Virginia goes to AAHKS

Virginia Goes to AAHKS

The first week of November, I had the opportunity to journey to Dallas, Texas and attend the 2017 AAHKS (American Association for Hip and Knee Surgeons) annual meeting. I spent 2 solid days listening to papers and symposiums, selected from over 1400 submitted, to be reviewed at the annual AAHKS meeting. Topics covered ranged from antibiotic coverage, to surgical technique, how to increase patient outcomes and avoid patient complications. In addition to the talks presented, there was a large exhibit hall with vendors demonstrating everything from surgical implants to positioning devices and products to aid in patient care. I was also able to visit with and discuss processes with other orthopedic providers. It was a great learning experience and I look forward to bringing back to our practice the new evidence based recommendations and assisting to implement them at Tadje Orthopaedics.  

Meet Mikayla

Why do you work with Dr. Tadje and his team?

My name is Mikayla and I am Virginia and Dr. Tadje’s medical scribe. As a medical scribe, I accompany Dr. Tadje and Virginia as they see patients and dictate their notes for them. I detail the history of the injury, hands-on exam, imaging reads, and treatment plan. I have been with the Tadje Ortho team for about 8 months, and let me tell you, it was the best decision I have ever made.

My medical field journey began with working as a CNA. I had worked in both skilled nursing and assisted living facilities in high school and college, so upon graduation, I was ready for a new and exciting challenge. I began working at St. Luke’s as a Unit Clerk/CNA on the orthopedic/ENT medical/surgical floor. This is where I met Dr. Tadje. He rounded on several of our patients as an orthopedic hospitalist. He was always a doctor that stood out to me, because no matter who you were, he always made it a point to say hi or good morning. He seemed like a genuine person and it showed in how he cared for his patients.

One day, Dr. Tadje contacted me and asked me to join his team. While I was completely surprised and overwhelmed, I was excited for the opportunity to work with Dr. Tadje and to meet his team that he spoke so highly about. Little did I know, his team was even better than I could have imagined. They welcomed me with open arms and have taught me so much.

Since joining Team Tadje, I have encountered countless experiences that have shaped my future in the medical field. While Dr. Tadje is my boss, he and Virginia both are concerned about ME, as a person too, which is nearly impossible to find in the workforce anymore. While I strive to be a good employee, Dr. Tadje and Virginia are both supportive of my long-term goals in the medical field. I am currently undergoing the PA school application process. Dr. Tadje has allowed me to shadow him in the operating room and Virginia teaches me new things in clinic such as exams, injection techniques, and how to read x-rays. They both are role models to the caring and invested provider that I aspire to be someday. Steve, our x-ray tech, has taught me several x-ray techniques in his spare time. Tracy, our nurse, has taught me how to authorize and order MRI’s, take medical histories on patients, draw up injections, cut casts off, and remove staples and stitches. Teia and Lacey have taught me about our EMR and insurance coverages. All of these aspects are things I would have never learned without coming here.

Until now, I had always worked at a “job.” Now, I genuinely look forward to coming into work. I get to work with amazing people and learn while doing it, what more could I ask for? I love working with a team that is dedicated to their patients and that puts patients first. And while I may not be with the Tadje Ortho team forever, I will forever remember them and what they have done for me.

~Mikayla Taugher

Coltin's Story

Foot vs Commercial Lawnmower

Coltin Steele grew up in Eagle, Idaho as a confident, tough farm boy with a large supportive family. In June 2010, life became especially busy for him. He was working hard mowing fields and preparing for his upcoming wedding. The day before his wedding, his time was already filled with last minute preparations when his friend asked him to take over a mowing job for him. Coltin agreed, but felt quite rushed.

As he started mowing the field with an old tractor and mower, one of the wheels became wedged against a fence post. Normally, he would have turned off the machine before unjamming the wheel, but he was in a hurry and the tractor was old and difficult to turn off. He decided he would just move the wheel quickly and be on his way. That decision changed his life. As he tried to maneuver the wheel loose, he lost his footing on the wet grass and slipped into the back of the mower. He quickly pulled himself out, but to his dismay, his shoe was completely gone and his foot was severely damaged. All he could think was, “I can’t believe this just happened. This is NOT good.”

Instantly, he started making phone calls. The phone call to his father was particularly distressing as the shock of what had just happened began to sink in. His family, along with his fiancé, Candice, and her family rushed to meet him at the hospital. When he arrived at the ER, the on-call doctor immediately assessed him and determined that his foot was not salvageable. The doctor started preparing to amputate Coltin’s leg up to his knee. His family was devastated. They promptly decided to do whatever was in their power to avoid that outcome. They knew Dr. Tadje personally, so they started trying to track him down. Dr. Tadje was headed out of town with his family, but as soon as he heard about Coltin’s predicament, he rushed into the hospital to see what he could to.

Dr. Tadje promptly took over Coltin’s care, and much to the family’s relief, had a more hopeful prognosis. He pledged that he would do everything in his power to save Coltin’s foot. Though there was no guarantee that the surgery would be successful, the skin would survive, or the foot could be functional in the future, he promised to try. Coltin’s family was overwhelmed with gratitude, and decided that anything was better than amputation. They decided to move forward with a reconstructive surgery, remaining full of cautious optimism.

Dr. Tadje expertly handled the long surgery, and was able to successfully piece Coltin’s foot back together despite how badly it had been mangled. For weeks, Dr. Tadje nursed Coltin’s foot and little by little it started to heal. The process was long, painful, and traumatizing for both Coltin and his family. He had been knocked down and his confidence was tried. However, he clung to positive thoughts like a lifeline.

Incredibly, he and Candice were able to get married just 3 months later. His healing process was far from over, but the worst was behind him. Within a year, he was selling security systems door to door. This job required him to walk all day. At first, his foot ached so badly he could hardly cope. But gradually it became stronger. Not long after, he was able to return to sport and enjoy his favorite activities again. Though in the beginning he took some guff for an embarrassing wipe out on the indoor soccer field, no one ever knew he had a compromised foot.

He and his wife now enjoy a wonderful life together. Coltin has graduated from Boise State and has a great job. He and his wife have twin toddler girls who keep them very busy. They are grateful to Dr. Tadje who opened doors that were threatening to close. They are grateful for the willingness to try and save what had been deemed unsalvageable. Coltin can’t claim to have a beautiful foot, but he has a fully functional foot that allows him to live life to the fullest. And for that, he is incredibly thankful.

Virginia's Story

Why do you work with Dr. Tadje?

Although there are many reasons I work with Dr. Tadje, one of the main factors in my decision to work at his practice is his dedication to his patients. When I was getting my master’s degree, I was working at St. Alphonsus as a charge nurse in the Operating Room. Any time there was a level-1 trauma case admitted, they were sent directly to the emergency room. One night, a patient with a level-1 trauma injury to his foot was admitted, and I was paged down to the ER. The patient was in his early 20’s, and his foot had been run over by a commercial lawnmower. This was a very significant injury, and his foot was in really bad condition. On top of that, I found out from some of the other nurses that the patient was going to be getting married within the next couple of days. The orthopedic surgeon who was working in the ER looked at the patient’s x-rays, and determined that the foot wasn’t salvageable, so it, as well as part of his leg, would need to be amputated. When they informed me of this decision, I was so upset because this poor young man was going to lose his foot the day before his wedding. We all felt badly for him, but there didn’t seem to be anything we could do.

Within 15-20 minutes of hearing that he would be losing his leg, I got a call from Dr. Tadje telling us that he was going to come to the ER to try to save the patient’s foot. It turns out that the patient’s family were close friends of Dr. Tadje's, so they had called and asked if there was anything he could do. Dr. Tadje and his family were on their way out of town for a vacation when he received the call. They were on the highway heading out of town, but Dr. Tadje decided to postpone the vacation and head to the ER to help his friend. He showed up at the ER and promptly took the patient to the operating room for surgery. Although it was difficult, he ended up saving the patient’s foot. It’s not a pretty foot, but at least he didn’t have to undergo an amputation. To this day, he is still walking around with a fully functional foot. I felt inspired that Dr. Tadje would put his vacation on hold to help a friend and patient. Seeing his dedication showed that he truly cares about his patients and his practice. I knew I wanted to work with someone who is so committed to putting patients first, which is something I value as well.

~Virginia Jeppesen NP-C

Meet Mitch

Fractured Fibula and Complete Quadriceps Tendon Rupture

The good news: I got to spend Christmas Eve 2016 with my family while I was visiting Idaho. 
The less good news: We had to spend it in the emergency room.

About 8:00 pm that night, I was in an accident that left me with a fractured fibula and a fully ruptured quad tendon in my left leg. If any of you were around during the winter of 2016, you’ll remember it was (not so affectionately) referred to as, “Snow-mageddon.” Credit that—and a little clumsiness on my part—for my adventurous holiday. 

I haven’t lived in Idaho since undergad, so not only was I facing an injury in a strange land, I had no idea what surgeon to consult to help me out. The ER doc told me he was setting me up with Dr. Tadje—whom I didn’t know at all—and my family all breathed a sigh of relief and enthusiasm. All of us are athletic and we’ve all injured ourselves enough to know something about the medical pros in our areas. My sister’s comment to me after the ER doc left was, “Wow, that’s terrific news. I wanted to see him for my shoulder—he’s one of the best in the valley.” 

And indeed he was. I didn’t get to actually meet him until two days later right before my scheduled surgeries—one to pin the ankle, and the other to repair the badly damaged quad tendon. 

When Dr. Tadje entered the pre-op room, I liked him immediately. He greeted me with a confident smile. I could tell he was smart and knew his stuff by the way he talked to me about the procedures I was about to undergo. But he was also smart without making me feel dumb (I work in marketing—medicine is a bit of a mystery to me).  That made me feel a lot more comfortable since he left me with a good idea of what he was going to do, and what I’d be facing in terms of recovery and physical therapy (PT) over the next several months. 

The surgery went well and was very successful. I went home that evening and all things considered, felt pretty good. But, I’m not gonna lie—once the anesthesia block wore off, the pain set in with a vengeance. Dr. Tadje had been kind enough to give me his private line, and while I knew he was headed out for his own Christmas holiday with his family, I texted him anyway out of sheer desperation. He responded immediately and gave me a supplemental drug for the pain. I don’t think I’ve ever had a doc respond so quickly—certainly not over the Christmas holiday. 

That first 48 hours was pretty rough—but I felt equipped to deal with it since Dr. Tadje had told what to expect, and he’d made himself available to help out. Facing those hours alone and without a doc who had not only informed me but made me feel like he was by my side, would have made it a pretty scary experience. But I never felt like I had to do this alone—Dr. Tadje was right there if I needed him. 

As the weeks progressed, I returned to California and my ankle healed well. Mine was a super complicated situation given both injuries (in fact, in the literally hundreds of hours I’ve spent on the web researching them I’ve never encountered someone who experienced both on the same leg at the same time), so it would be misleading to say it was a cake walk. And, it’s not exactly comforting to google your injury and have virtually every orthopedic website describe it with terms like “devastating” and “severely disabling,” so that—combined with Dr. Tadje being very honest with me about my recovery—helped me understand this would be a challenge.  

Dr. Tadje stayed in touch even after I went back to California, and proactively reached out to me to see how things were progressing. While the news for the ankle was good—it was a bit less so for the quad repair. One of the things that’s required to heal the quad repair correctly is vigorous PT, and because of the ankle break I was unable to do much of what was required to work on the quad repair. As a result, my knee built up a lot of scar tissue and flexion became an issue—due only to the complex nature of trying to deal with both injuries. 

In retrospect, I know we did the right thing by healing the ankle first so I could walk again and do the required PT for the knee. I was in a race against time, and given my body is one that builds scar tissue rapidly and in vast amounts, by the time the ankle was healed sufficiently my knee flexion was blocked by significant scar tissue build up. Despite my best efforts—and the best efforts of my awesome PT team in California, I became a candidate for a procedure known as “manipulation under anesthesia” or MUA. 

Because I’d been working so closely with Dr. Tadje—and because I liked and trusted him—I made the decision to come back to Boise to do the procedure. I’m slated to do that procedure in a little over a week, so my adventures with Dr. Tadje and his staff (who also rock, more about them in the next installment) will continue.  I’ve also made the decision to remove the ankle hardware this fall—and will once again be working with Dr. Tadje on that, so there will be a part three to all of this. 

“Why don’t you just have those surgeries done in California?” Yes, I get asked that all the time. And the truth is, I certainly could—there is no shortage of qualified surgeons in my area. But it’s important to me to know that the doc operating on me knows my case, is skilled, and is personally invested in my success. That made the decision to fly back to see Dr. Tadje pretty easy—he’s got all three qualities in spades. 

I do have one complaint, though—it’s about the scar on my knee. All my female friends are envious because it’s healed so beautifully and is almost invisible. But hey, I’m a guy and after going through this adventure I wanted a gnarly war wound to show off as a badge of courage! But kidding aside, I think it’s a pretty cool testimony to his skill that I can emerge from a major surgery like this without looking like Dr. Frankenstein rebuilt my leg. 

Oh, and maybe the best piece of news—Dr. Tadje told me to expect a full recovery. That means a lot to me as a weightlifter. In fact, a month prior to the accident I hit a personal best on my Romanian Deadlifts (RDLs) , at 550 lbs. The gym and working out are really important to me, so hearing Dr. Tadje say the words, “You’re going to make a full recovery,” meant a lot. And the best part: I believe him. 

Sometimes it can be tough to find things to be grateful for when you’re facing an ortho injury—large or small. But I gotta admit, I’m sure grateful I drew Dr. Tadje’s card that night in the ER. He’s made my experience a lot less scary and painful—for me, at least, that’s a surgeon worth keeping.