Fracture

Humanitarian Trip to Cambodia

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In 2017, Dr. Tadje took a humanitarian trip with his son Andrew, to Phnom Penh, Cambodia. They were able to provide much needed assistance to a place called CICFO (Cambodia International Children Friendship Outreach). CICFO is a home where about 30 children live in a family environment, so they can attend school. The children are accepted through an application process and are able to live in this home until they are finished with their education. An organization called CICFO-USA raises funds to support the needs of the CICFO family. The CICFO children travel occasionally to visit their birth families, but CICFO is their true home. The children live as a family, sharing meals, chores, love, and support. CICFO is an upgrade for the children who are used to living in absolute poverty. However, even at CICFO, the children sleep in unbearable heat, packed together on the ground, owning nothing but the clothes on their backs. Dr. Tadje and his son wanted to help.

They spent a week staying with the CICFO family. They worked with Kea Botevy, the head of the home, to tackle projects that would improve the children’s living conditions. Dr. Tadje and his son bought some mattresses for the kids to sleep on and installed fans to help with the intense heat and humidity. The Tadjes were able to create a safer living space by covering exposed wires. They read with the kids and played ball with them. Dr. Tadje was impressed with these amazing, impoverished children. In spite of their circumstances, they are happy and optimistic about life. They are content. They look out for one another and work together to provide a safe and peaceful space to exist and grow. Dr. Tadje was grateful for the opportunity he had to help and learn from the CICFO family.

Written by: Rebecca Howard

Tracy's Thailand Trip 2018

Our Nurse Tracy Travels to Thailand

 

In January, my husband and I traveled to Thailand as a part of the Trauma and Emergency Management Program. This program provides training, support and essential medical supplies to mobile, community-based “backpack” medics. The “backpack” medics hike through difficult terrain to deliver lifesaving emergency care to people in remote, landmine-contaminated areas of eastern Myanmar (Burma).

On the plane from San Francisco, California to Bejing, China.

On the plane from San Francisco, California to Bejing, China.

 

Our Journey began on January 24th, 2018. We flew from Salt Lake City, Utah to San Francisco, California then to Beijing, China. After a 24-hour layover in China, we finally flew to Yangon, Myanmar (Burma) to begin training. The initial trauma training was supposed to take place in Burma, however due to political instability in the region, the training was moved to Mae Sot, Thailand. Since my husband and I were already in Burma, we decided to stay and explore the city.

The training took place in Western Thailand, in a district called Mae Sot (see border of Thailand and Myanmar).

The training took place in Western Thailand, in a district called Mae Sot (see border of Thailand and Myanmar).

 

While in Burma, we stayed at the Hotel Kan Yeik Thar, located in Inya Lake. Hotel Kan Yeik is approximately 15 minutes from the Yangon International Airport. From there, we toured the city on foot and via Uber/taxi. We visited the Yangon Zoo, Inya Lake, and the Shwedagon Pagoda.

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This beautiful landmark (shown below) is a stupa or dome shaped structure. The stupa houses Buddhist relics and gives the people of Myanmar a place to worship. We toured the pagoda with an English-speaking tour guide, took photos and loved learning about its history.

 

We left Yangon on Sunday, January 28th. We flew to Mae Sot, Thailand to meet the rest of the TEMP team. There were 7 team members which included 4 trauma/ER doctors, and an RN. The training began on Monday, January 29th. While in Mae Sot we stayed at the J2 hotel. The J2 was our home for 7 days while we attended the training.

 

The length of the training was 6 days. It took place in a classroom located next to a now abandoned hospital. The “compound”, as they called it, was now used to house the students while they attended training. Each member of our team was assigned specific subjects that were used to teach the medics. Some of the subjects included: Anatomy & Physiology, Limb Injury/Amputation, starting IV’s and pregnancy and childbirth. Bryan and I were given fracture/dislocation, splinting and bleeding management. We also assisted with a “jungle operating room” which included the pig lab. On this day we studied and taught anatomy using pigs from a local farmer.

We started each day with an activity or “ice breaker”. Since the students did not speak English, it was a good way for all of us to get to know each other without having to use the translators. One morning Bryan and I decided to teach them the Macarena!

 

Some of our responsibilities during training included making and building models for the medics to use in class. We used sugar cane and paper towels for the fasciotomies and nebulizer tubing, as well as gloves for tracheotomies. For the abscess lab, we used sponges and strawberry yogurt.

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Although the training took up a lot of our time, we spent most of our evenings trying out the local cuisine with the rest of the team. Family style is how they do things in Thailand, and boy, did we eat!

 

We met so many wonderful people and learned so much while on our trip. But after almost 2 weeks we were ready to go home and share our experiences with friends and family.

 

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We hope to someday return to Thailand!

Thailand Trip 2018- Trauma and Emergency Management Program

Tina's Long Road to Recovery

Tina's Long Road to Recovery

By: Rebecca Howard

Tina Fitzgerald used to be a medtech. But in 2013, one of her patients accidentally parked an electric wheelchair on top of her right foot. It took 6 people to finally remove the chair. Her foot had been completely crushed. Her active, outdoorsy lifestyle came to a screeching halt. She found a doctor who performed and failed 2 foot surgeries. She was left unable to work, with daily pain and a foot that hardly functioned.

 

Fast-forward to Christmas day, 2016. Tina and her husband were heading into a friend’s house to celebrate, when Tina slipped on some black ice. She fell hard on her left hip and hit her head on the side of the house. She woke up a few moments later in terrible, nauseating pain. But it was Christmas and she was embarrassed about the fall, so she decided to just keep the pain to herself.

 

Days went by and the pain didn’t improve. She thought maybe it was her bulging disk acting up. She took ibuprofen, but nothing helped. No matter what she did, it felt like she was being stabbed in the groin. She couldn’t walk up stairs, she couldn’t get into a car, she couldn’t dress herself, she couldn’t push her handicapped dog in his stroller. Going anywhere was excruciating. It even hurt to lie down. She was used to limitations because of her foot, but this was beyond anything she had experienced. 6 months went by and she kept hoping for relief, but the pain was actually getting worse. She needed answers. Now.  

 

She went into her spine doctor, who gave her a spine injection, but it didn’t help. One day, she thought maybe a bath would bring some relief. But when she couldn’t get out by herself, she told her husband she had to go see a pain manager right away. The doctor did an X-ray of her back and ordered an MRI. The MRI came back normal, but Tina and her husband knew with absolute surety that something was wrong. They kept trying to find someone to help, but no one would listen.

 

One day when she stood on her tip toes to put a coffee mug on the top shelf, she felt a distinct and painful separation in her hip. Her foot felt like it was 100 lbs. That was the last straw. She went to ER, but they wouldn’t do another MRI since her last one had been normal. Tina and her husband were beyond frustrated. They were desperate for answers and a reprieve from the constant pain. Her spine doctor agreed to order another MRI, this one for her leg instead of her back. They weren’t even home before they received a phone call that she had a fracture in the neck of her femur.

 

Tina’s husband had been seeing Dr. Tadje for some issues with his shoulder, and really liked him. He called to find out if Dr. Tadje treated femur fractures. They found out he does! Happy day! They talked to Teia, the office manager, and told her their situation. She consulted Dr. Tadje, and he agreed to perform surgery for Tina the next morning. Finally, someone who would listen and agree to help! At that point, she had been coping with her fractured hip for 9 months.

 

Tina met Dr. Tadje the next morning before the surgery. Because of the 2 failed foot surgeries in her past, she was terrified of a bad outcome. Dr. Tadje reassured her that he had spent time the night before researching the best method to treat her fracture. She was within inches of needing a full hip replacement, but since she had a small portion of bone still intact on one side, he would be able to attach some screws so her natural bone could heal. And best of all, he was able to find a way to make her hip immediately weight bearing. She had been expecting to be confined to a wheelchair for 6 months, so this was very good news.

 

When she woke up after the surgery, she was surprised and excited to find that the pain was gone! No more stabbing. After one night in the hospital and some training from a physical therapist, she was up and moving with her walker. It was a miracle! A complete turnaround within a day! Now, a few months later, her limitations from this injury are non-existent, and her quality of life is markedly better. She only wishes she would have known about her “rockstar,” Dr. Tadje, for her foot surgeries. Dr. Tadje has given Tina her life back, and she’s excited to live it to the fullest.  

Meet the Koubas

Fast Rides, Tough Breaks

By: Rebecca Howard

The Kouba family is the kind of family that’s always on the move. Jennifer and Charlie Kouba
introduced their boys, Austin and Bailey, to motocross at a young age, and they were instantly
enchanted. They ate, slept, and breathed motocross. They spent their time either riding or
thinking about their next ride. But those who know motocross, know it carries a high risk for
injuries. Austin and Bailey have both had a good share of wounds through the years.
Consequently, Dr. Tadje has been a valuable part of their lives over the last decade.


At 13 years old, Austin was speeding around a corner in an intense race at Owyhee Motorcycle
Club when his front wheel lost traction. His whole body propelled into the handlebars with so
much force, his femur fractured. From the stands, Jennifer and Charlie could tell something bad had happened when they saw Austin lying on the ground. They watched the paramedics rush in to assess the situation. Upon seeing Austin’s bone protruding through his motorcycle pants, the paramedics instantly called an ambulance to transport him to the hospital. In the ER, Jennifer and Charlie were overwhelmed with stress and worry as they awaited treatment. When Dr. Tadje walked in to consult with them, they describe feeling instant comfort. Dr. Tadje explained that Austin’s femur had an open fracture, and at age 13, there are 2 possible treatments for this type of injury. Inserting a rigid rod would allow Austin to walk on his leg within a few days, but there would be risk of compromising the growth plate. Inserting a flexible rod would put Austin in a wheelchair for 6 weeks, but it would preserve the growth plate. The Koubas were relieved to find out Dr. Tadje is a father, and asked him what he would do if Austin were his child. Dr. Tadje recommended the flexible rod. Even though the process was longer, Austin’s femur healed beautifully. Dr. Tadje and Austin had an instant bond. It’s a good thing, since they would be seeing a lot of each other throughout the years!


The next time the Koubas needed Dr. Tadje’s help, Bailey was the one in the spotlight. At 12
years old, Bailey was in an off road desert race. As he raced down a sand wash with dozens of
other bikes, he hit some extra rough terrain and flew off his bike. A motorcycle ran over his arm
as it raced past, fracturing his radius. They instantly knew who to call. Dr. Tadje performed the
necessary surgery and Bailey was able to move and shift within the week.


A few years later, Austin was racing at OMC again when his front wheel lost traction and his
shoulder hit the ground hard. Fractured Collarbone. The Koubas wondered if maybe Dr. Tadje
would preach or apply pressure to give up the sport. But they were grateful when all they got
from Dr. Tadje was understanding and support. Austin asked Dr. Tadje to do whatever he could
to get him back on his bike as quickly as possible. Letting it heal on its own would take months, but surgery reduced the time to weeks. So, of course surgery was the answer!


Something similar happened to Bailey shortly after, while arena racing in Utah. He came up
short on a jump and… fractured collarbone. The Koubas brought him back to Boise where Dr.
Tadje fit him in for a quick surgery so the family could take off for a vacation.


Since then, the Koubas have reached out to Dr. Tadje for help on several other occasions. Dr.
Tadje has continued to be close to the family, most recently supporting them as Austin healed
from an open fracture of his forearm.


Now at 20 and 22 years old, Austin and Bailey don’t have as much time for their favorite sport
as they used to. While most of their time is spent working and going to school, they still find
plenty of time for camping, mountain biking, trail riding, racing, and off roading as a family.
Their active lifestyle has shaped them into the people they have become, and they are grateful
for the experiences they have had and for the tremendous care and support have received from Dr. Tadje. They are grateful for his knowledge and personal touch, and that in a very real way, he has made their active lifestyle a possibility. Who knows what the future will bring, but they’ll definitely know where to turn if something goes south.

(Orange Plaid: Bailey, Green: Austin)

Meet Teia - Our Receptionist/Office Manager

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

It all started in 2007, when I moved from Reno, Nevada, to the great state of Idaho, to be closer to my Grandparents. I was blessed enough to quickly land a job as a Certified Nursing Assistant at St. Alphonsus in Boise on the Orthopaedic Trauma floor. While I had been a CNA on an Orthopaedic joint replacement floor in Nevada, the difference in care, medical procedures and technology was astounding. I had never been exposed to Orthopaedic trauma before and I quickly grew to love it. Through the five years I worked for St. Alphonsus, I got to know many different Orthopaedic surgeons. While they were all wonderful and skilled, one really stood out to me – Dr. Tadje. He was so kind and compassionate, and it was evident by watching the way he interacted with patients that he not only had a true passion for his work but also for helping others. While there are so many different stories I could tell (read Coltin’s Story below), I remember one in particular. I was working with a patient that had been critically injured in a motorcycle accident when Dr. Tadje happened to stop by to check on him. The patient had a head injury, multiple fractures and a long list of internal injuries. Although the accident happened almost a week prior, it was the first time the patient had been able to meet Dr. Tadje because he had been unconscious. Dr. Tadje shook his hand, pulled up a chair and sat down next to the patient, which was something I’d never seen any doctor do before. He talked with the patient for quite some time, detailing the multiple injuries he sustained, how he had treated each injury and what the patient should expect as a result. Dr. Tadje and the patient continued to talk about “normal life” things – family, kids, work and hobbies. Before leaving, the patient thanked Dr. Tadje for “putting me back together.” Dr. Tadje promised him that he would do his very best to care for him so that he could get back to playing with his kids. Once Dr. Tadje left, the patient looked at me and said, “I think he really means that.” After watching Dr. Tadje interact with the patient I was able to confidently say “I know he does.” From that moment forward, I knew Dr. Tadje was not only a skilled surgeon, but also as a kind, caring and uniquely compassionate person.

Over the next several years I completed a bachelor’s degree in Health Science Studies and was lucky enough to continue to work with Dr. Tadje on the Orthopaedic floor at St. Luke’s.  A little over two years ago Dr. Tadje asked me to join his team. After doing inpatient orthopaedics for over 10 years, leaving the hospital was the hardest decision I’ve ever made, but I knew I couldn’t turn it down. I had always thought of Dr. Tadje as top-notch, and while I expected his team to be as well, I’m still surprised and amazed at how awesome they are. Virginia is so thoughtful and deeply cares about her patients, many of whom she knows on a nearly personal level. Tracy is all about making sure every patient is taken care of. Mikayla is detailed and on the path to become a PA. Steve, has years of experience as an x-ray tech and enjoys talking with our patients. Lacey, our newest team member, has a heart of gold and fits right in. Each day I go home knowing that every person I work with genuinely cares about our patients, not just for them.

In addition to working with an amazing crew, I also get the opportunity to know our patients over time and to watch as they improve. Whether it’s a work-related injury, a fracture or a condition earned after years of having fun, I know that our patients are going to get the best treatment in a kind and caring atmosphere. For me, the best thing about being a part of Team Tadje is watching our patients get back to doing the things they love.

~Teia

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.