The skin grafting surgery is still planned for this Thursday at 2:30pm in Chicago. We are driving to central Illinois Wednesday evening after work and will head to Evanston, IL on Thursday morning. I need to be at the hospital at 11:00am. Evanston Hospital is affiliated with Northwestern University. It has been a busy several days at work and feels like we just got unpacked from last weekend. I was able to hire two more staff individuals today for summer camp (at work), so it is a relief to have that done.
My mom is going to stay with the pastor and his wife that married them. They live about 25 minutes from the hospital and have not seen each other since they were married. She will have lunch with them on Thursday, so hopefully that will be a short break for her. I have a small spot on my foot that developed today where blood is pooling under the skin and it is purple in color - hopefully this is nothing. It is the area on the foot that is the most painful, but I've never had this before ... obviously, the foot is stressed. I cancelled all of my physical therapy sessions for the beginning of June and am not sure when this will resume.
Keep praying for safe travel, all the hospital details will go smoothly, pain relief, and no nausea after surgery. Three trips to Chicago in three weeks is a lot of driving for my mom. Our plan is stay with family on Friday evening and return to St. Louis on Saturday.
We probably will not have Internet access until we return to St. Louis, but will update the blog as soon as we arrive home. Thanks for your endurance in praying in the midst of challenging circumstances .... I appreciate your encouragement and faithfulness. Signing off to the most successful skin graft ever!
je
Tuesday, May 29, 2007
Sunday, May 27, 2007
Skin Grafting this week ...
We are home from Chicago! I apologize that I didn't get the blog updated sooner ... there were Internet problems at the hotel. It has been a long and emotionally tiring several days, but overall all went well with doctor visits and traveling.
Skin grafting needs to happen and it is a bigger deal than I thought. I didn’t want to do this necessarily in Chicago, but it looks like that is what is going to occur. I wasn't able to locate a surgeon in St. Louis that would work with me on an open foot wound. We will have made three trips to Chicago in three weeks ...
The toe pins are out! The dynamic positioning issue continues to be baffling and puzzling. The surgeon had a med student join her from Northwestern University and he had never seen anything like it. She (surgeon) had talked with the plastic surgeon and gave him the background of my situation, which helped significantly.
I agreed to do whatever is needed to get the wound to close and four weeks of physical therapy. If at the end of the therapy month, the pain and function have not improved then our only choice is to transition to the prosthetic option. We could amputate either the front half of the foot or at the ankle (and keep the heel area). Lots to learn on this yet …. she is still hopeful that the pain will decrease and the function will improve, but at the same time understands that I need closure with all of this.
We met with the plastic surgeon in Evanston, IL (about 20 minutes from the orthopedic surgeon's office) that has a particular interest in wound care and getting challenging wounds to heal. He said that the wound is not going to heal on its own and skin grafting is needed. The blood flow is okay, no hardware needs to be moved, and the pulse in the foot is okay. It looks rawer now than ever – he opened it up more in the office, to allow it to drain.
There is no infection in the wound now, but the longer we go with it open … this risk increases. We planned the skin grafting surgery for this Thursday, May 31st (2:45pm) in Evanston, IL. I need to spend one night in the hospital and then return for a follow-up appt. six days later. We will likely graft skin from my hip. No weight on the foot for at least a week and then the foot needs to remain elevated for 90% of the time for the next few weeks. He cleaned out the wound and the plan is to keep it as clean as possible until the surgery happens. No physical therapy can happen until the skin grafting is healed. Obviously, you can't live with a chronic open wound, so we have to try what is needed to get the wound to close.
Thanks for your continued prayers. I am not going to to be able to travel to Portland as I had planned for work. Managing the foot situation and two weeks of summer camp is going to be a lot for June. I am thankful that the plastic guy was able to work me into his schedule this coming week, but am not anxious for more surgery, sutures, pain, etc.
Hope you have a great holiday weekend!
je
Skin grafting needs to happen and it is a bigger deal than I thought. I didn’t want to do this necessarily in Chicago, but it looks like that is what is going to occur. I wasn't able to locate a surgeon in St. Louis that would work with me on an open foot wound. We will have made three trips to Chicago in three weeks ...
The toe pins are out! The dynamic positioning issue continues to be baffling and puzzling. The surgeon had a med student join her from Northwestern University and he had never seen anything like it. She (surgeon) had talked with the plastic surgeon and gave him the background of my situation, which helped significantly.
I agreed to do whatever is needed to get the wound to close and four weeks of physical therapy. If at the end of the therapy month, the pain and function have not improved then our only choice is to transition to the prosthetic option. We could amputate either the front half of the foot or at the ankle (and keep the heel area). Lots to learn on this yet …. she is still hopeful that the pain will decrease and the function will improve, but at the same time understands that I need closure with all of this.
We met with the plastic surgeon in Evanston, IL (about 20 minutes from the orthopedic surgeon's office) that has a particular interest in wound care and getting challenging wounds to heal. He said that the wound is not going to heal on its own and skin grafting is needed. The blood flow is okay, no hardware needs to be moved, and the pulse in the foot is okay. It looks rawer now than ever – he opened it up more in the office, to allow it to drain.
There is no infection in the wound now, but the longer we go with it open … this risk increases. We planned the skin grafting surgery for this Thursday, May 31st (2:45pm) in Evanston, IL. I need to spend one night in the hospital and then return for a follow-up appt. six days later. We will likely graft skin from my hip. No weight on the foot for at least a week and then the foot needs to remain elevated for 90% of the time for the next few weeks. He cleaned out the wound and the plan is to keep it as clean as possible until the surgery happens. No physical therapy can happen until the skin grafting is healed. Obviously, you can't live with a chronic open wound, so we have to try what is needed to get the wound to close.
Thanks for your continued prayers. I am not going to to be able to travel to Portland as I had planned for work. Managing the foot situation and two weeks of summer camp is going to be a lot for June. I am thankful that the plastic guy was able to work me into his schedule this coming week, but am not anxious for more surgery, sutures, pain, etc.
Hope you have a great holiday weekend!
je
Tuesday, May 22, 2007
Plastic Surgeon in Chicago found .....
We made a little progress today on the open incision situation (that has not healed), thankfully!
On Monday, I spent several hours calling plastic surgeon offices in St. Louis trying to find a doctor that would do skin grafting on a wound on the foot. I tried several referrals from my St. Louis orthopedic surgeon and was unable to locate anyone that was willing to see me/or operate. All the plastic surgeons in St. Louis seem to be interested in cosmetic surgery ($$) and not repairing wounds.
I e-mailed the Chicago surgeon and informed her that it didn’t look like that skin grafting was going to be happening in St. Louis. She e-mailed me back two names of Chicago plastic surgeons this morning. I called them and was able to get an appointment at 3:00pm on Friday afternoon (May 25th) in Evanston, IL (suburb of Chicago). If surgery is necessary (which we think it is), the initial plan is to have the skin grafting done on Tuesday, May 29th in Evanston, IL. My orthopedic surgeon in Chicago is going to talk to the plastic surgeon before my appointment on Friday afternoon.
Friday, May 25th
10:30 – Meet with Orthopedic Surgeon – toe pin removal
3:00 – Meet with Plastic Surgeon – incision consultation
– decide about skin grafting/vacuum implanted
Tuesday, May 29th – possible skin grafting surgery – in Chicago
I am extremely thankful that I was able to get an appointment with the “plastic guy” on the same afternoon, especially right before a holiday weekend. We will not know until after the afternoon appt., as to whether or not surgery will happen on Tuesday. Return plans to St. Louis are undecided, depending on what we learn on Friday afternoon.
Thank you for earnestly praying the past few days ….. I didn’t think there was any chance of this coming together yesterday and things came together for an initial appointment nicely today. God continues to be good and He has it all under control, even when things feel “out of control.” Keep praying that if we need to schedule the skin grafting surgery for Tuesday, that details for this will happen easily.
Looking forward to having pins out on Friday and hopefully getting the incision permanently fixed soon ….
je
On Monday, I spent several hours calling plastic surgeon offices in St. Louis trying to find a doctor that would do skin grafting on a wound on the foot. I tried several referrals from my St. Louis orthopedic surgeon and was unable to locate anyone that was willing to see me/or operate. All the plastic surgeons in St. Louis seem to be interested in cosmetic surgery ($$) and not repairing wounds.
I e-mailed the Chicago surgeon and informed her that it didn’t look like that skin grafting was going to be happening in St. Louis. She e-mailed me back two names of Chicago plastic surgeons this morning. I called them and was able to get an appointment at 3:00pm on Friday afternoon (May 25th) in Evanston, IL (suburb of Chicago). If surgery is necessary (which we think it is), the initial plan is to have the skin grafting done on Tuesday, May 29th in Evanston, IL. My orthopedic surgeon in Chicago is going to talk to the plastic surgeon before my appointment on Friday afternoon.
Friday, May 25th
10:30 – Meet with Orthopedic Surgeon – toe pin removal
3:00 – Meet with Plastic Surgeon – incision consultation
– decide about skin grafting/vacuum implanted
Tuesday, May 29th – possible skin grafting surgery – in Chicago
I am extremely thankful that I was able to get an appointment with the “plastic guy” on the same afternoon, especially right before a holiday weekend. We will not know until after the afternoon appt., as to whether or not surgery will happen on Tuesday. Return plans to St. Louis are undecided, depending on what we learn on Friday afternoon.
Thank you for earnestly praying the past few days ….. I didn’t think there was any chance of this coming together yesterday and things came together for an initial appointment nicely today. God continues to be good and He has it all under control, even when things feel “out of control.” Keep praying that if we need to schedule the skin grafting surgery for Tuesday, that details for this will happen easily.
Looking forward to having pins out on Friday and hopefully getting the incision permanently fixed soon ….
je
Saturday, May 19, 2007
Big Decisions Ahead ....
On Friday I had the stitches removed from the incision, although it has not healed as we had hoped. The incision continues to drain and the open wound remains present. This wound has now been open since early February. There is no infection, but clearly my body is not able to allowing the normal healing process to occur.
After a rough week emotionally, I spoke with the Chicago surgeon on Friday evening about 7pm. We talked for about twenty minutes on the phone and she answered my questions and listened to my frustrations. She said that "enough is enough" on the incision and it is time to have it surgically closed (either with skin grafting or a suction device implanted) by a plastic surgeon. She has contacted my St. Louis surgeon and we will begin the process for this to happen - probably very soon.
The Chicago doctor will remove the toe pins next Friday at a post-op appointment in Chicago. She strongly wants me to do 4 weeks of physical therapy (during June) in St. Louis. If at the end of June the pain remains and my function issues continue with walking, she is willing to work with me on transitioning to a prosthetic foot (amputation). There is no further surgery that can be done to correct the positioning problem that still remains. There is a definite positioning deformity that still exists and is not something that can be fixed via surgery. Going with a prosthetic foot obviously is a huge decision, which requires much research and skill on the part of the surgeon. No one "wants" to go this route on someone my age, but we are also at the place of needing closure.
She (Chicago doctor) still feels that physical therapy may help, so we will give it one more try. In the past, it has not been beneficial. I will agree to cooperate with four more weeks of therapy, if there is a four-week time frame. I am in need of closure and finality to the situation, which cannot take all summer. I will get stronger pain medication when I meet with her next week.
I am thankful that I was able to speak with the Chicago surgeon on Friday evening. My work schedule is extremely busy beginning June 1, so I am concerned about getting the plastic surgery done, pain, energy, stamina, etc. I am looking forward to getting the pins out on Friday, May 25th. We will go to central Illinois Thursday evening and then will head to the Chicago area early Friday morning.
Thanks for your continued prayers as big decisions are ahead .... wishing you a joyous weekend!
je
After a rough week emotionally, I spoke with the Chicago surgeon on Friday evening about 7pm. We talked for about twenty minutes on the phone and she answered my questions and listened to my frustrations. She said that "enough is enough" on the incision and it is time to have it surgically closed (either with skin grafting or a suction device implanted) by a plastic surgeon. She has contacted my St. Louis surgeon and we will begin the process for this to happen - probably very soon.
The Chicago doctor will remove the toe pins next Friday at a post-op appointment in Chicago. She strongly wants me to do 4 weeks of physical therapy (during June) in St. Louis. If at the end of June the pain remains and my function issues continue with walking, she is willing to work with me on transitioning to a prosthetic foot (amputation). There is no further surgery that can be done to correct the positioning problem that still remains. There is a definite positioning deformity that still exists and is not something that can be fixed via surgery. Going with a prosthetic foot obviously is a huge decision, which requires much research and skill on the part of the surgeon. No one "wants" to go this route on someone my age, but we are also at the place of needing closure.
She (Chicago doctor) still feels that physical therapy may help, so we will give it one more try. In the past, it has not been beneficial. I will agree to cooperate with four more weeks of therapy, if there is a four-week time frame. I am in need of closure and finality to the situation, which cannot take all summer. I will get stronger pain medication when I meet with her next week.
I am thankful that I was able to speak with the Chicago surgeon on Friday evening. My work schedule is extremely busy beginning June 1, so I am concerned about getting the plastic surgery done, pain, energy, stamina, etc. I am looking forward to getting the pins out on Friday, May 25th. We will go to central Illinois Thursday evening and then will head to the Chicago area early Friday morning.
Thanks for your continued prayers as big decisions are ahead .... wishing you a joyous weekend!
je
Friday, May 11, 2007
Stitches remain a bit longer ....
The stitches didn't come out today, as I had hoped. The incision has continued to drain this week and my St. Louis doctor thought we should wait another week. Ugh! I am to return next Friday (May 18th) to see if it looks healed. He agreed that the foot is not laying flat and he feels there is still an undiagnosed nerve problem. We talked very briefly about where to go from here. He recommended physical therapy for 4-6 weeks after the pins are removed on May 25th. I have very mixed feelings about this and the lack of success that I've had in the past.
Toes 1-3 continue to be in the air and he didn't feel that they would come down or make contact with the ground, once the pins are removed. Meanwhile, the pain continues to be substantial and my hip is having issues with the continued strain of not walking correctly. Clearly, the last surgery didn't solve our issue with pain or improved walking. The frustration of the situation continues to linger and increase. In two weeks, it will be three years since we started all of this. We have spent a significant amount of time and money on this medical journey with little success.
The Chicago doctor is going to call me one evening next week and will answer the questions that I e-mailed to her earlier this week. Hope you have a relaxing weekend!
je
Toes 1-3 continue to be in the air and he didn't feel that they would come down or make contact with the ground, once the pins are removed. Meanwhile, the pain continues to be substantial and my hip is having issues with the continued strain of not walking correctly. Clearly, the last surgery didn't solve our issue with pain or improved walking. The frustration of the situation continues to linger and increase. In two weeks, it will be three years since we started all of this. We have spent a significant amount of time and money on this medical journey with little success.
The Chicago doctor is going to call me one evening next week and will answer the questions that I e-mailed to her earlier this week. Hope you have a relaxing weekend!
je
Tuesday, May 8, 2007
Stitches out soon ....
The stitches over the medial wound come out this Friday ... yeah! The incision has been very itchy this week, so I am ready. I thought the wound had stopped draining and e-mailed the Chicago surgeon with this improvement last night and then the drainage continued all day today ... who knows!
The area where there has been pain all along (medial side of the foot)has continued to increase. I am using the boot, but am not walking much. Toes #2 and #3 are definitely straight, but they do not touch the ground. I am not sure if this is because of the pins or if this is the permanent position. Either way, the pain has returned and walking continues to be a significant challenge.
I e-mailed the Chicago surgeon yesterday with seven additional questions, so I am hoping to hear back from her with answers shortly. I suggested that we talk on the phone, rather than having her take time to write out all the answers. We are making plans to return to Chicago on May 25th. I have substantial concerns about the quality of life and function ability aspect with the foot.
Keep praying for patience .... and an openness for both surgeons to honestly tackle tough questions. It is my desire to be realistic about what is possible and what is not at this point with further medical options.
Looking forward to being "stitch free" by the weekend!
The area where there has been pain all along (medial side of the foot)has continued to increase. I am using the boot, but am not walking much. Toes #2 and #3 are definitely straight, but they do not touch the ground. I am not sure if this is because of the pins or if this is the permanent position. Either way, the pain has returned and walking continues to be a significant challenge.
I e-mailed the Chicago surgeon yesterday with seven additional questions, so I am hoping to hear back from her with answers shortly. I suggested that we talk on the phone, rather than having her take time to write out all the answers. We are making plans to return to Chicago on May 25th. I have substantial concerns about the quality of life and function ability aspect with the foot.
Keep praying for patience .... and an openness for both surgeons to honestly tackle tough questions. It is my desire to be realistic about what is possible and what is not at this point with further medical options.
Looking forward to being "stitch free" by the weekend!
Wednesday, May 2, 2007
Mid-week update ....
Work is going well and not having a cast has been a huge blessing this week with warmer temperatures outside. I am guarding the "straight as arrow" toes and the two external pins (i.e. "pearls"), as to not bump or disturb them in any way. Walking on the heel is very tiring, so there is not a lot of walking happening. The post-op pain is generally gone and I have not been able to put enough weight on it to know if we have solved the pain issue.
I wrote to my Chicago surgeon and asked what she meant by foot still having a "dynamic problem" .... this was her response: The dynamic component is when you (Jenny) stand, load your foot, react to the ground, the muscles and tendons fire and power your foot, not necessarily where we want it to be, but when you (JE) are totally relaxed under anesthesia, the limb is without deforming force and lies perfectly flat. Bottom line: What you see during surgery, is not always what you get as for positioning long term!
Her explanation tells me why so many surgeons have thought that they have corrected the problem during surgery and then later the foot appears to have changed positions. This is not any "new" information, but I thought her the way she explained my situation was clear and understandable. It is like trying to correct a problem in the operating room that you cannot see!
As for my scooter color .... it is boring blue. No color choice here. A flashy hot-pink or animal print design would surely be a marketable improvement. The kids in the Village all think it is the coolest thing and want to ride it .... little to they know, it is not as appealing as it looks. However, I keep it on "rabbit speed" all the time and do have to be careful not to zoom into anything while riding.
I am trying to be patient and not be concerned with shoes, pain, not driving, getting back to my house or walking yet. All are still weighing heavily and I think about these things more than I should. We are taking it one day at a time and doing the best we can with what we have. Hope you are having a blessed week!
I wrote to my Chicago surgeon and asked what she meant by foot still having a "dynamic problem" .... this was her response: The dynamic component is when you (Jenny) stand, load your foot, react to the ground, the muscles and tendons fire and power your foot, not necessarily where we want it to be, but when you (JE) are totally relaxed under anesthesia, the limb is without deforming force and lies perfectly flat. Bottom line: What you see during surgery, is not always what you get as for positioning long term!
Her explanation tells me why so many surgeons have thought that they have corrected the problem during surgery and then later the foot appears to have changed positions. This is not any "new" information, but I thought her the way she explained my situation was clear and understandable. It is like trying to correct a problem in the operating room that you cannot see!
As for my scooter color .... it is boring blue. No color choice here. A flashy hot-pink or animal print design would surely be a marketable improvement. The kids in the Village all think it is the coolest thing and want to ride it .... little to they know, it is not as appealing as it looks. However, I keep it on "rabbit speed" all the time and do have to be careful not to zoom into anything while riding.
I am trying to be patient and not be concerned with shoes, pain, not driving, getting back to my house or walking yet. All are still weighing heavily and I think about these things more than I should. We are taking it one day at a time and doing the best we can with what we have. Hope you are having a blessed week!
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