Monday, May 27, 2013

Bunion Surgery and Recovery 2013 (Part 2) AKA: My Pound of Flesh

My Pound of Flesh

Last weekend was the 4-month mark since my bunion surgery.  To celebrate, I went on a 3.5 mile city walk with a group of friends, and also rode my bike up to and around my son's neighborhood about 3 miles away.  These were fulfilling victories!  Why did it take 4 months to be able to do those simple physical activities?   Well, on January 25 I gave up my life of activity,  exercise, and service, and embraced the life of an invalid, though I anticipated living that role for only 6 weeks.  But Shylock demanded his pound of flesh, and I gave it up.  Literally.  And willingly, to save my foot.   Thus the extra long recovery.

Continuing from Part 1 of this story:

[NOTE: I have included some icky photographs of the wound at the end of the post.  After the last part of the text there will be a gap, then the photos.  That way you can look at them only if you want to.]

The plan for reconstructive surgery was in 2 parts:  first, to clean out the mess of infection in my foot and plant some antibiotic granules in the cavity.  Second, two days later the doc would take a hunk of tissue out of my arm  to fill in the cavity in my foot.  That would be watched for 3 days, then I could probably go home.  So, Monday morning, March 18, this ordeal began in Emanuel Hospital's burn unit,  the best place to treat a bad case of tissue damage.  Coming out of surgery I was surprised and grateful to find that the doctor had done both steps in the one surgery--yes!!  It had taken maybe 5 or 6 hours.  Using a high powered magnifier he tied the blood vessels from the transplanted tissue into the foot blood vessels.

I was in the ICU and awakened about every 15 minutes by a nurse w/ a probe.  He or she put the probe into the wound in my foot to test the blood flow.  Sometimes it was hard to find, and it sure wasn't pleasant having that probe rooting around in my raw flesh.  But during every single probe I made sure that I too could hear the whoosh of the blood flow, it was that important to me to know the transplant had worked.  After a while the probe went to every half hour and after a couple of days it was down to every hour.

fun times in the ICU

No one likes a hospital stay, and this one was tough for me.  Tubes and lines were hooked everywhere, and the catheter prevented me from changing positions in the bed.  I had almost no appetite the entire week; just the thought of food was nauseating.  There was an odd smell in there that made me more nauseous as the week went on.  I never figured out what it was.  After 5 days of it I finally barfed.

As for my foot, the first time the doc unwrapped it I was appalled at seeing this ghastly mound of ragged flesh perched on top of my foot, only held down by a couple of stitches.  The piece of flesh taken from my arm was about 7" long, 1.5" wide, 1" thick.  And there it was in all its giganticness.  It was not stitched down until just before I went home, because the doc had to make sure the transplant was successful first.   Pain was controlled by a spinal, and various antibiotics were streaming through an IV 24/7.  36 hours after the surgery a picc line was put in my right arm in preparation for home use.

Besides Dr. V, the plastic surgeon, Dr. C. and some of his staff of infectious disease specialists became my new best friends.  Resident physicians also made the rounds.  One of them told me a story about a friend who was paralyzed in an accident, and found that by accepting his limitations and finding new and tame activities, he was enjoying his life.  I just stared at him and he went on to talk about other things.  When he stopped in again later, I asked if he had been trying to tell me something.  He had.  And thankfully he was wrong.

Near the end of the hospital stay the physical therapists came in to help me start walking with crutches.  Amazing, all the effort it took to get out of bed just to move to a chair next to the bed.  The bathroom was the next frontier.  Then a walk down the hall which might as well have been the Oregon Trail.

That Friday Doc V stitched down the rest of the tissue transplant.  I am deeply grateful that it "took."  Modern medicine is full of miracles.  Doc pronounced me ready to go home Friday afternoon.

For the next 4 weeks I daily infused antibiotics (ertepennum) at home via a picc line, under the instruction of a home nurse, with Craig doing the hookup.    Every other day my foot had to be re-bandaged.  That was an ordeal as it involved:

a precise, methodical cleaning, including stripping off excess flesh
placement of Xeroform (a petroleum-pregnated patch of gauze) on the wound
layers and layers of thick pads strategically placed
yards of gauze bandage wrapped to hold all that together
tape to keep the entire thing stable
eventually a pressure sock was added to the above

And twice a week I visited the "wound clinic" which I'll post about tomorrow (and it will be the last post on this).

As of right now I really don't need a bandage, just padding to protect the top of my foot.  In June I'll have surgery to reduce the size, so that I can wear regular shoes again.

 Icky photos below




























Day after surgery: my borrowed pound of flesh partly covered by a Xeroform gauze.  The purple X was made by the doc when that chunk of flesh was part of my arm; it designated the donor site




a few days later without the bandage, and this time it is stitched down



side view of the transplant


the donor site on my upper arm; I generously offered a big chunk of flab from my belly but the doc declined it


about 3 weeks after surgery; it really is healing!


a month after surgery, looking great


2 months after surgery, edges completely healed; this is a weird photo--it isn't really red and this wide, that's just poor lighting


2 months after surgery, side view

4 comments:

  1. Mom, you are Frankenstein!!! Great post. I'm glad you're healing and able to be active again.

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  2. Wow I can't believe it. Well done for surviving and having a positive attitude!

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  3. Glad you are healing. Thanks for sharing about your ordeal.

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  4. Very good written story. It will be supportive to anyone who employees it, including myself. Keep up the good work – can’t wait to read more posts.

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