Thursday, March 30, 2006

Break a leg

Today's clinic session was very interesting.
I think I must have spent longer in X-Ray than I did in Theatre. It's very difficult to get a clear picture of the bone healing through all that metalwork. I feared that the problem might be because there was nothing to find, but when we got good pictures there is a significant amount of new bone growing in the right place.
We also had a good look at the skin graft which seems to be looking good too.
We are now all systems go for admission on Sunday so that we can start the lengthening process. On Monday morning I go into theatre for the breaking of my leg at the top of the Tibia. After 10 days to get used to the idea I start turning the screws. I have been told that it will be a bit painful and that I will need to work on the physio so that my calf muscles stretch with the bone, otherwise I will end up with a bent knee.
We also talked about the infection which has been quite painful recently. It seems to be focussed on the heel pin and it is now possible to remove the foot ring which will hopefully settle things down. I could have had this done today, but decided to leave it until theatre on Monday.
Without wanting to start getting too optimistic Mr Dennison seemed to be suggesting that the frame might be off a bit earlier than he had expected. That would be a good result if we can achieve it, but I'm just pleased that things keep moving in the right direction.

Friday, March 24, 2006

Moving On

It's strange to think it's over 16 weeks now.
Just when you start getting into a routine it's time to change it. I've managed a couple of trips out courtesy of Maggie and some friends - it's a real pain needing someone else to provide transport. A friends birthday dinner was followed a few days later by a walk in the park. Well, a short hobble is nearer the truth. Single crutch only these days, but probably no more than 100 yards with two long rests on the park bench.
I went to the office on Wednesday and we started planning for my return to work on a scheduled basis rather than doing the ad-hoc stuff that I have been asked to help with over the past few weeks. I definitely feel able to make commitments to a certain level of performance now although I have to acknowledge that the painkillers do slow the brain down a bit, and I do tire a bit too quickly for comfort.
Can't wait to find out whether we can get on with breaking and lengthening my leg - more news after next Thursday. I've not even sneaked a peek at the skin graft so don't really have any idea how it looks, but no obvious sign of distress.
The MRSA seems to be back. I lasted about a week after the antibiotics ran out before it started up again. If we can lose the foot ring I'm sure that will do the job as it's really only evident in the heel area.
Looking back now I remain delighted how things have progressed. There's still a long way to go and many potential pitfalls, but I really am now starting to feel capable of getting back into real life. Still no long term targets cast in stone, but I do have flight tickets booked to travel in October so I suppose I've started to put my own expectations into action.
Now, when can I start gliding again.........

Tuesday, March 14, 2006

Hard graft pays off

Just returned from a check up.
The skin graft is healing really quickly, just a bit of seepage from the remains of the hole but otherwise nicely scabbed over now. A light dressing has been applied (sorry, no photos this week). The donor site is now dry and healing so the dressing has been taken off.
I have an appointment for X-Rays on 30 March and, assuming things are OK, I go in for an operation to break my leg and start the lengthening on 3 April!
Mr Dennison can start sharpening his chisels as my leg is on it's way.

Tuesday, March 07, 2006

Sound of Silence

The vacuum dressing has gone!
The Consultant was not around today so Maria took this picture on a mobile phone and mailed to him for review. He then called back and discussed it with Maria while one of his colleagues had a look at it.

The skin graft seems to have taken OK over most of the wound. On the photo the "string vest" is the graft and I am told this is a great result although it will need to look a bit more like skin before I am able to see it. This has now been covered with a light dressing to protect it.

The donor site has been dressed again and is still a good deal more painful than the grafted wound.

Back again next Tuesday.

Sunday, March 05, 2006

Thoughts on Skin Grafts

It's 5 days on since my skin graft.
I wasn't entirely sure what to expect and I'm certain that different people have different experiences, but I have learned a few lessons.
Firstly, I was told that the donor site was more painful that the graft site. This I can confirm first hand. The wound site has given me no trouble at all. I suppose this might have something to do with the vacuum dressing which is anchoring the graft in place on the wound but somehow I doubt it. The donor site however was fairly uncomfortable when the painkillers wore off and frankly is a real nuisance. It is quite high on my left thigh and was initially dressed with a crepe bandage around it. As soon as I stood up the dressing slipped down my leg. The second dressing put on by the nurses on the ward suffered the same fate. In the end we opted for a guaze dressing secured by tape onto my leg. This didn't slip, but it did leak. About 3am Thursday I woke up in a small puddle that had oozed from the dressing. Temporary relief was provided by more tape and a couple of old towels until the district nurse came to change the dressing. We have now gone with a dressing of Mepilex which is like a large elastoplast which allows air to circulate. This has proven so successful that I can feel a scab forming under the dressing, which is great until they want to change it! Every time I flex my thigh it does stretch the scab and can be a bit painful which has curtailed some of my physiotherapy.
Perhaps the biggest potential problem was the need to keep weight of my left left for 4 days so as not to disturb the graft. This was sprung on me by the physios who made me walk through the ward and up and down a flight of steps before they would let me go home. I don't mind admitting that this was hard work. My right leg is better that it was, but it is still broken, and hopping even with the aid of crutches was not entirely comfortable. I was able to complete the task in the hospital but must confess to the odd relapse at home. Sadly, I had already made two trips to the toilet with full weight taken on my leg before the news was broken to me, so hopefully that didn't do any harm. Frankly, my ankle is so well anchored that I don't think the wound site moves very much when I walk and bear weight on that leg.

Admittedly I don't know the results yet, but based on my experiences so far the discomfort is certainly not disproportionate to the benefits. I don't expect to have a perfect leg after this, but anything that reduces the healing time and protects against infection must be worth doing. The pain is all in the donor site and is easily managed by the painkiller regime already in place.

Wednesday, March 01, 2006

Did you bring a toothbrush?

Yet another surprise.
Went to Sheffield for a change of VAC dressing on Monday 'cos the Consultant wanted to see how far we were from being ready for a skin graft. He took one look and made arrangements for me to stay in so that he could do the graft the following morning. That's just 5 weeks of VAC therapy to get the wound ready for grafting.
The graft was taken from me left thigh and has been fixed under a VAC dressing which will remain in place until next Tuesday when hopefully the graft will have taken and we can start thinking about the next stage of the process - breaking my leg and starting the distraction phase.
I took the opportunity to ask Mr Dennison how he would break the leg and was given a very thorough explanation of the options available (basically; hammer and chisel, saw or drill). He prefers to make a small incision and then use a hammer and very sharp chisel to break the bone from the front. I'm glad I now know what I will be missing while I am asleep in theatre.
This Monday news came on the back of a pretty good weekend of progress so things are still pretty positive apart from the MRSA which is clinging on into my second course of antibiotics.

We discovered an interesting new product recently. Ellactiva are sweets designed to supplement calcium intake. Two chews contain 100% of the RDA of Calcium and Vitamin D. They aren't cheap but are a simple way of getting extra calcium. I've discovered that you can only eat so much Yoghurt every day.