Cipro, Levaquin and my shattered left ankle

Cipro , Levaquin and my shattered left ankle

-thanks Public Citizen, CNN and Google

My left ankle shattered about 10 a.m. Saturday, April 5, 2008. I have no memory of the event.

I last remember sitting back in bed to finish the newspaper. During the period I cannot recall, I apparently was able to function despite what must have been intense pain as my husband found me screaming on my bedroom floor. Upon becoming aware of my circumstances about two hours later in the ER at the Ocala Regional Medical Center with my left foot extended in an unnatural position (“ fall injury with severely displaced distal ankle fracture”), I asked to speak with my husband. The attending nurse said I had already done so three times and neighbors later reported that I had spoken to them as the ambulance took me away. I had no difficulty recalling telephone numbers during and following my black out.

After an x-ray, CT scan and MRI of my brain along with a cursory interview with a neurologist (Dr. Nieves), the surgeon (Dr. Nirav Gupta) put a plate and a couple of screws in my left ankle the next day. Operative report describes procedure as “open reduction and internal fixation of lateral malleolus and medial malleolus ankle, left side.”

Following my hospitalization and several weeks at the TimberRidge rehab center, I insisted on seeing another neurologist in an effort to determine just what precipitated this event so that I wouldn’t again injure myself or possibly others should I be driving at the time. The second neurologist (Dr. Jose Gaudier) did an exhaustive interview (with my husband present) and ordered a carotid artery examination and an EEG of my brain. Again, nothing abnormal was found.

On July 9, 2008 I heard Dr. Sanjay Gupta report on the links between Cipro and broken tendons and other injuries the day after the FDA issued its “black box warning.” Public Citizen had requested such a warning in August 2006 and Dr. Gupta said on his broadcast that doctors have known about the dangers of the drug since 1992. The FDA approved Cipro for use in 2000 and Levaquin in 1996. None of the doctors who’ve seen me have mentioned, suggested or even implied any causal possibility between use of Cipro and/or Levaquin and the injury I endured. Moreover, after googling the drugs and ankle injuries, I found that there are literally hundreds of personal reports of injury similar to that which I have.

Despite a predisposition to avoid unnecessary drugs, I had not earlier connected repeated use of Cipro and more recently Levaquin to my accident. I simply ascribed the following to stress as a caregiver for an extended period.

Before my Father died May 1, 2005, I experienced difficulty stepping out of bed because of pain on the bottom of my left foot. I could not even go to the bathroom without wearing shoes. . More recently I have had trouble standing at peace rallies and walking my dog. I also have felt faint at various meetings and luncheons. . Occasionally the pain on the bottom of my left foot upon getting out of bed recurred. I simply chalked up these episodes to my exhaustion in caring for a disabled husband who is unable to contribute much to running the household and to my activities in the community. Fatigue has been a constant in my life for many years along with shortness of breath and general lassitude.

During recent years I have taken Cipro fairly frequently for recurring urinary tract infections. Last November when an infection did not respond to Cipro my internist, Dr. Jose Roman , sent me to a(n) urologist, Dr. Paul Jo, who prescribed Levaquin.. Because the infection had persisted and I wanted to rid myself of it, I took the Levaquin DESPITE the fact that I experienced considerably more severe pain on the bottom of my left foot than I ever had before. Since Dr Jo gave me a prescription with 12 renewals (?) I took Levaquin again when a UT infection recurred yet again in February, I believe.

In the months just prior to my accident I also experienced several very brief transient surges in my brain like flashes of electrical charges – basically the left rear quadrant as I recall. Then about a week or ten days before the accident I had an earache on the left side which later extended into my left jaw . I’ve had good dental care and the only thing wrong with my mouth is that a crown has fallen off a tooth. But my husband, a disabled dentist, said there was no cause for concern as it could not be a source of infection since it had a root canal. Nevertheless I went to see a dentist, Dr. Stephen Dunn ,on March 27, I believe. Dr. Dunn, after taking new x-rays, concurred with my husband’s assessment. However he said that if the pain continued he would send me to a neurologist in case I had trigeminal neuralgia. I was first to return to Dr. Dunn about ten days later. After reading about trigeminal neuralgia online and because the pain had subsided, I knew I had not experienced this disorder. The accident occurred before I was able to return to the dentist.

Please note that I was again taking Levaquin for the recurring urinary tract infection.. . When I got to the rehab center the attending physician (Dr. Gabriel Umana) put me back on Cipro because he said that it was the standard for UT.

I’ve since had much outpatient therapy but still am not able to walk well and the foot/ankle remains in large part immobile ( like concrete as one therapist observed), swollen with scarring and a protrusion on the right side where the screws were inserted. Surgeon who I see again July 24 opined that injuries such as mine take 9 months to a year for recovery although he acknowledged that the ankle will not ever be entirely normal. My surgeon and the therapists said that any injury to the foot is the most difficult to recover from (worse than hip, pelvic fractures) because the foot bears the weight of the entire body.

Although I am now 72 years of age, my parents were long-lived. They both walked every day with my Father even mowing the lawn up north until he was 98. My Father died totally competent just three weeks short of 100 and my Mother died at age 91 of breast cancer which had metastasized. Thus I have expectations of living another 20 years or so, especially given the fact that I have always been well fed, have always had good medical attention and have never indulged in personal excesses of any kind. Dr. Roman, our internist since moving to Ocala in September of 2000, has always authorized routine checkups and appropriate tests for whatever ailment I may have had over these years including a bone density test just months before the accident.

I have learned that there is an array of drugs which were used effectively for urinary tract infections before Cipro and Levaquin were put on the market. Apart from the pain and disruption to both my husband and my lives and the psychic and financial costs involved thus far, I am most appalled at the prospect of circumscribed use of my legs for the rest of my life . I hobble around the house, I can’t garden as I used to and my golden retriever breaks my heart by bringing me her leash for a walk.

I suddenly am old.