Sunday, December 20, 2009

There have been so many times in my life when I have been at a loss for words (shocking--but true). Standing in front of a Mom who has a son in the hospital with cancer, or a young girl who is sad about her parents' upcoming divorce--I can listen and sympathize--but I really can't fully understand what they are going through because I have never experienced those things myself.

This Christmas, I have been thinking a lot about Doug's Mom and my dear Aunt Jan. Both of them lost their husbands suddenly and unexpectedly during the last year, and will be facing their first Christmas without them. My prayer would be that there are some women out there who can come alongside them with understanding that comes only from experience.

I know that I have the same thing with my ankle. When I share with someone some of the tentative reports coming back from my doctors and my peace with possibly facing an amputation, the simple response of, "Well, you just have to stay positive," can sometimes feel like a judgement. Although I know that their words have good intentions, I still feel like I have to defend myself saying, "Well, I am being positive--it's just that having been at this for a year, I kind of know the warning signs and need to be realistic, blah, blah, blah." On the other hand, when Sarah (my email friend who fell of her roof and is recovering from horrific injuries) emailed me after my last blog entry and said, "Anne--you just have to stay positive," it kept me going for the next week. Weird how that is, huh?

I guess it just makes me realize that the personal struggles we have each encountered in our lives make us unique agents of love and comfort. Our pain and how we got through it can be transformed into one of the most valuable gifts that we can give to others. Cool how that works.

Anyway--when you sleep all day and then can't fall asleep until 3 a.m.--these are the things one thinks about. :)

As for my silly ankle, my infectious disease doctor has been encouraged by the gradual decrease in drainage. In fact, when I changed my dressing this morning, there was actually a scab forming on the spot that is always stubborn to heal. Ask Elise--the girl is so excited about my scab (Mom--last time it took almost 7 months to heal and this time it has only been four weeks!!!).

I have been a good little patient and stay still with my foot up--only going out for doctor's appointments and church. Dr. Carbonell spelled things out really simply. Basically, over the next three months, if my bone begins to grow into the cadaver bone, then I might possibly be on my way to starting physical therapy! The success rate for this is about 60% so that is why he put the bone growth stimulator inside of my foot. The process of the capillaries and other tissue beginning to grow inside the porous cadaver bone is extremely delicate--therefore it is very important that I not move my foot unnecessarily. And then, of course--if there is any kind of infection, the fusion may never happen at all.

If my bone does not grow into the cadaver bone, then I will have another big surgery around May-ish. They will basically do this fusion surgery again, but this time use bone harvested from my pelvis to increase the chances of the bones growing together. The harvesting process is apparently very painful--therefore they always start with the cadaver bone.

Blah, blah, blah . . .

Doug has been amazing at taking care of all of the household stuff, kid stuff, cooking stuff, as well as all of the preparations for Christmas. If ever there was a man who deserved to be pampered on an island somewhere--it's Doug. He and the girls have been incredibly patient. I just pray they won't still be serving me breakfast in bed by this time next year.

My parents' neighbor is a postman who works with a man who grows out his beard each year to be "Santa." Every year, Raffi and his wife host a big party outside their house and arrange for Santa to show up on a big red firetruck, red hotrod, etc. Very sweet.

Anyway, those are my thoughts for today. I love and appreciate all of you so much.

Pray for union.

With much love,

Anne

P.S. I put a link to the "Carol of the Chins" on the side bar just to give you a stupid laugh. It reminds me of the skits we used to do for our church youth group fundraisers. An oldie but a goodie. Just type in the name of any Christmas song and they will sing it for you. If they don't know it--they will let you know (12 days of Christmas always cracks me up).

Thursday, December 10, 2009

OK--don't worry--I'm not standing on the railing of a bridge somewhere. I woke up on Monday morning--ready to face my fears. I called the insurance company and found out that they were just making a courtesy call (would have been nice if they could have indicated that along with the scary message they left on my answering machine). I went to Dr. Carbonell and he felt pretty confident that my drainage/bleeding issues were unusual but normal. I was able to clear up some questions about how much I was allowed to move my foot, keep it elevated, etc. So, since then, we have been doing book reports, taking Christmas card pictures, and sleeping (I do a lot of that).

So, just when things were seeming dandy, I went to see my infectious disease doctor today. Not good. Turns out that the pathology reports coming back on the bone taken from my ankle show that the bone is infected. Furthermore, the drainage that is coming out like gang-busters from my incision site is a scary sign that there is still infection inside. Dr. Jacobsen's gut tells him that the bone is not going to fuse because there is still debris inside the wound. Dr. J and Dr. C spoke on the phone today, and Dr. C indicated that there are still small pieces of metal lodged inside the bone. However, for him to remove it all, he will have to destroy all of the bone that we need to fuse. I don't know exactly what it all means--but it doesn't sound good to me.

I actually had the courage to buy a pair of rocker-bottom shoes online the other day. I thought--I just might be wearing these things by summer. Today, I am finding myself googling "lower leg amputation" instead.

Don't worry--I'm not giving up. I want this baby to fuse. But the writing on the wall is looking all too familiar.

We haven't let on that anything is up to the girls because they are really hoping and praying that this fusion surgery might be a sign that this ankle ordeal is almost over. I don't want to freak them out.

When I was doing a little research about amputation, I had to laugh at this little cartoon included in the take-home instructions following an amputation. Doesn't that look like the happiest little amputee you have ever seen? I can't tell if he is in pajamas or just so excited to get back to work that he is wearing a suit everywhere he goes. Gave me a laugh.

So, today I am praying that we can beat the odds and get these bones to fuse. I pray that God will give my doctors wisdom to work with each other for the best outcome possible. I just don't want to still be talking about ankles next year, you know?

Love to all of you, my dear friends . . .

Anne

P.S. OK--I was done. But I just got this email. The memo read, "Funniest Christmas Picture Ever!!" Oh yea, I am just CRACKING up.

The caption under the picture reads, "Good news is that I truly outdid myself this year with my Christmas decorations. The bad news is that I had to take him down after two days. I had more people come screaming up to my house than ever. Great stories. But two things made me take it down. First, the cops advised me that it would cause traffic accidents as they almost wrecked when they drove by. Second, a 55 year old lady grabbed the 75 pound ladder and almost killed herself putting it against my house and didn't realize that it was fake until she climbed to the top (she was not happy). By the way, she was one of the many people who attempted to do that. My yard couldn't take it either. I have more than a few tire tracks where people literally drove up my yard."

It's all funny until it happens to you . . . :)

Sunday, December 6, 2009

I had one of those downer days today. Just not feeling very hopeful. I know, I know . . . think positive. I am. I just had a few setbacks (pain, bleeding, insurance hangups) this weekend that made me feel down.

Which brings me to an email I received last week. I get this email from "Sarah" who somehow found my blog on the internet. She, too, fell while dealing with blasted Christmas lights. However, this amazing woman is in her early twenties and has been at this for two years now.

She wrote, "My own journey began when I fell off our two story roof on November 30, 2007. My left leg and foot took the worst of it, I shattered my calcaneus, talus, and the lower part of my tibia and fibula. I had spiral fractures running the length of my tibia, followed my a tibial plateau fracture. My knee cap was dislocated, and tore my ACL, MCL, PCL, patellar tendon, medial, and lateral meniscus. My right ankle sustained a trimalleolar fracture, which has healed wonderfully, leaving me with very little or no pain at all. I had a total of three separate pelvic fractures, which required the use of an external fixator to hold it together while healing. Then moving upward I fractured my L1, and L2 vertebrae, which thankfully didn't cause any spinal cord damage. Followed by a broken left wrist and elbow, which required surgery as well."

Bless her heart, she has recovered from the majority of her injuries--except for her left ankle. She had almost the same surgery I just had last February, but the bones did not join. She is now struggling to decide whether to amputate her leg or to spend more time in an external fixator.

We could share that idea of feeling like life is passing you by as you wait for your body to heal. Sarah tells me that she thinks I am so strong--when it is SHE that has inspired me.

I had a down day, yes. But if Sarah can still have dreams of getting back to college, starting a business, and getting back into life--than so can I. Good grief--I am just dealing with an ankle.

So for today, I would love it if you could pray for my new friend, Sarah. She doesn't like people feeling sorry for her (I can relate). But she really needs to decide how to move forward with her treatment. As for me, I pray that a few financial details can get worked out tomorrow and that my doctor can give me some encouraging words on my healing so far.

Love to you all--

Anne

Thursday, December 3, 2009

Howdy! I just got back from hearing Annika sing in her school Christmas concert tonight. I missed her Spring concert last year because I was in the hospital so I really wanted to try and make it. After struggling to assemble the dumb wheelchair in the parking lot, Doug and I managed to get me to the auditorium. She said we embarrassed her because we were smiling so big in the front row (handicapped seating). So sweet.

Speaking of sweet--some wonderful people in our church felt badly that we all missed out on a "normal" Thanksgiving day. So, they all pitched in and made awesome food for us. I'm telling you--I think we are going to milk this ankle injury thing for all it's worth!

Well, I went to Dr. C yesterday and am now armed with all my X-rays. Ready to pretend that you are a radiologist??

First, I want to introduce you to my new bionic foot (insert cool Bionic Man music here).

I wasn't quite catching the angle of the screws from the side shot, so I made up this one from the front:

Next, I wanted to see how my ankle slowly went downhill, so I made up this slide:

It is so amazing that even though my talus was shattered at the beginning (in the first picture), look at that awesome space of cartilage above the talus! That just slowly gets smaller and smaller as it dies over the following months. Sad to me.

Finally, I was looking at my X-rays and thought I was just seeing things . . . was that my fibula cut off like a dagger in my leg??? So, I called Dr. Carbonell just to see if I was going crazy. Yep--it's gone. He cut the dumb thing off.

I almost feel like I should have kept it and given it a burial or something. Turns out, your fibula is a non-weight bearing bone. It is designed to help your foot/ankle manipulate uneven surfaces. Now that my ankle is fused I don't need it anymore. Best of all--everyone always suspected that the fibula might be harboring some bacteria because it had that metal plate on it for so long. No fibula--(hopefully) no infection.

Looking over all these images just makes me so sure of what I need to pray for . . . UNION. I would covet your prayers that the cadaver bone, and my smooshed up leftover talus, and shaved off tibia all grow together in a healthy chunk of ankle. If they don't, I am seriously looking at amputation.

Pray for union.

Pray for union.

Pray for union (or for more patience to endure what else might come next).

OK--now that all of you are ready to head the radiology department of a hospital near you, I am going to bed.

Love to you all!

Anne

Tuesday, December 1, 2009

Hello, I'm home! Mom and I left the hospital around 7:00 pm on Monday night and finally got home. The house was neat, Doug was working on spelling words with Elise, and Annika was getting her stuff ready for school. Sweet, sweet, sweet.

Since then, I really haven't left my bed other than to go to the bathroom and sit in the living room to look at our Christmas lights (no ladders were used in the hanging of the lights this year). I just want to be still and rest. I don't want to do anything to mess up the outcome of this surgery.

One of Dr. Carbonell's residents, Mai, came by to see me on Monday and took all of the bandages off (Click on "Great Fall Wound Pics" to see them). The stitches look awesome. There is a large incision site on the right side of my ankle, and then two smaller sites on the left side and under my heel. These are all the places where the screws would have been put through the bone. I can't wait to see copies of the X-rays to see what is in there.

Lord willing--I really think these will heal up in a few weeks like normal wounds (not like ones that take 10 months to heal).

I make a ton of noise with my walker at night (the four trips to the bathroom, getting my antibiotics loaded into my PICC line, taking meds, etc.) so Doug is sleeping in Elise's room. Besides juggling all the responsibilities with the house, kids, etc.--he is getting back to school, and dealing with a lot of sadness. I want for him to get as much sleep as he can and let my night nurses take care of me.

So, Annika slept with me last night. We cuddled, read, and talked about her trip to Michigan. It was so nice to be with her. She suddenly seems so much older to me.

Tonight, Elise and I did some homework and then watched a movie of the Nutcracker (starring none other than a very young Macaulay Culkin as the Young Prince). She is going to see it in real life tomorrow on a field trip with her class. As my night nurse tonight (here she is on duty), she made me promise that she could put the flush and heparin in my PICC line tomorrow morning.

I have to mention that Shannon, my dear niece back in Michigan, colored in this beautiful poster for me as a get well card. It is now next to my bed making me feel better. I, too, will someday be a Beach Princess (or at least be able to get my foot wet with salt water!). Thanks, Shannon!

I should be going to see Dr. Carbonell soon so I will let you know what is going on then.

Love to you all, my friends--

Anne

Sunday, November 29, 2009

Dear Lisa and the Carpers came by to visit today. I promised them that the trip up to my room would be worth the view. The view of the outside of the elevator shaft--that is. Gorgeous, isn't it? If I hobble over to the far side of the room, I can look at parked cars. Very inspiring. They say that patients heal much faster if they can see something from nature outside their hospital room window --a tree, growing grass, flowering plants, etc. I am drawing my healing power from painted stucco. It must work on some level because I am feeling pretty good today. I am now on Percocet (no delaudid anymore) and am feeling like my mind, body, and spirit are in balance. Thank goodness. God is good.

And now for the best thing ever . . . my babies are back. Mom picked them up from the airport this afternoon and drove them straight to the hospital. My cell phone was ringing before they even got here. Annika was feeling a little stressed that she didn't feel prepared for school tomorrow--wondered what homework she should be doing--what outfit would be clean and nice for her first day back, etc. etc. Meanwhile, I hear Elise screaming in the background about every imaginable detail of their time in Michigan. I don't think it had even occurred to her that there was a school in Miami--let alone a school that SHE was going to have to be at tomorrow. Hilarious. Yes, my two little girls do march to the beat of different drummers. :)

After visiting with my sweet family, there are a few things that can be said with certainty . . .

1) My girls LOVE their cousins.

2) They wish they could live by their cousins.

3) They are excited for Christmas to come.

4) Seeing me in a hospital gown isn't as scary as it used to be.

5) They are ready and willing to help me recuperate from the surgery--such troopers.

6) My Douglas is very sad that he doesn't have a Dad anymore. You can tell that he literally feels sick in his heart.

It felt so good to see them again. The girls looked so much older to me--so grown up. And Doug just looked plain handsome. I loved being able to feel them again.

I hope that this Christmas season can be a time of both physical and emotional healing for us all.

Love to you all--

Anne

Saturday, November 28, 2009

Well, I am still in the hospital and will be staying here until Monday.

It has been a weird few days. On the one hand, you desperately need the pain meds because--without them--you would seriously consider gnawing off your foot with your own teeth just to escape the pain. On the other hand, the combination of these meds and the pain sends you on a mental journey that travels between feeling so happy and loved and content, to feeling tormented, miserable, and depressed. So, while enduring each moment of this journey, you are being asked to stay still, have your first bowel movement, prove you can use your walker, scale your pain from a one to a ten, drink pro-biotic drinks, remember to ask for your pain meds (they can't just give them to you--you have to ask for them), and keep out a watchful eye for any unusual or suspicious symptoms. It sounds simple, but it is actually quite weird and yucky (best way I can put it).

So, WISELY, Dr. Carbonell wants me to slowly wean myself off of my pain meds before I leave the hospital. Yesterday, I was allowed to have 2 ml of dilaudid, while today I could only have 1 ml. Tomorrow--no more dilaudid--just percocet. I am not looking forward to it. Although I have felt much clearer today by being on less pain meds, the pain is obviously more intense. Tomorrow should be interesting.

My Mom just arrived and we are going to watch a movie on my laptop together tonight. Sweet to just hang out with Mom. Just to give you a little insight into how she feels about me . . .

Last night Mom said, "Honey! You got a star on your door! Did you do something special?? You better ask!" All night I quietly wondered if maybe I had been nominated for the "Positive Patient Attitude Award," or "Patient Most Likely To Walk in the Near Future." Turns out that a star on your door means that you are a "fall risk." Just keeping me humble.

OK--hopefully I will be getting another PICC line put in my arm on Monday morning, making a quick stop to the Infectious Disease office for some antibiotics, and then home to my bed.

I can't wait to see my precious husband and kids again tomorrow.

Love to you all--

Anne

Thursday, November 26, 2009

Hello! My surgery went without a hitch on Wednesday afternoon and I was back in my room recovering by 10:00 pm. The pain is ridiculous. My Mom faithfully wiped my brow with a wet washcloth as we struggled to figure out the right mix of pain meds to make my life tolerable. It is now Thursday night and I am feeling the need to put up a few pictures to share a few details of the last few days.

Once again, I am blown away by the kindness of strangers. My doctors and nurses are endlessly giving, kind, intuitive, patient, caring, and informative.

This is the face of Dr. Carbonell who has faithfully seen me through a ridiculous amount of ups and downs over the last 10 months. I am very grateful to have such a wonderful doctor. One of his residents stopped by yesterday to give information and answer questions about my surgery.

Amazingly enough, he told me that they were shocked to find three remaining fragments of landscaping fabric still hiding out in my ankle.

Unbelievable.

This is the piece of bone taken from the calcaneus of a cadaver and cleaned up and sent to me. When Dr. Carbonell got in my ankle, he discovered that the bottom half of my talus was still alive while the top half was dead and crushed. Therefore, he sculpted this cadaver bone to replace the top half of my talus. He also inserted a battery operated bone growth stimulator next to this bone to encourage it to grow into the other bones.

Among the many doctors and residents who watched Dr. Carbonell perform my surgery were my old dear friends, Bozena and Maribel. These lovely women were there for me during my first three weeks in the hospital following my fall. They saw me through some very dark and scary times with lots of love, advice, and information. It was delightful to see them again.

Several doctors have raised a few concerns and are having me take a few precautions. 1- I am now on blood thinners to eliminate the chance of developing a blood clot in my ankle. 2- I am blowing into this contraption 10 times every hour to decrease the chance of fluid building up in my lungs while I recover. 3- I am on antibiotics to keep any chance of bone infection at bay. Dr. Jacobsen (my infectious disease doctor) stopped by yesterday and told me that I might have a PICC line put in again so that I can take 6 more weeks of IV antibiotics at home. He doesn't want to have the bone infection issues with this new bone that I experienced with the old one.

One way to get out of making a Thanksgiving meal is to have a major surgery during Thanksgiving Break. I was delighted to find this lovely feast on my meal tray today. Awesome!

Well, it turns out that seeing the Sponge Bob float while on pain meds was neither an opportunity to fly above New York, or a terrifying experience. It was just a plain old Sponge Bob float. So now I know.

So this is what I know. I know that I have the most wonderful husband who is grieving the loss of his Dad while faithfully checking up on me. To say that he is "so sweet" doesn't begin to describe the man. Just the sound of his voice on the phone is an immediate comfort.

My Mom has been amazing while seeing me through some very rough times of extreme pain. Even at 40, there is nothing better than cuddling with my Mom to make me feel better. I think the whole experience has been a boost to her self-image, too--Two people today asked if my Mom and I were sisters.

My dear girls have been asked to get through some pretty rough stuff over the last year and they are handling it beautifully. I love them so much. I can't wait to feel their tiny hands in mine. I feel so blessed to be surrounded by such faithful friends. People have already offered to make meals or drive the girls home from school when Thanksgiving Break is over. Amazing to me.

Some of you have asked about my Dad. It turns out that--unbeknownst to anyone--he had a mersa infection while fighting a case of mono! When he went into the hospital, as the doctors treated one symptom, it would aggravate another. It took a "House" style of doctor to finally put it together that he must be suffering from a virus--tested him for a few--and came back with a positive result for mono. Dad is now at home recovering from what was a severe blast to his system. So glad that he is still with us.

As for me, I continue to feel blessed all over.

I love all of you so much.

Talk later (when my head is clearer).

Anne

Tuesday, November 24, 2009

Praise the Lord--I am in the hospital! I was admitted tonight and am going through the motions of getting ready for surgery tomorrow afternoon at 4:30.

Here's what is on the menu for tomorrow . . .

My ankle and sub-talar joints will become permanently (hopefully) fused using seven screws as stabilizers. Because my talus collapsed, "cadaver bone" will be used to replace the destroyed bone. Dr. Carbonell will also insert a small battery-operated bone growth stimulator inside my ankle to encourage the bones to grow together.

I will most likely be in the hospital for a day or two following the surgery to help manage the pain. This means that I will be watching the Thanksgiving Day Parade and the Dog Show while on some serious pain meds. Lisa thinks that I will be on this happy high--thinking that I am soaring through the air like the Sponge Bob float in the parade. However, judging by the way those meds made me feel the last time I had a big surgery, it is more likely that Sponge Bob will be coming out of the T.V. to devour my ankle. I'll let you know how it goes.

Once again, I feel absolutely showered with blessings. From the Thai food meal my parents and I ate before coming to the hospital, to the doctors who were expecting my arrival and had everything ready to go when we got here--life could not be better.

Here is the most amazing thing . . . On the way to the hospital, my Mom told me that she had run into a woman (named Loretta) this morning at church who has been faithfully praying for me every day since my fall. Even though I hardly know her, Loretta has had a burden on her heart to pray for me. OK--so that's amazing. But what was even more amazing, was that when we arrived in my hospital room, guess who was my nurse for the evening--LORETTA! My Mom just about burst into tears. Loretta set me up with a private room and even brought me my favorite hospital midnight snack--jello and crackers.

So--Can you see why I never question God's plans? Unbelievable.

OK--so I am tired and ready to go to sleep in my nice bed. I am happy. Missing Doug and the girls, but happy.

By the way, Doug has been having a blessed time in Michigan while mourning the loss of his father together with his family. They have been able to talk to so many people who have expressed such deep love and respect for Dad Heetderks. He was quite a man.

Love to you all--

Anne

Sunday, November 22, 2009

Late Saturday night, we received a call that Doug’s Dad had died. It hardly seems possible.

When I think of him, all I think of is a man who was always filled with life. Doug’s Dad was a middle school principal, Science teacher, career elder at his church, director of a children’s Science camp, lover of nature, faithful servant, loving husband, awesome Dad and Grandfather, and one heck of a father-in-law. He was wise, kind, patient, and knew how to cut through nonsense to get to the simple truth. When you were with him, you were always learning something new, or discovering something you had never thought of before. Whether collecting eggs from his chickens in the backyard, picking up leaves at Camp Roger, or taking a walk in the woods, Dad always made you feel special and happy to be with him.

After much deliberation, Doug and the girls left this morning to go to Michigan for the wake, funeral, and Thanksgiving break. I so wish that I could have joined them. However, Doug and I both knew that knocking my ankle around while travelling would not be helpful for anyone. Part of me hopes that I can have my surgery while they are gone just so the girls don’t have to see me in the hospital. We will see. The girls were very brave—they said that Grandpa was such an “alive and active” man and that they didn’t want to think of him as being gone. Doug is very sad but feels a great deal of peace knowing that his dear Dad is in heaven breathing with ease. Dad Heetderks was not a man who would have wanted to be hooked up to a respirator.

I know that many have said that our family has been hit with a lot over the last year. It is true. But somehow God has given us the strength to get through it. It hasn’t always been pretty—and I grieve for our girls—but we have been given the opportunity to be lifted up by God and others in ways we would have never known had we not gone through this time of trial. Seriously.

I will write more later when I know more.

Love to you all.

Anne

Wednesday, November 18, 2009

On Monday, I went in to see Dr. Carbonell with my faithful friend and teaching assistant, Lisa Arslan. My head was full of a lot of things.

- My Dad had been admitted to the hospital over the weekend with strange, serious symptoms. While at the office, my Mom called and told me that Dad had tested positive for a mersa infection and that his liver and heart were under a great deal of stress.

- Doug’s Dad was continuing to have many up and down days in the hospital. We were hoping that new tests might reveal a better way to help him to improve.

- I was in a lot of pain and was concerned about taking more and more Percocet to get through each day. Yuck.

When we arrived, Dr. Carbonell was able to see me right away and started assessing what was going on. Our first surprise when we took off my bandages was to see that my wound was healed! It had been acting like it was going to close over the previous weeks but we weren’t sure when if would finally happen. The closed wound looks like a squished bellybutton—just big enough to hold a tick-tack (gross!). Dr. Carbonell told me that when I have my big surgery, he will cut out the bellybutton and sew it back together as a flat piece of skin. Who cares—I can take a real shower now for the first time in 10 months!!!

The next thing he did was to take out three huge needles and fill my ankle joints with Cortizone. Although I didn’t feel any difference while at his office, I felt like I was ready to take up ballet dancing by the next morning. It was wonderful to live without pain for a few days.

Finally, we took a new X-ray of my ankle. When we looked at the image of my foot on the screen, the first thing I noticed was that the metal was gone. Duh—I knew I had just had a surgery to take it out but I hadn’t seen it until just then on the X-ray. The next thing we noticed made us all go, “Ohhh . . . .” My talus had collapsed. The talus is the bone that was shattered in the fall, put together by my brilliant doctor, started to die, but was holding its own. The plan was to fuse it together to my tibia this summer—making it unable to move but pain-free (hopefully).

The fact that it has collapsed means that I really need to do the surgery right away. When you look at the X-ray, you can see that the tibia is out of place on top of the talus. This explains why I have been in so much pain (thank goodness--I was beginning to wonder if I was just being wimpy). Dr. Carbonell will take some cadaver bone and build up the area that has collapsed so that my legs won’t end up being different lengths. Then he will continue on as planned, putting screws through my foot at different angles so that it will hopefully “fuse” into one solid piece. The recovery will be intense and long. Right now, I am hoping that we can do the surgery soon so that I will only miss the three weeks between Thanksgiving Break and Christmas Break. Time will tell.

Now that we have had some time to think and do a little research, I am planning to meet with Dr. Carbonell on Monday (the 23rd) to figure out what we will do.

Good News mixed with Bad News.

Today we give thanks for a closed wound. We have prayed for this for so long. I had imagined a Wound Closing party for a long time and now it is kind of mixed in with a whole new hurdle. That’s OK. I am almost relieved to just take this battle on and get it over with. If this is God’s plan, I’m all about it.

Love to you all--

Anne

Friday, November 13, 2009

Wow—It has been a while. So many of you have been checking in to see if I am maybe dead, depressed, or somewhere in between. Well, I’d say that the last two months have been about “getting through it.” I haven’t wanted to talk about my ankle, write in my blog, give updates, etc. In fact, I sometimes wish that the whole subject could be ignored. I am just tired. Since the time I fell, I have usually been “up” with a cheery disposition--reassuring people that things are moving along and that I will be fine. I still believe those things, I just don’t have it in me to be cheery. I could fake it, but it doesn’t seem like I should. Sometimes getting through it isn’t cheery.

So now that I sound like Scrooge, I must tell you that I really am doing very well. I feel so blessed to be able to spend my days with my beautiful family and my awesome students at school. We have spent our days doing plenty of great things: painting faces at the church picnic, hosting a Halloween party (Annika arranged the whole thing!), going to local events like the Air Show, etc. My kids at school are amazing and are the best medication for distracting me from the pain in my ankle. They are so sweet.

So, since the last time I wrote . . . I had my surgery and they removed all the hardware from my ankle. They drilled a 1/4inch-sized cylinder from my talus bone to test it for bone infection, and then filled the hole with antibiotic beads. They also scraped bone from several areas of my ankle to see if they could find traces of bacteria. While they were in there, my doctor discovered that a good deal of my talus is now dead, and the cartilage that was once alive is now dead, too.

To make matters worse, the ankle is full of arthritis (pictured here). Following this surgery, Dr. Carbonell told me that I would definitely need an ankle and subtalar fusion. This is a big surgery with an even bigger recovery time so we agreed that I would do the surgery in May so that I would have time to get better over the summer.

While I was at the hospital for this surgery, a PICC line was put in my arm by a Dr. Groper (his future in gynecology was doomed from the start). When I was on the table getting it done, the familiar smells of latex and paper gowns, mixed in the sounds of monitors and machines lulled me back into the realization that we were “back at it again.” I found myself telling my story to a whole new set of people who were about to take me on the next leg of my journey towards healing.

The next day I found myself at the Infectious Disease office to get some tests done and to pick up my antibiotics. It didn’t take long for my kids to get used to seeing Mom with tubes hanging out of her arm 24/7, antibiotic balls shoved in next to carrots in the fridge, and 5 a.m. alarms going off for the first treatment of the day. I was even able to get through six weeks of treatment without my students at school noticing that I had an IV bag hidden in my smock! With a steady supply of empty syringes in my trash can at school, I was wondering when the janitor might feel compelled to report that there was an Art teacher with a drug problem on campus.

Even though my foot looked like it had been through a meat grinder following surgery, it immediately began to heal much faster than we had seen before. It seems that my body is finally infection-free and that my wound is on the way to being closed.

The constant bright spot in my life is my job, Doug, and the girls. I can be in so much pain—dreading the thought of moving my foot across the room—and then the kids will come in and everything is OK again. They say such funny things that you can’t possibly be in a lousy mood when you are around them. Likewise--when I finally get to just lay down and cuddle with Doug or the girls—life is good.

People have been so good to me. Teachers at school say that the kids ask to pray for me every day. Families bring meals for us. Friends send emails of encouragement. I even continue to receive get well cards. It absolutely amazes me that people still want to know how I am doing after all this time. I feel very badly that my “hunkered down” vibe might give people the impression that I don’t appreciate all that they have done for my family and me.

Mixed in with all of this has been growing concern for my father-in-law, Bob Heetderks. After breezing through two heart valve repairs, his recovery became complicated by a recurring build-up of fluid in his lungs. Now, two months later, he is becoming weaker and weaker while tests continue to offer little help to explain what is really going on. What was once, “He is going to be fine . . .” is now, “I hope he is going to pull through this.” It has been very scary.

I have been in quite a bit of pain and will be visiting Dr. Carbonell on Monday in his office. I will try to do a better job of keeping my blog current for you again!

Love to you all!

Anne

Saturday, September 5, 2009

Can you feel the adrenalin rush? Can you sense the crescendo of "survival" fever kicking in? That's where I am. I am getting fired up to start climbing out a a valley that I hadn't seen coming. Rock on, dudes!

On Monday, we learned that my ankle is in sad shape. We knew it was sad--but now it is downright depressed. The dark space by Area B shows where there is cartilage still on my talus. You can see that there is no dark space on Area A--indicating that the bone is resting right on bone. Not good for a moving part carrying all of your body weight. Area C and D shows the top of my talus--the part that I shattered. Area C died a long time ago--you can tell because the area is not white--it is gray. The bummer thing is that in the last two months, Area D has become gray. This either means that it is infected or dead. Without C & D, my ankle will not work.

On Thursday, Dr. Jacobsen pretty much confirmed everything that Dr. Carbonell was suspecting. He took one look at my ankle and said that it looks exactly like something that is fighting a deep bone infection. He was thrilled to see how much my wound had closed up, but was clear in communicating that wound closure is not the problem anymore--it is a symptom of a much bigger problem. Worrying about VAC machines, dermagraft, skin grafts, and pig intestine is now a thing of the past. We now have to figure out how we are going to "save" my foot.

When I first fell, a lot of dirt and debris was mixed up in between the fragments of my talus. I had three surgeries just to try and remove the debris, and to put the talus back together. After that, I was on very heavy IV antibiotics for five months in order to kill the bacteria that was lingering behind. We thought we had beat it, but it is obvious now that some bacteria is still inside my ankle. I would love to just ignore it and pretend that it isn't there, but we MUST remove the bacteria or it will eventually kill off everything in my ankle.

Don't worry--the infection isn't going to race up my leg and kill me--it is a slow process. But just like we have seen with trying to close my wound--nothing in my foot can do what it is supposed to do when it is fighting bacteria at the same time.

Although my news wasn't great, I left feeling that I am in--and have been in--REALLY good hands. When Dr. Carbonell told me of his suspicions on Monday, I thought, "Oh man, we waited too long. I should have known this would happen. I probably should have gone back to Dr. Jacobsen a long time ago . . ." Yada, yada, yada. But, Dr. Jacobsen was so reassuring in letting me know that we would not have known this without the passage of time.

So . . .

Phase 1: Have surgery soon. Back out the screws that are holding in the metal plate (the one shown in this picture), and scrape the holes that are left behind to remove any infected bone. Dr. C will also probe all around my talus to find bone that is infected or dead (we already know that there is plenty). Even though I would like for him to hack away, both Dr. C and Dr. J say that it is best to be conservative in removing bone around the talus. They would rather leave some dead bone behind (dead doesn't necessary mean infected), than to cut out so much that my ankle can not function properly anymore. Dr. Carbonell will also take multiple biopsies of the bone to test it later.

Phase 2: Kill me with antibiotics. Dr. Jacobsen would like for me to start back up on my heavy-duty IV antibiotics the day after surgery. I will take them for six weeks (that's what they always say--haha!--47 weeks later . . .). This will be the wait-and-see time. Wait and see if the wound starts to close up. Wait and see if I am running fevers. Wait and see if green gooky stuff is coming out of my leg.

Phase 3: If Phase 2 goes well, we will wait some more and see what happens when I am off the antibiotics. If Phase 2 does not go well, I will go back in for more surgeries to remove more bone and take more biopsies.

REALITY: Even though the doctors talk about trying to save the talus, I know in my heart that I will eventually have my ankle fused in a permanent position. Whether it happens now or in two years, I know that I can not possibly walk on dead bone with no cartilage. So--even though my doctors might be disappointed if they have to cut away so much bone that the talus is useless--I am cool with it.

I am just happy that I have doctors who are willing to stick with me through the "long haul." Even though I am ready to chop of my foot and call it done, they are firm in insisting that we take it slow and conservative.

I have read an awful lot of blogs written by people with ankle problems who have also begged their doctors to pull out a chain saw and chop off their feet. However, when they finally have had to go through the long, painful, and complication-prone process of having a fusion, they are grateful that their doctors forced them to exhaust every foot-saving possibility before "giving up."

For some strange reason, I am feeling OK. I am changing my mental picture and realizing that we are not going to be free of Anne & Ankle for a few years. I am going to do my best to continue on without "trauma drama" and just plug away quietly. It has been incredibly wonderful to be back in the classroom teaching. (I DO NOT EVER want to be on disability again. That is why I really have to be careful with those killer antibiotics.)

Annika and Elise are soooo happy. They love their friends and teachers. They enjoy being at school and helping out wherever they can. They have really come alive as things have seemed more settled. This is why I hate having to stir the pot again.

My heart goes out to Doug. These setbacks really take a toll on his spirit. His dear Dad had a big surgery two weeks ago to repair two of his heart valves. Dad Heetderks was recovering beautifully until last night when we found out that he developed pneumonia. We know that he is strong and will recover, it is just hard to be so far away. Worrying about me--and now his Dad--has been hard.

Thanks for reading this novel and sticking with me throughout this journey. Your notes of encouragement and sympathy are always a boost! Love to you all!

Anne

Monday, August 31, 2009

Well, my friends . . . I got thrown a little curve ball today. Thought I better share . . .

Since I last wrote, I have been LOVING school, and working on walking with my boot. I am hooked up to my VAC again so my students have the pleasure of watching my body juices slowly move through the tube as I teach my lessons. The VAC also makes intermittent fart-like noises that are always appreciated by my amazingly mature students. :)

Last week at Wound Care, I expressed that I was still feeling a lot of pain when I tried to walk. So, Dr. Carbonell asked that I come to his office to get an injection of some stuff that would bring down the swelling around my ankle--and hopefully make walking less scream-out-loud-painful. Not only did I end up getting the shot, but Dr. Carbonell assessed that most of my pain was being caused by tendonitis. Therefore, he fit me for a brace, told me to try to flex my ankle a little more to start building strength in the muscles and tendons, and set me up to start physical therapy.

My students were SO excited to see me wearing a regular shoe and "walking" with a walker on Thursday morning. I almost felt like this was the beginning of the end . . . My wound was humming along on the VAC and I was flexing my ankle in a "walking" motion. I could almost see my wound being closed and walking with a cane by Christmas.

Insert here: curve ball.

On Friday night, I was practically crying out loud at the excruciating pain in my Achilles. Forget about the brace--I was moving back to my stable, non-flexing boot.

On Saturday morning, I noticed that my VAC tube was full of greenish looking mucus. Sure enough, when I went to change my dressing on Saturday night, it was OBVIOUSLY infected again.

I called Dr. Carbonell on Sunday morning and he called in a prescription for more antibiotics and told me to come in first thing on Monday morning.

Well, here is what we found out.

We now believe that there is a deep infection in the bone. Despite 5 months of major IV antibiotic treatments, the original infection was probably never killed from inside the bone. Although we kept it at bay for a while, it is coming back over and over now and using my wound as a drainage spot. This would most likely explain why my wound has not healed.

The x-ray taken today also shows a large area on my talus bone that is gray rather than bone-white. The gray area either indicates bone death or infection. We knew that the bone had died in some areas, but that should have stopped at the 6-month point. The fact that the gray area has grown significantly in the last 2 months seems to be another indicator of bone infection.

So . . . I am going back to my infectious disease doctor (good 'ol Dr. Jacobsen) on Thursday. He and Dr. Carbonell will discuss how to proceed then. Most likely, I will be going back on long-term IV antibiotics (PICC line in the arm, balls of antibiotics in the refrigerator, injecting myself every 8 hours) and having surgery to take multiple bone biopsies. If the bone is indeed infected, they will either try to treat the bone to kill the infection, or start removing the bad bone. If they have to take away too much, the ankle will be basically useless and will have to be fused.

Basically, rather than seeing the light at the end of the tunnel, I am now a ways back at the entrance.

I feel a bit like I have been hit in the gut. I had a moment or two this afternoon where I felt like I was drowning in the whole situation. I can not STAND to see the sick look on Doug's face when he finds out stuff like this. I hate to do this to him again.

However, on the whole--I feel like it makes good sense. It is do-able. It is not going to kill me. I am in good hands. We will make it. No freaking out is necessary. God has a plan (He always does).

The End.

P.S. I will write you to tell you what happens on Thursday with Dr. Jacobsen. That appointment will be VERY interesting.

Tuesday, August 18, 2009

Well, I guess I have to admit that I have been ignoring you a little. I have just been in a mental place for a bit where I would just like to be in denial of that thing on the end of my right leg. I think, "Can anyone stand to read one more entry about this wound that will never heal?" I know that's what I have been feeling myself. Will I ever get to be just "Anne" again? Or will I forever seen as "Anne & Ankle?"

Anyway--It has been one entire MONTH since my last confession--I mean, entry--and I am feeling the longing in my heart to bare my soul again a little.

When we last met, we were heading off to a Heetderks family reunion at the Spring Mill State Park near Indianapolis, Indiana. Doug's parents and siblings are all from Grand Rapids, MI, so they drove and we flew. Despite the fact that my boot tested positive for explosives while going through airport security, we had an easy flight and enjoyed travelling through these sweet little towns on our way to meet up with the family. My foot was feeling so good on this trip that I almost felt like I was faking an ankle injury. I was able to travel most distances without my scooter, and (when I concentrated really hard) thought that I looked kind of "normal."

When we returned, I got ready for my surgery. I had high hopes that the wound would finally be closed and I could start back to physical therapy by the time school started. Unfortunately, despite staying still in bed for nearly three days following the surgery, the staples once again popped back open--leaving me with a larger wound than before. Just to add insult to injury, the wound became infected again with this lovely green gook (check out Great Fall Wound Pics).

Now that I have been on two rounds of antibiotics, the infection seems to be cleared and we are making new plans.

1) We will start me back on the VAC (Vacuum-Assisted Closure) machine. Although I am not thrilled at the idea of having the tube hanging out of me again (everyone always thinks it is a catheter coming from my ankle), I am REALLY excited at the idea of letting my body heal on its own again. It just has become very obvious that my wound does not want to be squeezed shut with staples.

2) After some skin starts to grow again, we will try to get a few layers of Dermagraft put on the wound to help it along.

3) Once that takes hold, I will go to a plastic surgeon for some celebratory "cosmetic enhancement"--NO!--I will go to a plastic surgeon for skin grafting.

So . . . those plans should probably take us into the new year so we can celebrate the one year anniversary of my fall from the ladder! Yippee!

Ever since the surgery, it is very, very painful for me to put pressure on my foot. Nevertheless, I know that it is important for me to walk on it. So, I just use the scooter for long distances and "hoof it" for short trips to the toilet or around my classroom.

Speaking of classrooms . . . I AM PROUD TO SAY THAT I AM BACK AT WORK!

I can honestly say that I have thrown away all timelines for my foot and could really care less when it heals. As long as I can keep dragging my stubborn foot into work via my own power, chariot, lawn mower, roll-a-bout, walker, wheelchair, or office chair--I WILL BE THERE WITH BELLS ON! I love being back with the kids, planning lessons, dreaming up ideas, working with teachers, making plans, and feeling healthy!

So . . . for right now . . . ask me about my class. Ask me what I am teaching about. Ask me to tell you about some of my great, new students. But don't ask me about my ankle!!! :)

No--that's not true. I so appreciate everyone's prayers and concern for my family and me. We just need a little time to feel like our lives are not "hanging in the balance." Doug and the kids need to be able to feel that life is returning to normal--even if my ankle issues are not resolved yet. My ankle will heal in God's time. Talking about my ankle all the time just makes them feel like we still have such a long way to go. Even though I have said this a million times, we have no idea what the future holds and when things will feel complete again. What I do know is that we are solidly in God's hands and that I don't have to wait with baited breath for a positive end to this journey. It will come.

Let me tell you about some good things . . .

1) Dad is Alive. Dad had a major 7-hour surgery two weeks ago to clean out the spinal column of several of his vertebrae. When they were finished, they created a wire "cage" that will keep his vertebrate in place for the rest of his long life. Even when doped up on morphine, my Dad was busy listening to the family troubles of his nurses, complimenting the food service ladies on their flavorful jello, and inviting his doctors to go sailing when he was feeling better. So sweet. He is feeling a little guilty that his wound has already healed, and he has the strength to take long walks around the block. I say, "Thanks be to God!" :)

2) My girls are happy. Elise and Annika have officially entered the 3rd and 5th grades and are loving every minute of it!

3) The emus are clean. Doug just got a kiddie pool for his emus. Now just imagine seeing them with their legs straight up in the air when they want to get their backs wet. Too funny.

4) Rounded bottom shoes have somehow become a fashion trend. When they told me that I would eventually need to wear orthopedic shoes with a rounded sole, I was a little afraid. I was even more terrified when I actually looked at the styles available. U-G-L-Y! But guess what?!? Somehow, rounded bottom shoes are now being hailed as a great way to stay in shape! I am so encouraged to know that I just might have some slightly normal looking shoes to wear someday! (It is the little things that really count!)

Thanks to all of you who have written to see if I am still alive.

I am alive AND VERY WELL.

Love to you all,

Anne

Saturday, July 18, 2009

Surgery #7 . . . coming on up!

After getting my bandages unravelled at Wound Care the other day, we found that my ever-lovin' wound is still very happy with the pig intestine. The wound has really filled in. If my insurance company was willing to pay for Dermagraft (the human newborn foreskin stuff), we would start covering the whole wound with that to create a final top layer of skin. However, since they won't, Dr. Carbonell has decided to try to sew the whole thing shut during a short surgery. He will probably make some cuts on either side of the wound and then sew it together--once and for all--HOPEFULLY!

We have been planning to leave on Monday for Doug's family reunion in Indianapolis for one week. The last time I had a surgery and then left immediately on a trip--my whole face blew up from the antibiotics. Therefore, we decided to hold off on having the surgery until we get back. Just in time for school to start!

Speaking of school . . . Doug and I are getting into our usual July groove of endlessly researching possible teaching themes for the new school year. Doug, Annika, and our neighbor boys went to pick up some emus for Doug's barnyard. Between keeping athletic socks over the emus heads, trying to keep the six-foot animals from standing up in the car (after breaking through the duct tape holding their legs together!), and attempting to keep green, goopy poop from getting on every inch of Doug's upholstery, it was an interesting--and somewhat terrifying--ride. The boys next door are begging to come along when Doug has to pick up the next load of animals.

I was in the bathroom the other day when one of God's creatures--a cockroach--came creeping out from who knows where. I felt like it was coming out in broad daylight, just to emphasize the fact that I can't move fast enough in my current condition to stomp on him. He literally looked straight into my eyes and said, "Oh, yea, disabled lady . . . like you are going to catch me." Cocky little cockroach.

I did my best to use a roll of toilet paper to smash it while navigating on one foot around my scooter and the toilet. But, alas--he was too fast for me. Just when I thought I would have to surrender to that cocky bug, he decided to take refuge under one of the wheels of my scooter. With one easy push of my finger, I rolled right over that cockroach and killed him good. Score one for the disabled lady.

Love to you all!

Anne

Wednesday, July 8, 2009

Hey, Hey, my friends! Our family reunion in Marco is over, the suitcases have been unpacked, the pile of mail waiting for us has been processed, and we are back to our summer chores.

We had a wonderful time reconnecting with my brothers and their families. Once again, we were able to borrow a friend's condo in Marco Island for wonderful evening dinners, walks on the beach, and time to roll around with the cousins. Elise even got to come home to her 8th birthday celebration on 07/08/09. Very exciting.

Even though we were able to get away, that doesn't mean that I haven't had my regular dates with my good doctors! During my last two visits to Wound Care, we have all been encouraged at the progress being made using the Oasis (pig intenstine). The wound itself has actually grown larger because it is spreading out a little. However, as a result, the wound is not as deep and (as Dr. Carbonell said last week) my foot is starting to look like a foot (you can enjoy the current wound pics if you click on "Great Fall Wound Pics").

I have decided to throw out all timelines and just be happy when it is all over. I made a comment to one of my nurses that I have been hearing, "it should be closed within 4-6 weeks," for about 6 months now. She said, "Oh, that's just what we tell people otherwise they would be overwhelmed by the reality of how long it takes to close up a wound." I was like . . . oh!--would have been nice if someone had told me that 6 months ago!

So--truly--I think my wound might actually be healed in 4-6 weeks--really!

As for the bone . . . I have been waiting for the 6 month mark to have my final X-ray. At four months, the X-ray had shown that the talus bone was dying around the outside of the bone. However, Dr. Carbonell had said that if the bone was going to die completely, we would be able to tell on the 6 month X-ray. So . . . with fear and trepidation, I went to his office yesterday to get the news.

It was awesome to see the X-ray. It is so funny to see MY foot with all these screws and plates inside of it. I forget that I am walking around with half of Home Depot inside my foot! The good news is that the bone has not died any further than what we had seen at the 4-month point. This means that the blood supply has returned to the bone, and that the time in my bone-growth stimulator has been time well spent!

The not so great news is that the tibia is resting right on top of the talus without any cartilage to act as a cushion or lubricant. Dr. Carbonell thinks that I will probably be able to tolerate this for a year or two, but over time, the area will become very arthritic and painful. At that point, I would probably undergo an ankle fusion (a four-month process). Dr. Carbonell showed me how they would use two long screws to permanently fuse the tibia and talus so that the ankle is unable to bend. As this certainly is less than desirable--being able to walk is definitely something to celebrate!

On July 17, we will have been at this for 6 months. I feel like Doug, the girls, and I have slowly allowed ourselves to relax, breathe, and move out of "anticipating-the-next-disaster" mode. We don't really think about the fact that I wear a boot, cart around walkers, sit by the edge of the pool with a bag on my leg, or use the electric scooter at the grocery store. This is our new reality.

We will just keep rolling along with the progress as it comes.

Monday, June 29, 2009

Ham, bacon, pig latin, swine flu, pigs feet . . . there are many things that come from pigs. But for me, none of them are as awesome as pig intestine! When they took off my bandages last week, my wound looked really good. Now that I have a little bit of my own tissue covering up the metal, the pig intestine creates a "bridge" for my skin cells to grab onto.

So, now we are just going to put on a layer of Oasis (the official name of the pig) each week and pray that my skin keeps growing. We think, LORD WILLING, that my wound will finally be closed by August or September. It will be so sweet when that thing is finally closed.

I am still enjoying walking with my boot--knowing that it will all come to an end when I start up with physical therapy again. Without my boot, my foot almost feels like a skeleton being held together by nothing more but a layer of skin. Everything inside feels very loosey-goosey--like it could fall apart and crumble at any second. Once I can start back with PT, my dear Margarita and I can strengthen my foot and HOPEFULLY get me walking on it. I have learned not to put timelines on these things anymore--it will happen when it happens.

Doug and I are going through a few growing pains as we figure out our new "roles." I have always enjoyed being the one who chips away at the coral rock to dig a hole in our backyard, puts together the new furniture from IKEA, or builds the new pergola by the pool. As I look around and see things that need to get done, it is so hard for me to sit by and wait for Doug to have a chance to get to them. I feel like he is having to do everything alone--whereas before we would have done it together.

I had the best time helping the girls build a fort the other day. As long as they are available to go after my tools, I can cut wood and nail on one foot with no problem. :)

Both of my brothers are coming in this week so we can have a little immediate VanderZee family "reunion." My younger brother, Glenn, is already here with his whole family and we are having a great time. It's nice to be up and walking for my brothers. So good to be together.

I will let you know about my next meeting with the pig!

Anne

Saturday, June 20, 2009

"Weebles wobble but they don't fall down . . ."  Do you remember that jingle?  That is the theme song I have running in my head when I try to walk.  I kind of wobble side to side like a penguin.  

Do I sound like I am complaining!?!?  NO . . .!  I love being able to move from place to place AND hold something in my hands AT THE SAME TIME!  Such a concept.  I basically go without my walker when travelling short distances . . . bed to bathroom, kitchen sink to refrigerator, couch to TV, etc.   The rest of the time I use my walker for extra support, and to take a little weight off my foot.  

Thanks to my newfound mobility, we were able to join some friends on their boat.  It was fantastic.  The girls enjoyed looking into the water, fishing, swimming, looking for sea critters, and playing with good friends.  I kept my foot dry by putting it in a bag.  After four hours in the sun, it was nice and "fork-tender" by 

the time we got back to the dock.  Just in time for dinner.

Doug and I worked in the yard today, trying to accomplish some of the tree trimming we started (and abruptly stopped) on the day I fell in January.  When I went inside to put my foot up for a while, the girls suddenly came in screaming saying that Dad was on a ladder.  They grabbed a camera to gather "photographic evidence" of his risky behavior (do you see him in there?).  Even though he managed to live through standing on the top rung of the ladder (don't we ever learn?!?!?), he later stumbled on a tree root and cut his leg with his saw.  

Luckily I have enough medical supplies in my house at this point to safely perform a face transplant in my bathtub.  However, Doug and I wonder if we might live longer if we just hired people to take care of our yard.  Something to consider . . .

We are all looking forward to Father's Day tomorrow.  

Love to you all!

Anne

  

Tuesday, June 16, 2009

For the last 5 months, I have either walked with great aid from a walker, or rolled around on a scooter.  Although my scooter is great for holding my purse, supporting Annika as she learns to use a ripstik, and attracting a lot of curious onlookers, it is an apparatus I would love to permanently park in my garage someday.

Sometimes I watch people walking and can hardly put it together in my brain how their body is able to balance, move, and have forward motion--all at the same time.  It has seemed hardly possible to imagine how my body could ever figure out how to walk again . . . UNTIL TODAY!

OK--I will fill you in on the details.  Here's the deal . . .

The good Lord knows that I adore my dear Dr. Carbonell.  But sometimes I feel like he has tunnel vision on my wound right now and doesn't let me in on what he is thinking about my entire case. So today, as he was running from patient to patient at Wound Care, I blocked the door of my exam room and asked if he could give a little "State of the Nation/Ankle" address to an audience of one (me).  

He basically told me that we have three things to work on with my ankle.  First, we need to get the wound to close (it is getting smaller, but still not sealed up).  Then, I need to get back to physical therapy to gain strength and motion in my ankle.  When that is done, I will learn to walk independently without a boot or a brace.  (All that being said--we also need to keep praying the the bone doesn't die.)

He said that--right now--my ankle joint is like a tire without any tread.  If it is constantly flexing without the help of strong muscles and tendons around it, the talus bone runs the risk of collapsing.  So . . . he told me that he would like for me to WALK USING THE BOOT so that my ankle is kept in a fixed position while getting my leg muscles back in shape. 

I thought, "Well, yea.  You can give me three balls and tell me to juggle but I may just end up throwing the balls in the air and watching them fall to the ground.  Cause, you know--I am real good at falling."  Walk?!?!?  

So--I went home, hauled out the boot, put a big shoe on my good foot, and took a step forward.  IT WAS A MIRACLE!  I walked all the way across the house like I actually knew what I was doing!  Too weird.  Now--mind you--it ain't pretty.  I won't be winning any gracefulness contests on America's Top Model but I am getting from Point A to Point B on my own power.  

In addition to giving some clear directives, Dr. Carbonell also opened up his bag of "wound-closing" tricks to try to get my ankle healed up by Christmas (my new realistic goal).  He has tried human newborn foreskin (didn't work), horse heart (didn't work), and a medieval torture device (kinda worked)--so we are now trying . . . PIG INTESTINE!  Yep, I now have some "Oasis Matrix" in my wound to try to create a "bridge" to connect my own skin tissue together over the hole in my ankle.  

Later, my sweet nurses put a flexible "cast" on my entire leg to keep it stiff.  They were especially kind today, telling me that I have been a real "trooper," and that I need to keep hanging in there.  Their kindness was a blessing.

I read a little thing recently that said that you should always be kind to others because you don't know what battle they may be going through today.  It is so true.  My battle is very visible and obvious.  However, so many of my friends are having quiet struggles with bad marriages, difficult children, shrinking bank accounts, low self-esteem . . . and the list goes on and on.   

Thank you for the kindness that you have shown to my family and me throughout this entire journey.  I will work to "pay it forward!"

Love to you all!

Anne

Wednesday, June 10, 2009

OH MY GOODNESS!  I have never gone this long without writing!  I wish I could tell you that during the last two weeks my wound closed, my bone healed, and I am now running a 6-minute mile BUT actually, nothing has changed.  

Nevertheless, we have been busy enjoying our summer.  

Before we left for our cruise, my Mom and Dad threw a lovely dinner party to

 celebrate my 40th birthday.  It should go without saying that I never expected to be disabled on my 40th.  Last year Doug and I talked about having a big party at our house.  I pictured myself being thin, fabulous, and dancing.  Needless to say . . . that didn't happen.  

However, what we celebrated instead was being 40 and ALIVE!  I am so grateful to everyone who has helped me to reach 40 this year through prayers, words of encouragement, and tons of support!  Love to you all!

Right after school let out, we packed our bags and went on a 4 day cruise to the Bahamas.  We would have been fine if the ship never even left the port--we were just so happy to forget about doctors and just relax, eat, sleep, go to shows, and

 watch our girls run from the waterslides, to the miniature golf, and then off to the next crazy event. 

Elise and Annika LOVED the 24-hour ice cream parlor and pizzeria.  

Doug and I would be sitting by the pool and would suddenly realize that the girls were gone.  Just when we were about to be concerned, we would see them smiling from ear to ear, coming back with gigantic bowls of ice cream.  They also loved being able to eat as much bacon as they wanted for breakfast.

Some dear friends arranged for us to have birthday cakes served to us at our dinner table on our birthdays (mine was on Wednesday, and Doug's was on Thursday).  Although Doug usually cringes at surprises, he handled having the entire food service crew sing "Happy Birthday" to him with the grace of a 51 year old.  :)

There was a kid on our cruise who also had a scooter to help him in recovering from a football injury to his foot.  His

 mother told me that when he saw me on my scooter, he swore he would only use his crutches (you know you look bad on your scooter when a high school boy would rather die than look like YOU!).  However, on the day we disembarked the ship to visit Nassau, he used the scooter.  I was so jealous!  His is so sporty looking!  I decided that if I end up needing my scooter on a permanent basis, I want to write to American Chopper or something to get my scooter "souped up" a little.  Maybe some flames painted on the side or something.

Since I had just had surgery a week before the cruise, Dr. Carbonell put me on antibiotics--just to make sure that my wound wouldn't get infected while we were away.  Well, the morning we were leaving, my upper lip swelled up and my throat felt really thick and funny.  This had happened before when I was on the antibiotics so I knew it would probably go away. 

However, the next morning, I awoke to a huge bottom lip and welts all over my body!  I pretty much spent the entire cruise looking like my husband was beating me up every night.  I just figured that no one on the cruise knew what I looked like anyway so they would just think I was a woman from Miami with extreme collagen lip treatments!  Now that we are back in Miami, I am off the antibiotics and have slowly returned back to my "normal" self.

So, as I said before--nothing has really changed over the last two weeks.  I continue to be non-weight bearing to avoid causing the wound to open further.  When I do place a little weight on my foot, I can't help but notice that it is significantly more painful than before. I look forward to when I can start the physical therapy again.  

To add insult to injury, my scooter wheel hit a rock the other day and I went flying over the handle bars and landed hard.  I was fine (THANK goodness), but it was one of those moments where I just had to cry and admit that this is getting really old and discouraging.  I am usually feeling positive and can honestly say that I believe things will get better, but falling like that made me realize how easily I could hurt myself again.

Next week, it will be five months since I fell.  I am helping with Bible School at our church this week and am taking to heart one of the songs . . .

Faith to see beyond what I can see,

Faith to know that you will do great things.

I will trust you, Lord, I’ll always believe,

As I hold on to my faith, Jesus you are holding on to me.

Love to you all!  

Anne 

Wednesday, May 27, 2009

I was thinking about that typical scene on soap operas, where a character's (let's call him Sloan) face and body is wrapped in 18,000 miles of gauze due to some terrible accident.  Following upteen surgeries to reconstruct Sloan's body, the family is called to the hospital to witness the removal of the bandages.  The nurse slowly unwinds each layer of gauze as the family members grimace with eager anticipation and dread.  As the last bandage is removed from Sloan's face, the music swells, the family gasps, a scream is heard, and . . . fade to black for a commercial break.

I kind of had that same drama playing out in my head when I went to the Wound Care Center on Tuesday.  My foot had been wrapped up since my surgery on Thursday and I was dying to see what my newly closed wound would look like.  Would it be cinched up like a bellybutton or smooth with lots of stitches?  Bloody or clean?  Macerated or dried up?

Well, as my nurse slowly unwound the 18,000 miles of gauze that encircled my ankle, the final removal of the bandage revealed . . . a nice, OPEN wound.  Grrrrrrr!

Although the wound had been closed in surgery, the staples tore through my flesh and the wound popped back open.  Stubborn little bugger. (I included a censored picture here out of respect for my squeamish readers.  To see the real pictures, click on "Anne's Great Fall Wound Pics" in the upper right column). 

After a little disappointment and some time to think, Dr. Carbonell decided that he would try to close it back up again.  We first tried to staple it shut again but it just didn't want to stay shut.  So, he used steri-strips instead.  I will see him tomorrow for him to take a second look.  

I have no idea if this thing will actually close up this way.  Time will tell.

On a happy note, we surprised our girls tonight with news that we are going to take a 4-day cruise next week.  A cruise seemed like a good travel option for us right now (with me on the scooter again).  The girls were really excited--very cute.  I just hope the security guys don't get concerned when they see my bone growth stimulator in my suitcase.     

 

Saturday, May 23, 2009

Many of you have asked for pictures but I didn't want to gross out my squeamish readers. So, if you want to see wound pics, just click on "Anne's Great Fall Wound Pics" in the upper right column. Enjoy!

Friday, May 22, 2009

I made it!  The wound is now closed and secured with staples.  I may not move my ankle or put any weight on it for about two weeks so I don't tear the thing back open.

As I told you earlier, I was feeling really lousy on Wednesday night before the surgery.  Annika was very distressed by this.  She said, "I know I am not supposed to worry about you and I am trying to be positive but I am looking at you and you do not seem the same like you were before like when you were laughing and joking and now you look sick again and that is making me think that you are not getting better and maybe you are getting worse . . ."  While Doug was working to reassure her, I was trying to reassure myself.  

I was still feeling very faint and weak by the time I went in for surgery on Thursday.  So, my ever-faithful Nurse Judith hooked me up to the IV and put some liquids back in me.  That helped a lot.  

It was so funny going through all of the prep that I had just done two days before.  From the nurses to the lab techs--people kept saying, "Weren't you here for surgery just the other day?!?!?"  Yep--I just can't stay away from being poked, prodded, and knocked out!

The funniest part was seeing people's reactions to the Dermaclose apparatus on my foot.  Dr. Carbonell told me it was the first time it was used on a patient at Jackson Hospital.  I could tell.  Everyone who came by would look at my ankle, smile, and then do a nasty-faced double take to look at it again. 

The anesthesiologists were particularly grossed out by it. (You can see here in the pictures that one felt the need to hold his nose, while the other kept saying, "Eewww!"  I told them that was not very professional.)

Although it looked terrible, the little thing did its job . . . IT CLOSED THE WOUND.  Praise the Lord.  Dr. Carbonell and his residents were very excited to see how well it worked. 

Dr. Carbonell finally got a look at my x-rays and told me that there are signs of bone death along the top ridge of the talus.  That is not very good news.  If the bone continues to die over the next 6 months (the usual time range for bone death after an injury), we will then have to consider more serious options (ankle replacement or ankle fusion).  However, if the bone is finished dying, I should be OK.  He said that he has had many patients who have been able to function well with the same amount of bone death that I have right now.  So, let's just pray that the blood supply has been restored to the bone and that it is in the mood to stay ALIVE!

Last night, I had this conversation with Elise . . .

"It's good that you don't have to wear your big boot anymore. Right, Mom?"

"Yes, honey."

"And, it's good that you don't have blood all over your bandage. Right, Mom?"

"Yes, honey."

"And, it's good that you didn't die during surgery. Right, Mom?"

"Yes, honey."

Sometimes life is just about the simple things. 

Wednesday night, May 20, 2009

The strings keep pulling tighter and tighter on the Dermaclose device.  I am becoming more and more convinced that this thing really could be used effectively in torture situations. (Google it and look at the case studies if you aren't convinced.  It may work wonders on wounds but it sure looks freaky!!)

I scared myself a little tonight because I was running a slight fever and was feeling really achy.  Between that and the pain, I was feeling like I was back where I was about two months ago--feeling lousy.  So . . . I ate a TON of food and that kind of boosted me back up.  I also took a percocet (I hate taking those things) which took the edge off the pain. Hopefully the fever is because my body is working hard to balance itself out after the surgery.  I don't even want to THINK about the possibility of it being from infection.

My Mom and Dad are back from visiting my brother and his family in California so they will take me to surgery tomorrow morning.  My surgery will be at 11:30am and should be a quick one if everything goes as planned.  Will keep you posted . . .

Wednesday, May 20, 2009

We went round and round wondering if I should spend the day by myself today, or if we should get a "babysitter" for me.  Looking back on my blog, we noticed that I was pretty "out of it" the day after the last surgery (the one where they removed the external fixator).  Although I am in some pain today (feeling the little timer pulling on those strings!!!), I am happy to be taking lots of naps and working to schedule my surgery for tomorrow!  

I had two thoughts though . . .

One, you would think that having surgery would give you permission to "check out" from being a Mom for a few hours.  Not true.  The minute the kids got home around 8:30pm, we were dealing with the last-minute stresses of finishing homework, packing lunches, walking the dog in the rain, and choosing appropriate clothes and shoes for the Hawaiian dress day.  Of course, I was trying to manage all this from my bed--which usually results in a lot of yelling with no one listening.  When everyone was finally quiet, we all realized that the stress is really just about one thing--the fact that Mom having surgery is scary, brings up lots of bad memories, and invites new concerns about the future.  Not very fun.

Two, when I wake up from surgery, there is really only one person I want to see . . . my husband.  When he walks into the room, my heart still does a little happy flutter.  He has been so patient, and loving, and long-suffering throughout all of this.  I love him.  I love him.  I love him.

Tuesday, May 19, 2009

Hey!  I survived!  

Last night, I ate a ton of food right up until midnight (the food and water cut-off time for surgery), and then stayed up and watched T.V. until 2 am. My plan was to sleep in this morning as late as possible so I wouldn't notice that I wasn't going to be able to eat until after 8:00 pm!  I made it through the morning without any accidental snacking and took a nice, hot shower--knowing it would be my last for a while.  

When my friend, Nancy, came and picked me up to bring me to Jackson, I felt like I was leaving for a haircut.  Seeing as this is my fifth surgery since my fall, I feel like I have the surgery routine pretty down pat.  The blood work.  The EKG.  The lovely gown.  The gazillion medical questions.  The endless search for a good vein.  The annoying need to go to the bathroom right after being hooked up to the IV and heart monitor.

I was assigned to Nurse Judith.  A by-the-book, on-the-ball, to-the-point, not-messing-around kind of nurse.  She was wonderful and even brought me peanut butter and jelly with some crackers after my surgery.  Best meal I had all day.

I like a nurse like Nurse Judith MUCH better than the dropping-the-needle, misplacing-the-armband, rolling-the-eyes-at-the-doctor, what-was-your-name?-kind of nurse.  That had happened the day before when the nurse walked in and said, "OK, Ms. Heetderks, we are ready to take you for your chest X-ray . . ."  I thought, "I am getting my ankle fixed and getting a cosmetic enhancement at the same time???  Hot-diggedy dog!!!"

Anyway, when it was time for the surgery, a man came in with Dr. Carbonell to explain the procedure that they were going to use on my foot.  Basically (look at the picture), they would staple a number of metal brackets around the perimeter of my wound.  A wire would be strung through the rings and attached to a timer (the blue and white thing).  The timer will gradually pull the wire over the next two days--slowly cinching the wound closed.  The diagram shown here is so pretty.  When I saw what it looked like on me after the surgery (I chose not to include a picture out of respect for my squeamish readers!), it reminded me of some fancy new advancement in torture technology.  

The surprise for Doug and I was that I will be having another surgery in two days on Thursday!  This will be a quick surgery where they will remove the brackets and the timer, and then secure the closed wound with staples.  Amazing.

Dr. Carbonell is hopeful that this procedure will actually work and will be the end of my open-wound days.  If it is successful, we will still have to keep a close eye out for infection or rejection of the tissue on the metal.  For now--we will stay positive.

It was so funny.  On Monday, I had a full x-ray done of my foot.  When I was leaving the radiology department, there was a dark room with the door open.  Here inside were two men staring at computer monitors with a big foot illuminated on their screens.  They were discussing various aspects of the image, so I was trying to inconspicuously hang around so I might catch a word or two of what they were saying (as inconspicuously as a big woman with a turquoise walker and a tube hanging from her leg can look).  As I was analyzing the image, sure that I was recognizing hairline fractures in the talus, and slight bone death on the perimeter of the bone . . . I realized . . . the foot didn't have any pins or metal plates screwed into it.  What an idiot!  It wasn't my foot at all.  Remind me not to quit my day job to pursue a career in radiology.

Dr. Carbonell said that he didn't get to see MY ankle x-rays because the computer was down. Just as well.  I don't want to get any bad news about bone death.  Today is just about wound closure.  

A special word of thanks to all of you who have been praying for my family and me.  God has been allowing us to learn so much through this experience.  Every day is a blessing in its own way.  

Love to you all!

Anne

P.S.  As if having his aquarium explode wasn't bad enough . . .  This morning, Doug was getting ready to do a little presentation at our morning faculty meeting, when he heard the maintenance guys using the weed whacker around his barn.  Unfortunately, they were not aware that two of Doug's hens have been faithfully sitting on eggs underneath the chicken coop over the last few weeks.  By the time Doug reached the coop, it was too late.  The hens and all of their eggs were weed-whacked to smithereens.  He had to reach under the coop and pull out the dead hens and all of the broken eggs with the little chicks inside.  So sad.

Monday, May 18, 2009

Hello! 

On Friday, I went to visit my infectious disease doctor, Dr. Jacobsen.  I haven't been to that office in a while, now that I am off of my antibiotics.  It was a riot to see everyone again.  Dr. J. was happy to hear that Dr. Carbonell was going to close up the wound on Tuesday. He can't tell me enough times that as long as the metal hardware is exposed--my risk of infection is very great.  Even with tomorrow's surgery, he still has his doubts that the wound will heal over the metal.  I just have to hope that my body will surprise him.

I attempted to go shopping for some clothes . . . a first since my fall.  I was delighted to see that long, sleeveless dresses seem to be in for this summer.  Perfect fashion to disguise a big, black boot!  Hooray!

Doug and the girls took a late night run over to the home of a family friend to witness the birth of puppies!!!  It was quite an eye-opening experience to see this dog give birth to 10 puppies--one every half-hour.  The girls LOVED it.  

Unfortunately, this experience may have wiped out any chance of us having any grandchildren.  The girls concluded that they don't EVER want to get pregnant now that they know what is involved in giving birth!

I am one of the leaders of our middle/high school youth group at our church.  So, on Saturday, we got on a bus and had a beach outing at Bill Baggs Beach on Key Biscayne.  To protect my foot, I wrapped it up in a garbage bag and hoped that no one would throw it away on accident (just kidding).  The kids helped carry me down to the water and set me up with all my garb on the beach.  The only problem was that I fell asleep and when I woke up--everyone was gone.  I was burned, thirsty, and I had NO way to get back to the picnic area!  So funny.  

Elise was able to come along with us and had a great time hanging out with the big kids.  She was even very impressed that I was able to jump up the three steps of the bus all by myself.  She is such a cheerleader for me.

Annika hung out with Doug on Saturday and brought chickens from the Discovery Barn over to a local farm.  They spent the day checking out animals that could become the newest members of Doug's Barn program.  So much fun.

We are gearing up for having me "out of commission" again this week.  I am excited to begin a new chapter of my healing (maybe even get rid of the tube attached to my ankle?!?!?).  I will let you know how it goes.  

Thanks for all of your prayers!

Anne

P.S.  As usual, Dr. Jacobsen ended my appointment on Friday with a bad joke.  Here it is . . .

So, Dr. J. was meeting with a husband and wife who had just found out that their son had been in a terrible accident and was in need of a brain transplant.  The doctors explained to the parents that there were two brains available for the transplant.  One was the brain of a young man which would cost $100,000.  The other was the brain of a woman which would cost $30,000.  As the parents considered their options, they felt they had to ask why there was such a difference in the cost of the two brains.  The doctor said, "Well, the woman's brain is used."

Baddum-bum.  (I told you it was bad.)

Wednesday, May 13, 2009

We are making progress, people!

Sometimes it is the little things that make all the difference: the cherry on top, the new windshield wipers, or the cold drink on a hot day.  For me, right now, the little thing that is making me so happy is my new, sleek, FLESH-colored compression sock that I bought yesterday at a medical supply store!  No matter what—I need to always wear an elasticized stocking to keep blood from pooling in my foot throughout the day.  But the one they have been giving me at the Wound Care Center each week--called a tubigrip (pictured here before I burned it)--always ends up looking so frayed and gross.  

The guy at the store told me the new stocking wouldn't work because it would run when I put a hole in it for my VAC tube.  He obviously has never used a bit of clear nail polish to stop a run in a new pair of pantyhose!!  Please!  I globbed on a ton of polish, poked a hole in the middle, and VOILA!, a custom compression sock!  Please enjoy the picture of my sexy leg in its new compression sock while being treated by my bone growth stimulator (are we sure this site is still rated G?).

My other big news is that I am having surgery on Tuesday!  As expected, my wound has decreased in size but my skin just doesn’t want to heal over the metal bracket.  Rather than create a new 5-inch incision to remove the bracket, he is going to do a procedure that he describes as “pulling purse strings.”  Basically, he will sew metal threads around the perimeter of my wound (it is now about the size of a nickel), and then pull the strings to close the wound.  Prior to pulling, he will remove some of the scar tissue that has caused the healed area to be so dense and thick.  HOPEFULLY, this will finally bring an end to my open wound issues!

He is also going to do a procedure to my big toe to allow it to flex again.  He said that it is common for the toe to become “frozen” as a result of an ankle injury like mine.  He will cut into the toe to release something or other (didn’t catch the name) that will allow me to walk better in the future.  He warns me that this will be the most painful part of the recovery.

Unfortunately, this will mean that I can’t go to see Margarita for at least two weeks while I heal.  I have to remember that this surgery will probably set me back for a while again.  I have been enjoying a period of time where things seem to be moving forward and I can almost actually believe that I might walk on my own again.  Being immobile again will probably be a little scary.  Remind me of this when I start whining on my blog at the end of next week, OK?

Love to you all! 

Anne

Mother's Day--Sunday, May 10, 2009

Loving me has been more complicated than usual during the last four months.  I could understand how my family was wondering, "Well, hasn't every day been 'Mother's Day' lately??"  Nevertheless, I woke up to sweet cards, a beautiful necklace, and a wonderful assortment of handmade plastic key rings.  We had Thai food for lunch, shopped at the Falls in the afternoon, and cuddled while watching TV at night.  Couldn't be sweeter.

Saturday, May 9, 2009

I have been walking around for the last week primarily feeling like a huge, sweaty, blubbery beast on four walker wheels.  When I look down, I see that I am wearing the equivalent of a knee-high sock like I wore in Junior High (my compression “sock”).  The only problem is that I am only wearing it on one leg—and, this one is bone-white, frayed on both ends, and has a ugly hole in it large enough for a tube (carrying yellow body fluid) to fit through.  No outfit on earth seems to want to blend with the orthopedic-looking white sneakers, the ever-present black “purse” (which contains the collected body juice), and the hunched over body position I seem to be in 80% of the time. 

And then . . . just when I have deemed myself too despicable to take up space on the planet, I run into someone who says, “OH MY GOODNESS!  YOU LOOK FANTASTIC!!!”

One has to wonder . . .is this what people say when they really want to run away in complete fright and horror?

Amazingly enough, when I look into their eyes and see that they are genuinely delighted at the sight of me, I realize that they are “seeing” something different than what I see in the mirror each morning.  They see someone who had ashen-colored skin three months ago and barely had the energy to carry on a two-minute conversation on the phone.  They see someone who is now “walking” down a hallway instead of being pushed in a wheelchair.   Most of all, they see an answer to prayer and a reason to give God great praise.

Friday, May 8, 2009

Whereas my usual routine used to be going to the Infectious Disease office to get my blood drawn and to collect my cooler of antibiotics, I now take a usual pilgrimage to the Physical Therapist office at Baptist Hospital. 

Just like at the Wound Care Center, there is a lovely collection of people with terrible stories to tell. There is a guy I see regularly who lost his leg in a hit-and-run accident 24 years ago.  He wants my scooter so he can use it in the middle of the night to get to the bathroom without bothering with his wheelchair.  He is pretty much in a constant process of strengthening or “repairing” one part of his body.  Just when one thing gets better, another part starts to deteriorate.  Nevertheless, he is always in a great mood. 

Margarita shows me the most mind-blowing things about my foot.   Each tiny bone and tendon functions together so beautifully—until someone smashes one part to smithereens in a freak ladder accident.  Then all of a sudden, it is like a big line of dominos standing up on end . . . someone knocks over one domino and the rest fall down in defeat.  So now, we work each day to slowly tinker away at each part of the foot until it performs in perfect unison once again. 

I have a whole selection of exercises designed to strengthen all of the affected areas of my foot.  Some involve surgical tubing, while others employ the use of wooded wedges.  Each piece of equipment is ingenious in its simplicity.  My favorite tool is this big blue plastic saucer.  The saucer has a ball screwed into the bottom of it.  My job is to roll my foot forward and back so that the front and back edge of the saucer gently touches the ground.  Later, I do the same thing side to side.  It is a killer but it really works my foot in so many places.

Anyway—Margarita says that she has never seen an injury like mine in the 28 years that she has been doing physical therapy.  She is pleased by my progress and thinks that (if everything proceeds without incident), I should be walking in about 6 months.   Patience . . . patience . . . patience . . .

I feel like I am making things up because every day I have a different pain than the day before.  Thank the Lord, the majority of the pains seem to have fairly innocent explanations and are just part of the process.  Let the healing begin.

Wednesday, May 6, 2009

Just when I said the pain wasn't coming from the bone, the pain started coming from the bone.  Oh, joy.  I had crazy pain last night every time I tried to flex my ankle.  When I went in to see Margarita today, she said that it was not the tendon--but the bone.  Scary to me.  So--she wants me to stop "walking" if I feel pain and to put my big Frankenstein boot back on.  

It is so hard for me to know what is good and what is bad.  They say . . . Yes--you need to put pressure on the bone or it will not heal.  No--you shouldn't put too much pressure on the bone or it will shatter.  I just want to follow my directions and get better.  The problem is that no one really knows exactly what directions to give.  It is just a waiting game of doing the best you can, and then hoping and praying for a positive result.

I was at school today trying to iron out a few details that have been causing Doug and I a bit of stress.  Just when I was feeling low, one of my students came around the corner and stopped dead in his tracks at the sight of me.  Although he can be a student who sometimes needs a little help staying focused, he looked right at me, clapped his hands together and squealed, "Mrs. Heetderks!  Your boot is gone!  You are healing!  I can't believe my eyes!  I have been praying for you every night!  You look so much better!  Are you going to be our teacher again??  I can't believe you are healing!"  He literally bounced up and down with his hands clasped like I was a modern miracle in plain sight.  What a blessing.  What a blessing.  

Tuesday, May 5, 2009

Well, I am technically “walking”—just not very fast.  Margarita has me wearing my shoes, using my walker, and s-l-o-w-l-y taking one step at a time.  My goal is to roll my foot in a walking motion.  Never thought I would have to think and work so hard to do something I have been doing since I was one year old!

Although walking is pretty painful, I am happy that my pain does not seem to be coming from the bone itself.  My tendons, muscles, and joints are just being asked to do something that they haven’t done in a while!  I just need to be really careful to listen to my body and not overdo it.

My wound is getting smaller but the bracket is still exposed.  Dr. Carbonell told me today that he would do surgery to remove the bracket and close up the wound if it doesn’t close on its own in the next four weeks.  Although we have talked about this option plenty of times before, I think it will really happen this time if things don’t improve.

Dr. Carbonell left my room saying, “So, we will wait to see what it looks like in four weeks on June 4.”  I told him that June 4 was the day after my 40^th birthday (June 3).  To which he said that June 4 was his birthday.  Guess what—my Douglas’s birthday is on June 4, too!  To think that the two most important men in my life right now were both born on the same day!   

The man who runs the Jackson Hospital Wound Care Centers stopped Dr. Carbonell and me to say that a local news station wants to do a news story about the Center and needs a doctor and patient to interview.  Guess who he wants to use for the story??  I’ll let you know when to tune in . . .

The girls just told me that they think that we should celebrate Father’s Day this weekend instead of Mother’s Day.  They say they have already done enough for me over the last few months and that Dad really needs more attention than me.  So nice to be loved. 

Love to you all!

Anne

 

Saturday, May 2, 2009

Howdy, my friends!  It has been a while!  

I was very busy this week working on our big Art Fair at school.  On Friday, over 400 of my students and many of their parents came to see the artwork and to participate in art-making activities.  Needless to say, I spent most of the day in bed today napping and giving thanks that all went well.

I had a nice visit with Dr. Carbonell on Tuesday.  My wound continues to plug away at closing up so we are just going to be patient and hope that surgery will not be necessary.  When talking about bone death, he told me that he does expect some of the bone to die.  That was news to me.  However, his hope is that the bulk of the bone will live to the ripe old age of at least 97.

I started physical therapy on Wednesday.  What a trip.  My therapist, Margarita, is like the bone whisperer.  She practically laid hands on my ankle and allowed it to tell the whole story from the last 4 months.  I can see that everything so far has focused on major issues of healing.  Her job is to start fine-tuning the healing.  She is thrilled that I am not in a lot of pain and that my ankle has nice range of motion.  What has been shocking to me is how the rest of my leg has deteriorated.  For example, my toes and the ball of my foot act like they are frozen in cement.  When we took my boot off and tried to bend my foot in a "walking" motion, it was totally stuck in one position.  So, we worked two days last week to begin freeing up that area and to build up strength.  She wants me to start wearing a shoe and to try to force myself to walk (with the walker, of course) in a natural motion.  Amazing.  

I now have two more interesting gadgets in my life.  The first is my new 4-wheeled walker.  It rides like a dream.  I love it.  It has an awesome basket that holds tons of stuff, has brakes for going downhill (like my driveway--scary!), a little seat to sit on if I need to rest and . . . it is absolutely silent.  Even with tennis balls on the legs, my old walker sounded like I was rummaging through my kitchen drawers every time I used it.  AND I couldn't hold anything while I was moving.  My new basket allows me to walk and carry things at the same time (what a concept!).

My other gadget sounds much more exotic than it is . . . it is a bone-growth stimulator.  When they called me to arrange a time for a "fitting," I imagined a warm, vibrating apparatus that would cause me to feel like I had been holding on to a lawn-mower all day.  Nope.  It is this thing that I rest my foot on that creates an extremely powerful magnetic field around my ankle. 

 This causes the cells in my bone to begin healing.  I have to do this every day at the same time for 30 minutes.  You feel NOTHING.  According to the guy who came to our house, the unit costs $2500 and is only covered by insurance if 90 days have passed since the original injury.  I guess they figure if your bone hasn't healed after three months, you probably need a little extra help.  After nine months, the unit will automatically self-destruct and you have to throw it away (just to keep you from passing it around to all of your friends with broken bones).

    

I feel like I have entered a new chapter of my healing.  Although the physical therapy will be time-consuming, painful, and a little scary at times, it feels really good to begin working towards walking and "normal" functioning.  My scooter makes me feel very healthy and independent, but it keeps my foot completely immobile.  It is time for me to slow down again, use my walker (even though I look and feel 83 when I use it), and SLOWLY walk step after slow step until it feels familiar again.   

For now, I am OK with slow.

Love to you all!

Anne

Sunday night, April 26, 2009

This just in . . .

I took a few steps on my own tonight and it felt really good.  Mind you, everyone in my family was screaming at me to "knock it off" and use the walker again.  However, I am looking forward to going to physical therapy for the first time on Wednesday and see if I am ready to become more weight bearing.  

(Just had to share.)

Anne

Thursday, April 23, 2009

It has taken me a few days to write because I have been digesting some things that have happened this week.  I find that I am having a hard time getting excited about improvements in my situation because they are always counter-balanced with real, potential set-backs.  I am continuing to have a positive attitude and everything--it just seems like all good news is always followed by a big warning of caution. 

So--here is my news . . .

Good: My wound is getting smaller.  It really is.  I can see it with my eyes.  Even though Dr. Carbonell thought it would have closed by now, he still thinks that in about 6 weeks it should be closed.

  

The Not-So Good:  The problem is that the wound needs to close over metal hardware (see the pictures?).  Everything we have done so far (foreskin, horse heart, etc.) has rejected the metal.

My infectious disease doctor, Dr. Jacobsen (the guy who always tells all the bad jokes), does NOT believe my wound will ever close over the metal hardware.  He and Dr. C. had a nice talk and agree that I should have surgery to remove the hardware if the wound does not start to close.  In that case, I would have a skin graft to cover the wound.  I would welcome the surgery (let's get things moving) but don't want to push for it if my body can do it on its own with a little time.

Good: Dr. Jacobsen took me off of the antibiotics!  Shocking!  I couldn't believe it when he said it.  He had the nurses pull the PICC line out of my arm and everything.  I was able to take my first shower last night since I fell because I don't have to keep my arm dry anymore.  This is all very liberating!  I can't believe that I don't have to cart around syringes and antibiotics with me everywhere I go!  

The Not So Good:  The only reason he took me off of them was because I have been on them for 13 weeks and my body really can't take much more.  He says that the antibiotics have done all they can and now it is a "wait and see" situation to see if the bone starts to get infected and die.  Cheery.  In that case, they would start to do surgeries to remove the dying bone and fill it with cadaver bone.  

The Good:  I am starting physical therapy next Wednesday.  A parent at school had a similar injury two years ago and had a wonderful physical therapist that she felt was very instrumental in her recovery.  So, I just got it all finalized today that I will get to use the same therapist to get me walking again.  

The Not So Good:  I am really not supposed to start PT until my wound is closed.  The open wound will really hinder what they can do with me.  Dr. Carbonell just didn't want me waiting around for another 6 weeks to start PT.  Hopefully, this amazing therapist (Margarita--I already am loving her name!) will be able to work wonders without disrupting the healing of my wound.

The Good:  It feels good to put weight on my foot.  It really does!  I have really good range of motion and can really believe that I will walk again.

The Not So Good:  They keep warning me that the bone may be dying and will shatter under my body weight during the next 6 months.  This thought scares me to death.  Everyone says, "Oh, that won't happen . . ."--but it might.  And it would really, really stink if it does.  It is mentally discouraging to me to think that all of the improvements I have patiently waited for could mean nothing, if--indeed--the bone is dying.  This is the one thing I really need to get past.  It will take me a while to figure out how I am going to put a mental spin on this so it doesn't mess with my head.

Just Plain Good:  I have been working all week at school putting together the Art Fair.  It is so great to see the kids and feel like a person again.  Driving has been WONDERFUL.  I can get to my appointments without my Mommy (although I miss seeing her as much!).  I feel like a teenager with a new license.  My four-wheeled walker is due to arrive in a week so I can start chasing the kids down the street (haha).  It will even have a fold-down seat for when I need to take a rest (but no cup-holder--the insurance wouldn't spring for that luxury).  

I really do love all of you and appreciate your continued faithfulness.  It seems very slow right now but I know that things are moving forward.

Anne

Saturday, April 18, 2009

I just took a little trip down memory lane in order to ground myself.  Long story short--I am feeling like we are going nowhere again.  It just seems like we have been at the same thing for soooo long.  I was talking to a man who experienced a similar injury eight years ago and he said that you really have to look back to see how far you have come.  If you just live in the moment, it seems like you haven't moved forward at all.  

So . . . I just looked over all of my pictures and can clearly see that my wound has gotten much smaller, I am no longer bound by the external fixator (I almost had forgotten that thing!), my facial coloring looks more life-like, and I know that I have much more energy than I had in the beginning (or even a month ago).  

People always ask, "How are you doing?"  I'll say, "Great!"--but its not great.  I am still taking killer antibiotics, have an open wound, and have no idea if my bone is even alive.  But I can't say, "Oh, I am not so good . . ." because I am really doing great!  I have come so far!  I actually feel like a person now and I can sort of get around more!  

Yes--we really have come a long way over the last 13 weeks.  Nevertheless, it still seems slow.

My girls really seem to be fearful of the next "bad thing" that might happen to our family.  There have been two times this week where the girls have been in absolute hysterics because they were afraid that one of us was hurt.  Just tonight, the girls and I came home and Doug was not here.  We tried calling his cell phone but it went straight to voice mail.  For the next 45 minutes, both girls were screaming, praying, crying--absolutely convinced that he was dead or had been in an accident.  When his headlights beamed against the window, they both jumped up like a true miracle had just occurred.  They are really fried . . . 

Dr. Carbonell officially signed my paperwork to keep me on disability through the end of the school year.  It is hard to believe that I will have missed 4 1/2 months of school by the end of May.  Sad to me.  Even though I should be at home doing nothing, I am very busy putting together our annual Art Fair.  I may be down but I am certainly not "out for the count!" 

On a happier note (this is a pretty depressing entry!), life behind the wheel has been wonderful.  I can not tell you how amazing it is to be able to drive to my own doctor's appointments and to  pick up my kids from school.  The most exciting part is figuring out the location of handicapped parking spaces, and discovering the electric scooters at the grocery stores.  I just love using my walker to get into Winn Dixie, and then actually having the right to take one of those little drivable carts and zoom around the store!  

Anyway--please say a prayer for our family.  We are all in a state of "alert" waiting for the next shoe to drop.  We need to be able to just chill out and figure out how to take this in stride.  

Love to you all--

Anne

P.S.  Speaking of unexpected disasters, Doug went to school today only to realize that his 250 gallon fish tank had cracked over the weekend.  Of course, it flooded half of the library, a conference room, a classroom, and 12 computer desks.  We now have some very stunned fish in a bucket outside our door.  Anyone looking for a sucker fish???

Tuesday, April 14, 2009

The horse was sent to the glue factory.  Very sad.  Long story short, the horse heart just never wanted to attach itself to my body--or really--to the metal hardware in the middle of my wound.  Instead of drying out like a scab, it just stayed incredibly goopy and kept falling off the wound.  When Dr. Carbonell saw it again yesterday at Wound Care, he decided it would just be best to throw it away. He also scraped the last little remaining bit of dermagraft (the foreskin stuff) that was hanging around my wound.  My body is just insisting to close up this wound on its own without help.  Very independent wound. 

 

So, now being into this for 12 weeks, I am still dealing with an open wound, IV antibiotics, weekly liver and kidney blood tests, regular visits from my home health nurse to take care of the wound, a rickety walker, lots of medicines, and an unbelievable inability to move with ease from place to place.  But, heah!--what did I think was going to happen?!?!?  No biggie.  Nothing a smile and a positive attitude can't conquer.  

The one thing that has made a huge difference is . . . (I hate to tell you) . . . I am driving.  It seems a little odd that someone who can't walk should be trusted behind the wheel--but it has been going very well.  I have driven about four times now and know how to position my foot for optimum strength and comfort.  On the night that Elise and I came back early from Marco Island, I decided that I would take Elise over to Walgreens to get some milk.  Elise is always up for anything so she didn't seem too concerned to get into the car with me.  However, when I happened to check up on her at a stoplight, I noticed that she had secured all THREE of the back seat seatbelts on herself--just in case.  Stinker.  

Dr. Carbonell also decided to go ahead and send me to physical therapy even though my wound is still open.  He really wants me to work on getting more weight bearing and (drumroll) to work on learning to walk again.  He continues to caution me that the bone may shatter or die in different places over the next 6 months (that would be bad--many more months of recovery from new surgeries).  

So--I will continue to think good thoughts, pray, stay positive, do what I am told to do, and love my family!  What more can I do?

Love to you all!

Anne

Saturday, April 11, 2009

I have been thinking all night about some pictures that I found on Doug's iphone last night.  No--nothing that would break up a marriage . . . Rather, they were pictures that gave me insight into what Doug has been going through since my fall.  

So many people who have been through similar hardships have warned us about the emotional toll a long recovery can take on the primary caregiver.  While the one who is hurt (me) will often get a big "I am going to beat this thing" rush of adrenalin that will carry them through some dark times--the caregiver (my dear Douglas) is left to keep the family's "normal" life moving forward.  They usually have to stuff their feelings of worry and fear down pretty deep just to keep their heads above water.  

When I look at Doug's pictures, I see that he has spent many, many hours taking care of me when things weren't looking too good.  He has probably heard a lot of scary words from doctors that he has or hasn't passed on to me. He has had to encourage our kids to believe that I will get better.  AND he has had to do this while going to soccer games, being the lone parent at school

 musicals, teaching weekly lessons to his 450 students, caring for a cranky new bird, making meals, cleaning the house, and much, much more.  All of this is very stressful.

These pictures make me more aware than ever that he has been so faithful to me and to our kids.  The fact that he is feeling a little wear and tear from this experience makes all the sense in the world.  

My healing is nowhere close to being over. My biggest prayer is that we can roll with the bumps that will come along the way and remember that we are in God's hands.  There is nothing that we have to "freak" out about, or see as a sign of impending doom.  These pictures show me that God has been with us through some very dark times, and he will continue to be with us to the very end.

 

Friday night, April 10, 2009

Well, hello!  It has been so long since I have checked in with all of you!  We had a wonderful time relaxing, reading, talking, playing games, watching movies, laying out in the sun, swimming, and taking lots of naps!  Although I never made it out to the beach (too difficult to figure out how I would travel on the sand), Doug and the kids enjoyed collecting shells, jumping waves, and taking long walks at sunset.  Annika was thrilled to have her good friend, Quinn, join us for a few days (to celebrate her 10th birthday), and Elise was just happy to have a new bucket of Easter playdough to play with on the balcony.

Marco Island is filled with very tan, active, and friendly senior citizens.  I was getting a little tired of looking into the faces of fit and beautiful 70 year old women (with tennis racquets in hand) as they asked me questions about my fall with unbelievable pity.  Everyone wanted to know where I had gotten my cool scooter, or how long I had been on antibiotics, or when my doctor thought I might walk again.  But even though they were all very polite, they were the ones heading off to the courts to hit their tennis balls back and forth, while I was the one fitting tennis balls onto the legs of my walker.  

My doctors all worked together to make it possible for me to be away for one, entire week.  I don't know what I was thinking when we made these plans.  For the past three months, I have seen a doctor every other day . . . how did I think I would be away for 7 days without seeing a doctor??  So . . . my infectious disease doctors taught me how to mix antibiotics the old fashioned way instead of using their cool refrigerated antibiotic balloons (they only last 3 days).  This meant using a tall IV stand and priming a lot of fancy tubing before each infusion--made me feel like I had already graduated from medical school.  

Dr. Carbonell wanted me to continue to have the dressings on my wound changed every other day (which is usually done by my home health care nurse).  This was especially important because of the new horse heart bioimplant on my wound.  So . . . the nurses taught me how to do my own VAC/wound care and I did it on my own in Marco!  

Everything went great until Wednesday night when I changed my dressing and thought things looked a little funny.  Without giving too many gross details, I will just say that there was a lot of slimy gook and an odd odor coming from my wound.  Even though we were planning to stay until Friday night (right now), I did not want to be responsible for my wound getting infected while on vacation.  So, my Mom, Elise, and I headed back to Miami on Thursday morning to see Dr. Carbonell.  Turned out that everything was fine (whew!) and he even wrote me a prescription for a walker with 4 wheels and a fold-down seat (the seniors in Marco will really be jealous, now!!).

Although our vacation ended a little abruptly (Doug and Annika came back this morning), it was wonderful to get away and even make an awkward attempt to swim in a pool!

Life is good.

Anne

Friday morning, April 10, 2009

Hello!  So many of you have written to me about my Dad.  

Most of you who know him are 

a) in agreement that he is an incredibly giving and caring man,

b) amazed that he would divert from his regularly scheduled shaving routine,

c) thrilled that he is doing something for himself,

d) insisting that he will look great no matter what he does with his facial hair!!

Turns out that he agreed with most of you and decided to shave his hair in the "Van Dyke" style. Cute, huh?

Saturday, April 4, 2009

Well, hello from Marco Island!!  Some friends of ours from Chicago are letting us use their lovely condo on the beach for Spring Break (I know--we are really suffering).  So on Friday, my father loaded up his car with 8,000 saline syringes, 70 miles of gauze, a portable IV stand, a 35 pound box of antibiotics, a walker, a wheelchair, a scooter, and everything else necessary to keep me alive for the next week--and we drove over to Marco Island.  Doug and the girls came later and my Mom is coming in a few days. 

I could talk about the fact that it is Annika is turning 10 on Wednesday, or that I bought a New Balance shoe that has already changed my life, or that we have already been to the Urgent Care Center in Naples for a strep culture (negative--thank goodness), or that Elise can talk a mile a minute and play RummiKub all night long, but . . .

I would rather talk about my Dad.

My Dad has run two miles every other day for his entire life--never missed a day.  My Dad has called every member of his congregations on their birthday since he started his pastoral career.  My Dad finds everyone fascinating.  I don't think he has met a person he doesn't like yet.  My Dad has worn the same pair of swimming trunks since 1973 and still thinks of them as "new."  If you buy him a new pair, he will put them in a drawer for a "special occasion."  And . . . my Dad is the kind of guy who will load up his van with an obscene amount of stuff just so his daughter can have an encouraging week away from home.  Quite a special man.

My Dad is also a guy who does the same thing every day.  Same breakfast.  Same exercise routine.  Same mid-morning nap. UNTIL THREE WEEKS AGO . . . when he decided to grow out his beard.  Shocking.

I include here a picture of him as he appears now.  We are all debating where he should go next with his look . . . friendly mutton chop? a van dyke? what about a hollywoodian? What do you think?

Love to you all!

Anne

Wednesday, April 1, 2009

It really has felt like my ankle and I have been in a holding pattern for a while.  We have been waiting for my wound to heal so that I can start physical therapy and (hopefully) quit taking the antibiotics.  Last week, Dr. Carbonell said that he hoped the tissue would grow over the exposed metal and that the wound would close up on its own in about 2 months (maybe).  Tick . . . tock . . . tick . . . tock.

Well--guess what!?!  I went to my usual appointment at the Wound Care Center with Dr. Carbonell yesterday and THINGS ARE MOVING AGAIN!

Let me tell you what happened . . .

After saying hello to all of my friends in the waiting room (a lovely mix of people with crazy foot issues--we look like the Land of Misfit Toys), I was called back to the go to one of the examination rooms.  My favorite nurse, Judy (Shaun Cassidy's mother-in-law--no kidding), took the dressings off my foot and thought it looked great.  

Then Dr. Carbonell walked in and was amazed at how much I could move my foot around.  He told me that I should start "walking" on it as much as possible to strengthen the bone.  We decided that he would let me go to physical therapy ONE time so I could learn how to use the walker while being about 75% weight bearing. 

 Then he said that he felt like I could start DRIVING again!  Judy and I both were like, "WHAT?!?!?"  He said that the ankle is strong enough now to be able to apply pressure to the pedals (one more reason for you to stay off the road!!).  I think I will hold off on that for a while but it sure was a sweet idea.  Ahh . . . independence.

THEN . . . he noted to himself that the tissue is still having a hard time growing over the bracket.  Just then, he left the room and said to someone in the hallway, "I think this patient would be a wonderful candidate for your new product."  In walks a pharmaceutical rep (I had noticed him hanging out in the waiting room previously) who looks at my wound and says, "Yep, I just saw another patient who had exposed metal in his wound and the orthadapt worked great on it." 

Dr. Carbonell looks at me and says that this rep is introducing a new product and would like to donate one application of it to a patient of Dr. Carbonell's choosing.  I immediately got the feeling that I was about to receive the equivalent of a free kidney or something.  Turns out that orthadapt is a very expensive "bioimplant" made from the sheath that surrounds a horse's heart (it wasn't enough that I already have human newborn foreskin on my wound--now I have a horse's heart, too!!!).  The orthadapt is cut to fit the wound and is then attached using multiple stitches around the perimeter of the wound.  As a result, the now-covered wound begins to produce enzymes that accelerate epithelialization (growth of tissue over a wound).  

As the wound heals, the outer edges of the orthadapt becomes dark and hard.  Eventually, the entire orthadapt will be dark and fall off like a scab with my own skin healed underneath!!  From the research I saw today while googling, I can see that this is really great stuff and should increase the liklihood that my wound will heal on its own (and faster!).  

It was obviously such an amazing blessing that I would be there just when the rep was visiting, and that Dr. Carbonell would choose me from his other hundreds of patients to receive the one free piece of horse heart.  So awesome.  Of course, I still have all the scary stuff looming (infection, death, or shattering of the bone resulting in an ankle fusion) but for today, it was great to have some good news!

Of course when it was all over and I mentioned to Judy that I was hungry, she said, "I bet you could eat a horse!"  Then when I tried to get down off the bed on my own she said, "Hey!  Hold your horses!!"  Let the horse jokes begin . . .

Tuesday, March 31, 2009

We had a great time at the Fair the other night.  A friend from school got us a VIP pass that allowed us to get in for free, and park right by the entrance.  So, my parents, brother, sister-in-law, Doug, the girls, and I all jammed into my parents' car with the wheelchair "securely" tied to the top of the car.  Hilarious.  

I quickly realized that one has complete loss of control when being wheeled around in a wheelchair.  I have never thought about how I "navigate" through a crowd, but being at the will of someone else's choice of movement was very interesting.  I spent the entire night reassuring frightened strangers that my outstretched leg was not about to impale them (when really I wasn't sure if that was going to be true). 

When being pushed by Elise, she would be talking about the cotton candy stand just as I was seeing a huge trash can coming straight for me.  It wouldn't be until we hit the can that she realized that she wasn't watching where we were going.  Other times I got stuck in front of the guy with the microphone beckoning me to try to get the ring on the neck of a bottle to win an ugly, overstuffed animal.  I can't stand that section.

The plus side of being in a wheelchair is the automatic connection you have with everyone else who is getting around without walking.  From the disabled guy in the battery powered scooter to the old lady in the wheelchair, we all kind of find each other and share a knowing smile. Being able to have the front row seat at every show is really nice, too.

The sweetest part of being at the Fair was hearing my kids squeal in delight when twirling and whirling on the rides.  Things always haven't been real joyful for them lately so it was great to see them having some good ol' fashioned fun at the Fair.

Good times.

Sunday, March 29, 2009

I will write later about our weekend trip to the Miami Fair, but I first wanted to share the following email with you.  It arrived in my mailbox under the heading "How Smart is Your Right Foot?" 

I opened it thinking that it was some sort of inspirational poem about my right foot but it was something a little different.  I have to wonder what kind of friend (Judy Forjan) would send this email to someone who can hardly move her right foot in the first place (!), but I will let it go.  

Try it!  Here it is . . .

"You have to try this please; it takes 2 seconds. I could not believe this!!!  It is from an orthopedic surgeon and will boggle your mind. This is sure to keep you trying over and over again to see if you can outsmart your foot but you can't.  It's pre-programmed in your brain!

1. Without anyone watching you (they will think you are GOOFY!!) and while sitting at your desk in front of your computer, lift your right foot off the floor and make clockwise circles with it.

2. Now, while doing this, draw the number '6' in the air with your right hand. Your foot will change direction.

Isn't it weird that this simple task is such a challenge?  Send it to your friends to frustrate them too..."

 

Friday, March 27, 2009

Howdy!  I have actually been able to get out of the house during the last few days!  I spent one day at school on Wednesday and began doing a little work for our Art Fair.  It is so much fun to see all of the teachers and kids.  Makes me feel like I am back in "the land of the living" again.

My dear friend, Lisa, who has taken over my class is doing such an amazing job.  Watching her enthusiastically teach class after class that came in made me realize something that I really didn't want to admit . . . That I do not have the energy right now to take on teaching full-time quite yet.  Just trying to maneuver my ridiculous body around the room was difficult in and of itself!  

The other thing is that my foot is still so fragile.  Just being up a little while makes it swell up like crazy.  I can not compromise healing just because I am antsy to get back to work.  Hopefully I will be able to return about half-time by the last month of school.  Dr. Carbonell told me that I can go back to work in August.  As usual--time will tell.  

Love to you all--

Anne

Tuesday, March 24, 2009

Hello!  Throughout the past week, I have been amazed at how my wound appears to be getting smaller.  Sure enough, when Dr. Carbonell saw my wound, he was thrilled.  He said (if he was a betting man), it would probably be closed in about 6 weeks.  Even though the metal bar is still running through the middle of the wound, there is some tissue that seems to be acting like it wants to start to go over the metal.  If this works out, it would mean that I don't have to have another surgery in the next month.  That would be great.

I also asked Dr. Carbonell for his best guess at my future.  As a result, I feel like I got a realistic picture of what is to come.

Basically, assuming the wound heals, we will now be dealing with the bone.  There are a number of hurdles that will face us that will just be a "time will tell" situation.

Hurdle #1:  Death of the bone.  Even though the bone is alive right now, it could easily start to die over the next few months because of all the capillaries and blood vessels that were severed during the fall.  If the bone can not get enough blood, it will die.

Hurdle #2: Infection of the bone.  If they take me off the antibiotics too early, they are afraid that the bacteria that may have been trapped inside the bone fragments (that have now healed into a solid mass) will take hold of the bone and kill it.  There will come a point soon when they need to take me off of the antibiotics because of all of the negative side effects associated with their use.  Then it will just be a "wait and see" situation.

Hurdle #3: Collapse of the bone.  Once I go through physical therapy and start putting my full body weight on the bone, there is about a 50-50 chance that the bone will shatter and collapse.  Dr. Carbonell said that if it is going to happen, it will usually take place within the 6 months after being weight-bearing.  

If any of these hurdles occur, I will most likely have to have an ankle fusion.  This is where they permanently put the ankle in a fixed position so that it is not using the compromised bone in any way.  There are a host of yucky things that go along with ankle fusions--one being the four months of recovery required after surgery.  

So . . . my prayer is that we will take each of these hurdles one at a time and beat each one.  I know I have no power over any of it so I fully release it to my OH-So-much-smarter-than-me God.  

Love to you all!

Anne

Monday, March 24, 2009

Well, hello!  It has been a while since I last wrote!  If you notice a few days passing between entries, it is usually a sign that I am feeling a little down.  When I feel the blues coming on, I am finding that I am better off ignoring the situation for a little while rather than writing all about it in my blog.  Nevertheless, I am back on an upswing so . . . here I am!

Doug is back and the girls and I could not be happier.  What a blessing to have his whistling, happy body back home.

My friend, Marjorie, told me that her mother fell getting out of bed and broke BOTH of her ankles!!!  She now wears the same black boot that I wear on BOTH of her feet!  Poor thing!

Marjorie told me that her Dad refers to the boots as her "Frankenstein" boots.  Well, never having been a fan of Frankenstein, I did a little research to find out what he was talking about.  I have included a picture of Frank's boots and have to agree that they do bear a striking resemblance to my new footwear.  Although I might feel like the a pathetic version of the monster hobbling around with my walker (now fitted with tennis balls--I might add!!!), I much prefer Elise's perception of my appearance.  :)

Matt and Vera, my brother and sister-in-law, just arrived from Chicago to visit us and to attend a wedding.  Just when I was feeling like I was the only one attached to weird contraptions while sleeping at night, Matt pulled out this new thing he has to wear for his sleep apnea.  It is basically a blow up projectile that he straps on to keep him from rolling over onto his back while sleeping.  I just about peed my pants watching him demonstrate this miraculous development in modern medicine. 

I head to wound care to see Dr. Carbonell tomorrow so I will let you know the latest news as soon as I hear it.

Love to you all!

Anne

Thursday, March 19, 2009

Before I begin, here is a late St. Patrick's Day joke told to me by my infectious disease doctor . . . Here it is -- Name a famous Irish outdoorsman.  (Answer at the end)

I really miss Doug.  I feel like we are just barely limping along (literally and figuratively) without him.  He left me these sweet little lunches in the fridge so the girls can grab them in the morning and leave them by my bed.  It will be good to have our family back together again on Sunday night.

My friend, Nancy, wheeled me through the entire Miami Metro Zoo this morning (a huge walk if you haven't been there before).  We went early to miss the school field trips and such.  All of the animals were awake and active--like they were waiting for us to come.  

I am still milling over all the news Dr. Carbonell gave me on Tuesday and am feeling a little "antsy in my pantsy."  I want to get hopping on doing my physical therapy.  I am ready to just rip some skin off my thigh (never looked very good in a bathing suit anyway so may as well do some permanent damage) and put it over my wound.  This waiting around for natural healing is boring.  :)  Just kidding.  

I act like I have all these better things to do but the reality still remains that I SLEEP CONSTANTLY.  I am just-plain pooped.  I sat in a wheelchair this morning at the zoo for less than two hours and came home feeling like I had just run a marathon.  I felt better when I had a home evaluation this afternoon from my home nursing company.  The nurse just emphasized again that the antibiotics that I am on completely wear you down and urged me to GET THE REST I NEED.  I feel guilty resting.  I feel like I should be working.

Oh well--just venting a little again.

Love you all!

Anne

P.S.  Answer:  Patio Furniture!

 

Wednesday, March 18, 2009

 Well, it only makes sense after my Saturday entry that I am now telling you that my husband is leaving me.  NO--not "leaving"me--heaven forbid.  He is just leaving to go to New Orleans for a science conference until Sunday night.  I am in a little bit of denial about what this really means for us.  I am sure I will be writing you soon to tell you of the piles of laundry, filthy floors, boring (or non-existent) meals, and the eerie dullness that has plagued our house since his departure.  If any of you would like to stop by around bedtime to help us all get settled in for the night.  Feel free!  

 

Tuesday, March 17, 2009

WATCH OUT FOR THAT CURVE BALL!!!  I think that is what someone should have said before I entered Dr. Carbonell's office today.  Just when I thought I knew what was going on--everything changed.  

One--I need to stay on the antibiotics for at least another month (maybe longer).  Both of my doctors agree that there is a great likelihood that the bacteria is still hiding out in the bone. They are both afraid that if I go off the antibiotics, that the bacteria will come out from the bone, kill it--and then I could lose the foot.  Oh . . . I hadn't heard about that.  This is a very real concern--one they will have to weigh with causing damage to my kidneys and liver from being on the antibiotics for too long.

Two--I am NOT going for physical therapy anytime soon.  Dr. Carbonell wants my wound to be closed up first before I start sweating and moving my foot all around.  For now, he wants me to continue to move it around on my own and put pressure on it when I walk with my walker. (The pictures show my wound before and after dermagraft.  The milky appearance is the dermagraft that my own tissue has "absorbed."  The VAC will now encourage my own skin cells to fill in the rest.) 

Three--He foresees me wearing my velcro boot and using my walker until AT LEAST August.  Now picture this in July with a bathing suit (Really--I'm not complaining).

Four--If it means that I have to be in a standing position--he does not want me to return to work until August.  I think I will figure out a way to teach sitting down.

Five--If the wound does not close up in a month, he will have me go through another surgery to remove the plate by my ankle and use my own skin to cover the wound.  Right now, my own tissue and the dermagraft is resisting growing over the metal plate (you can see from the pictures).  The plate is quite long so he would really have to cut far above and below the wound to remove it, but if it refuses to heal--we will have no choice.

Six--I am wearing the VAC again (see the tube?).  The constant suction will encourage the tissue to grow.

FINALLY--on a personal note--I wore real pants today for the first time (wipe away a tear).  And . . . I was able to speak to my students today at their weekly chapel to talk about the struggles and blessings that have come from this injury.  So good to see them.

Love to you all!

Anne

Saturday, March 14, 2009

The life of a caregiver is never easy.  You have to watch over this person who is very needy and helpless and wants you ALL THE TIME for something.  You don't get cards in the mail.  Nobody sends you flowers.  You are expected to be happy, and caring, and loving--without ever a word of complaint.  You just keep taking care of this person who was dumb enough to climb up on a ladder without help.  And somehow, because of their stupidity--you are stuck cleaning bed pans, making lunches, and taking on the jobs of two people.  

Understanding that my Douglas (my caregiver) has been absolutely amazing, I have sat by and listened to a story he has been repeating since I came home on Thursday.  Mind you, the last few days have been a bit of a blur.  Sleeping a lot.  Taking pain meds. Moving my ankle a little.  Using the bed pan (highly over-rated).  But I keep hearing this story.  Over and over.  The same story.  So I will share it with you now . . .

You will have to have Doug tell it to you to get the full effect . . . something about me thinking that I could walk a mile the minute I got home from the hospital.  That he saw my knees begin to buckle when I tried to "walk" to the bathroom and that he caught me from behind.  That I kept telling him I was fine--and then I would suddenly go limp again.  That he dragged me to the toilet, only to have me throw my head back and start making a deep, guttural sound (he will gladly reenact it for you).  He will also show you how my eyes rolled back in my head and that I turned the color of a banana peel.  He yelled and yelled at me, but I wouldn't answer.  I kept looking worse and making fewer noises.  Then he says that he tried to hold me on the toilet while trying to dial 9-1-1 but mistakenly dialed 9-1-1-1 so the call wouldn't go through.  And just when he was ready to say good bye to me for good--to thank the Lord for the 15 wonderful years we have had together--I jerked my head up and said, "What in the world are you calling 911 for?!?!?  There is nothing wrong with me!!!!"

I think it was at that point that he decided to quit his job as my caregiver.

Say a prayer for Douglas tonight that he will not have heart problems by the time my ankle has healed.

Love to you all!

Anne

Thursday, March 12, 2009

Mom brought me to Jackson South this morning for my surgery.  Everything went extremely well.  Dr. Carbonell was able to remove the fixator, remove a little hardware, and cover the wound.  He also manipulated my foot out of the 90 degree angle-position that it has been in for the last 8 weeks.  He says that in order to do that, he tore apart a lot of scar tissue--painful--but good.  The best news was that the talus bone looks like it is alive.  Thanks be to God.

I have been feeling good the last few days--zipping around on my scooter and visiting school. So, I think I kind of had it in my head that I was going to have my surgery and continue improving.  WRONG!  I can see that I am now almost back at the beginning.  LOTS of pain. Very painful movement.  Strong spasms.  We found that I can't even get up to go to the bathroom 

without blanking out from the pain so we are back to using the bed pan.  Fun!  

I called Dr. Carbonell about it and he let me know that I will be experiencing some pretty extreme pain for the next few days because of the ankle manipulation during the surgery. However, hopefully the pain will begin to subside so I can start to take on physical therapy next week.  Time will tell.

I am encouraged.  This is all part of the process.  My spirits are good.  My family is amazing.  My friends are incredibly supportive.  

Love you all so much!

Anne

Wednesday, March 11, 2009

As I sit here, I can hear Doug talking to Annika.  She is trying to settle down for bed but is heartbroken about my surgery tomorrow.  She is so worried about ankle fusions, infection, bone death, amputation--things a kid really would never know about unless they were planning a future in podiatry.  I hate to hear her cry--wondering why this had to happen to me.  I hate to think that I have caused her such deep angst.  She is trying so hard to let it go--but it is eating her up.  

In reality--tomorrow will be wonderful.  It will be amazing to get this fixator off of my leg--I think my leg might fly up in the air the minute they take it off.  I am also thrilled at the idea of covering up my ugly wound (actually--it has gotten pretty darn good looking if I do say so myself).  I also just might be pretty close to getting off the antibiotics because I have now managed to live through eight weeks of treatment!!

I mentioned before that this surgery will most likely be the beginning of a new chapter of my story.  I now know that to be true.  On Monday--I will begin my first day of physical therapy to see what my poor ankle can do.  But it will also be when we get to look at the new x-rays to see if the shattered pieces of bone were able to stay alive.  If the talus bone was just too damaged for the blood to return to the bone, it will be dead.  I'd like to think that I have my very own Easter miracle going on in my foot right now and that the bone is alive!  Whatever the case will be--I am up for it.  Who cares.  It all makes life interesting--right???

Please be praying for Doug, Annika, and Elise as they each handle their concern for me in their own way.  They have been so brave throughout this whole deal.  I love them so much.

Love you, too!

Anne

P.S. A wonderful artist and author, Jim Arnosky, came to talk to our students today at school so I went to hear him.  So great to see him at work--but also to see my students.  They all tell me that they have been praying for me every night and that they are so proud of me.  What amazing kids.

 

Tuesday, March 10, 2009

Good Morning!  Today is a big day because I am going to all my doctors to prepare for my surgery which is now on THURSDAY at noon.  

Remember when I wrote you that I was perfectly happy staying in bed all day sleeping?  Well, my body must be doing better because I am DESPERATE to get out of the house.  I went to school yesterday and was delighted to see so many of my students--it really fed my spirit.  So many people have mentioned that it is common to go through a time of depression/anxiety when going through something like this.  Well, I have really been fighting it a little during the last week and it has been wonderful to combat it with PRAYER, PEOPLE, SUNSHINE, AND OUTINGS!  

Praise be to God for the dear people who have encouraged me--sometimes without even realizing it.  One friend brought me a toe ring to put on my foot.  She told me that every time I look at it, I can remember that God loves me.  A sweet student at school yesterday gave me a note and ended it with, "For I will restore your health to you and heal you of your wounds," says the Lord (Jeremiah 30:17a).  The wounds feel both physical and emotional this week--so I am taking that one to heart.  So many have continued to remember and encourage us in such amazing ways--we are so blessed.

Love to you all!

Anne 

Saturday, March 7, 2009

After a difficult night, I woke up this morning to an unexpected email from a friend.  She wrote, “Because of the Lord’s great love we are not consumed, for his compassions never fail.  They are new every morning; great is your faithfulness (Lam. 3:22-23).”  At the very moment I read those words, my ever-whistling husband began whistling, "Great is thy Faithfulness" off in the kitchen.  It was another confirmation of what I have been trying to allow myself to fully believe--that God is in every detail.  He knows everything I need.  He will take care of me.  I do not need to worry.  God is good.

As my ankle pain begins to subside and my healing is moving along, more of "real" life is beginning to creep back into my life.  The cost of this injury and the realities of budget

 issues at our school has brought about new concerns that are hard for me to "let go and let God."  Somehow it is easier for me to give my ankle over to the Lord because it is obvious that I am powerless to do anything about it.  But when it comes to money--it feels like I should still have to bear some of the responsibility to take care of it.  I am working through this.  It has really gotten me down and I just can not slip downward.  I have too far to go.

So--today I got out of the house and went to Annika's soccer game.  I saw so many people from school and was greatly encouraged by many of the conversations that I had with them.  It was good to see sunlight, hear the joyful voices of children, and be hugged and kissed by friends.  Life really is good.

Love to you all--

Anne

Tuesday, March 3, 2009

I have news!  I went to see Dr. Carbonell today and found out that I am scheduled for surgery for next Friday (the 13th).  He is going to remove the metal plate that is still exposed on my bone, close up the wound with dermagraft, and then . . . (drumroll) . . . take off the external fixator!  

Following the surgery, he will fit me with a boot and start me on physical therapy for three times a week.  Also, even though the wound will be covered with skin, Dr. Carbonell would still like me to continue with the VAC therapy.  That means that I will still need to carry around my little machine all the time and be seen by my home health care nurse twice a week.  

In addition, by next Friday, I will have been on the antibiotics for eight weeks.  So . . . it just might be that my infectious disease doctor will have me stop taking the IV antibiotics (the ones that are still causing me such wacky side-effects).  

So many changes . . . can you stand it???

I had planned to host a chapel presentation at my school on March 17 (the Tuesday after my surgery) so I hope that I will still be up for it.  I have been so anxious to go back to my sweet students and talk to them about this entire experience.  I want to talk to them honestly about how difficult this process has been--but that it has been such a blessing, too.  Even though they may be as young as five years of age, many of them are experiencing tragedies far worse than my little ankle problem.  I want them to know that God has a plan for them--no matter how bad it may seem right now.  

So many of you have written me such amazing things.  I have heard from old friends from college and my childhood, Kindergarten students, people currently going through horrendous hardships, wonderful parents of my students, dear members of my church, my crazy brothers, and even people I have never met.  Each of you have reacted to tiny things I have said in my blog by sending me jokes, ridiculous videos, words that let me know that you "get it," inspirational verses, offers for rides and meals, and medical advice given to you by doctors or friends.  One of you even sent me a picture of a person's ankle after it had been mauled by a polar bear--sure proof that there is an ankle out there that is definitely worse than mine!  :)

I love each of you so much and appreciate that God is using you to bring me through this time.  

Thank you so much.

Anne

Saturday, February 28, 2009

OK, OK!  I won't do any more googling!!!  So many of you have written to tell me to get off the computer and take this whole thing day by day.  I now know that giving into the temptation of taking a sneak peek at the future really FREAKS ME OUT!  

Since being discharged from the hospital, the only reason I have left the house is to go see a doctor.  Well, last Thursday, I took my foot on a big field trip to our school.  I helped Annika and some classmates make chili for a chili cook-off, and Elise got to explain all of the medical gadgets attached to me to her class.  It was good to be at school again--and I was glad that I felt at peace being there.  I left feeling like--I know that I will one day return to teach, but I am in no shape for that right now.  All in good time.  

After two hours at school, I was totally exhausted and came home and slept and slept and slept. Every time I woke up, I thought about my students and colleagues who were happy to see me, my good friend who has done a fantastic job taking over my Art classes for me, the kind school parents who are bending over backwards to help us out, my dear girls who seemed relieved to see me out of the house and in my usual surroundings, and my precious husband who is managing to keep our family afloat with a smile.

Doug and I enjoyed some time together this weekend because the girls both had sleepovers on Friday night.  We managed to watch The Bucket List without falling asleep.  This was actually a really big deal because--prior to my fall--we had rented that movie three times without ever watching it before the due date!  

Then, on Saturday, we got really ambitious and went to the movie theater to see Slumdog Millionaire (my second field trip of the week!!).  Now, when I get in a wheelchair with my leg straight out and my foot propped up on 5 pillows--I am quite a sight.  I literally scared small children at the theater.  We laughed and laughed trying to fit me and my foot into the handicapped bathroom. It was good to be out doing something normal.

On a bummer note, my insurance is "officially" unwilling to pay for the dermagraft necessary to close up my wound.  I don't know what this means for me, but I am sure Dr. Carbonell will tell me what is next soon enough.

Thanks for all of your encouraging notes!  Much love to you all!

Anne

Thursday night, February 27, 2009

I just made the mistake of googling "ankle fusion."  Freaks me out.  There are a ton of people who have written about what it is like to recover from a bad ankle break.  All of a sudden it is dawning on me that I may be looking at a future of living in constant pain.  I don't want to be on pain meds for the rest of my life.  I am also realizing that when they talk about these future surgeries--we are talking about a long time of recovery.  I kind of had it in my head that I would just have to make it through this recovery . . . but not a few more!  And so many people write that the one surgery causes another problem that results in another surgery.  I want to get back to work and my life.   How long will this take?  What are we talking about here? I think that I just might be dealing with this for the rest of my life.  What in the world was I doing on that ladder?

I am just thinking about my friends, Joyce McKimson and Sharon Carper.  These are two amazing women in different stages of dealing with cancer.  They, too, will be dealing with their cancer for the rest of their lives.  And yet they are facing life with courage.  Taking life one day at a time.

Get over yourself, Anne.  Deal with it.  Everyone has their stuff that they have to deal with. Yours just happens to be your ankle.  You will make it.

Thanks for letting me vent.  

Anne

Wednesday, February 25, 2009

Well, the people have spoken.  66% of you voted that you would enjoy seeing a current picture of my wound.  It looks good, huh???  Lucky for the 8% of you who voted that my wound pictures gross you out—this picture isn’t too bad compared to the first ones (feel free to scroll down to look at some of the earlier pictures if you don’t believe me!).  I still have that pesky little hole (see it below the wound?) where fluid drains out.  The hole should close up eventually.

When Dr. Carbonell saw my wound yesterday, he was more convinced than ever that I need to get the wound covered with dermagraft (a skin substitute made from human newborn foreskin).  Hopefully the insurance company will approve it soon.

It is interesting that the focus so far has been on keeping the infection at bay and taking care of my open wound.  We really have not talked at all about the bone itself.  When I mentioned it yesterday, Dr. Carbonell kind of smiled—like—we are not ready to go there yet.  The nurse even said that my body is producing the fluid in the ankle area (that is sucked out by the VAC) because it is trying to fill in the areas that would normally be filled with bone.  That one was new to me.  Made me think that I should go out to the front yard and look for those pieces of bone that got left behind. 

I can see that once the external fixator is taken off and x-rays are taken, a whole new chapter to this story is going to begin. 

I feel encouraged that I seem more human-like lately.  When I am not sleeping (I sleep about 15 hours a day), I feel like myself—a non-mobile version of myself—but still myself.  That is good.

My friend, Natalie, drove me to my appointments yesterday and managed to meet someone she knew at each office.  She even ran into a close relative at my wound care center.  My foot is bringing people together. Who knew?

Love to you all!

Anne (and my foot)

Monday, February 23, 2009

Hello!  My Mom has been taking care of me over the last few weeks—coming by to feed me lunch, drive me to appointments, take care of my kids, provide me with Gatorade when I look like I am about to pass out, and give me good ol’ motherly love. 

Well, she has left me.  Left to go to California and Chicago for two weeks. 

So, I am now spending my days alone.  All alone.  With no one to care for me. No one to pick me up off the bathroom floor when I have tripped over my VAC tube.  No one to spoonfeed my DanActive drink into my trembling lips.  No one to help me wrestle my underwear up over my external fixator. 

But I will make it.  I will.

And all kidding aside—I hated it today when I knew that I would not hear the sound of her coming through the door and calling out, “It’s me, Annie!”  There has been something so wonderful about needing my Mom again—like I did when I was little.  She is an amazing woman who has been so willing to drop everything for her daughter.  And although she may regret raising me to be the independent type of girl who would decide to climb up a tall ladder without help, she loves me—lame foot and all.

Enjoy your break, Mom. 

Love, Anne

P.S.  I got a handmade card in the mail today that said, “She had a great fall . . . and love came tumbling after.”  I am feeling the love from all of you.  Thank you so much.  --Anne 

Saturday, February 21, 2009

It was five weeks ago today that I fell from the ladder.  I don’t mean for it to feel like an anniversary or anything but I can see how the five-week mark is messing with my head today.  It seems like five weeks has been enough. 

Doesn’t it seem long enough?  Doesn’t it seem like I should have a little more energy, or need to sleep a little less, or be a little more “Anne”-like?  How is it that I am NOT going stir-crazy?  Everyone keeps saying, “Are you bored out of your mind?  Are you dying to get up and get going??” 

The simple (and surprising) answer is, “No.”  The basic act of getting up ten times in one day to go to the bathroom is about all the physical activity I can handle right now.  I get exhausted just having a two-minute conversation on the phone.  And yet there is a part of me that is feeling guilty that I am not ready to do more.  Don’t you always hear that the best thing someone can do is to get up and get going again? 

On Friday, I went to my Mom’s to take a shower, got my haircut, and had a very low-key visit (on our couch) with a dear friend of ours from Alaska. It didn’t seem like I had done anything major—I took two-hour naps in between each of those activities.  But I could tell that just taking the shower was about as much as I (or my ankle) could handle for that day. 

By the end of the day, my ankle felt weird and was very swollen.  Part of me felt very guilty that I had pushed my body too hard.  But the other part of me thought, “You have got to be kidding me!  I can’t even do that without my body freaking out??”  Yes—I guess that is the case.  My body is telling me that I still need to rest.  And I have a feeling that in another five weeks, I will still need a lot of rest.

So yea—It has been a long time. Elise told us that she sometimes wishes that she could get in a time machine and go back to the morning that I fell.  She says that she would go back to tell me NOT to get up on the ladder.  Annika says that she just wants all of it to just “go away.”

But it happened.  And for now we have to be thankful that we have each other, that my body is healing, that we are keeping infection at bay, that we are loved, that we are alive, and that we have a God that is looking out for us all the time (even when it seems a little slow).  Once again, I feel incredibly blessed that—although today is bugging me a bit—I am ready to allow myself the time to heal.  I do not feel like I am climbing the walls, I am not bored—God has allowed me to accept this as my reality and trust in His wisdom. 

God is in control, so I am just going to CHILL.

 

Friday, February 20, 2009

I . . . HAVE . . . SHOWERED!!!!!!!

Thursday, February 19, 2009

Well, folks—It may not be pretty, but I am going to get through it.  That’s all I have to say.

Dr. Jacobsen told me that we have run out of options for antibiotics so I have to stay on the one I am on now.  He wants me to take the Benadryl to try to control the itchy/swelling side effects, and take Advil to ease the fever and achiness.  We are all hoping that I can manage to just get through the next three weeks on it and then I will be “out of the woods.”  He is going to have my blood tested twice a week to make sure that my white blood cell count doesn’t go seriously low again.  If it does, he will have no choice than to take me off of it early.  That is a little scary--especially because the wound is wide open with exposed hardware right now. 

Because of this, Dr. Carbonell is really trying to get the insurance company to approve covering my wound with dermagraft.  He thinks this will work much better than if he were to cover the wound with my own skin.  From what I can tell, dermagraft is a “skin substitute” that stimulates your own skin cells to multiply and heal around the wound.  If I am taken off the antibiotic a little early—at least the wound is covered. 

On a more personal note—Elise was my night nurse last night.  She has been afraid to stay by me at night because she is afraid that she will kick me.  She never kicked me—just kept me nice and warm. 

Love to you all!!!

Anne

Wednesday, February 18, 2009

Mom and I took my foot out for another field trip today to the Vascular and Spine Institute (we even used the handicapped sticker for the first time!). 

After waiting for a looonnnggg time in the waiting room (hence, the name), I was brought into an operating room to have a PICC line put in my arm. A PICC is a long, flexible tube that is put into a vein in your arm and threaded up into a large vein just above your heart (see the diagram). It can stay in your arm for up to a year and does not have to be changed.  

Right now I give myself antibiotics through the PICC line every 8 hours.  The antibiotic is placed in a pressurized ball that slowly releases the antibiotic over a half hour (the pictures show one that is full and one that is empty).  I don’t need a nurse to come and do it and I don’t need one of those IV stands that you typically think of when you hear about IVs.

Dr. Jacobson took me off my old antibiotic because it caused my white blood cell count to go really low.  Now, on the new antibiotic, I have been noticing that my hands will itch really badly and swell.  Today my lips even started swelling (very Angelina Jolie-ish).  I won’t be surprised if they pull me off of this antibiotic and put me on yet another one!  Have to keep going with the flow . . .

I am getting a little excited because I see that my countdown to my weekly shower is getting very close!!!

Love to you!

Anne

Tuesday, February 17, 2009

Tuesday means that I wake up, eat, take antibiotics, sleep, eat, and then go to the Jackson Wound Center to see Dr. Carbonell.  I am telling you, when that man walks in the room, the clouds part, the sun starts shining, and everything starts making perfect sense. 

He loves the look of my wound and wants to do a skin graft on it soon.  He expects that my insurance company is going to fight it so he wants me to start working the phones tomorrow to get an approval moving along. 

He also thinks that he will be able to remove the external fixator in a month or two.  This will require an outpatient surgery for them to get the pins out.  I am telling you, at first I was not wild about my amazingly humongous piece of footwear but I have really worked it into my personal style.  I think I will miss stretching my underwear and pants beyond the limits of man-made fibers when it is gone.  Ha ha.

When he removes the fixator, he is also going to remove one of the plates that they screwed into my bones during the second surgery.  I didn’t really get it all at the time but now I understand.  You see, in order to reach the talus (the bone that I reeeeeaaaaalllllllyyy destroyed), he had to get around the fibula (look on the left side of the bone diagram).  So, he simply cut the fibula bone away, did his magical work on the talus, and then put the fibula back in place using a metal plate (see it on the x-ray?).  If my wound had just healed without getting infected, the plate would have stayed in there forever.  However, because it got so infected and they had to cut away all of the external skin, that plate has been exposed for the last month.  In the mean time, the fibula has actually healed and doesn’t need to be held together by the plate anymore so he is just going to remove it!  One less thing to set off the metal detectors.

Every day brings another baby step towards “normal.”  Today I felt strong enough to go and sit out on the driveway while the girls played with our dear neighbor boys, Kory and Nick.  My little nurses set up chairs for me, brought out plenty of food and Gatorade, and then carefully “walked” me to the driveway.  It was great. 

Annika so needs to be comforted sometimes with absolute knowns: No—I am not going back to the hospital.  Yes—I will walk again.  No—the wound is not going to get infected.  Yes—I will be able to go to your chili cook-off next Thursday.  However, she and I both know that I cannot promise any of these things.  So it was just nice to escape these sad unknowns and just feel “normal” for a bit. 

Love to all--Anne 

Friday-Monday, February 13-16, 2009

Long story short . . . time and detective work have revealed some new truths.  The PIC line was, in fact, NOT infected.  So, I no longer need to take the Cubicin antibiotic.  They are glad about all this because it means that there was no new bacteria introduced into my bloodstream.  I will go in on Wednesday to have a new PIC placed in my arm so I don't have to use these temporary IV lines.

I had a blood drawn today to see if my white blood cell count is higher.  Judging by the fact that my fever/body aches have decreased, I really think it will be much better this time around.  In the end, I think the change in antibiotics (from Zosyn to Primaxin) has made the difference.  Unless there are any major developments, I will continue to take the Primaxin for another couple months to keep the ankle site clear of infection.

Although I still have very frequent "crashes," where I suddenly get very weak, clammy, and faint--most agree that I just need to eat plenty of good food, get lots of rest, and have Gatorade or apple juice nearby for a quick boost.

I decided to include some pictures from our weekend together.

These show . . .

- Me all wrapped up to take my first shower in 11 days!!!

- Doug and Mom (my caretakers) reading my blog about how much I appreciate

 my caretakers!!! :)

- Me waiting for Doug to get the car outside Dr. Jacobsen's office.

- Elise and me opening up all of the wonderful "Get Well" cards that we have received from all 

of our wonderful friends and family!!!

- We tried to have a family movie night where Dad did not fall asleep during the first 3 minutes of the movie . . .  Not only did he fall asleep but so did the dog.

- Elise gave me a fantastic leg and foot massage while watching Arthur.

- Annika has been sleeping with me every night because she is a great nurse AND she doesn't wake up when I hobble (loudly) to the bathroom a million times throughout the night.  Elise wanted to try out being a night nurse, too, so she decided to sleep on the floor (she was worried that she might kick me in her sleep).

Wednesday and Thursday, February 11 & 12, 2009

OK—here’s my update.

I continue to have intense body aches, a mild fever, dizzy/fainting spells, and an overall feeling of being a wet dishrag (+pain).  One moment, I can look at food and think it looks pretty good, and the next moment the near mention of food can make me want to lose my lunch.  I have hardly even thought about my ankle for the last few days (and thank goodness—it has been doing very well!).

In an effort to figure out what is going on, Dr. Jacobsen (the infectious disease doctor) is running a lot of tests on my blood. 

On Wednesday, they just went ahead and assumed that the PIC line was infected (the actual results will come back late Friday) and removed it.  I now have a temporary IV line in my lower arm that needs to be changed every other day.  They put me on yet another antibiotic (Cubicin) to kill off the bacteria in my blood from the PIC line.  If it turns out that the PIC line was not infected, they will take me off of the Cubicin.

Some blood results came back today (Thursday) and showed that my white blood cell count is very low.  On the up side, my other levels are a little low but in the normal range.  They now think that the Zosyn (the antibiotic that I have been on since the first day of my fall) is the cause of the low white blood cell count, and the chills and fever.  Therefore, I go back to Dr. Jacobsen’s office tomorrow to get a new IV line, take more blood cultures, and get a whole new supply of antibiotics that will fight the type of infection that was in my foot (but hopefully NOT have the fatigue/fever side effects).

It was nice to have a day today where I did not have to go anywhere.  My Mom just keeps filling me up with food and Gatorade, and my Dad has been working on making my wheelchair “external fixator accessible.”  He also went to DMV and got me a handicapped parking sticker good until 2012!  I am thinking that when I finally get better, EVERYONE is going to want to take me along to ball games, Publix, and wherever else the parking is impossible!

The Blanco family surprised us with two frozen deep-dish pizzas—delivered straight from Chicago!!  The pizza was wonderful and the dry ice in the box provided lots of entertainment for Doug and the girls.  Our house continues to be filled with wonderful food that is keeping me going.  Thanks to so many of you who have been helping us out! 

Elise and Annika came home on a Valentine’s Day high—their arms filled with notes, flowers, candy, and love.  Just when I thought everything was great, Annika expressed sad disappointment that I wasn’t there today for her V-day party where she read an essay that she written about when Doug and I met.  What to do.

I want to leave you with one last thought:  You know how people always say that being a parent is thankless job??  Well, I found one even worse—being a caretaker.  My Mom, Dad, Doug, Sharon, and the girls were never really asked if they would be willing to drop everything to take care of me, but they did it because they had to.  And guess what . . . on average, the patient (that would be me) is quietly letting the caregiver know that they are doing a lousy job.  No kidding.  I try not to be ornery or needy or “short,” but between being extremely emotionally fragile, feeling totally lousy, and being unable to do a single thing for myself—I end up taking out my frustrations on the one person who is keeping me alive—my caretaker!!!  When I was in the bathroom at Dr. Jacobsen’s office, I was annoyed that my Mom kept knocking on the door to see if I was OK.  But guess what—I would have been annoyed if I had keeled over on the floor and she failed to check on me!  Doug is killing himself to find food that doesn’t make me crazy, and instead of saying thank you, I get all annoyed that he is putting food in my face that is making me feel sick.  It absolutely goes against all logic or “survival of the fittest” thinking that one would bite the hand that is feeding me.

So . . . Mom, Doug, Dad, Sharon, Annika, and Elise—

I am in awe of the fact that you have served, served, and served—without expecting anything in return.  I am so deeply sorry for the times that I let my neediness overwhelm me and I treat you with an attitude anything less than “extremely grateful.”  In the end, I will be healed, and it will be because God gave you to me as His angels to set your own wants and needs aside and simply serve a very flawed and annoying patient.  I love you so much, Anne/Mom

Wednesday morning, February 11, 2009

Today is one of those mornings where the sight of the sun signals an end to the struggles of the night, and provides hope that the light of day will bring about some healing and peace.

Yesterday was pretty rough.  Although I woke up feeling “with it,” I had a series of near-fainting spells throughout the day.  Luckily, my home healthcare nurse had just stressed the importance of attaching my cell phone to my walker so that I could call for help at any time.  So when I felt myself slipping away yesterday morning in the bathroom, I was able to call my mom and she came within 2 minutes to help me.

I had my first appointment at the Jackson South Wound Care Clinic yesterday afternoon to meet with Dr. Carbonell.  Mom pumped me up with enough food and Gatorade to summon enough energy to get into the car and handle the drive to the clinic.  Sure enough, even though we had a mapquest map and directions from the clinic, we (of course) could not find the place.  When we finally did, we were 10 minutes late.  Mom parked illegally and went inside to find a wheelchair.  She immerged with a wheelchair so wide that she had to partially fold it to get it out the door of the building to the car.  You can only imagine, then, how easy it was to get me back inside when sitting in it!  Sitting in this huge wheelchair while holding a VAC, antibiotic drip, my walker, purse, med bag, etc. while keeping my leg up (on my own strength since no wheelchair is designed to accommodate an external fixator)—and then trying to figure out how to get through the narrow door . . . Mom and I decided we had better laugh before we started crying.

Mom and I ended up sitting in a small waiting room for an hour with at least ten of Dr. Carbonell’s patients.  Some were wearing VACS, some wore interesting orthopedic shoes, some had taken the bus from across town just to get some meds, and some were recovering from recent skin grafts, while others were there to get a dressing change.  Most were diabetic and spoke of the ridiculous years of running from this specialist to that specialist—trying to find a doctor who could actually care for their needs.  All of them spoke of Dr. Carbonell as if he was a miracle worker.

Long story short, Dr. Carbonell was thrilled at the sight of my wound.  It really looks great.  He asked his assistant to begin work of getting approval for a skin graft, and signed paperwork to enable me to get a handicapped sticker for whoever is driving me around. 

He and Dr. Jacobsen (my infectious disease doctor) suspect that my night fever is a sign that my PIC line is infected.  They also think that my fainting spells are a sign that my blood levels are off.

Sweet Dr. Jacobsen gave me his personal cell phone number so that I could call him if I got another fever (last night).  Sure enough, by 11:00 last night, I had chills, deep body aches, and a 100.6 fever.  Dr. Jacobsen told me to plan on going in to his office today, getting blood work done, getting the PIC line removed, and using some more antibiotics to kill the bacteria in the blood.

Annika is so worried that I will end up in the hospital again.  She is trying so hard to “go with the flow,” but I really think that she just needs s a few day of “normal.”  Bless her heart.  It just seems like every day has yet another issue that we are dealing with.  I think this is what Dr. Jacobsen is talking about when he says that the next few months will be a “long haul.”

Overall—I almost feel embarrassed that I am so blessed.  Dr. Carbonell arranged that I would be his first patient next week at the wound care center so that I won’t have to wait in the lobby.  Dr. Jacobsen is encouraging me to use his personal cell phone number if I have any weird symptoms.  Unlike the patients I met yesterday, God placed the most talented doctors in my life the FIRST time around—not after several failed experiences with other doctors.  In light of these blessings, the least I can do is joyfully “go with the flow” and patiently suffer through the pain and struggles of getting “better.”

Thanks to Penny Lyn for the awesome exercise mat, my Mom for putting in some long hours, and to all of you who have been filling my house with fruit, meals, cookies, brownies, sweet and encouraging things for the girls, and healthy meals for my family!  You are all a blessing.

Love to you all—

Anne

Friday afternoon - Monday, February 6-9, 2009

Hello, my friends.  It seems weird that I have not written to you for a while.  I have now been home for three

 days and feel like I have started an entirely new journey.  Having spent three weeks in the hospital, I had--without realizing--become accustomed to certain routines, limitations, and expectations.  Now that I am home, I am having to start all over with a . . .

• new environment (how am I supposed to get on that toilet?!),
• new people (well, hello, Nurse Douglas!),
  
• new scares (who do I call at 3 a.m. when I have a fever??),
• new equipment (why is my mini-VAC making all those noises??),
  
• new questions (is it OK that my toes are turning purple??),
  
• new challenges (how do I sit up in bed when we have used every pillow in the house to prop up my foot??),
  
• and a new set of joys (What?? I get to cuddle with my family in bed??).

Having said that, I will give you a quick run-down on my life since Friday morning . . .

Friday, February 6, 2009

After sharing the amazing notes from Ms. McCoy’s class with you, I expected to live out the rest of the day in eager anticipation of my big return to my abode.  In reality, it felt like all of the positive thoughts that had been carrying me through the prior week were just the labored clicks of a roller coaster, slowly ascending up to the peak of the track before the big, scary, heart-in-your-mouth DROP. 

Since the first day of my accident, I have found great comfort in knowing what this is NOT . . . I am not paralyzed.  I can speak.  I can move.  I am alive.  I can continue to be a good mom and wife.  I can teach.  I am alive.

And if everything goes wrong, the worst that will happen is that I will have a prosthetic foot or undergo an ankle fusion.  I can live with that.

However, as the discharge papers were being prepared, I came face to face with something that I really did not want to think about . . . what IS. 

I was reading things like,

• “Patient has a very complex, limb-threatening injury, fracture, and deep infection that will require multiple treatment modalities and surgeries.” 
  
• “After the procedure, I discussed with the patient’s husband the significance of the type of injury that she has.  It is unlikely that this patient will have normal functioning after sustaining an injury such as this.”
  
• My most trusted resident’s starting answering questions that I really had not wanted to ask,
  
• “No, the cartilage on your talus bone is gone.”
  
• “No, you can not grow it back, or use artificial or cadaver cartilage.”
  
• “Yes, no matter how well we rebuild your ankle, you will always be bone on bone.”  “You will most likely develop arthritis within a year or two and will find it painful to walk.”
• “Your best bet would be to get a ankle fusion where the entire ankle is fused into a fixed position.”

All of a sudden I was imagining myself at the beginning of next school year . . .

Am I in a wheelchair?  Do I use a cane?  Do I limp?  Am I living in constant pain?  Can I go to the beach and walk on sand?  Can I walk with everyone else when exploring a new town or site on a vacation?  Do I have to wear a weird shoe?  Can I drive?  Am I a burden?  Do I hold everyone else back?  Do we begin to talk about who Mom was “before the accident?”

By about 3:30 p.m., my genuinely positive, can-do spirit was broken.  I was scared to leave the hospital for fear that I wasn’t going to be able to take care of all of my tenuous issues.  I felt disgusting with a VAC tube leading out of me with gook, an IV line coming into my arm, a hairdo testing the limits of what is socially-acceptable, and the undeniable recognition that I just might be wearing my open-backed gown for the rest of my life because it was the only thing that would fit over my external fixator!  And one more thing . . . I was going to throw my IV stand at the next uninformed student nurse who walked in and said, “Woowww. . . that looks really bad.  What’dga do?” or “Oh, don’t worry—You’ll be fine!!!!!”

When my Mom came at about 4:00, I told her to shut the door, pull the curtain, and stand guard by the door.  I walked into the bathroom, sat down, rested my head on my walker, and sobbed.  I sobbed and sobbed and sobbed.

And for those few moments, I allowed myself to stop being positive.  To stop thinking the best thoughts.  To stop putting my best foot forward.  And to just see it for what it was . . .

That falling off a ladder, suffering a catastrophic injury, facing a world of unknowns, and wondering if you are going to be a burden to your family for the rest of your life really, really, really STINKS.

 

Friday night – Monday, February 6-9, 2009

OK—Don’t worry.  By the time I left the hospital around 6:00 I was ready to take on the world one day at a time.  I wasn’t going to take on the scary unknown.  I would just rest in knowing that God continues to have an amazing plan for me.  I was glad that I was able to release a little steam/pressure before I left the hospital so that I could

 face the new challenges at home with renewed energy.

In a nutshell, we are figuring out where I hang out, how to manage my medications, how to keep me safe around the house, how to manage a few hours of uninterrupted sleep, how to get Doug some time alone to work at school, how to support the girls and talk through their feelings, and how to create a household that seems pretty “normal.”

My home healthcare nurse, Fiona, came for the first time on Sunday and changed my VAC.  She is a school nurse over at Calusa Elementary, is proud to be from Jamaica, has one teenage son, and takes care of a few patients during the evenings and weekends as an extra job.   Dr. Carbonell’s residents and I had made a video explaining some of the special issues with my ankle.  It was obvious that our little video was slightly patronizing in light of her amazing skills.  She knew exactly how to care for my wound and had my situation figured out in no time flat.  She will come to our house now on Thursday night and on Saturday.

Although I have been taking it REALLY SLOW these first few days, we have still had a few minor scares.  The first night I was home, my foot swelled up like a balloon again.  As Annika left for a soccer game on Saturday morning, she was convinced that I would be back in the hospital again by the time she got home.  Luckily, the doctor told me to stay off of it for a few days and elevate it to the sky.  Since then it has looked good.

Also, for the last two nights, I have suddenly felt incredible chills and body aches all over my body.  I run a fever of 100.3 for a few hours and then it goes back down.  Seeing as it is happening again tonight, I will be sure to call the infectious disease doctor in the morning.  We have learned not to react to these setbacks—but to just see them as bumps in the road that we will deal with soon enough. 

THE ABSOLUTE PLEASURE OF LEAVING THE HOSPITAL IS BEING ABLE TO SPEND TIME WITH MY FAMILY! 

My Mom has been sewing cute little external fixator “socks” to keep my foot covered.  She has also made about eighteen trips to Sports Authority to find the perfect sportswear that fits over a gigantic foot. 

Elise has become my little nurse who LOVES reminding me to take my medicine and even takes part in giving me my antibiotic injections!  If I ask her to get something for me, she runs to get it and returns saying, “Now what?!?!?!?!” 

Annika has this incredible ability to sense when I am thirsty, cold, or uncomfortable.  I took this picture right after she said, “Mom—your foot looks cold.  I am going to put a sock on it.”  My favorite is when she slathers lotion on my leg. 

And then there is Douglas.  Dear Douglas who is doing laundry, putting together healthy meals, managing homework and bedtimes, responding with concern to every little sigh or moan that leaves my mouth, keeping calm during setbacks, getting dressed up for the Father-Daughter Dance, filling up my water glass, making sure thank you notes are written, figuring out a way to wash my hair in the tub, and keeping up with a full time job . . .

All while telling me over and over that he loves me so much, that he is so incredibly proud of me, and that he never would have married anyone else. 

What a man.

Tomorrow I head to the Jackson South Wound Care Center to meet with Dr. Carbonell.  I am excited/anxious for him to check out my wound and to see where we are headed next. 

Thank you so much for the amazing ways in which each of you have supported my precious family.  Even though I don’t always get to name you specifically by name, please know that the love and generosity that you have bestowed to our family has been indelibly written on our hearts.

With much love,

Anne

P.S. Do any of you have one of those things that you put behind your back in bed so that you can sit upright?  Also, I need a thin exercise mat to put on the floor so that I can do my exercises on our tile.  Any ideas?

Friday morning, February 6, 2009

I got the sweetest package of notes from Ms. McCoy’s class last night.  After reading some of the comments, you will easily see why I adore working with young children.  So precious . . . 

Dear Mrs. Heetderks,

• “I know that God is taking care of you and I don’t want you to forget that.”
  
•  “I have been praying and praying.  We all need Jesus’ healing every once and a while. I just wish that the 10 foot ladder was only one foot tall.”
• “Mr. Heetderks told us about you on January 27 and he almost cried.”
  
•  “You are the best art teacher in the whole world.  You taught me stuff that my brother doesn’t know and he is in 8^th grade.”
  
• “I prayed for you last night.  My family prayed for you and even my hamster prayed for you.”
  
• “You are really blessed.  My mom said that it is a miracle that you are alive.”

In addition to these sweet kids, I know that so many of you have been praying for my family and me.  Thank you for

 all of your words of encouragement. I hope to be sending my next update to you from my home.  Time will tell. 

Love to all--Anne

(The pictures show my students making their own Sistine Chapel by painting on the underside of our tables, and creating Michelangelo-inspired gesture drawings of their peers.)

Wednesday, February 4, 2009

“OK . . . don’t get excited.  Don’t react.  I have good news, but . . . the news could go bad at any second.  So again, don’t get excited.  But I do have good news.”

This is the general gist of what I heard today.  So I am going to pass my good news along to you—but remember . . . DON’T GET EXCITED! 

Good News: The most recent bacteria culture they took a few days ago came back negative.  We have finally beaten the gram-negative rod bacteria!  I can now go home late Friday (to my house—shocking!) and administer the antibiotics on my own for about the next two months. 

Doctor’s Voice of Reason:  This is a positive step but the bacteria can easily mutate and begin attacking my wound from a different angle.  I need to know that this is going to be a “long haul.”  I need to be on the constant lookout for new signs of infection.  I may also have problems (yeast infection, thrush, diarrhea, etc.) from killing off the “good” bacteria with the antibiotics.

Good News:  The wound is healing beautifully.  The VAC has encouraged a ton of new, healthy tissue that is full of bright, red blood (the first picture shows all the dead tissue from when I first got readmitted to the hospital, the second was from Monday, and the third was from today).  The new tissue is slowly covering the exposed metal hardware that they screwed into my bone.  If the tissue stays healthy and continues to “fill in” the wound, I will get a skin graft in a few weeks.

Doctor’s Voice of Reason:  Although the wound is looking good, there is small pocket below the wound that keeps filling up with gook.  We keep trying to get the VAC to suck it up, but the pocket is just a little too deep.  Hopefully, the home health nurse who will visit me every other day to change my VAC will be able to stay on top of removing the gook and keep it from getting infected.

Good News:  The wound is healing and we have the infection under control.

Doctor’s Voice of Reason:  If we can keep this up, the bone will have a good chance to stay alive and heal.  However, the fact still remains that the talus bone was badly broken, the cartilage was destroyed, and many essential parts of the talus bone are missing (left behind in my front yard and/or floating around in my ankle).  There will be a long road ahead as Dr. Carbonell rebuilds the talus bone and tries to get it to function properly.

OK—so I won’t get excited (well—maybe just a little).  But I will tell you one thing:  I look forward to step into my own house, eat with my family, sleep next to my sweet husband, cuddle with my precious girls, stroke our dog, smell fresh air, and boldly step into the next “leg” of my journey.  Thank you so much for coming along for the ride!  With much love--Anne

Tuesday, February 3, 2009

On a medical note . . . My infectious disease doctor added another type of antibiotic to my daily does of bacteria-killing meds that I am taking.  We will get test results on Thursday or Friday to see if we have managed to kill off the bacteria from the wound.  Time will tell. The VAC continues to suck out gook from my wound and the sponge will be changed tomorrow.  

On a personal note . . . It is funny how getting good news can allow you to come up for air, breathe a little, and get out from under the gravity of your situation for a while.  Today has been like that.  It was Student Nurse Tuesday today (I have been in the hospital so long now that I actually know the weekly work, meal, and activity schedule by heart) so I was asked to tell my story twelve million times to all of the student nurses.  Later, their supervisor came in to assess if they had asked me the correct questions, collected the appropriate data, and checked out every part of my body to make sure it was working (or “moving”) properly.  It was amazing how some students could make an instant connection—putting me at ease, anticipating needs, offering genuine encouragement, etc.--while others were essentially “going through the motions.” 

As one who is now in the constant care of nurses and doctors—I get what it is to be on the receiving end of someone who enjoys what they do and desires to do it well.  Nurse Cam remembers to bring me orange jello and saltine crackers whenever she gives me my Percocet.  Nurse Mae giggles when she walks in on me doing my exercises and tells me that I am the only person who does them without a physical therapist standing by.  On a dark morning, Nurse Michelle shared her favorite nugget of wisdom with me: “It is my resistance to what is that causes my suffering.”  Nurse Jorge taught me how to take a shower without getting my foot wet.  Nurse Miriam called me from her home to give me the name of a web site that we had been talking about the night before.  Nurse Ingrid brought me a “magic eraser” from home so that I could clean my laptop.  Mind you—all of these things are happening while these nurses are just “doing" their jobs—taking vitals, administering medication, assessing changes, etc. 

Since being in the hospital, I had one day that I had a nurse who mixed “doing her job” with subtle put-downs, an attitude of annoyance when I asked questions, and an unwillingness to respond to my basic needs in a timely manner.  Although she technically performed the duties of her job, her attitude nearly crushed my spirit.

My realization for today is that people can have an amazing impact on the world by serving others with joy and love.  May we all be a blessing—even when we are just “doing our job.”

Monday, February 2, 2009

We got a lesson in patience and faith today as we waited for Dr. Carbonell to stop by and respond to my disappointing lab results from yesterday.  Amazingly enough, when he came and removed the VAC and the bandages, his face lit up like a Christmas tree (I even got a picture of him when he smiled).  He was very pleased with the tissue growth and felt like the wound looked very healthy.  Although I continue to test positive for infection, he feels that we will be able to eventually beat the infection with time and antibiotics.  If the wound was not healing, he might think that we should go in for another surgery and do a deep cleaning of the entire wound again (to see if there was some nasty piece of mulch still hiding somewhere).  However, because it is indeed looking healthy, he will simply keep me in the hospital so they can clean out the wound daily and keep me under close supervision. 

Even though I would love to go home, watch my daughter in her school program on Thursday, and be a part of my family again, I must be patient and know that I must stay in the hospital until my body has rid itself of this infection.

I waited patiently for the LORD; He turned to me and heard my cry.

He lifted me out of the slimy pit, out of the mud and mire; 
      

He set my feet on a rock and gave me a firm place to stand.   Psalm 40:1-2

As a woman who got lifted out of a muddy, dirty flower bed, these verses remind me to just chill out and wait for God to do His work in His own time.  My day to stand up on my own on a firm place will come soon enough.

 

Saturday, February 1, 2009 - 5:00 p.m.

Bozena, Dr. Carbonell's resident, just came by to clean the dressings of my wound and change the VAC sponge.  She told me that the final results had just come in from my bacteria culture and that it showed a "positive" result for gram negative bacteria.  That is a bummer.  

Tomorrow I will meet with Dr. Carbonell and find out what our next step will be.  Thanks for your prayers.  Anne

Saturday, February 1, 2009 - morning

We continue to wait for the results of the culture taken on Thursday.  If the results come back negative, that will mean that the antibiotics have managed to kill off the infection in my wound and I will be able to go home.  Over the last few days, Dr. Carbonell's residents have continued to clean and rewrap my wound every day.  The VAC has already sucked out an amazing amount of "gook" that otherwise would have stayed in my foot.  I have decided to refrain from posting a picture of the collection tank on the VAC--NOT pretty.  The suction of the VAC not only removes drainage, but it encourages blood flow and tissue growth in the wound.  Who knew suction could make such a difference--but we have already noticed new growth and healthy-looking tissue from just three days on the VAC. 

I was able to reconnect with Doug and the girls this weekend which was a blessing.  Nothing like sharing a little chicken curry together (and a visit from the therapy dog) to heal the soul.  Thanks to all of you who have written such beautiful words of encouragement, prayed fervent prayers for healing, and lifted my family up by doing everything from making meals to installing a shower head with a hand-held wand in our bathroom!  I will let you know the results of my test when I get them.  Much love to all--Anne

This is the beginning of the blog! DEAREST FRIENDS AND FAMILY--

Since my fall on the 17th, so many of you have expressed an interest in knowing the details behind my disastrous attempt to take down our Christmas decorations from the front yard.   I thought I would write out a quick “run down” of the positive developments, setbacks, and blessings that we have experienced so far.  From today (January 28) on, I will continue to update this blog with the most recent developments!  

Saturday, January 17, 2009

I placed a ladder on the walk leading up to our house and set it against the palm tree in the center of this photo.  I reached up to take down a star that we had hung up in the tree when the ladder suddenly twisted around the tree and came down.  As I fell, I can remember seeing the faces of Doug and my girls and thinking, “This is it.  This is how someone dies.”  When I landed in the plant beds (in the second photo), I looked down and saw that my foot was literally resting back on the calf of my

 leg.  I grabbed it and kind of tossed it back into place and decided not to look at it again! Doug immediately ran over, cried out, and started calling 911.  As I lay there waiting for the sounds of sirens, I was overwhelmed with gratitude.  Although I knew that my foot was going to be an issue, I realized that I was ALIVE! My body was strong. I didn’t feel pain in other parts of my body. I wasn’t paralyzed. I could talk to my family (even telling the girls to get their shoes on in time for the ambulance’s arrival).  I just needed to keep my cool and wait for help to come. 

As the emergency personnel began rolling in, I repeatedly heard the term “open bone fracture” being mentioned.  They spoke of the amount of dirt and debris on my wound and even poured water over it before bringing me into the ambulance.

Long story short—I was taken to the hospital and immediately prepped for surgery.  During the surgery, they found the talus bone of the foot had been forced through the skin and was broken in many, many pieces.  Furthermore, they found mulch, dirt, ivy leaves, metal fragments (from my landscape lighting?), landscape fabric, etc. mixed throughout the blood, pieces of bone, severed blood vessels, and skin of my foot.  Pretty.

Following the surgery, the Doctor informed me that I had suffered a “catastrophic” injury to my ankle.  He said that he was only able to clean the wound and carefully place the pieces of bone back into my foot and sew it back shut.  He said that he would have a difficult time finding a doctor who would be willing to take such a demanding case.  Even as he was telling me this, I was kind of thinking, “So, I think this means I will probably need a sub for a few days next week.”  Therefore, I was a little taken aback when he told me that I would be needing to take at least three months of disability from my work.  That was a bit of a reality check.

Sunday, January 18, 2009

On Sunday, I was told that a Dr. Carbonell had agreed to take my case and would be performing surgery on Monday afternoon.  I immediately recognized the name and wondered if this doctor could possibly be the father of one of my 1^st grade students named Peter Carbonell.  Sure enough—by the next day I knew that the kind Dad who always showed up at school in blue scrubs to pick up Peter was going to be my doctor.  What a blessing. 

Monday, January 19, 2009

While being prepped for my big surgery, Dr. Carbonell stopped by and informed Doug and me of the challenges facing us in the surgery. 

First, he said that the talus bone sometimes breaks in two pieces during a major injury.  When this happens, they pin the two pieces back together and the patient has a very good chance at a complete recovery.  What made my injury so “catastrophic” was that—while the talus did indeed break in two pieces—one of the pieces was shattered into a gazillion pieces (my words—not his) making it almost impossible to pin anything of significance back into one piece of talus.

Second, there was a remarkable amount of debris inside the foot that was causing significant infection.  To avoid blood poisoning, bone death, and/or an inability for the body to heal, it was very important that they clean the wound well, take cultures from the inside of the foot to identify the specific type of bacteria growing in the foot, and then use the proper antibiotics to fight the infection.

Third, any kind of movement following surgery would take the bones out of alignment and make it impossible for the bones to heal properly.  Therefore, I would be fitted with the most beautiful foot accessory ever created—the external fixator.  J  Pins would be placed through the bones of my leg and foot and permanently attached to the fixator. 

As I was being wheeled into surgery, Doug and I both noticed that there were a lot of physicians hanging around.  Turns out they were all waiting for my surgery to start.  Dr. Carbonell later told me that many people wanted to see my surgery because it was very interesting and challenging, and had not been performed in a Miami hospital for at least two years.  You know—if you are going to destroy your ankle, you may as well go all the way and make yourself a superstar . . .

I woke up in recovery at 2:00 a.m. believing that I had just returned from my first visit to the moon.  I truly saw myself wearing an enormous

moon boot, stepping down onto the surface of the moon.  It wasn’t until the anesthesia had worn off a bit that I realize that my moon boot was really a $20,000 piece of space-age metal in the shape of an external fixator (wrapped up here in an ACE bandage).

My Dad spent the rest of the night with me in my hospital room.  It was such a comfort to see the light of the moon reflecting off of his sweet, bald head.  Every time I looked at him, I knew that I wasn’t alone in all of this.

Tuesday, January 20, 2009

Doug and I were hanging out in my hospital room when we received Dr. Carbonell’s report regarding the previous night’s surgery.

1)  He was thrilled to discover that when he went into my ankle, he was actually able to find two pieces of the talus large enough to screw back into one piece.

2)  The cultures they had taken from inside the wound had already started growing some significant bacteria in the incubator.  They found all of the samples were “gram negative rod” bacteria (Don’t you remember the day in high school when we learned about rod, spiral, and comma-shaped bacteria???  Well, I am now a rod bacteria woman).

3) Because so many of the blood vessels had been severed, they would be placing me on Lovenox (a blood thinner) for at least a month to make sure that I didn’t develop a blood clot.

4)  I will wear the external fixator for about 2+ months while the soft tissues of the ankle and the talus bone repair.  After two months, I will probably work through approximately 2-4 months of physical therapy.  

5) After a total of six months, they will assess the function of the ankle.  If the healing has not gone well, they will consider fusing the ankle into a permanent, non-moving position.  If the healing has gone well, they will perform another surgery to remove the small pieces of bone that never attached to the mass of the talus.  Dr. Carbonell will fill in parts of the talus that are missing with living bone from a bone bank using something called the “OATS” procedure.

That night, I watched the inaugural ball with my Mom and one of the many sweet nurses from my floor.  It was the first time since entering the hospital that I felt like I could forget that I had a major problem and just enjoy the moment.  That was nice.