No progress yet ....

This week has been somewhat disappointing and frustrating, as we've made no progress on anything. The San Antonio surgeon is still willing to close the wound, but he has not talked with the St. Louis orthopod, so nothing has been able to be scheduled. I cannot schedule this directly myself, otherwise I'd have done it already. I'm feeling like the weeks are going by quickly and we are losing more and more foot motion - discomfort, walking, and the shoe situation are all still big obstacles. I have not slept well this week and there have been several big stressful situations at work, so overall it has been a challenging week. If the San Antonio doctor is booked out several more weeks to schedule surgery, that plan is not going to work. I'm not sure why we are struggling to get a surgical appointment, but we are for whatever reason. Hoping to hear something via e-mail from the St. Louis doctor this weekend ....
je

Scheduling in process ...

We are working through scheduling details and are making plans to go to San Antonio to meet with the plastic/orthopedic surgeon. There are two surgical options, but I am guessing we won't decide which one is best until we meet with the surgeon. I don't have exact dates/times yet, but hope to get things finalized early next week .... we are trying to go in the next two weeks. The surgeon has agreed to see me one day and then do the procedure the following day. There is one more cat scan/dye test (related to blood vessels) that needs to happen yet, so we will do that quickly in STL and will bring the results to the Texas surgeon. It will tell him where it would be best to hook up new blood vessels ... this is really complex & I understand some, but not all of it as of yet.

I have insurance details lined up, but need to schedule flights as soon as I hear back from the surgeon's office. Not sure on the length for a hospital stay, but hopefully not real long. I'm very thankful for my STL orthopod's willingness to coordinate initial details ... he has done a lot of e-mailing this week between the three parties involved. Will keep you posted ....

je

Progress made today ....

My appointment yesterday with the STL orthopod was okay. He explained the my open foot wound is in the shape of a "V" and it is deep (involving bone). Therefore, a normal skin graft cannot happen because there is nothing to fill in the "V" shaped hole. Finally glad to hear an explanation on this! He agreed that we are not making the necessary progress locally and he recommended that I see a plastic/orthopedic surgeon located in San Antonio, Texas. Clearly, I need a doctor referral on this, as it is not working to walk in on my own & get action beyond what we have already tried. This doctor is someone that he has worked with in the past (military medical experience) and he said that he would go to Texas, if he had a foot with my situation. His referral to the Chicago orthopod was good and I would have never found her on my own, so I am thinking this may be the same deal. It is fairly unuseal for a surgeon to have plastic and orthopedic experience.

The STL orthopod e-mailed the San Antonio surgeon yesterday and he responded today saying that he would be willing to see me and close it. I have a lot of details to learn yet, but the procedure is fairly complex and involves a hospital stay (not sure for how long). We are in the process of working through scheduling details, need to look at flights, insurance paperwork, etc. I e-mailed the Chicago orthopod today and am seeking her advice.

The positioning of my foot also looks questionable now as well, so we need to get this fixed ASAP. The STL orthopod thought it looked worse yesterday, compared to my last visit with him in December. Not worrying about this at the moment, but clearly we need to get back to wearing a tennis shoe and exercising as soon as possible. I am doing what I can w/exercising and moving the foot at home.

Thankful for the following ....
- Possible doctor to close the wound and that he responded quickly.
- That the STL orthopod appreciated that we need "closure" on all of this.
- For his willingness to facilitate scheduling details. Hopefully we can work through follow-up care details, too. Traveling to San Antonio is a hike!

- Snow day today .... chance to rest, do home "stuff," be off the foot, etc.
- Slept well last night.
- Progress yesterday & today, when it looked bleak earlier this week.
- Friends and family that have prayed during a rough week.

Continue to pray for peace, wisdom, details to happen in a timely manner and that we'll be able to schedule with the San Antonio surgeon fairly quickly.

Love & hugs,
je

Rough several days ....

Keep praying! I've seen three plastic surgeons in two days (1 in Chicago and 2 in STL) and met with the Chicago orthopod yesterday in Chicago. The only good thing that has happened is that it was good seeing the Chicago orthopod and we are both very frustrated together at the lack of other surgeons willingness to help. Neither of us can believe how difficult this is, since we no there is no infection or blood flow issue. Apparently the wound is so deep, that no one wants to close it surgically, but can't offer much else. No one fully understands the longevity of this issue and that we need "closure" in more ways that one. We really made have made no progress. It is a long medical explanation as to why we haven't made progress - too long to explain on the blog. I'm stressed, emotional and at my wits end with this. The pain level is fairly high and I'm taking entirely too many narcotics for this problem ... walking was very hard today.

I had to be gone for two appointments today that totaled 4 hours away from work, so I worked tonight until 8:30pm. Trying not to take a "leave of absence," but that may happen yet. I'm seeing the STL orthopod tomorrow morning at 8am, but ancipate that he won't have much new to offer .... it has been awhile since he has seen the wound, & he needs to see it again. Long day today & I could be fairly negative today, if I don't stop .... hoping for a something positive to transpire on this soon.

je

Blood flow okay ...

The blood flow test that we did on Tuesday came back normal today. The report stated that there is adequate blood flow and circulation for tissue healing, which means that "trauma" to the foot area has to be the reason for the non-healing area. I have appoinments with three plastic surgeons for Friday, Monday and Tuesday, although I probably will not keep all three appointments - two will probably be enough to consult with.

Teaching today went okay, although it made me appreciate that I am not in the classroom full time with the foot situation. We arrived thinking there were 17 kids in the class and it turned out that there were 31 kiddos! Needless to say, I was taking apart Valentine goodie bags and scrambled to get through the day. I had brought extra materials, but not 31 of everything!

Happy Valentine's Day!

Quick update ...

All is about the same .... I made some more phone calls today to various plastic surgeons and am seeing what I can put together in the next several days. No change in the wound ... it is still draining significantly. It always amazes me how much liquid can come out of such a small area. At 2:30 tomorrow, I am having this blood flow test done (MO Baptist hospital) to see if adequate blood is getting to the foot. It is similar to an ultrasound, so nothing major. Although the blood flow is not spectactular, I expect it will come back adequate. I've been told before that blood is getting to the area, so I anticipate this to be the same now. Pray that I can get the technition to tell me initial results or perhaps it will be obvious to me. I need pain relief to happen soon. I have to clean the wound with a toothbrush each day and as you can imagine, it is not a pleasant experience.

I'm teaching economic lessons (through JA) to a 4th grade class in the city all day on Wednesday of this week. I am excited about the opportunity, but it will be a long day. I am bringing another adult as a helper, so I'll teach and she will do all the "running" & passing out things to the class. We have kids in BizTown tomorrow and then nothing the remainder of the week .... although there are 4 visit days next week and two nights with meetings, so next week will be very busy.

Keep praying for wisdom, details to happen quickly and clear direction ....
je

Bummer day ....

It has been a long day today with a lot of foot pain, so this is going to be brief. The appt. w/the plastic surgeon today didn't go so well. It is a long story, but he thinks I have a blood problem, that I've been told I don't have. He won't do a skin graft, which I've been told is the only option at this point. I spent an hour at his office and really didn't get anywhere. I need to get another opinion, but will have to start over in searching for another name. I'm feeling like it is constantly a "fight" to get medical help with this, which shouldn't be the case. Nothing happening on this in the short term, but pain and drainage continue to be huge issues. I am starting to lose mobility that I had in the foot back in November, as it has now been three months with no exercise. Tomorrow is a new day ....

je

Plastic Surgeon Appointment ...

I heard back from the Chicago orthopod on Monday and she said that it is time to seek the advice of a plastic surgeon and have he/she close the wound with skin grafting. She agreed that both of us have tried diligently to get the wound to heal and we did our best. I have no regrets for trying and for the past three weeks the wound did look like things were headed in the right direction with healing. She said that obviously the area cannot heal and seal on it's own and we've tried all conservative options. The was no bone or soft tissue infection, so this is not stopping it from healing. Needless to say, I was disappointed ... we both get the orthopedic perseverance award (that should include a trip to Hawaii).

Today my St. Louis orthopod referred me to a plastic surgeon in St. Louis that he thought would be willing to close the wound. I called this surgeons office and they said it would be two weeks for an initial appointment. Thirty minutes later they called back and had a cancellation for tomorrow (Thurs.) at 3pm .... yippee! I am going tomorrow and will seek his advice. This doctor operates three days a week (which is a lot), so hopefully I can fit into his surgery schedule somewhere soon. Pray that he knows what to do, is willing to work with me, am comfortable with him, and that I can make it happen with my work schedule. If there is any way to be able to have this taken care of in St. Louis, this would be much easier. If it doesn't work out with the doctor tomorrow, there is a possibility of returning to the plastic surgeon in Chicago (although scheduling w/him is challenging). The past three days have been long with the wound draining - hanging in there & still smiling.

Taking things day-by-day .... will update after the appt. tomorrow.

je

Ugh .... not happening as planned.

Tonight I realized that the incision either had either never fully healed or has come open in not one, but three tiny spots. Obviously, this is not going as planned or hoped. There was only one area on Friday that looked questionable, so 48 hours later it is somewhat falling apart. There is some discomfort in the area and it requires badage changing several times a day, due to the drainage. Pray that this doesn't become "all consuming & discouraging" this week. I have a really busy week at work this week and having to give attention to wound care wasn't on my radar screen. I have not thought ahead yet as to the next step ... am sure I'll contact the Chicago orhtopod after a few days & will get her advice. Both of us thought on Friday that we had made good progress & the majority of the wound was closed, but now I'm thinking otherwise. I'm not regretting the decision that we made to close again surgically but since the past 2 1/2 weeks went well, I really thought we had solved it.

I did read some neat thoughts this afternoon from Max Lucado. God is whispering, "It is going to be okay." Trust Him. Believe in Him. If God can make a billion galaxies, He can make good out of our bad. After all, He is God.

Blessings for a joyous week,
je

Home Safely ...

Thanks for praying on Thursday afternoon and night as we traveled to Chicago. It was a snowy night, but we made it safely and arrived around 9:30pm. My suregon called about fifteen minutes after arrival and wanted to make sure we were okay ... she is so caring. Chicago got more snow than expected and had a strong 9-10 inches. All the schools & many businesses were closed on Friday.

On Friday morning, she removed the stitches one-by-one and made sure that the incision stayed closed before progressing. We both looked at each spot and agreed that it all looked good. It is better than where we were three weeks ago, but the center of the incision is still open. I was told in the recovery room that this was a possibility. The drainage has returned, so we are going to watch it closely over the next few days & will see what happens. Not sure if skin grafting will still be needed or not. We went almost three weeks with a totally dry incision and everything looked closed. Frustrating to say the least ....

We also discussed my inability to wear a normal shoe (or anything closed) on the operative foot. She agreed it is due to my inability to bend right behind the "toe line." The two inches behind the toes is rigid w/no movement. You bend at this spot every time you push your foot into a shoe and I cannot do this. I was told in the fall that whatever motion I was going to get back with therapy had occured. I've been wearing different shoes on both feet for the past 4-5 months (fall/winter). I'm disappointed and somewhat frustrated that after all we've been through, this major issue still exists. There is a surgical fix but given where we are at, no one wants to discuss that option. It is not good for my left hip situation as well. Sring or summer shoes are somewhat easier, but not comfortably wearing the same pair of shoes is a dilemma. I went to another shoe shop in Chicago (specializing in shoes for people w/foot issues) and must have tried on 15-20 pairs with no luck. It doesn't sound like a big issue, but it is hard and affects a lot. In the short term, we need to continue to focus on the incision and then come back to the "shoe issue" at some point. In the meantime, wearing two different shoes will probably have to suffice.

Will see what next week brings ....
je