Welcome to Anne's blog!

If you are new to the blog, you probably want to start at the beginning of the whole sad story. To get there, use the "Blog Archive" tool in the right column of the blog and click on "2009," and then "January 25." From there you can continue to click on each week to see the weekly entries.

I would love to hear from you! If you would like to leave a message, you can reach me at aheetderks@wcsmiami.org!

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,


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 . . .


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--


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!


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--


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--


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--


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.

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).


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--


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.


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--


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!


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!


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,


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!