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Sunday, June 23, 2013

Preparing for Foot Surgery

On Thursday, we saw an orthopaedic foot/ankle surgeon. This doctor is located in the big "professional office building" next to the charity hospital where Bob gets his financial aid. Before seeing the doctor, an assistant came into the room and told us that Bob needed an x-ray. I figured they would be sending us to the hospital's imaging department next door and was surprised when the assistant had me wheel Bob down the corridor to a little room in their office suite.

There was only one x-ray technician there, pretty much running the whole show. She kept putting Bob's foot up on the x-ray plate and as soon as she went back (behind the curtain) to zap a picture, Bob's foot would move. Now this is Bob's "unaffected" foot and he used to be able to move it well, but since the dystonia in that foot and leg, he cannot seem to control it. Anyway, finally, she called me in and asked if I could hold his foot still so she could take some pictures of it.

To do this, she had me put on a lead "coat" or "tunic" or whatever-you-call-it. It wasn't just an apron. This thing was cut like a hospital gown (open in the back) with a belt and it covered me neck to knees. I tell you, it weighed about 50 tons. And it was bulky. I felt like an iron-clad walrus wearing that thing. And I couldn't get the belt to hook. I mean, I kept hooking the buckle together and it kept coming apart. So this lead walrus-coat was sliding off me every time I moved.

She had me crouching on the floor, in a very cramped space, trying to hold Bob's ankle to keep his foot still, all the while this stupid, heavier-than-hell lead coat was sliding off my shoulders and slipping toward the floor.  Add to that my getting-old-here knees, which do not always cooperate when I am crouching/squatting/trying to crab walk around Bob's wheelchair and especially, trying to get up from that position with 50 tons of lead holding me down.  But I did manage to hold Bob's foot still for the first picture.

The second picture, she wanted me to lean over Bob and sort of hold his ankle on the side. Now this position was near impossible with that darned lead coat, which kept falling off onto Bob. Finally, I thought, this is really stupid because Bob is sitting right there NOT wearing a lead coat, so why do I have to wear this stupid thing? So I took the darned thing off. The x-ray tech didn't say a word. And we got the other two pictures taken.

So, add that to my ever-growing job description: "assistant x-ray tech"! ha!

After the x-rays, we talked with the surgeon, who looked at Bob's foot and agreed with the new neurologist that his curled toes are caused by dystonia. So that makes three doctors on board with the dystonia diagnosis. And to think it took over a year and countless other doctors who looked at Bob's foot and agreed with the old neurologist that it was "neuropathy" and there was "nothing you can do" about it.  Sometimes, I swear, these doctors are all just yes-men, nodding their heads and agreeing with whatever another doctor has said.

Anyway, this surgeon said he can fix Bob's toes. He will make a couple of incisions on Bob's calf and cut the tendon which will release the muscle contracting the toes. Unfortunately, the big toe and the one next to it are "too far gone" so he will then cut the "knuckle" out of those toes and fuse the bone together with some kind of splint and a screw. Yikes.

But he did say this was a fairly simple surgery and it would be done as "outpatient" surgery and they usually do not have to put the patient to sleep, just numb the area. He said that Bob would lose his ability to "move" those toes, but right now he can't move them anyway, because they are all curled up. And the benefit would be that Bob would be able to stand on that foot again, so we could go back to rehab and back to the parallel bars and pretty much start all over. Not to mention, once it all heals up, the pain should go away. Which will be a huge relief for Bob.

Surgery is scheduled for July 8th. However, before then, the surgeon wants a "medical clearance for surgery" which means getting in with the primary care doc (which is next to nearly impossible) and having a bunch of blood tests, chest x-ray, urinalysis, etc, done. And of course, he wants to take Bob off the warfarin --- so I'll be messing around with lovenox shots again. And all that has to be scheduled and figured out and completed in the next two weeks. Plus we have Botox scheduled for July 2nd!

Looks like it's going to be a couple of busy weeks.


Jenn said...

Make sure to eat your Wheaties!
Boldly go forth!!
Hang in there!!!
What doesn't kill us makes us stronger!!!!
A day without sunshine is like, you know, night!!!!!
If the facts don't fit the theory, change the facts!!!!!!

Yes, this is a lot of nonsense. And don't ya detest all those exclamation marks? LOL Laugh, I say! Laugh!!! Oy.

DebbieL said...

Well, glad to hear you are an x-ray tech, too! I am very accomplished at that too now. So glad to hear that the surgery is supposed to be fairly simple. Gosh, wish I would have found your doctor before we had the surgery last summer to amputate Kaj's toes. Maybe it would have worked for him. But giving you lots of healing love! It will be a busy few weeks! But isn't it always! :)

J.L. Murphey said...

At least he is not losing his toes! He'll need them for balance. The good news is you shouldn't have to fight for rehab after the surgery... it's expected.

As far as taking the knuckle out and fusing the bone...I've had that done before with a thumb and a couple of fingers. Yes there is loss of motion, but they also behave like normal afterwards within the new range of motion. Plus there is no pain after it heals.

Hold onto your panties. It's going to be a bust couple of weeks. Bob may just be able to walk with his hemi after all. Remember to have faith, rest, and breathe.