X-rays from last week

Last week Tuesday (or maybe Wednesday... morphine brain is a forgetful brain) I had another appointment at the fracture clinic. My surgeon was out of the province, so I was going to see one of his colleagues. I was excited to go because I was due to "dock" soon. Docking refers to two ends of bone making contact. At this point, the bone transport process is over and the compressive loading stage begins. We expected that I would dock around March 31st. It is really important to keep an eye on this because the ends of the bone have to have smooth surfaces to connect properly, hence the appointment with another surgeon.

Unfortunately, the x-rays taken (the first since surgery on March 11th) did not show what we were hoping for or, and it really hurts to hear these words echoing in my head, what we expected. The x-rays should have shown a very teensy weensy gap between the end of the bone, about 2 mm wide. Instead, the gap was much large - the ends of the bone were almost 1 cm apart. Whoa? How on earth could that happen? To say it was disappointing was an understatement. On top of that, we didn't actually get to see a doctor. The ortho technicians and nurses were wonderful,as usual. But we really needed a doctor at that moment. The nurse I saw did send my x-rays to my surgeon though, so we hoped to hear back from him.

Here are my x-rays.

Beyond frustrating! The week before my surgeon had been talking about removing the damn thing mid to late April. Obviously that won't be happening now.

After we left the fracture clinic, mum bought my some tea from the hospital cafe. Then we sat in the courtyard in front of the hospital and I promptly broke down in tears. Crying in public. I felt awful. All the different possibilities were running through my head and I didn't like any of them: broke fixator? Probably not, since I could still make the adjustments and nothing seemed misaligned or anything. New heterotopic ossification? That would be awfully soon after surgery. Premature consolidation? Bingo! Most likely option as my bone had been growing quite fast (hence the heterotopic thing to begin with) and I had to stop turning that week before surgery. *sigh*

The next day, I think Wednesday, I noticed that there was some resistance when I did the turns. There had occasionally been a tugging sensation below my knee the week before, but I wasn't sure what to think of it. The added resistance was troubling and made me concerned.

On Thursday morning, around 8:30 am, the nurse I saw on Tuesday called. The surgeon had contacted her to pass on a message: "keep turning".

Then, over the next few days, I began to notice my pins bend. By Sunday it was quite noticeable and causing pain so I decided to stop after my morning turns.

On Monday morning I called my surgeon's office, as I already posted about, and was told to stop making adjustments. And that is where we are. At physio today, my physiotherapist was quite shocked to see the bent pins. They are really irritating the tissue at the bottom of my leg/near my ankle.

I suspect that there is premature consolidation, but only tomorrow's x-rays and the conversation with my surgeon will tell for sure.

On a related note, it is really difficult to get a hold of my surgeon or anyone who knows anything about fixators when something goes wrong/if I have concerns. This is not my surgeon's fault and he is still as amazing as ever. But because external fixators are rare and he only has a few patients who have them per year, there is no special fixator clinic or dedicated staff just for fixators. If things go wrong and my surgeon is away, I can't even call his office because the office is closed when he is gone. The only thing to do is go to the ER where the doctors will tell me that I have to see my surgeon. At best, they will try to contact my surgeon, but that is not always possible. It is really rather frustrating. That frustration is made worse when I hear about other people in other countries who have a dedicated team that specializes in external fixators and who they can call at any time. People who are literally given their surgeon's/consultant's e-mail address so have direct access to him/her when questions or issue arise. Meanwhile, I'm lucky if I can get a hold of my surgeon through the ER department. *sigh* Rant done. This whole experience is a giant lesson in patience.

Let us all keep our fingers crossed for tomorrow. If the bone has prematurely consolidated, I will likely need more surgery. We don't want that!