We have determined that the reconstructive surgery that was done a month ago in San Antonio has not healed as we had hoped. A very small section of the incision did heal, but the skin that was moved over to cover the original wound did not stay together when the stitches were removed after three weeks. The area has continued to drain, and remain open in about a 3” skin section. We did not make the wrong choice with the last surgical decision, as you always to try the least invasive procedure to allow the foot to naturally heal as much as possible (before skin grafting). Obviously, we must do something else to cover over the open area, and it seems my foot now needs a new healthy blood supply brought into the foot to promote healing.
At the top of every foot are 5 bones called “metatarsals.” A normal foot bends at this area (right behind the toes), and these are what allow you to walk normally, push into a shoe & provides foot movement. Because of the fusion surgery that was done in February, ‘07, I lost all of this motion. We’ve talked for over a year about removing part of the metatarsal bones, which would give me move toe movement & hopefully would provide the hope of wearing a shoe again someday.
The incision to remove the metatarsal head bones and my current wound are the exact same spot. Common sense would tell you that if I need more toe movement, now would be the time to fix it before we get the wound closed. Once the wound is closed/healed, it cannot be opened again (i.e. like forever). It is a “do it now” or “never” deal.
I would be devastated, frustrated and very upset if we got this to close and then I still couldn’t wear a shoe or walk well. I’ve looked at shoes enough over the past year to know that I cannot wear much of anything without more toe motion.
After much discussion with the three surgeons (St. Louis, TX, IL), all three agree that it is best to do the two procedures. It has been a very challenging & heartbreaking decision on our part. We had hoped that both could be done in the same operation, but that is not possible.
The plan is as follows:
April 22 – Metatarsal head removal on 4 toes – in St. Louis w/orthopod
- Outpatient; pins & cast; use the same incision that is now open
- Should allow toe movement & increased mobility when healed
May 12 – Radial Forearm Flap surgery – in San Antonio w/plastic surgeon
- Week in the hospital; cast; move skin & blood vessels from the forearm to the foot; large forearm incision & no weight on the foot for 4 additional weeks. New & healthy blood supply will get to the foot; new blood vessels are attached at the heel. Same TX hospital as were at before.
If by some miracle the skin would close after the first surgery, we would cancel the May 12th plans (please pray for that!). The second procedure is fairly extensive, but if the skin will not remain closed, there is no other option. With a new and healthy blood supply brought to the foot, it has a very high probability of being successful.
I will plan to take a short “leave of absence” from work (4-5 weeks) starting on May 12. As you can imagine, it has been an emotional and challenging week filled with making decisions that we’d hoped we wouldn’t be making. We are still trying to process it all and think through details related to the weeks ahead. We need to do whatever it takes to make the next two months a time of complete healing. There is a long road ahead over the next two months. None of this has to do with surgeon expertise or skill…we have three of the best doctors in the country working on this. Dr. Ingari in San Antonio specializes in orthopedics, plastic surgery and microsurgery. People from all over the world see him to seek his expertise and surgical skills. All of this is difficult to explain and understand, so if it seems confusing or never-ending, we understand and share some of the same feelings.
We know that God continues to be in control here and even in the details (large and small), and we truly remain hopeful that it will all work out in the end. We’ve come too far to give up now and are blessed that this is not a terminal medical situation. Thank you for praying for healing, patience, acceptance and wisdom. Your support and love has made a huge difference!
je
1 comment:
Dear Jenny,
My heart hurts to read of this development. More importantly, hold onto the fact that God also weeps as Bill mentioned in last week's sermon. You have taken the complex and made it very understandable in my opinion. We'll trust that getting the metatarsals taken care of now will be a huge blessing.
Linda Sjerven
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