon to discuss if removing the plate might help me progress even more. We had our final appointment 7/30/24 and now the home care program is all on me.
11/26/24 surgery to remove left arm plate was successful
Begin OT again 1/30/25 and am cleared for all activity with some home exercises that are going well. It is likely that my fingers will remain stiff and painful as there’s not much to do to help with that, but even just having this realization has helped me feel more comfortable with the pain/stiffness: it’s not something to fix, it just is…
Legs and ankles:
Mobility continues to improve and I continue to progress with my PT exercises and increasing walking distance again. I am building back up to my previous strength before back to back surgeries in fall of 2023. I continue to have regular pain in my SI joint, hips, thighs, knees, and ankles.
MRI and x-ray results: I have fibrosis of the hoffa’s fat pad in both knees, arthritis in my left knee, and a partial labrum tear and subtle tear of the gluteus Maximus in my right hip.
I had a cortisone shot in my hip on 10/28/24 and am still having pain. I met with the orthopedic surgeon on 11/5/24 and he referred me to a “hip preservation orthopedic specialist” in Boulder
12/12/24 surgery to remove L ankle plates was successful though many screw heads came off so I have more metal remaining than I expected and the surgery was more invasive than the surgeon anticipated; I’m healing well and gaining strength and mobility slowly but surely
Next steps:
continue home PT 3x/week and continue to see various other providers to help with pain and increased mobility
3/18/25 initial appointment with hip preservation specialist - orthopedic dr in Boulder
Insurance:
All of my 2022 and Colorado outstanding bills have been handled - my patient advocate is amazing! I am so grateful for all of her help.
As of March 2024, my dental-related reimbursements have been successfully processed through my medical plan, and I’ve received about ~$10k back. This is SO helpful!
I have a case manager assigned to help me with 2024 continued care approvals. I will still have to navigate approvals for all of my care moving forward but it should be somewhat straightforward and easy compared to what we have had to deal with.
Starting in Oct 2024, I was getting calls again from the collections agency about my initial ambulance bill that has not been paid. Finally in early 2025, the bill was dropped and I am officially clear from collections agency trouble!
Now that my dental-related care is progressing, I’m back to the battle with BCBS for getting my care covered. What a headache!
