Ugh

I don't even want to tell you this. I don't want to write it and make it real. I saw Dr. McGorgeous on Thursday. We talked a little about how the bone scan was positive for an injury, and how it had been 7 weeks and nothing was really getting better. He grabbed my ankle and pushed a few spots. It drives me nuts that he always knows EXACTLY where to push to make it hurt. And then he looked at my scan again, looked back at me, and asked "So what do you want to do now?" omfg. He is asking me what I want to do. This can't be good. And so I tell him that resting and wearing my boot are making things worse, so I don't rest and I don't wear my boot like he asked me to. He tells me that at this point an MRI is one possibility, an ultrasound being another. I have no problem with either of these options, but I was sort of confused by WHY we would need another test when the bone scan has already confirmed the stress fracture. And in case you think I've learned one single thing in the past two years of doing this, I'm about to prove you wrong. I ask him, "Do we really need to do another test? It's not like you repair stress fractures, right?"
Wrong.
Turns out that all stress fractures are not created equal. My stress fracture is in my medial malleolus. This is considered a "critical" stress fracture because they are notorious for not healing. Surgery IS an option. Plates and screws to hold the bone together. Medial malleolus stress fractures are rare (of course) and even if I do not have surgery, it can take a year or longer for my body to repair this injury on it's own. Dr. McGorgeous mentioned an NBA player who had this injury and it took him 2.5 years to heal. Granted, I am not trying to play professional basketball here, but that's a good example of how nasty these injuries are.
So what now? Well, we do the MRI. We see how bad the fracture is. We make decisions based on the facts. In the meantime, I wait. And wait. And wait. I have spent the last 5 months putting my life back together after my 6th surgery. I am trying to imagine losing all the things I have gained in order to have a 7th. For the most part, I just CAN'T go there right now. At the same time, my other option is to be in pain for a year or longer to heal naturally. Rock vs. hard place.

And the winner is......

Not me! It turns out, I was right. I do have a stress fracture. Back in the boot for a yet-to-be-determined amount of time.
But I know you're all curious so I thought I would post an update pic. I am now 18 months out from the first surgery and 4 months out from the most recent surgery. I don't make pretty scars :) I see Dr. McGorgeous in two weeks, so keep your fingers crossed that I am somehow, someway completely healed by then!

Over/Under(reactions)

Overreaction: thinking that the instability I was feeling meant there was a new issue. After a month of careful observation, it seems that the instability comes when I reach a new level in physical therapy, hangs around for a few days, then goes away and stays away.

Underreaction: thinking that the pain on my tibia was of the same nature as the instability. Turns out it's a stress fracture. X-rays have been taken, updates will be given as necessary.

Mary Go Round

The more time passes, the more I appreciate the title of my blog. I'm giving myself a big ole pat on the back right now. To me, the title means that I just keep going around and around in the same circle. First the good news, then we'll discuss my centripetal force. The infection is dead and gone. No issues with that. I have passed my latest doctor's appointments with flying colors. I can walk to and from class. I can even take a walk on a nice day. But here's the problem. I'm STILL having instability. It started one evening when I had been sitting for awhile and then stood up. Yep, that's all it took to send me into a panic. And the official diagnosis? "Functional instability". Meaning, it feels broken, but it's not really. See also; every blog post I've written prior to this August. Because that's the diagnosis I kept getting when I mentioned the instability before. And Dr. McGorgeous was wrong on that one. It was ACTUALLY unstable. And he tightened a ligament. So, I totally respect him. And I would defend him to the death since he hasn't given up on me yet. But, I apparently have trust issues. So I don't know how to believe him now that there isn't actually something else wrong. In the meantime, the best things for me to do are to start training my ankle how to move correctly again. So, physical therapy, massage therapy, yoga. Back on the merry go round.....

On the mend?

Maybe. My infection is completely cleared up! I'm allowed to wear a shoe at work and at home (but not outside) and I'm set to start massage therapy and physical therapy again this week. Even though it feels like this recovery is taking FOREVER, my surgeon reminded me that the infection set me back a couple weeks in terms of healing. So, instead of thinking of myself as week 5 post-op, I need to think of myself as week 3 post-op. Also, the incision looks great and he was amazed at my lack of swelling. All good signs. Also, the pain I've been having isn't necessarily a bad sign. I'd describe it as an ache, and Dr. McGorgeous describes is as a "toothache you can't get rid of". It's true. I doesn't matter if I'm in the boot, in my shoe or even just sitting on the couch, there is no rhyme or reason to when the pain starts. It makes sense though. In order to fix the osteochondral fracture, he "microdrilled" down into my bone marrow. I then proceed to slowly bleed out stem cells from my bone marrow, and they fill that fracture back in and repair it. It's not a perfect technique- it won't repair my cartilage with the same type of cartilage that I originally had, but it's a hell of a lot better than just having a fracture. Anyways, the process of repairing actually causes me some pain, and might continue to cause me pain for a couple more months. Also good news- the ligament seems to be stable. He did a stress test, and it didn't hurt and I think I got an A because he didn't say I failed. This time he used a dissolving suture (so I don't reject it) and it should be completely gone in about 2 more months. I guess right now my main concern is physical therapy. I won't lie. My heart isn't in it. I have given physical therapy my ALL on three separate occassions. I don't think anybody who saw me work through the pain would argue (reminder- I worked through the pain of a foreign body reaction, scar tissue wrapped around my nerve, a torn ligament and an osteochondral fracture to my calcaneus). And I worked through that pain for a grand total of 6 months. And it didn't get me anywhere. Rationally, I know that it was because there were still injuries. But, there could STILL be injuries now! How do I psych myself up to deal with the pain and the effort when there have never been any physical rewards for going through it in the past? I can't quit. I know that and there's 0% chance that quitting will happen. Hopefully when (if?) I start to feel some progress, the attitude will follow.

Quaratine!

So after being informed that I was headed to the hospital, I was told to go home, pack a bag and wait for a phone call to tell me what floor to go to. Instead, I packed a bag, unloaded and loaded the dishwasher, watered my plants, turned in my homework and went back to work. By the time I finished telling my boss what was happening, it was time to go. I found my floor and the nurse took me to my room. As I passed each room I could see that everyone seemed to be elderly. These were some very sick people. And they also appeared to be sharing rooms. I was not too excited about this. But, my room was empty when I got there, and only contained one bed! This, I learned, is because I was being quarantined until I learned whether or not I had MRSA. Fine with me! I got set up with a hospital gown and the remote to the TV (which gets better cable than I do at my apartment) and nobody came back for over an hour. It was amazing. As bad as I felt, and as hard as I had been pushing myself since the surgery, just resting in bed felt incredible. After an hour, the hilarity began. The first 2 people to enter my room were a student nurse and her instructor. The instructor asked if the student could start my IV. I hesitated and the student said "I know what you're going to ask, and I have started one before". I reluctantly agreed, but warned her that my veins are deeper than they look. They both looked for a vein for about 10 minutes as I felt the cold sweat of fear starting to drip. They eventually decided that my deep veins were a job best left to a pro :) Bullet dodged. So now I've been in the hospital for an hour and a half, an IV started, and no bracelet. With as much experience as I have as a patient, I am always on the lookout for ways that medical errors can be avoided. So I ask for a bracelet. And although I assured I will get one, another half hour passes without any identification on me. Then the lab tech shows up to get blood. She's about to start drawing blood and asks to see my bracelet. I explain that I still haven't gotten one. She asked how long I had been there, and I told her two hours, and she flew out of the room and I had a bracelet within the minute. So with the blood sucking vampires satisfied, I get to order dinner (the stir-fry is disgusting, go with the pork loin) and rest and visit with friends. At 10pm, my first dose of antibiotics arrives, and with it, a shot of Heparin. A blood thinner. So I don't get a clot in my leg. I express my disbelief that my 27 year old, non-smoking, non-birth control taking legs are going to clot, especially because the Heparin is injected into your stomach every 8 hours, but I feel too tired to fight this very much. Nighttime is terrible in the hospital. My IV pump is noisy. I'm awake to check my vitals at midnight and 4am. My next dose of antibiotics are at 6am, so I'm up for that too. And I'm up all morning. By the time my disgusting lunch order shows up and it's missing cheese, I'm in tears. I was just SO TIRED. One of the several wonderful nurses I had told me about a little thing they have called EARPLUGS. I slept from 1-5. Dinner, friends, TV, antibiotics, earplugs and sleep again. The next morning, my surgeon shows up around 6:30am. He tells me it's NOT MRSA, and asks what I want to do. I believe my response was "GET ME OUT OF HERE!" So just like that, my vacation, I mean, hospitalization ended. I walked out of there with a new prescription for oral antibiotics and went home to sleep away Labor Day weekend.

The Gift That Keeps on Giving

So as you all know, this was my 6th surgical procedure. To say that I have some practice in surgical incisions is an understatement. Generally, my instructions are to keep it clean and dry and change the dressings twice a day. I use dressing-changing time to monitor for any signs of infection. Last Monday night I changed my dressing and went to bed. All was well in the ankle world. Since I changed the dressing immediately before bed on Monday, I did not change it first thing Tuesday morning. I noticed that I had some increased pain, but my pain had been increasing for a few days and I attributed that to overdoing it. By lunchtime on Tuesday, I was VERY uncomfortable. I had lunch with a friend, and told her I thought the bandages had bunched up under my boot, and I needed to straighten them out. I un-booted myself and as I unwrapped the gauze it became clear that the friction I had been feeling was not from the bandages, but from a large lump of rock-hard swelling. And to top it off, my incision had turned a beautiful shade of Barbie hot-pink. I proceeded to stare at it dumbfounded. Not because I didn't know what this meant, but because I DID know what this meant. And I could not believe that after 5 previous successful surgeries, my background in biology, and the fact that the incision was almost 3 weeks old, that I had become infected. I was almost in denial about it. I was hesitant to call the doctor because I truly thought there HAD to be another explanation, and that in an hour or two, things would return to the way they had looked just a few hours prior when I had changed my bandages. My disbelief eventually wore off, and I called the doctor's office, who called me in a prescription for antibiotics, sight unseen. I had a regular post-op appointment scheduled for Thursday, so the plan was to get two days of antibiotics in and reassess then. I spent all day Wednesday and Thursday morning sweating and feverish at work. My incision did not look better and I felt worse. My appointment Thursday was scheduled with the nurse, and I called that morning to see if Dr. McGorgeous could sneak me in to take a look. Since Thursdays are OR days for him, he was booked solid. At my appointment the nurse was very nonchalant. She was able to squeeze my incision hard enough to get a sample to culture. I will not go into detail on the amount of pain that entailed. Just imagine someone grabbing your fresh incision and squeezing. Hard. I was concerned that after 48 hours of antibiotics I was actually feeling worse. She said that was normal and I should just go home and wait for the culture results. I wasn't pleased with this, but I had decided that if she didn't take this seriously, I could always just go to the ER. As we were wrapping things up, there was a knock on the door, and Dr. McGorgeous walked in. I have no idea how he knew I was there, or what made him decide to come over from the surgical center, but there he was. He looked at my ankle, listened to what I had been feeling and the first words out of his mouth were "I'm sticking you in the hospital". He continued with "Don't be offended, but based on your history, I'd rather be safe than sorry". So began my first hospital admittance since birth.
To be continued....