Incision Wound Issues ....

We are back from Chicago! We met w/Dr. Howard (plastic surgeon) on Friday afternoon & it was good that we went.

He cleaned scar tissue & other yellow “junk” out of the wound in his office (thank goodness for Darvacet & mom driving). Glad I have a strong stomach. He did get the tissue area to bleed, which was a good sign. The area is probably the size of a small lima bean, although it is deep. He cleaned down to the bone & thought several things …

- he guessed it has not healed because of the scar tissue in the area.
- the edema was less yesterday (have had it up)
- the circulation in that area is probably compromised and thus it
affects healing. He compared it to a type of “crush injury.”
- there is a possibility that the bone there is infected or has bacteria
around it; don’t really know unless we’d biopsy it.

THE PLAN:
The plastic surgeon prescribed cream called silver sulfadiazine & wants me to put this on the wound and keep it packed w/gauze, keep it moist, continue w/antibiotic. If it is going to start to heal on its own, he said I should see some improvement in a week (could take a long time to fully heal). He suggested that I elevate most of the time and try to be non-weight bearing for the next week, to see if this aids in healing.

If it isn’t responding in a week, then he’d likely clean it out surgically and re-stitch and see if we could get it to hold together. Skin grafting isn’t an option because of the bone involved in the area. We didn’t totally rule out the oxygen treatment suggestion. Insurance, time & practicality are big issues here.

We are going to talk or e-mail w/the plastic surgeon toward the end of next week and see where we are headed. Best case would be for it to start to heal on its own, but sounded like it could go either way. I will be blessed if this happens.

I think that between holiday stuff and the hive issues, that I’ve just been bandaging longer than I realized … I kept thinking that the drainage would stop. I’m usually on top of things more than I was this time. No issues w/snow – sloppy and rainy, but that was it.

It will work out .... God is still in control of it all. Thank you for praying on such quick notice. The visit went as well as could be expected. I'm very thankful that I could see the plastic surgeon so soon; this is a huge praise!

Happy New Year!
Jenny

Friday Chicago consult ....

Pray about for wisdom about the incision healing at 3pm tomorrow (Friday). We are headed to IL tonight and onto Chicago tomorrow morning to consult with the plastic surgeon (that we've worked with in the past) as to why the latest incision is not closing. Our trip will be rather quick and we are hoping for safe travels with no or little snow, which seems to be in the forecast for Chicago.

I e-mailed with the Chicago orthopod earlier this week and she thought it was wise for me to see the plastic surgeon regarding wound closure. I've e-mailed with him several times since Tuesday, but the future direction on resolution is unclear. He needs to see it & then we need to make a decision as to the best option. Skin grafting may or may not be an option. He has suggested an alternative treatment option (very involved), but from my research this doesn't look real viable. Hopefully we can come up with a better solution. I thought we were on the "right track" with this, but I am at about 6 weeks post-op and it shouldn't be open & drainage should not be continuing. This wound is smaller than the area that would not close last May, but it is in a different spot on the foot. We will probably return home on Saturday morning.

Thanks for your prayers!
Jenny

Keep praying ....

I am at 5 weeks post-op, since the hardware removal surgery. The incision has not healed as I had hoped. It has continued to drain liquid, has been more swollen than usual and is not totally closed yet. I met with the St. Louis orthopod this morning and he didn't think there was an infection, but my feeling is that I'm at the early stages of one. We started antibiotics today just to be on the safe side. The incision looks very similar to last spring, when we kept waiting & waiting for it to heal and it never did. Pray that the drainage will stop and that the wound will close naturally. I am not up for more skin grafting.

The blood work for the possible wheat allergy came back okay. We didn't test for gluten, so that may happen yet. The "skin issue" progressed to my hands this week, causing the skin on all my fingers to crack & be painful. I have never had issues with skin like I have in the past 6-8 weeks. I've been really discouraged about it this week, as it seems to be going on and on, with no end in sight. I feel like we've tried everything with little success. We are trying several steroid creams, but I really need closure on this. The itchiness continues to be significant. The dermatologist thinks that it is related to the foot and it is the bodies way of dealing with the stress of it all.

We are headed to the Eickhorst farm in Illinois tomorrow to celebrate Christmas. Pray for a good weekend of family time together, calm skin, and that the antibiotic will prevent any possible infection from starting in the foot.

Love & hugs,
je

Holiday Happenings ....

The foot continues to heal and the incision area is remaining closed. Still wearing a tennis shoe or Croc style and am walking as much as possible. I have students on Monday and Wednesday of this week and then am looking forward to a 4-5 week break with no kiddos. Wearing a "normal shoe," is still challenging ... I think this is due to minimal toe movement, but I'm not totally sure.

Overall the hives have been better the past week, since I've been doing the wheat-free diet. It has been challenging because wheat is in the majority of foods, but the hives have been significantly less. I've gotten to know Trader Joes & Whole Foods better than I ever thought possible.

I was thankful that I wasn't on crutches this weekend with the big snow. I shoveled my driveway on Saturday and couldn't remember the last time that I did it myself. I baked, wrapped gifts and had hot cider today. It was a cozy and chilly day in St. Louis today, but fun to be at my house and enjoying small holiday treasures. We are headed to Illinois next week for the Eickhorst family Christmas.

Hope you are enjoying the majesty of the manger ...
Jenny

Quiet week ....

There hasn't been a lot new happening this week. The foot has felt pretty weak this week, so I'm thinking we need to do some strengthening exercises at home. It has been almost 2 1/2 weeks since the hardware removal surgery, so it is still fairly early. The incision is healing, although it easily needs another week. It is hard to tell totally, but I think it is remaining closed. I am able to wear a tennis shoe or "crock" style shoe. I have students at work next week on three days, and then will have about a four week break with no kiddos .... this will be good for the foot - resting period. I don't have a follow-up appt. scheduled to return to Chicago. We are just seeing how things progress and what happens. We've been
e-mailing as needed, so for now that is working.

As for the hives, they have been somewhat better the past few days. I stopped eating wheat and all wheat products last Sunday. I'm not sure if I have a true wheat allergy or not, but there have been less hives. Wheat is in a ton of foods, so it would be good if there is not an allergy to this. I am supposed to see the allergist again next Tuesday afternoon. My Chicago orthopod suspects that the hives are caused by stress and we may never know the exact cause.

Hope you are staying warm!
Jenny

Stitches Out!

All went well with having the stitches removed on Friday morning. I was in and out of there in all of fifteen minutes! I easily need another two weeks for more healing to take place. Thankfully, the incision is staying closed - whew! It is still pretty tender and I can't do a confined shoe yet. I did wear a tennis shoe this afternoon for several hours. I am back at my house now and am able to drive.

It is clear that because there is minimal movement with the toes, this is always going to make wearing anything other than a tennis shoe challenging. A "mule style" shoe is a better choice, but that isn't the best for my hip situation. I'll figure it out somehow.

I had to stop the medication that was working on the hives. The increased heart rate and heartburn was almost worse than the hives. I woke up Saturday morning with the hives all over both hands. They subsided somewhat by the afternoon, but clearly there is something that I am still allergic to - you'd think we'd have figured it out after three months.

Hoping for a "hive free" week ....
Jenny