A Leg to Stand On

Well, it’s been a rollercoaster. But I promise you this completes a trilogy of the Long Norse Saga of a Boy and His Leg. Part 1 I hope was upbeat and optimistic, Part 2 apologetic but dreadful as we plumbed the depths. I really didn’t expect to write about my leg again, but the up-again, down-again, up-again just did not stop! So, Part 3.

As you may recall, the operation to insert a rod down the length of my tibia unexpectedly opened the incision from previous surgeries. Quite soon afterwards I could put weight on my leg with no problem, and after only a month, X-Rays showed good bone growth, so the rod was doing it’s job. At the same time, despite a wound vacuum and regular home care from a visiting nurse, the open wound was slow to heal. Both orthopedic surgeons (the one who took the plate out and the one who put the rod in) now recommended a skin graft which they said would accelerate healing, at the price of another soreness on my body from where the skin would be taken! Well, I don’t know. A fifth operation under sedation in the space of eight months? But I dutifully went to see the plastic surgeon, who introduced yet another technique. He put silver nitrate on the wound to decrease the hyper-granulation that was starting to appear. (Another method to keep the hyper-granulation under control was to put a bit of pressure over the wound from a tight bandage, or to wear a knee-length compression sock.) He thought it would be ready for a skin graft to be stitched over the wound in a week or two after some of the swelling went down.

 

It was not to be.

 

The following day, which was the Saturday before New Year’s Day 2018, I woke up feeling absolutely awful and could not get out of bed all morning. I have never felt worse in my life. Seriously. My leg was quite swollen and red in new places, and I had a headache (which lasted three days). Eventually Penny dragged me off to Urgent Care close by where we live. The surgeons had always said to avoid infection at all costs, and to call or go to to Urgent Care if I suspected anything, and this was the first day of a three-day holiday weekend, so Urgent Care it was. I experienced a fit of uncontrollable shivering while waiting, and another one later on. But they tested me for the Flu and it wasn’t that. They were reluctant to do anything else because of my history with this leg, and strongly suggested I go to the Emergency Room (ER) across town where my surgeons are based. They told me to expect an MRI to see what was happening inside the leg, and intravenous antibiotics via a PIC line, but sent me away after two hours with nothing!

 

So we spent the rest of the day at the ER, another eight hours. They ran blood tests and took a swab from the still-open wound on my shin. It was incredibly inefficient and at midnight, after Penny dared to ask if there was a timeline, they told me the wound was infected, I had cellulitis, and they sent me home with oral antibiotics (no MRI, no PIC line). After a couple of days I felt like a human being again, a rash higher up my leg was reduced in size, the swelling was reduced to a single area just below the wound, and the headache slunk away. A day or two later surgeon #3 who inserted the rod transferred me back to the care of surgeon #2 who removed the plate. Surgeon #2 thought that swelling might be an abscess so I had a fourth operation very quickly on Monday, January 8 to cut into it and find out. I finished the course of antibiotics on the table just before operation number four. Turned out it was “just” another hematoma that needed draining. No abscess, no infection, or no infection no more. But there had been bone fragments floating around and irritating things, so “irrigation” was a good idea nevertheless.

A few days later in January, feeling almost normal again though with two open wounds now, I went to see to my primary care physician both to bring him up to date with the events of the last three months, and to ask him what he thought about a skin graft. Turned out he had had one, two actually since the first one didn’t take! Also grafted onto his lower leg (he rides a Harley-Davidson, but I didn’t ask if that had anything to do with it…). He said the place where the skin is taken from, usually the thigh, hurt like hell. But that there are alternatives, such as pigskin and synthetics. I also learned that it might save a month of healing, but heck I thought, what’s another month? And I told surgeon #3 on our next meeting that I preferred to wait rather than have another operation.

 

I stopped using the knee scooter in December I think, and walked with a cane instead. In early January I went for my first one-mile walk in nearby Catalina State Park, with walking poles of course. Unlike Sir Roger Bannister’s 4-minute mile, this was a 40-minute mile. Later in January I had the stitches taken out from the last operation, and I went for my first bicycle ride. Then healing seemed to accelerate, with the wound(s) rapidly shrinking in size between the nurse’s visits. After so long with no apparent change it was a relief to actually see visible progress. I even abandoned the cane. A month later on February 22 I was discharged from home care because the wounds had finally healed over. Hooray! I went for my first off-road ride since the accident, on the big bike this time, the following day. I have one last X-Ray scheduled for May just to check all is OK, but basically I’m done with care. I’ve got some physical therapy sessions again, but mainly to suggest exercises that I can do on my own over the next several months, to “recondition” muscles and regain lost strength. Surgeon #2 has advised that it could take up to a year following the last operation. I also need to lose weight!

My calendar shows that in the last 9 months I have taken 21 trips across town to see specialists, a 48-mile round trip so approximately 1,000 miles in total!!! I now own a small museum of prosthetics – one pair of crutches, a prosthetic boot, two knee scooters, a walker, and a cane. I’ve started swimming, and yoga too. I’m looking forward to hiking and backpacking again!