Midway through October 2021, Eric MacAulay noticed a nagging pain in his right foot.
Figuring it would go away soon enough, he didn’t give it much thought.
MacAulay, 30, kept hustling to fill orders and make deliveries for his small business, which produces bottled cocktail kits.
At the same time, he poured his energies into preparing for an upcoming wedding celebration with his wife, Taylor Ballek. The late-October event, delayed by the pandemic, commemorated the pair’s elopement two years earlier.
After the party, the couple, residents of Grand Rapids, Michigan, capped off their celebration by spending a week in New Orleans.
By the time they got home, MacAulay couldn’t walk without limping.
“It started as a dull pain that I thought was going to go away on its own, but it didn’t go away. It just got worse,” he said.
With the holiday season approaching, he made fixing his foot a priority.
Orthopedic Urgent Care
Ballek advised her husband to contact the Spectrum Health Orthopedic Urgent Care clinic on Lake Drive, which provides specialized ortho care six days a week, with or without an appointment.
“I didn’t know that hospital systems had such a specified urgent care,” MacAulay said. “When she told me about it, I was like, ‘Really? Like specifically for these types of injuries? That’s awesome.’”
MacAulay went online and made a same-day appointment. When he arrived, he could “pretty much walk right in.”
Physician assistant Brian Lee, PA-C, examined MacAulay’s foot, zeroed in on his symptoms and ordered X-rays.
As soon as he saw the films, Lee believed MacAulay should see a foot surgeon. The injury, near the base of the fifth metatarsal, looked to Lee like a Jones fracture.
The fifth metatarsal, the bone that runs along the outside of the foot, has several fracture zones. The Jones zone is a little more dangerous than the others, Lee said, because the blood supply to that area is tenuous.
Low blood supply can interfere with healing.
To confirm his suspicion, Lee showed MacAulay’s X-rays to Marisha Stawiski, DPM, a foot and ankle specialist with Spectrum Health Orthopedics. The orthopedics group has its main office right down the hall from the Orthopedic Urgent Care clinic.
Dr. Stawiski agreed with Lee’s assessment, so Lee made an appointment for MacAulay to see the surgeon the very next day.
“That’s one of the luxuries of the Orthopedic Urgent Care,” Lee said. “We have almost immediate access to higher levels of care.”
This includes orthopedic specialists in hand and wrist, foot and ankle, knee, shoulder, sports medicine, trauma, oncology and pediatrics.
“Our teams communicate very well amongst each other to move mountains for people, when necessary,” he said. “We’re an extremely collaborative group.”
The next morning, MacAulay saw Dr. Stawiski, who explained his injury and walked him through his options.
Jones fractures, which are less common than other fractures of the same bone, can occur either with an acute injury or with wear and tear. MacAulay’s appeared to be a stress fracture caused by overuse, Dr. Stawiski said.
“He didn’t have a particular fall or anything,” she said. “He has a business with his wife where he has to carry a lot of heavy boxes and heavy things, so he was doing a lot of that and it just started hurting one day. … This heavy lifting must have been the straw that broke the camel’s back.”
One option for patients with a Jones fracture is to stay off the foot for eight weeks and hope the bone heals on its own.
Unfortunately, because of the blood supply issue, Jones fractures often resist healing and may then require surgery weeks down the road.
“The fractures in this area tend to have a higher rate of nonunion, which is where the bone doesn’t heal,” Dr. Stawiski said.
Going straight to surgery is the other option.
“Typically what we do is put one screw right down the center of the bone. And with that screw I am able to suck the fracture ends together nicely and get nice, tight compression,” she said.
In addition, during surgery she typically injects the fracture site with platelet-rich plasma spun down from the patient’s own blood.
This introduces growth factors into the area to encourage bone union.
Many patients, especially athletes, choose to have the surgery right away to foster healing and shorten their recovery time.
It didn’t take MacAulay long to opt for surgery.
“I definitely wanted to go with the option that would get me back up on my feet quicker,” he said.
The surgery took place Nov. 16, just six days after he visited the Orthopedic Urgent Care.
MacAulay was off his feet for about four to six weeks while the bone healed. Shortly thereafter, he was back at full capacity.
“He just had a model outcome as far as compression is concerned,” Dr. Stawiski said. “It went very successfully and I’m sure he’s going to do great.”
That’s music to MacAulay’s ears.
“As a small business, I take on a fair amount of the physical labor workload,” he said.
“It’s tough not being able to do any of that stuff—but fortunately we have some good people in our corner, and I have some good friends that we can count on to help us out.”
Lee commends MacAulay for seeking help as quickly as he did.
“He did the due diligence of listening to his body,” Lee said.
“He knew intuitively that it should be looked at, and it was critical that he did.”