My flat foot wearing a modified sandals and ready to walk.

An End In Sight

My little cheerleaders watching over the procedure.
My little cheerleaders watching over the procedure.

It’s been ages since I’ve written, and for good reason!  In the past month, my medical drama has steadily become easier and now this foot has taken a back seat the rest of the struggles and triumphs and heartbreaks and heart explosions that are my life.

I emerged from the dark cloud of anxiety and physical misery caused by chemical withdrawal from the high dosage pain medication so gradually that it is difficult to pinpoint exactly the day I just felt like myself again.  I remember an afternoon when I looked up at the sky and felt like smiling from all the happiness and love in my heart, and I realized I was okay.  I returned to being a busy working mother and allowed my foot to stop taking center stage.  Four of the five children in our blended household started the fall soccer season and their schedule on top of my demanding work schedule left me very little time to

Replacing the struts with stationary bolts for the long haul.
Replacing the struts with stationary bolts for the long haul.

worry about which wire was hurting the most.  I began to feel almost normal again.

The next phase of my healing journey had now begun.  My foot was flat with no further adjustments needed and in the follow-up appointment to my last surgery, the doctor placed two threaded bolts on either side of the frame to keep it from accidentally moving if the strut dials were bumped.  In the next appointment a week later, she placed two more threaded bolts toward the front of the frame and removed the adjustable struts one by one.  The girls accompanied me to this appointment and were exceedingly helpful attendants as they attempted to pocket some of the spare parts, spent an inordinate amount of time captivated by the water cooler and spilling water on the exam room floor, and had everyone on either side of the privacy curtains laughing hysterically at their giggling antics.

Bone heals fastest when it is under pressure as this stimulates the use of calcium; this is why strength training is the primary measure to combat osteoporosis- strong muscles put tension on the

Placing threaded bolts between the foot plate and leg frame.
Placing threaded bolts between the foot plate and leg frame.

attachment points of each bone, stimulating bone growth and increasing bone density.  Low risk weight-bearing activities are therefore considered essential to promote healing in an external fixator.  While I have been in a weight-bearing status since very shortly after the initial surgery, it was difficult to do more than rest a portion of my weight on my toes as I was standing while my foot remained cocked at a 40° angle.

Five wires pass through the bones in my foot- two through the metatarsals near my toes, two through the calcaneous, and one through the talus.  These wires connect my foot to the flat plate situated parallel to the ground; as my foot swells and my toes bend, the tissue around these wires aches and stings at various points throughout each day.  I was fearful of putting all my weight on my foot as it seems counterintuitive to avoiding pain- at first glance, it appears that any weight will just cause the wires to rip right through my skin!  To assist me with overcoming this fear, Patrick procured a fancy cane for me with a glow-in-dark handle and a violet floral print.  Little Riley takes every opportunity to use it as a sword whenever we are out and about and I let go of it for

My flat foot wearing a modified sandals and ready to walk.
My flat foot wearing a modified sandal and ready to walk.

even a moment.  With all of the wires in the way, wearing a shoe on my right foot is all but impossible.  I was able to modify a pair of sandals by cutting away the center strap and adornments; I tied loops on either side of the frame to fit the top strap through in order to keep the sandal from sliding off my foot as I walk and the result is a remarkably functional right foot.

The only hiccup I have had in the past few weeks was an infection in the deep tissue which failed to respond to antibiotics.  As the swelling and pain worsened at the site of the top bolt in the front of my shin, I began to worry the infection was spreading into the bone.  After an overnight stay in the hospital on iv antibiotics didn’t produce much improvement, my surgeon decided simply to remove the bolt.

There is much discussion on the online forum I frequent for individuals dealing with frames such as mine regarding the best method for removing the hardware for these frames once our time in the cage is complete.  Many individuals are proponents of having the entire frame removed in the doctor’s office with the aid of some valium and nitrous oxide.  My surgeon does not offer this option and instead schedules an OR visit with general anesthesia for every frame removal.  The reason for this, she explained, is that the large pins are actually threaded bolts which have been drilled into the tibia and fibula and adhered with an epoxy which can make them difficult to remove without some struggle.  It was one of these bolts which had become infected, but as she would only be removing one, we decided it could be done very quickly in the office and I would recover from the trauma.

Having experienced the fairly simple and painless removal of a long wire which ran all the way through my leg from one side of the frame to the other, I felt confident I could endure a single bolt being unscrewed.  After all, it didn’t seem to go that deep, right?  I walked into the doctor’s office a little nervous, but eager to have it out, and asked her if she would be using any gas or anesthesia.  She explained that she would have to go all the way downstairs and it was a very quick procedure hardly worth the effort.  I relented.  I wish I hadn’t.  I sat on the exam table with my legs up as usual and she placed a rachet over the top of the bolt and put her left hand firmly over my shin to hold my leg still.  She was about to turn to the rachet, but paused and looked at me

Pay no attention to that pool of blood under my leg.
Pay no attention to that pool of blood under my leg.

squarely and advised, “You’re going to want to lay down for this.”  I did as commanded and was grateful the nurse was near as I let out a blood-curdling scream as she cranked the first turn.  The nurse at my side grabbed my hands and squeezed, and they both reminded me to breathe as I clenched my jaw whimpering and the bolt kept turning.  She told me it was out, but the pain continued and I lay sobbing with my arms over my eyes as blood poured out onto the table from the gaping hole in my leg.  She quickly stuffed it with gauze, then wiped at the gory mess all over my skin so she could wrap the top half of my shin with a self-adhering rolled bandage.

Eventually the pain subsided and she asked me to stand on it.  I did and the pain was noticeable, but not unbearable.  She loosened the nuts holding the threaded bolts in place and told me to slowly walk around with my cane to see how my ankle could withstand the pressure without the support of the frame.  I paced around the room for a few minutes and she seemed pleased.  She tightened the nuts back up and gave me directions to loosen the nuts three times a day to “dynamize” the frame.  If I had no significant adverse effects from this, I am to loosen the nuts entirely on October 5 and leave them, walking completely on my own without any hardware support.

The last bit of good news for me was that my ankle is so well-healed she set the date for my frame removal on October 26.  This would be two months sooner than she had led me to expect before the first surgery.  I won’t see her again until my last x-ray to confirm the frame can come off just a few days before the removal surgery.  From now until then, I just have to walk and heal as fast as I can.

I’m so close I can already feel the flip-flops between my toes.



Walking with a Taylor Spatial Frame

I’ve created a short video of myself walking for posterity.  Someday I will show this to my grandchildren who will think I am much cooler than they had supposed.  Or maybe they’ll say , “Who watches videos anymore, Granny?  Why isn’t it a holographic projection onto my eyeball?”  Snot-nosed little shits.



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One thought on “An End In Sight

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