In the morning, I get to all my surgeon's office and have a conversation that goes something like this:
*me - picks up phone and calls the hospital*
Surgeon's assistant: Hello, this is the office of Dr. Bob**. How can I help you today?
Me: Good morning. I am a patient of Dr. Bob. I have been having trouble with my external fixator. Is it possible to leave him a message about it?
Surgeon's assistant: Certainly. What seems to be the problem?
Me: Based on my x-rays last week I don't think that I have docked yet. There is, however, quite a bit of resistance when I make the adjustments to my fixator and my pins are bending. This has started to cause pain and quite a bit of concern. I decided to stop making adjustments yesterday because of the issue with the pins but I am unsure of what to do now. Given all this, I was wondering if he would like me come in earlier than my scheduled appointment on Friday.
*We talk back and forth a bit, making sure she got everything jotted down and then I provide my name and contact info. Call ends*
** My surgeon's name it not Dr. Bob. I changed it for privacy reasons.**
That's what I get to do in the morning.
What does it all mean?
1) I still haven't docked which means that the two ends of bone at the bottom of my tibia have yet to make contact, something that was supposed to happen last week Wednesday or Thursday. Given last weeks x-rays, we (mum and I) know that I had close to a centimeter of bone left to grow. Bummer. Also slightly concerning as I had done almost 1.5cm worth of turns but only actually got just over 0.5cm of growth out of it.
2) Last week I started experiencing resistance when I was doing my adjustments. At the time I didn't (and still don't) know what that meant. I it could be a number of possibilities.
3) My pins have started to bend. This is something that is only supposed to happen once I have docked and the whole bone is compressed as I continue to make adjustments after I dock. As is evident by last weeks x-rays, however, I have not docked yet, so why the bending pins?
There are three possibilities that literally each explain all the issues described above:
i) The fixator is broken or malfunctioning.
ii) I have a new heterotopic ossification thing which is preventing the fixator from moving downwards. If this is the case, it means that more pressure is put on my leg and the fixator as I continue to make adjustments which moves the pins and bone closer together but then the bone gets caught on the heterotopic thing while the pins keep moving. Hence, bent pins.
iii) The new bone I have grown has prematurely consolidated (hardened too quickly). This would mean that the new bone I have grown had healed with the loose chunk of tibia that is being transported downwards. As a result, that piece is no longer loose bone but a part of the top half of my tibia. When I make adjustments, the pins still move forward but the bone doesn't. This puts a lot of strain between the two sets of pins. The bottom pins would have given way by bending, but not enough obviously for there to be no resistance when I make adjustments.
Neither of these is desirable; all of these would likely requires surgery to fix. While I won't know exactly what is going on until I see my surgeon and get another set of x-rays, it is obvious that things are going wrong. None of what I am experiencing can be explained by having docked and finished the bone re-growing process. That we know for sure based on last weeks x-rays - I should have grown 3.75mm since last Tuesday but had almost a centimeter left to grow. Logic tells us that it is one of the three issues described above that is causing issues, all of which require surgery to fix. Furthermore, this pushes back the date for when the fixator comes off. We were hoping for mid to late April. If I will need surgery and to have to grow at least another centimeter of bone after that, there is no way the lovely scaffolding holing my leg together is going to come off before the middle of May. And then we start talking about about whether that gives me enough time to recover before school and twelve hour clinical shifts start in September. No matter how you put it, it sucks. SUCKS. SUCKS. SUCKS. And there is nothing I can do about it. It's not an issue of being more positive, taking more medication or working harder in physical therapy. It is completely out of my control. That makes it all the more difficult - doing everything exactly as I should and hitting every speed bump and pothole there is while other people I know with fixators pretty much have smooth sailing (or as smooth as having a fixator can possibly be). I am just done with this. I want my life back.
We won't know anything for sure, obviously, until I see my surgeon at some point this week. So it is with uncertainty and thoughts of more surgery that I begin my week. So much for my surgeon saying that the previous surgery might have been the last.
I hope your Monday is looking a whole lot better after reading this. I would give anything to have a hectic Monday morning. Instead I have bent fixator pins. =(
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