Post-op Appointment - December 3rd

I had my post-op appointment for surgery number five on Thursday December 3rd.

After rushing home from the ER in the city I live to grab something to eat at home, change into some clean clothes, and brush our teeth, my mum and I set out to the hospital in Hamilton were I had the ex fix surgery done. Fortunately we made it in good time and were even able to nab a wheelchair at entrance to the hospital (they usually disappear pretty early in the day and then you have to use one of those weird hospital transport chairs, the one's with the metal mess for a seat that leave a weird imprint on your butt... link can be found here).

I am always amazed how grumpy people look in the fracture clinic waiting room. I was sitting there in a rusty old hospital wheelchair happy to be out in public and still have my leg firmly attached to my body and everyone else just looked miserable. I honestly don't understand it. If I am able to be happy and smile despite everything I have been through health wise (and am still going through with the external fixator), how can so many people with much less serious injuries look so miserable?

Anyways, that is just something I have noticed on quite an occasions while I sit in that waiting room.

Before seeing my surgeon, I was called back to get x-rays. Let me tell you, getting x-rays when you have an external fixator is no easy task. There is a lot of awkward twisting and turning as you try to get into the required position for the x-rays while trying not to bang the fixator off of anything. Plus all the stiffness in my knee; that makes it even trickier.

Once the x rays where taken I was sent back to the waiting room full of miserable looking people, sporting a variety of casts or braces, some on crutches, others in wheelchairs, some completely mobile on their own two feet. Not long after I was called back to the clinic.

Before seeing the surgeon, one of the ortho technicians took off all the dressings on my leg. This is how it looked a week after surgery:

The staff at the fracture clinic are incredibly kind and it is obvious that they strive to do an excellent job. Between my surgeon himself, his OR staff (many of whom have been in the OR with me during my last three surgeries), and his clinic staff, I am extremely fortunate. Not only do the clinic staff do a fantastic job, they are so friendly; I always have a good laugh or nice conversation with at least one person there. I have been going to this fracture clinic since the start or 2012, so there is some history there. I am sure that has an impact on the interactions I have with the staff. I am a familiar face!

Once the bandages were off, my surgeon came in and it was x-ray time!
These are my x rays:

Side view

Front view

We learned that the section of missing bone is slightly larger than we thought before surgery - 6.5 cm instead of 6 cm. My surgeon had done the math beforehand and calculated that I will be doing "the turns", or adjusting my frame, for 95 days. This includes tightening the slack out of the system and regrowing 0.75 mm of bone per day. When a frame like this is put on, there is not as much tension on the pins as is needed to actually get the bone transport moving, so it takes some time to work this slack out, if that makes sense. The 95 days is broken down into about 8 days of turning out the slack and 87 days of actually transporting the chunk of bone attached to the top to pins down my leg. After that, the frame will be on for several additional weeks to make sure that the new bone is hardening and the bottom of the loose piece of bone is connecting (or "docking" if you want to get technical) properly to the bottom part of my tibia.

After explaining this, my surgeon fished around the pockets of his scrubs and pulled out my new best friends, a small shiny wrench. He said, word for word, "If you lose it, go to the hardware store and buy a new one. It is a 7 mm wrench." I find that there is something laughable, almost absurd, in the fact that I am using a tool, a tool widely outside of the medical field, to regrow my tibia. XD

My wrench:

I keep thinking wench, like a pirate. But no. It is wrench. No r. I do not have a wooden leg (although it sometimes feels as stiff as one). I am not a pirate... there is no association with wenches and pirate ships and big black flags with a skull and cross bones on them. But I'm getting side tracked...

I adjust my frame three times a day. In the morning, I do half a turn, which moves the loose chunk of bone down 0.5mm, and a quarter turn in the evening (twelve hours later), which equals 0.25mm of movements.  

The surgeon said that he would send orders to the home nurse to take the staples out on fourteen days post op (the following Wednesday) and instructed me to keep cleaning the pin sites with hydrogen peroxide. He also said that I could put smaller dressings around the pins. And that was that. Mum made an appointment to come back in two weeks (Dec. 18th) while one of the lovely ortho technicians put a new dressing on my leg and then we took the scenic along the Niagara Escarpment home.

It did take several days for the home nurses to receive new orders for the pin site dressings and so that they could take out my staples, but we got there in the end. I had tried calling, without success, my surgeon's office on Monday but got no response. So I called the fracture clinic itself. They said they couldn't help me, so they put me through to the office of the ortho doctor on call at the time. No one answered, so I left a detailed message about what was going on. And then in the afternoon, my mum had the brilliant idea that I could call my infectious disease specialist's office. I am not sure who got what message when and who actually spoke to my surgeon, but the orders arrived on Tuesday and I got my staples out on Wednesday the ninth. All 57 of them. Yay! It has taken some time for the incision to heal. It's a good 20 some odd cm long, so that is understandable. We went through several packs of steri-strips, but it is almost completely closed now.