Hardware removal...be gone you nasty infection, be gone!!

April 8, 2013-Hardware Removal...seriously this time it will happen!

This time is was going to happen, no matter what. This infection seemed to just want to taunt me and my DR. It appeared when it wants to. I swear it had ears...As soon as it heard I was going to take a Friday off..it appeared. As soon as someone mentioned my Dr was going to be off, it appeared. As soon as my Dr was going to take care of it, it disappeared. This time not matter what, he was going to take care of it. Just in case it attached itself to the hardware, it had to go.

I got to UTMC this time bright and early. I had to be there at 5ish in the morning. As I was scheduled to be the first surgery for my DR at 7:30 AM. I got there, all prepped and all. My fav nurses were there, and they took great care of me, as usual. My Dr came in and explained everything. I tried to convince the Anesthesiologist that I did not need general, I still to this day to not think it was necessary...general anesthetic made me sick this time around too :-(.

My Hardware

Next thing I know it was over. I woke up in recovery with my proof of HWR, I got to keep my hardware. My Dr explained my surgery to my mom, and did not get to talk to me afterwards...Im sure I would not have remembered anyhow waking up from GA. I went home and recovered..I did end up emailing my dr that day who emailed me within minutes explaining my surgery, did I say my dr is awesome? because he is...lol I was back to work within 2 days after my hardware removal.

My pretty Post Op Splint

It all went very well. It was a lot easier of recovery than my initial surgery. I was expecting to be in pain, I was not. No pain pills were even needed. I did not even take any over the counter pain pills. I was able to be prepared. Prior to the surgery, and even before my non-HWR, I was able to prepare my house for my NWB period. I bought easy to prepare foods which were high in
protein and calcium. I had things made easier so I could easily get around on my knee scooter. I also practiced my crutches so I could use them in the house and leave me knee scooter out in my truck for work, and shopping.

I only had that post OP splint for a week. My Dr wanted to check my incision in a week to make sure the healing was going as planned. He  took off the splint and told me to keep the incision clean and wrapped. So I got to leave with ace bandaged. I did have promise to keep NWB, so my incision would heal. Also my HWR removal was still considered early, so I still had to be very carful. The next week, the stitches and staples got to go. I had stitches along the original incision. he has staples on another incision on the lateral side where I was having issues with pain. He cleaned both sides out during the surgery.  I was ok'ed to start weight bearing gradually.

Finally, an update, the continuation of the never ending Broken Ankle Journey!!

I know it has been like forever since I have posted. I have been getting back to my life, and kind of forgot about my journal. I know I needed to update it, because things have changed, for the better for the most part. 

Back to my journey----

Let's go Back to December ...sorry not the Taylor Swift song...

I left the story back in December after my first I & D, and surgery for my infection. That was on December 11, 2012. I reviewed my labs from that procedure, and it did reveal that I did have a little bit of a staph infection. It is the most common form of staph after an ankle surgery, "Staphylococcus aureus" (info from a medical journal, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690750/). 

I did all my follow up and the infection cleared up. My incision healed up quite nicely. I continued PT, and it went very well. I loved my therapists, and they challenged me every visit. My walking improved every visit. I am glad that I asked my DR for more therapy to work on my balance.

Wearing boots were one of my many major accomplishments of recovery. Walking long distances, especially while shopping was great. Making Christmas goodies, and just enjoying the holidays.

No matter what, through all of this I kept positive. I truly feel that being positive helped me the most during this journey. The encouragement of my friends, family, my BA family on facebook, and especially Dr's made this journey so much easier!!

The Return of the infection.....seriously??

It was not until the end of February that my infection, returned again. This time it returned with vengeance. I was very sore this time around. This was due to not only the return of the infection, but to some ligament issues. 

March 1, 2013-

I followed up with my DR, he scheduled a CT scan to check on the healing of my fracture. At this point he was debating Hardware removal. I had my CT that day. This was another Friday I had taken off of work, that I spent the majority of the day in the ortho department. To this day, I am afraid to take a Friday off. 

March 8, 2013-

Another Friday...I had my follow up for my CT scan. I discussed my results with my OS, and all the options and risks. We decided even though my fracture was about about 40% to go ahead and schedule Hardware removal for March 15, 2013. 

March 15, 2013-

Hardware removal, so it was scheduled to be...

I arrived bright and early for my procedure. My mom accompanied me this time. I got all prepped. The nurses all remembered me. I knew the drill. The resident came in and marked my ankle with his big ol'initials. explained the risks, etc. Also told me since my Dr was running behind he would not come in to see me before going back. Yet not to long after he left, my Dr was there. He looked at was was my infected sore....it was healed. totally healed up. It surprised my Dr. That is when he asked me if I wanted to proceed with the Hardware Removal...I told him it was up to him, because i trust his decision. He consulted with another Dr I know, and we decided at that time to not do the HWR.

He did aspirate the ankle joint, to check for infection. Basically took a big needle and took fluid out of the joint so it could be tested. Also if it looked cloudy, or infected he was then going to take out the hardware. It looked fine. Also due to the soreness in my ankle he did a procedure called "manipulation" he moved my ankle joint different ways to see what was causing the pain, insufficiencies in the ligaments, etc. He did this under fluoroscopy, which is basically live xray. It was very interesting because I was awake and could see it all.

I ended up discussing the results later with my Dr. He did advise me that the results of the labs came back clean and he discovered a possible issue with my deltoid ligament. This could be the reason behind the pain and instability I was having. We will take it day by day. Once Hardware is removed, then an MRI can be done to check on the ligament issues.

Of course...guess what? The infection came back...
I got in to see my OS, and in April...the hardware...this time...had to GO.

OMG will this happen to me?? Does everyone get an infection?

I do want to let everyone know that not everyone gets an infection. 

I am sharing my experience not to frighten anyone.

I am sharing it- 

to educate

to share with those going through the same situation

to get this experience off my chest

to show that some people can go through a difficult time, and as long as they are proactive, they will get better.

Everyone's experience is different. 

Everyone's recovery is unique to them. 

Not everyone goes into this in the same situation. 

Some people are at a higher risk because of many different reasons...

mine could have been my weight or even the fact that I was on pretnizone (steroid for dermatitis for a spider bite) prior to me breaking my ankle. 

For the most part, my recovery has been fairly good, minus the infection. I still to this day feel I have had the best possible care, by one of the best dr's.

The main thing, if you have any doubts in your care, get a second opinion. If you get an infection, be proactive. Do not wait. Seek medical attention. They go through many years of training for a reason. Do not try to diagnose yourself. 

Some signs of infection-

Redness

Heat at the area of infection

Fever

drainage (could smell, may not)

Soreness

Opening of some kind, sore, etc.

Call your DR, go into the ER. 

Get checked out by a medical professional.

It's been a while...

I know it's been a while since my last post. Work has been keeping me busy. Learning a lot, which is a plus. I always take any opportunity to learn more, if I get an opportunity to learn something. I am taking and putting forth my best effort. I do the same with my injury, I do what I can to learn everything I can about it. This is primarily because I have always been interested in injuries...yes I said injuries. I was an athletic training major in college before I switched. This injury of mine has sparked up my interest in studying medical and injuries. Now I am more interested in the healing and fixing rather than the preventing mind of the trainer. That is why I am currently looking into the possibility of going back to school. Not for athletic training, but Physician Assistant. 

It's Better to be Safe than Sorry!!

It's Better to be Safe than Sorry!!

That is one this I have learned from my Dr, as he's told be before "it's better to be safe than sorry". If you have any doubts in you healing, see anything strange like a blister or you incision is red, more swelling than usual, or abnormal pain...Call your Dr. That is what they are there for. I know I am guilty of not wanting to bug my Dr, but every time..but one...was an issue that needed to be taken care of...also...listen to your Dr. If you have suffered an ankle injury, one thing you will need to learn is the art of patience. You need to be patient, it will take time to get back on your feet, and listening to your Dr is key to recovery. That's my tips of the day :-) Now carry on.....

Should have listened to the Dr....

Should have listened to the Dr....

I truly learned a lesson from not listening to my Dr. Sure there were some times when I put weight on my ankle before I should have, or increased my PWB from 50% to 75%...but as my Dr told me at my last appointment, he did not have to worry...because I always tattle on my own self... Every time, I ended up fessing up to my Dr...LOL I just cannot lie to my Dr, I am honest to a fault as my friends tell me.

It was during my last visit, I should have LISTENED to my Dr. He had me walk from the chair to the exam table without my boot. I did fine, so he ended up telling me to loose the boot. I told him ok, but I will wait for therapy...Well my appointment with the Dr was 11/20/2012, but my PT was 11/28/2012. So I practiced in the safety of my home, bootless...but outside my house the boot was securely on my leg. I walked it up, but still in the boot. The day before therapy, guess what my handy dandy security blanket of a boot did...gave me a birthday present of it's own. A nice blister right on my nicely healed incision. I panicked a bit, but I will check with therapy... I got to work, the boot hurt like hell... the boot got the boot, under my desk it went. I got to therapy, by then it was broken and seeping. They attempted to page my Dr, which happened to be on vacation. They told me DON'T put the boot back on & contact my Dr as soon as he gets back.

I called my Dr on December 3, 2012, actually spoke to his Medical Assistant. Expecting it to be no big deal, maybe get an appointment some time that week or so...but no.. even though it was my Dr's surgery day, he wanted me in that day & he will come out of surgery to look at it. This really surprised me because I did not think it was that urgent...He checked it out & did not like what he saw. I asked if maybe it was a suture trying to work it's way out. I explained that it had to be the boot, the girls at PT located the exact spot in the boot where it was rubbing & I should have just listened to him to loose the boot...He disagreed with me thinking it could have to do with the hardware. He had me keep it clean & see him that Friday (btw I had Friday off, I requested it off to go shopping).

Friday December 7, 2012 came, I got all ready for what I thought would be a quick check. It was far from quick. my Dr was not happy with the healing at all. I was on antibiotics. He probed it and it was deeper than he thought. He was going to have to do a procedure right then, basically surgery with local. (thinking great there goes my shopping plans) I told him I trust him & do what he feels is necessary. I really do trust my ortho Dr more than any Dr I know. He has just been so honest, and actually takes the time to explain everything...I truly feel I have the best Dr...Now back to the story. He basically had to cut away the dead, infected skin of the blister. He did what they refer to as an I&D, a debridement. When doing this he realized it went all the way to the plate...not good. He then told me he would have to finish it in the OR. He had the residents wrap it up. Then my Dr scheduled the surgery with me  for December 11, 2012. My shopping trip to Detroit happened, my Dr approved me going shopping, only if I had my knee scooter :-)

December 11,2012, I was scheduled as an add on surgery. I worked all day until they called & told me I needed to be at UTMC. I got all prepped. The nurses remembered me. They were great as always. My Dr came up and explained the surgery and possible complications. and then we waited for an OR to become available. I also at that time asked my Dr if he could remove the syndo screws...he told me he would "think" about it, and only if he got close. (btw previous appointments I bugged my Dr about removing the syndo screws, and he always said no...lol) This surgery I was only sedated & nerve block. It was nice I was awake during the end of the procedure. It was nice being able to talk to the residents and everyone after the procedure and move myself off the table. It was also nice that I was able to talk to my Dr after I got back to recovery. He explained everything he did, it was a more through I&D, and he really cleaned it out. Before he explained anything, he had to tell me the news that I wanted to hear...he attempted to get my syndo screw, and he got half. :-) Half is better than nothing. I did let him know a day before I did feel my walking did get better, that is probably when it broke. One of the residents explained that on the x-ray it looked in tact but bent before he tried to remove it. I was to see him that Friday so he could check the wound.  I think I had the biggest splint ever that time...I could not find my toes if I wanted to...LOL

To be continued.....just the beginning....

The Healing Process

The healing is far from quick. One of the main things I have learned with this ankle injury was patience. This is something that time is not one your side. The first 4 weeks drove me crazy after my injury. I was stuck at home, in front of the TV. This is especially hard for someone who does not watch much TV in the first place. Thank God for NetFlix & Grey's Anatomy marathons. I was able to watch every season from 1 to the current...

Here is a little timeline for you:

I broke my ankle - July 14, 2012
Had surgery - July 26, 2012 (plate on the fibula and syndo screws)
First follow up - August 3, 2012 
-  Dr just checked the x-rays, and explained my surgery more. It was nice to hear about the surgery from the Dr, which was the first time, because after surgery he spoke to my mother, I was still out of it due to general anesthetic.
2nd follow up - August 10, 2012
- Got my hard fiberglass cast, wanted pink but got purple. This was actually a fun visit, I love the residents in ortho. The resident I had, I wish I remembered his name was soo nice & between him & my Dr they kept me laughing... Best news was the ok to go back to work, with my knee scooter :-)
3rd follow up September 5, 2012
- Got the sad news, 2 more weeks in the cast. One of the shortest visits ever. I kept my hard cast, no need to replace it for only 2 weeks (even though it had duct tape on it..LOL)
4th follow up September 21, 2012
- Got my walking boot, orders for therapy (25% partial weight bearing), and a bone stimulator. Thank God my DR is proactive in getting me started with the bone stimulator. I really believe it helped speed up my healing. My Dr was concerned that it was not healing fast enough for him. One thing he stressed to me if I had any pain when weight bearing to stop. I took him at his word, he made sure that I got that through my head.
Started 2 times a week physical therapy September 24, 2012
Physical therapy I feel is soo important. It helped me for one figure out what 25% PWB was, and helped me gain the strength and confidence to get back on my feet. I was soo lucky to have the girls at UTMC to rely on, Ashley & Liddy were great! I never once dreaded going to therapy.
5th follow up- October 10, 2012
Cleared for 50% PWB, my healing was going great.
Continued Physical therapy 2 times a week
Was able to ride the bike and do more Range of Motion exercises.
6th follow up - November 20, 2012
I was cleared for Full weight bearing & was told I could lose the walking boot!! He also said he was done with me, that was after we went through all of my x-rays. I am so glad he saved going through my x-rays until the end, it was nice to be able to go through them & the healing process with him. He explained every x-ray. I really could not of asked for a better Dr in Dr Lai.  He wrote me up another script for therapy & sent me on my way....If only if I listened to the Dr.....

I would soon find out..that visit...would not be the last time I would see Dr Lai.

To be continued.... ;-)