Anne's Great Fall

December 19, 2010 - Friends and Family . . . meet my leg.

2010-12-20T00:42:00.014-05:00

Yes--that's right . . . I walk. I walk with two feet. Can you believe it?

A week and a half ago, I went into Eugene Silva's office (my prosthetist at Advanced Motion Control) and he started messing around with my clear acrylic test socket. He accused me (nicely) of being a "shape-shifter." This is someone who shows up with one size leg one day, and then JUST when everything is almost ready to go . . . shows up the next day with a much bigger leg than the day before! Not very nice. I guess I will be doing this for a while--changing shape. My shorter leg (I am just going to call it a "nub" from hereon in . . .) seems to change shape depending on how long I have been up during the day, or if I just took a shower, or if I wrapped my ace wrap or shrinker sock a little tight, or if I have been eating the 30 pounds of chocolate given to me by my students for Christmas.

So he heated up the test socket a little and started stretching it out in places so I could get my leg in there (loosening a few screws helped, too)! The clear socket was cool because you could literally "see" the pressure points that needed to be addressed.

I came back last Monday to try on the new (and slightly bigger) test socket (seen here). We put a nice little sock on my nub, eased it into the test socket and VOILA!--it fit like a glove. When I would put weight on it (using the little tripod stool to act as the lower leg/foot that would be attached later), I could almost imagine how it would feel to walk. Very exciting.

So, on Friday, I went in thinking that I was showing up for another fitting--but in comes Eugene with my leg! I couldn't believe it. I didn't even think to bring a right-footed shoe along--those things are buried so deep in my closet it would take weeks to find one! So funny.

Anyway--Eugene took a pair of shoes from his shop, and put them on me and my prosthetic leg. Then he proceeded to take me slowly through the whole process of putting on the prosthetic sheath, followed by various thicknesses (ply) of socks, the liner, another sock, and then the leg! There was part of me that was ready to stand up and try it right away--and another part of me that was a little scared that I might be disappointed. Good thing I stood up. At first things were a little clumsy, but we kept tweaking the angle of the foot, the height of the leg--things like that. Eventually, I was walking around the office like I owned the place. So amazing.

Since I had to give Eugene his big black shoes back before I went home, we wrapped my bare (fake) foot up so I wouldn't get it dirty on the ride home! I wanted to wear the entire prosthetic leg home because I was afraid it wouldn't fit by the time I got to our house. I could just see myself ready to show off to Doug and the girls and not be able to get the dumb thing on!

When I got home, I found the pair of sneakers I had bought a long time ago when I first fell. Dr. Carbonell had instructed me to buy a good pair because I had to be able to support my body while wearing the external fixator. That was almost 22 months ago. Now I was hauling the sneakers out again and being able to use BOTH shoes. I put the shoes on and started walking around. Walking around MY HOUSE. What a surreal experience. Doug and the girls were thrilled.

I called my parents on the way home to let them know that I was wearing a leg. The minute I hung up the phone, they must have called everyone imaginable because I was getting 4 million text messages saying, "Where are the pictures? Update your blog NOW!"

But it has taken me a few days to be ready to broadcast myself. Getting my leg has almost felt like having a new baby. You are so excited for it to come and you dream of the day you will get to take it home . . . but then you have it and it poops and cries and keeps you up all night. Even though you love it so much, you need a few days to get used to the reality of it all.

So--yes, I adore my new leg. But I have needed to be smart and take it easy. Use my crutches. Take socks on. Take socks off. Make sure I am not getting any blisters. Not freak out when it hurts one minute and feels fine the next. Figure out how to maneuver around my house. Figure out how to dress this new body. Buy new shoes.

I remember when I first had my leg amputated, my leg felt so light. When I lifted my leg, it almost felt like it could fly straight to the ceiling without any effort. Now having a leg back on me, my leg feels so heavy and clumsy. I actually weighed my prosthetic last night thinking it must weigh at least 30 pounds. It weighed 4.5 pounds--and that was with the shoe on, too!

It all just takes a little getting used to. But WOW--what a payoff. I found myself today starting to say, "Elise, can you walk for me and get the . . ."--realizing that I could now go and get it myself!! I am still using my crutches and so it is still a little cumbersome to move around--but what a difference.

I am not at the point of looking back over the last two years and saying that the journey is done. It actually feels like I am starting a new one. A journey to freedom.

There will be a lot of tweaking with my prosthetic (I will get a new one in a few months once my nub settles into its final shape), physical therapy, development of callouses, dealing with new phantom sensations, etc. etc. but it is such a relief to see that this has been a good thing. If I am walking this well after having my leg for only two days--what will happen after a week? a month? a year?

I keep saying to Doug, "I am doing good, right? This is good, right?"

And he just looks at me like I am silly and says, "Yes, this is good. This is very good."

Thank you, Lord.

So anyway--let me tell y'all about my new leg! If you want to see me in action (just be sure to tell me how small my rear end looks in the video), just click on "First Day with my New Leg!" in the side bar (to get connected to YouTube) or just watch it at the end of this entry.

My leg is basically a socket (the flesh colored tube thing), attached to a pipe (so stylish and realistic), attached to a carbon fiber foot (that you can't see because it has a fake foot and a shoe over it). I'll explain it all in a bit.

Many of you haven't seen my real leg for a while. It is amazing how well it has all healed. The scar line just gets lighter and lighter all the time. Now that my poor leg is getting stuffed into a tight socket, I can tell that it is that scar line that is the most sensitive. When I feel it burn, I know I need to back off a little.

My phantom pain is also kicking back in now that I am bearing weight. The good thing is that my neurontin (nerve pain blocker meds) works great to tone down the pins and needle feeling that can become annoying.

Anyway--when I first put on my leg, I start by putting on a sheath that helps to "wick" away moisture from my skin. Then I put on different weights of socks. Today I started with two ply of socks but by the end of the day I needed four. Finally, I put on a liner that fits into the socket. Over time, Eugene will be able to thicken specific spots on this liner to match the parts of my nub that shrink.

After that is all done, I put one more sock over the liner so it will slide right into the socket of my leg.

After I pull my pant leg down, things look pretty good! The blue pipe will eventually get filled in with foam and then the whole leg will get covered with fake skin that will match my skin color. Of course the neighbor boy said to me today, "But what about if you get a tan???"

When you take the shoe off, you can see the fake foot that covers the carbon fiber mechanism inside (also very cool--I will show you a picture later). I tried wearing a pair of my walking sandals last night and it looked good. I just need to get a pedicure on the toes. Since this is just my starter leg, everything is pretty simple. When I get my "real" leg in a few months, I will get a foot with a split toe (so I can wear flip-flop type shoes) and an adjustable heel height. I won't be wearing any stilettos any time soon, but it will allow me to wear a slightly higher heel now and then.

All in all--I feel extremely blessed.

Thanks for helping us through all this.

Love to you all--

Anne

Wednesday, December 8, 2010

2010-12-09T03:50:00.005-05:00

OK--I'll just admit it . . . I am feeling a little panicky. Over the last few weeks, I have been enjoying the process of healing, sleeping, strengthening my body, and getting mentally ready for the big moment when I finally get my prosthetic. Well, that moment is now here and it is freaking me out a little.

If you read over the last two years of my blog, you can see that time and time again--things have been going well and then WHAMO--disaster. Well, everything has been going so well since my amputation surgery and I think I am starting to wonder if this has just been another prelude to disappointment. OK--now that I said it--I can easily see that this is "stinking thinking" but I can't help but get a little worried in the wee hours. We are so close to a wonderful ending and it scares me to hope for it too much. Stupid, I know.

Anyway . . . Right after my last entry, I decided to challenge myself to a little independent travel. So, I booked a non-stop flight to California to see my brother and his gorgeous family. I am telling you--it is great traveling with one foot. Everyone was killing themselves to help me with the wheelchair, cut to the front of lines, carry my bags--I even was treated to a very personal "pat-down" by a kind TSA agent. Very exciting.

I was a little nervous to travel by myself--but it ended up being wonderful. My nieces and sister-in-law are amazing and it was so fun to hang out with them for a few days.

My brother (Glenn) has picked up surfing (seen here out on his board on a very (too) calm day in Santa Cruz). Watching all those people in the water got me excited about doing new things when my body gets put back together.

While in California, I had to do some decision-making about going back to work. All along I had planned to return after Thanksgiving, but as that date was coming closer, many were encouraging me to stay home until after Christmas. Doug was very worried that I would go back, over-do it, and then possibly jeopardize the success of my transition into the prosthetic. As much as I was dying to go back, it was one of those things where I needed to listen to the wisdom of others rather than just go ahead and blaze my own trail. Amazingly enough, I went and spoke with my Principal at school and she was completely supportive of me coming back after Christmas. I feel so blessed to NOT have the added pressure of worrying about my job (even though I worry anyway).

So . . . we had some nice family time during Thanksgiving break hanging out, baking a turkey for the first time, and putting up Christmas decorations (all very low to the ground). Best of all--my Grandma came out from Chicago to spend some time with us during Thanksgiving.

She is now 90 years old, sharp as a tack, and so much fun to be around.

By the time Thanksgiving was over, I suddenly realized that things were happening!! How was I thinking I would go back to work with all these appointments?! I first went to see Dr. Hutson who looked at my X-rays (seen here first from the front and then from the side) and was thrilled to see that everything has continued to heal beautifully. I had been concerned about some pain I was having near the bone bridge but he said everything was fine. He gave me a little "talking-to" about what to expect when I start out in the prosthesis. He warned me to take it slow--to just wear it a few hours off and on through the day, and to not panic if it was uncomfortable at first. I like it when people give me warnings.

Then he wrote me a prescription for a new leg and sent me on my way!

I headed over to Eugene's office (my prosthetist) and he took a casting of my leg. It was cool how he would point to certain parts of my leg and say, "This is sore here, right?"--and sure enough--he was right!

He kept making marks on the cast and pressing in around certain joints and bones that will help in bearing my weight once I get in the socket.

He will now fill the cast with plaster to make a "replica" of my stump. He will then put a clear acrylic covering over it that will eventually become part of the socket (I think). For my next appointment, I will put my leg into the socket and we will be able to look through the clear plastic to see if everything is fitting properly.

This whole process gets me thinking about how I will be able to walk so well, get going with my family again, surprise my kids at school with my new leg, etc. etc. It all just seems too good to be true. That's when all the doubts set in again. I think I just need to remember to take it a day at a time and not rush forward. I really need to listen to and trust my surgeon, prosthetist, and physical therapist and believe that everything will work itself out in time. Breathe, girl, breathe.

Our girls are in a really good place lately. Elise just had her orchestra concert on Monday night. Can you believe there are five 4th graders who play the bass? They are all little bass-playing partners in crime up there struggling to get those instruments set up and in the right place. So funny. Elise has worked really hard and has made it to first chair. So sweet.

Annika is enjoying playing basketball and loves being part of a team. For all the miserable memories I have of my time in middle school, she seems to be eating up every minute of it. We are so proud of her.

Our hearts are heavy right now for a few of our friends. A neighbor boy who has been away at college came home with his best friend for Thanksgiving and were hit by a drunk driver. The friend was killed instantly. Robie, Jr. managed to hang on for a few days but eventually died, too. Our neighbors are--of course--stunned, heart-sick, and beyond grief. These boys were 4.0 students and stars of their school cross-country team. So sad.

Some of you might also remember that Vera's (the wife of my youngest brother, Matt) Mom was diagnosed with liver cancer right about the same time as my amputation surgery. While only 10 weeks have passed, they are having to make possible arrangements with hospice because of the rapid growth of her tumors. This has been devastating.

When we see how our friends and family are having to deal with such incredible losses, it seems silly to worry about how my new foot might fit. Who needs it. I just want to be thankful for every day.

We really and truly love all of you and continue to be blessed by the cards, words of encouragement, meals, and flowers that keep on coming. We feel overwhelmed by your love.

I will keep you posted on the making of my foot.

Love to you all--

Anne

Monday, November 15, 2010

2010-11-16T00:49:00.003-05:00

Shhhhh . . . listen closely. Do you hear it? That is the sound of NOTHING GOING WRONG!!!

Yes--it has been over two weeks since my last (confession) entry and things are progressing so well. I still spend most of my days storing up on sleep since I should be returning to work right after Thanksgiving break. In between siestas, I plug away at my recovery. Here is what I have been up to . . .

- I met with my physiatrist (Dr. Claudia Penalba) and she is going to coordinate my care between my prosthetist, surgeon, and physical therapist. She was so amazed at how well I was recovering and had never seen such a beautiful short leg!! When checking it out she noticed that I can flex my calf muscles (not a pretty sight--kind of looks like a hot dog taking deep breaths in and out) which was a true testimony to Dr. Hutson's genius work. Technically, I really don't need my calf muscles anymore, but it demonstrated how carefully he performed my surgery. Very nice.

- I had my first evaluation at my physical therapy place (Healthsouth). They were also so pleased with my recovery and strength. Since I only have 30 PT visits covered on my insurance, we are only going to use a few visits before I get my prosthetic. In those visits, they will teach me how to desensitize my limb, continue to strengthen it (because it is definitely getting weaker from just "hanging" around), and manage phantom pain. Once I get the hang of it, I can do the exercises on my own at home. I start tomorrow.

- I am trying to rent a newer wheelchair because mine is so lame. I would like to have one that I can propel on my own so that I can use it at school (when I go back). I will only need it for a few weeks so it is no big deal. Even though it is very rickety, it managed to get me around for our annual Cancer Free Kids 5K that we participated in on Halloween weekend. Actually--I should say it was my friends who got me around by taking turns pushing me along the route. Very fun. Next year I WILL walk it on my own. :)

- To date, I have not killed anyone with my car. Left foot driving seems to suit me.

- As I have been getting out more, I am getting more and more reactions to my missing foot. Some strangers were especially impressed at the lengths I went to dress up like a pirate (with a missing peg leg) who was dressed up as a Mom dropping her daughter off at a Halloween party. Very convincing. Then, the other day I was at Panera and a man asked me if I had lost my leg in the war. I hardly knew what to say. I guess it has kind of felt like a war but I don't think it was the one he was thinking of. For those who have known of my struggles with my ankle but haven't seen me in a while--the change is a little bit of a surprise. I saw one former school Mom the other day who said, "Good grief--you are still on those crutches!? When are they ever going to get you walking again?" So I said, "Well, I still have to wait a little before I can get my foot . . ." She looked down and she just about inserted her own foot into HER mouth. She was like, "OK--I guess I missed the memo . . ." :)

The funniest reaction is when I drop by school to pick up the girls. I usually come by a little late in afternoon so there aren't a lot of kids around. However, the handful that manage to see my car pulling up will always run over to see me. Without fail--I have had the identical experience with the kids over and over. First, they hug me and say how they are so happy to see me and have been praying for me. Then (or course), they want to see the leg. If my pants are covering my limb, they want me to pull up my pant leg so they can see it. They will immediately wonder if the shrinker sock is my real skin and (when I tell them my real skin is underneath) they will BEG ME to take off the sock. When I do, they right away want to touch and squeeze and rub and massage my scars and limb. No weirdness at all. Totally fascinated. Then--when I show them that my leg bends--they say, "It looks like a thumb bending back and forth!!!" Then--no kidding--they will look at me and say, "OK--well, see you later!!!" Game over. No big deal. Kids are amazing.

- I am happy to say that I have less and less phantom pain all the time. However, it never ceases to amaze me how it will express itself sometimes. For example, we were having a little colder weather and I was finding that my feet were cold at night in bed. I would put a sock on my real foot, but my other (missing) foot would stay cold. You might think that a sock on my limb would work but it wasn't buying it. I would finally have to get up out of bed, physically tuck the end of our quilt under the mattress so I could "see" that my foot would not be hanging out uncovered and put an extra blanket down by my feet. Only then did my missing foot warm up and leave me alone so I could sleep.

- I have been meeting more and more current and future amputees when sitting in the waiting room at doctor's visits, and through my blog. I can't tell you how many people lose limbs as a result of falls, car accidents, and lawn mowers. I talked with one lady today who lost her leg because she had been hit and then dragged down the road by her neighbor's car. Her neighbor (across the street) was backing out of the driveway, hit my lady friend who was standing in her OWN driveway, and then pulled away without knowing that she had hit anyone. Horrible. Another lady lost her leg when she was very young after her father inadvertently ran over her foot with a lawn mower. And yet here we all sit in the waiting room--missing limbs and all--talking about how we feel so blessed. And we are.

- I went to see Dr. Hutson again today and got a very positive report. My X-ray already shows that the bone bridge is joining with the fibula and tibia and is looking alive!!! I will see Dr. Hutson again on December 13, after which he will most likely approve me for getting my first prosthetic! On that note, I was a little surprised today to see a number of amputees walking with a bit of a limp when using their prosthetics. It reminds me again that I need to take it slow and do everything I can to heal properly.

Anyway--in other Heetderks news . . . Doug has two mating macaws, one newly waxed car, is making corn husk dolls with 3 and 4 year old children, is looking for a new home for his turtle, and is hoping to see his female emu sitting on an egg sometime soon. Elise helped to lead worship in church on Sunday, made cupcakes for the church picnic, danced the night away at a recent birthday party, and is excited about helping me paint our doorway. Annika made the Basketball team, did all the makeup for a recent drama production at school, and manages to keep current on Facebook and with her homework despite the fact that she has been running a 102 degree fever for the last few days and eating nothing but saltine crackers and Sprite. (I sound like I am writing one of those miserable "my family is better than your family" Christmas letters.) OK--throw in a few family arguments, my newly missing hubcap, our bulging waistlines, and the fact that our TV remote somehow fell into the bathtub and I think we are good.

Love to you all!

Anne

October 29, 2010

2010-10-29T18:53:00.003-04:00

Well, today was a big day. Not only has it officially been one month since my surgery, but I am now a LEGAL DRIVER! I at first had thought that I needed to go through occupational therapy at Baptist Hospital to become a certified left foot driver. But, after talking to an amputee friend of mine, I found out that I could order the left foot accelerator online, install it myself, and then go to the DMV to get a driver's test. So, this week, the accelerator device came in the mail and Dad made a nice base for it so it wouldn't move around at all in my car. Then, this morning, I woke up extra early at the DMV to take my driver's test.

The last time I took a driving test, I was in California, 16 years old, and driving my parents' yellow VW van (the one with the 3 foot long stick shift thing). I remember stalling out in the middle of my three point turn and having to start the van up again to complete the maneuver. So embarrassing.

Well, this morning, I was in my good old box car (the Scion xb toaster car) with (thankfully) an automatic transmission but with PEDALS REARRANGED! During the tests, I kept saying to myself, "The brake is in the middle. The brake is in the middle. The brake is in the middle." Amazingly, I passed.

The people at the DMV were positively lovely. When presenting my situation, they knew exactly what I needed to do to become legal. But more so--they were all so stunned that I was ready to start driving just one month after my surgery. They kept saying, "Your attitude is so great. You are an inspiration!" One lady said, "I woke up feeling sorry for myself this morning. When I see what you have gone through and how you are handling it so well, I just need to shut up and be grateful." Very sweet.

Anyway--Dad and I spent a lot of time together this week having lunch dates, celebrating his birthday, getting my car jazzed up, and going to doctors. It has been positively wonderful being able to spend so much time with him. I don't think I have spent this much "alone time" with my Dad since the days when he was teaching me to drive in that old VW van! He is such an incredibly giving and caring man.

I have decided to have a man named Eugene Silva to be my (lawfully wedded) prosthetist. I think that we will work well together and he was recommended highly by Dr. Hutson. Now I am looking into meeting with a physiatrist before choosing a physical therapist. This type of doctor would look at the physical medicine and rehabilitation involved in getting me back together and then help me to choose the right people to work with each of my issues (and let me tell you--I have plenty!!!) :)

I thought you might enjoy this picture of Eugene's work room where he makes the prosthetics. It is a very fun combination of medicine and art.

While I still enjoy doing the braided bread ace wrap technique to bring down the swelling in my leg, I REALLY LOVE my first new official shrinker sock. It makes my shorter leg look so nice. It feels really good to have everything squished together tightly.

I have been doing some interesting reading on phantom pain. Basically, the nerves are severed during the amputation and--despite the fact that the foot is gone--the nerves keep sending messages as if it is still there. Last week, I blacked out for a moment and found myself on the floor with major bruises on my hip and arm, a bent crutch, and a rug burn on my elbow and foot. Funny thing is--the rug burn on my foot was on my missing foot. It was as if my body knew that--if the foot HAD been there--it would have been injured during my fall. So, for about 5 days, as the rug burn was healing on my elbow, sure enough--the rug burn feeling on my foot started to slowly go away, too. So weird.

So anyway, I was reading this article that was discussing various ways to help alleviate phantom pain. One way--they said--was to redefine the feeling as a phantom "sensation" rather than "pain." When you think about it, your nerves are sensing feelings all day long--the fabric of your shirt touching your skin, the tightness of your shoe around your foot--but your brain knows that these feelings are not "dangerous" so they tune them out. They said that the nerves that were severed are sending me "danger danger" messages because no one has told them that everything is OK. My brain needs to learn to tune out these messages and learn that the nerves are kind of "crying wolf."

So--I tried what they said. At night when my pain is worse, I will consiously think to myself, "That is not pain, that is a sensation . . ." and NO KIDDING--the pain goes away. It is the weirdest thing. The only problem is that when I stop saying it to myself, the pain comes back. I experienced the same thing with the mirror therapy, too. When I see my "leg" in the mirror, the pain is relieved. But when the mirror is taken away, the pain comes back. So, I guess I just need to keep strengthening this "mental muscle" to the point that my brain will finally believe that all is well and stop responding to the messages. Time will tell.

We have been having sweet experiences this week that are helping the family feel like we are getting back into proper "alignment." Doug is so wonderful.

Anyway--we are taking part in a Cancer Free Kids walk tomorrow morning (I will be pushed in a wheelchair) and then getting the girls ready for a million Halloween parties. Should be fun.

Love to you all!

Anne

October 26, 2010

2010-10-27T04:18:00.007-04:00

Well, hello again! When last we met, I let you know that I was going to try to join in with the rest of society and stay awake during daylight hours. That didn’t last long. The day after my appointment with Dr. Hutson, I woke up with Doug and the girls around 7:00 am and stayed awake all day until they all went to bed around 9:00 pm. It wasn’t pretty. I kept myself busy during the day visiting my prosthetist, bringing my car in for some routine maintenance, writing some thank you cards, etc. etc. However, by the time the kids came home, I was feeling very ornery and in need of some shut-eye. By the end of the evening, we all agreed that I was either going to have to move out of the house and live a solitary life watching a lot of cable TV and learning to knit, OR get at least 5 hours of sleep during the day. That night, I slept through the night and allowed myself to sleep in until about 11 am. That is now my new routine and it is keeping all of us very happy.

Dad and I went to visit my prosthetist and he taught me how to wrap my shorter leg with an ace bandage (my official shrinker sock needed to be ordered). The method of wrapping makes my leg look like a flesh colored loaf of braided bread—all for the purpose of slowly shrinking my limb. Very cool.

In my search for a prosthetist and a physical therapist, I spent a lot of time last week talking with amputees. Good grief—such happy people. Literally—any one of these people would drop everything to help me out. They have lived what I am going through right now and they are so eager to give me whatever advice I need. One guy is helping me navigate through the process of driving left footed (legally), while another woman is sharing her experience with different types of prosthetic feet. Some themes seem to come up a lot . . .

1) Most have a certain amount of regret about pushing to get into their prosthetic too soon. Everyone is encouraging me to wait until my doctor is extremely sure that my limb is ready for a prosthetic. So many of them talk about the pain, sores, and other issues they dealt with because of their insistence to get fit with their first leg. Good to know.

2) Along the same lines, they all caution me to release the feeling that you have something to prove once you get your first leg. They all felt this pressure to let everyone know that they were OK and functioning “just like before the accident” with their new leg. They all said to be sure to start off slow. Your body will thank you for it.

3) They all admit that there are struggles with being an amputee. Whether it is phantom pain, soreness at the end of the day, the stigma of being “different”, or keeping up with the maintenance of socks, liners, leg, etc.—they all quietly confide that the appearance of being “normal” does come with a certain amount of physical/emotional pain. HOWEVER, what they all share is an effervescent, absolutely unstoppable, completely contagious and inspirational LOVE OF LIFE. They are all SO GRATEFUL to be up and moving again—and so appreciative of the parts of their body that work perfectly (without assistance). It is almost as if the loss of one body part has made the other parts seem all the more precious and valuable. And that alone is reason to CELEBRATE!

It almost makes me wonder if the process of losing a limb brings you to a crossroads of either jumping in and embracing the experience—or just fading back and letting it define you. There is a woman across the street from me who is missing an arm. I have never seen her leave her house—in fact the only time I ever see her is when she takes her cat outside for a little while. I don’t know how she lost her arm, but did the experience change her? Was she always quiet and secluded? Or is she just embarrassed to be seen?

There is definitely something to going out in public with a missing limb. I am already used to getting a lot of stares because of my scooter. But the stares I get now are very different. You can almost hear the collective, “Ahhh . . .” when I move around on my crutches. It is hard to tell if people pity you, are repulsed, interested, intrigued—so you are tempted to work really hard to exude this vibe of “I am totally OK with this and am so stinking happy to be an amputee.” I think that would become tiring to keep that up forever.

So instead, I am choosing to take the perspective that the average person is good, honest, well intentioned, and a bit curious. I can remember when a woman in our church had her big toe amputated. I SO wanted to look at her feet just to see what that looked like, but I didn’t want to get caught looking. Did I pity her? No. Did I feel bad for what she had experienced to reach the point of amputation? Yes. Was I dying to really look at her foot up close? Absolutely. Once I looked, would I need to look at it again? Not really. But most of all—did I think that she was any different now from when she was a ten-toed woman? Not at all. She was still the amazingly talented, beautiful, and interesting mother of two that she was before she lost her toe. No big deal—move on.

So—I invite people to look. Be curious. And I don’t have to put on a big show that I am OK. I am OK. I am just fine—I just don’t have two feet anymore. And if people pity me, I guess I would just hope that eventually they would realize that there isn’t any need to feel pity for me. I am still the same me--just a little shorter on one side. I hope that as I transition back to going to work, driving around, being out, etc.--that I don’t lose that feeling.

My biggest inspiration is a little girl in one of my Art classes who was born without her lower arm. Believe me, when you are five, you are surrounded by other five year olds who are all too eager to point out that you are missing a left hand. But she lives life without apology. I don’t care what project we are working on; she comes up with a way to do it in her own way.

It would be so easy to say, “Oh, look at that poor little girl who has to live like that.” But what a waste of breath! Poor little girl? There is nothing poor about her. She is more amazing, more admired, more inspirational, and more beautiful simply because of having one hand. When a boy came up to her recently and said, “Your arm looks weird.”—She looked at him like he was an absolute idiot (you really should have seen her standing there with her hand on her hip) and said, “I was born this way. God made me just the way He wanted to.”

She lives this verse to the fullest: I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. Psalm 139:14

I may not have been created by God with one foot, but circumstances have led me to this point. I need to have the quiet confidence that I am still wonderfully made. I am not something that is gross, or repulsive, or embarrassing—just a little different. And I still believe to my core that I am already better for it.

Anyway—those are just a few things I have been thinking about.

I feel so blessed that things are just progressing along beautifully—no drama, no late-night emergencies, no draining liquids—just a nice, healing leg and a sleepy lady.

I love and appreciate all of you so much—

Anne

Monday, October 18, 2010

2010-10-18T22:40:00.006-04:00

Howdy, friends! Dad and I took a little drive down to University of Miami again today to visit Dr. Hutson to see how the old "shorter leg" was doing. Turns out the incision site is healed and INFECTION FREE! Never thought those words would be used so often together with the mention of MY body!

I left the office with a stack full of prescriptions to get working on . . .

1) More percocet - Hardly need it.

2) Occupational Therapy for a Driving Evaluation - Hopefully I can get working on this soon so I can start to get myself around town for midnight dancing!

3) Physical Therapy - Since I have been on my scooter for so long, I need to work on strengthening my body so that it is ready to receive a prosthetic. The PT people will teach me how to de-sensitize my residual limb so that the phantom pain will hopefully calm down.

4) TENS unit - This is a nerve stimulator thing that has been proven to be very effective in decreasing phantom pain. The PT people will show me how to attach it to my body and then I will wear it regularly for a month or so (or so some of my amputee friends have told me).

5) Shrinker Sock - Right now, my residual limb looks like someone made a clean cut across my leg (funny--because that's what they did do!!). The shrinker sock will help my resi . . .

STOP RIGHT THERE!!!

OK--apparently it is really bad amputee etiquette to refer to the cut off part of your arm or leg as a "stump." So--you are supposed to call it a "residual limb." That term is way too long to say, and WAY too long to type over and over. I am resisting the idea of naming my st _ _ p because we don't know each other well enough yet. So far, I have been liking it better to refer to my legs as "shorter leg" and "longer leg" but that is getting ridiculous, too. I know that "left leg" and "right leg" will also be useless because even I have to think twice to remember which is which (also--it makes me think of the "left-over" leg and the "right"--as in "correct" leg). I am usually a problem solver but this one has me st _ _ mped. (I didn't even mean to make that joke--it just came right out of me!!!)

Anyway--where were we . . .

. . . dual limb reduce in size and become more rounded in shape. So, tomorrow I have an appointment to get fitted for a shrinker sock. Yea, progress!

Now that my shorter leg doesn't have to be in the knee immobilizer anymore, I am adjusting to life with a bending knee. Visually, I think my new leg was a little easier to look at when it was held out straight and wrapped up in medical gear. When I came home today, we all sat around the dinner table looking (with furrowed brows) at my leg going, "Hmmmmmm . . ." It just seems to be a little more obvious that there is a foot missing when it bends. Whatever--we will get used to it.

On the up side--I get to take a shower now! Hooray for hygiene!

One thing that Dr. Hutson would like for me to work on is staying awake during the day. He said that it is common for people to get their sleep patterns disrupted following amputation. Therefore, he wants me to try to sleep as much at night and then come up with things to do during the day to stay awake. Sounds positively painful.

So, rather than going straight home from my appointment (to take a nap), Dad and I went and shared a plate of stone crabs (first time for both of us!) and a grouper sandwich. What a delight! Tomorrow, Dad and I will stay busy by getting the shrinker sock and dropping my car off at the mechanic. I want to get it tuned up so it is ready to get my left-foot accelerator installed when I get the all-clear. That should keep me awake until at least noon.

I posted some st _ _ p pics in the Great Fall pics section again if you are interested.

Love to you all!

Anne

Saturday, October 16, 2010

2010-10-17T00:39:00.005-04:00

CONFUSION ALERT!!!

Many of you mistook the picture that I posted on Friday as visual proof that I already have my prosthetic. Sorry--no fake foot until at least Christmas-time.

That is a picture of me,

wearing black leggings (on my good leg and over the brace on my shorter leg),

and Elise sticking her foot out beneath my shorter leg (while hiding behind me.)

Sorry to get you prematurely excited.

Love,

Anne

P.S. Just for a little more clarification, here is a picture we took of me today. And no--that's not a loaf of bread I have in my arms--it's my shorter leg.

Saturday, October 16, 2010

2010-10-16T03:23:00.003-04:00

Well, it is 3:24 am and I am up.

For the last week or so, I haven't felt the need to take any pain meds during the day. For some reason, I sleep like a baby during the day without noticing much pain. However, the minute the sun goes down, my nerve pain kicks in so I usually take a percocet at bedtime. Although this helps with the pain, it doesn't seem to put me in a sleepy mood (it doesn't help that I sleep all day which is most likely throwing off my clock a little). So, I just lay in bed--listening to Doug snore and thinking happy, melancholy thoughts. That is one thing I can say for percocet--it always fills me with this overwhelming sense of well-being. I just lay in bed thinking of how much I love my family, how grateful I am for good health, how rainbows are so pretty after a soft rain, that kittens are some of God's most cuddly and precious creatures . . . things like that.

So, here I am thinking about how much I love the softness of my bedsheets, AND that I am wondering if I need to change the format of my blog. I started my blog to alleviate the need for Doug to repeat information to caring and interested friends and family over and over again. Never did I think that this blog would end up telling the story of a woman falling off a ladder and ending up needing a lower leg amputation--but here we are. I am grateful for the written record of my journey--both medical and emotional. It is a blessing to be able to read back over it and see how far we have come. God has been so faithful.

The only downfall of my blog is that readers have to periodically check in to see if I have updated it recently. I have always thought that it would be nice to have another format that would send out email or text notification of updates. Well--there is and it is called Caring Bridge. Caring Bridge is a website that would allow me to have my own page that would have space for me to write my usual ramblings (called your "Journal" page)--but it would also allow you to leave comments/words of encouragement, look at pictures, etc., etc.

I have come to love the look of my blog but I can see that it might be nice to make it a little more convenient for my readers (listen to me sounding like I am writing Newsweek or something).

Anyway--if you wouldn't mind participating in my poll--I would appreciate it. See it up there in the upper right hand corner? Just take a moment to tell me what you think and I will think about what to do next week.

OK--now that I have this dealt with, I will try to go to sleep. (If I am not successful, I will simply start searching for pretty pictures secretly embedded in my popcorn ceiling.)

Love to you all,

Anne

Friday, October 15, 2010

2010-10-15T14:51:00.015-04:00

We had a great weekend last week. First, I was able to get a haircut. Nothing like a haircut to make you feel human again. Before I left for the salon, Elise looked at me and said, "Your leg looks so normal I bet they won't even notice that your foot is gone." I said, "Oh thanks honey, but I am sure they will notice that something is missing." So--she came up with her own solution. She figured that if she walked very closely behind me that no one would know the difference.

Did we trick you? Look at this picture as proof that I have my leg back!!! (Not really--it is Elise's foot tucked behind my short leg. Pretty sneaky, huh?!?)

We also went to the park and the girls challenged Doug to a running race. After a lot of bravado that he would

easily win, Doug got his rear end whooped by his oldest daughter. Poor guy.

I have had a lot more phantom pain in my foot this week. It has kept me from sleeping at night so I sleep mostly during the day. I don't mind. It is kind of nice being awake in my house when I know that everyone is home with me--but they don't need anything from me. It is nice having a very low maintenance husband and kids.

A wonderful mother of one of my students just happens to be in charge of the physical therapy department at University of Miami. I spoke to her yesterday and she is lining me up for a whole bunch of great stuff. One, she gave me the names of some occupational therapists that work with you to get "certified" to drive with a left-foot gas pedal. This means that I will get an appliance installed in my car that will move the gas pedal from the far right to the far left. The brake will remain in the center. After OT has approved me, they will send me to the DMV for another driving evaluation. If I manage to pass without taking out any innocent bystanders, I will be completely legal to drive. That sounds great. Not cheap--but great.

She is also going to work to get me hooked up with a therapist that is trained to help amputees with phantom pain. There are a lot of different therapies that I would like to try (like the mirror therapy) that I am doing on my own because (so far) I haven't been able to find anyone that does it. Well, Teresa is setting me up with people who do. So awesome.

So many people have offered to help in gazillions of different ways. It is so wonderful that--when the need arises--I can call these people to get connected to people that can actually help me. I am so grateful.

I would love to write more but I feel another nap coming on (I sleep constantly!!!).

Love to you all, my friends.

Anne

Friday, October 8, 2010

2010-10-08T22:49:00.004-04:00

Howdy, friends! Dad and I went to see Dr. Hutson yesterday and EVERYTHING LOOKED GREAT! Thank goodness. He saw no sign of any kind of infection and said that he would be very surprised if we encountered any infection in the future. Love those words.

So, for the next week I have been assigned to continue to keep my leg in the knee immobilizer, do my regular leg exercises, take my medications, and keep my leg elevated as much as possible. Since the incision site is not completely healed yet, we don't want to stretch out that area with any kind of swelling (if you want to see it--click the Great Fall pics link). Therefore, he doesn't want me to ever stand with my leg hanging down for a period longer than 30 minutes. Ah shucks--that sounds like I won't be able to make any meals for my family in the kitchen. What a sacrifice.

I shouldn't joke that there would be any NEED for me to cook because so many people have been bringing us food!! What a precious precious thing it is to have good meals brought to your house. And then let's talk about the desserts! All of my silly students at school know that I love frosting so they have been sure to get plenty of frosting-covered whatevers (I don't care what they are because I just eat the frosting and then throw the rest away) to our house. I may just be 600 pounds by the time I am ready for my prosthetic.

While at the doctor's office, we discussed a few interesting things to think about. First, he stressed the importance that I NOT fall on my stump. I managed to take a shower for the first time in preparation for my appointment yesterday (the world rejoiced) but it felt a little like I was on the verge of disaster. I was fine getting in, but it got a little dicey when getting out. We may have to figure out how to install some shower grab bars or maybe remodel our bathroom a bit (oh joy). Second, we talked about driving. I have been driving with my left foot for some time now and can hardly imagine driving with my right anymore. Technically, it is not illegal for me to drive left-footed, but if some yo-yo crashed into me and our accident ended up going to court . . . I am sure someone would take issue with the fact that I wasn't driving with society's foot of preference. So, I need to figure out how to get some official "OK" to drive either with my left foot, or with some sort of modification to my car. Anyone know anything about this?

My X-ray looked awesome. How nice to see an X-ray up on the light board that doesn't have smashed bone, dead cartilage, massive screws, or gelatinous tissue. There was my pretty new stump with a perfect bone bridge put in between the tibia and fibula. Looked so nice.

When I get a prosthetic, the weight being put on the bridge will cause more bone to develop around the end (Wolff's Law of Bone Growth - the more pressure that is exerted on a bone, the larger and more dense it will become). Therefore, the end will become more rounded and strong. So cool.

Last night was a bit miserable because I was experiencing new kinds of nerve pain. It felt like I was stepping down on a bed of nails just to the point that the nails would start to pierce the skin (such a pretty mental picture). I was also itching to death. My leg felt like it had been bit by an angry mob of fire ants. Last but not least, I also got a bad charley horse-type pain so I hauled out the mirror and watched the image of my foot stretching out the charley horse. Amazingly enough--the pain went away! But then when I put the mirror away, the pain came back.

My friend suggested that I start wearing mirrored pants. Yes--I can just see how those are going to sell like hotcakes in the amputee community. Bathroom remodel here we come! :)

Needless to say, I spent most of the night listening to Doug snore and patting my leg from the outside of the bandage hoping that my leg would stop itching.

Do I sound like I am complaining? NO! All is well. It is such a relief to know that if I stay up all night fighting ants, walking on nails, and sewing a permanent mirror onto my knee immobilizer--I can still catch up on my sleep by sleeping all day. Which is exactly what I did today. Hard, hard sleep from 7am to 5:30pm. Guess my body needs it.

Our life has not been without its stresses this last week. We are all in a bit of a funk figuring out our new routines and responsibilities. I think it has been a little hard at times to adjust to the limitations of life with a "one-legged mom" (heard that once this week)--but we will sort all that out. We just need to be honest with our fears, quiet resentments, and hopes--and know that we just might be nearing the end of this particular journey (could it be, Lord?). Seems a little scary to hope for--but it would be nice for us to move forward to a life with full mobility.

Whatever--we will roll with it and know that (if I hear this one more time I will hurt someone) that we will be stronger and have built up a heck of a lot of character by the time we are done.

Again--can't tell you enough how much the cards, meals, flowers, rides, and the cans of frosting have helped us through the last week.

Finally--My brother and sister-in-law, Matt and Vera, found out late last week that Vera's Mom has liver cancer. Carolyn is the coolest Mom and it grieves me that their family is having to go through this scary time. It would be such a blessing if you could raise Carolyn and the rest of the Douma family to the Lord in prayer.

We love all of you so much!

Anne

Wednesday, October 6, 2010

2010-10-06T22:58:00.002-04:00

After sleeping all day, celebrating my Mom's birthday, and going out for a ride in my wheelchair (with Doug pushing and Elise riding beside in her roller skates), I came home and was feeling some burning nerve pain. So I tried something that I had seen on a VA hospital website as a therapy for phantom nerve pain. It was kind of fun to try and seemed to help a little. Just thought I would share some pics . . .

Here is what my legs look like while lying in bed . .

Now I am putting a mirror between my good long leg and good short leg . . .

Ta-da! I now look like I have two good long legs! When the nerves in my short leg tell me that my foot is asleep, it seems to help if I watch the image of my missing foot moving around. I don't know if it is more of a distraction or an actual help--but I am going to keep messing around with it.

I'll let you know how my appointment goes tomorrow with Dr. Hutson.

Much love to you!

Anne

Tuesday, October 5, 2010

2010-10-06T02:03:00.002-04:00

Well--it is very late but I just felt the need to share a few things.

1) I went all day without googling anything about amputation. Sometimes it is best not knowing.

2) I slept most of the day. In the morning, I dreamt that I was going around a very artsy village--breaking into cool shops and stealing all kinds of hand-made sweaters, jewelry, cards, etc. I was so excited and then I felt so guilty so I tried to return the items and things weren't going very well. I woke up just before I was about to get arrested. I have no idea what this dream means but I'm glad that I know that I am in no condition to go around shoplifting anytime soon.

3) I was thinking tonight that it would be so nice if my appointment with Dr. Hutson on Thursday afternoon could go well. Just then, I went to open two cards--one from my incredible Grandma (she has been sending me one card every day), and one from a dear older lady in our church who is affectionately known as Grandma Hyacinth.

Grandma's card said: "His eye is on the sparrow and He cares for you."

Grandma Hyacinth's card said: "I am with you and will watch over you."

Made me feel like God was sending me a clear message that He was keeping an eye on me. Forget about the flaws of our human medical institutions--I have the Great Physician watching over me.

Love to you all, my friends--

Anne

Monday, October 4

2010-10-04T13:50:00.006-04:00

I am still here.

It has been a bit of a roller coaster ride the last few days. We had thrilling highs, the scary lows, the waiting, the bumpy parts, but--just in the last few hours--I am feeling like this particular ride is coming to a calm end. I will just enjoy the peaceful reprieve until the next ride starts up again.

Basically, the day after they pulled out the pain pump I felt like I was having to beg for pain relief. On the one hand, I understood that they didn't want to give me too many IV meds if I needed to go home the next day, on the other hand--I was in pain and needed help! On the first day, the pain doctor wanted to treat me with neurontin--a medicine that treats nerve pain. However, on the first day following surgery while--yes--I was having nerve pain, I was also suffering major traumatic pain simply from having bone, muscle, and tissue cut and rearranged on my body! That pain could have been helped by some morphine--which the nurses didn't seem to think would help. When I really begged and pleaded for some good old narcotics, then they would reluctantly give me a little bit. Hutson later told them that they should have treated me with morphine--but that was only after I wasn't needing it as badly anymore.

The minute you have a limb amputated, you start to feel that everyone thinks that your pain is in your head. They have heard of phantom pain but don't really understand what it is or where it comes from. So when I am saying that my foot is burning (when there isn't a foot there anymore), you can tell that this person is thinking that you are imagining the pain that your foot is having way off in a dumpster somewhere. I could right away see why so many of the amputees I have spoken with prefer to talk about it as nerve pain rather than phantom pain.

Anyway, the physical therapy people forgot to come for me on Thursday, so they decided to let me stay until Saturday morning so I could have two sessions of PT before going home. It was fun to try and use my one-legged body for the first time. It was so weird to be able to feel my missing foot touch the floor when I stood straight up. You really have to spend a lot of time looking at your legs or else you get confused on what your brain is telling you. On the first day, we tried out moving with a walker.

But on Saturday, we were able to speed things up a little with crutches. That was nice.

They also gave me exercises to do three times a day to keep my leg strengthened. It is so strange to see this part of yourself moving around--but that it feels like a complete stranger. When I sit on a chair and go to set my leg up on another chair, I constantly find myself needing to pull it closer. I will see my leg coming down through the air to come to rest on the chair but it will completely miss it and end up on the floor. It is like getting a new car and needing to figure out how far you can pull into the garage without hitting the wall. I just don't know my angles yet.

We worked so hard on Saturday to get discharged, but everything was moving so slowly--and I don't just mean the help. Yes, PT didn't show up until noon, and the doctor's residents didn't come until even later. But my bowels decided that they were going to be a little late in moving, too. Before you can get discharged, they always ask for a few things: signed papers, required prescriptions, collection of personal belonging, and--oh, yea--proof that all systems are go in the bathroom. Good grief--Doug and I always knew that we knew each other well, but after one suppository, two laxatives, and TWO tries at an enema--we now can say that we know each other very deeply. When we finally had success, we were out the door and in the car before anyone could say, "Pee-U!"

The hard part has been this overall feeling that no one is really overseeing your care. Yes, there were wonderful people at Jackson, but there was no sense that they were working together as a team. Yes--Hutson may have told them to give me morphine, but if the pain management people didn't think that worked in their timeline, they did something different. The PT people didn't know if they should do exercises with or without my brace because no one had written up the order--and there didn't seem to be a way to call anyone either. So, you got this, "Well, we think this is what he would have wanted us to do . . ." kind of attitude that starts to get stressful after a while.

We have just come off of a year and a half of working so hard for things to go right--and seeing almost every step of the process go wrong. So when I finally come to the point that I am amputating my only right foot so that I can move on with my life--I NEED THIS TO GO RIGHT. I don't want to have every little person in the piece of the puzzle treat me with this attitude of, "Well, I think this is right . . ." I want people to be absolutely confident of what they are doing.

So, for example, I came home with these feelings of phantom pain so I started googling. Well, one thing led to another and I am finding that most people these days go home with a cast on their amputated limb because it has been shown to reduce swelling, increase recovery time, and help manage phantom pain. Well, here I am in a leg wrapped in gauze and an ace bandage! Why aren't I in a cast? So my mind starts to jump ahead--"Does Hutson know what he is doing? Does he do it the 'old school' way and doesn't know about this research with the cast?"

And what about these drugs I am taking for phantom pain? Why am I taking them? Aren't there different therapies I can be doing to help with this pain? Why hasn't anyone referred me to them? Am I just supposed to figure all this out by myself?

Who is in charge here? I need this to go RIGHT!

So, yea--this was all coming to a head around 2am last night, right as Doug was trying to get his lesson plans finalized because he had been in the hospital with me all week. Poor guy.

So--he was sweet as ever. Agreed that our stay in the hospital was not an experience that would build confidence in the care we were receiving. That, yes, we have been through a lot so to just tell us to go home and not worry wasn't really helpful. We like information.

Doug said that I have researched and talked with people and googled my fingers off--just to get us to the point of feeling good about amputation. I think that if we had hoped that I was just going to get to relax now that the deed has been done--I am wrong. I need to gear up for a whole new round of researching, talking, and googling to make sure that I am getting the best care and services available from this point of the process forward. A bit discouraging but probably true.

I am a little sick of the line, "You have to be your own advocate." I understand that. But at some point, can someone just show up who will do a good job and exude a confidence that lets me know that I can trust what they are saying, know that they have my best interest at heart, and that they are giving me the best care possible?

Why do I always feel like people are backing out the door before they even come in--and say just enough to have technically answered your question but not really have said anything new? Is it really that miserable to stay in a room and talk with me? Maybe I need to wear more deodorant.

So, this morning I woke up and started making phone calls. I called amputees I hadn't met before. I called recent amputees who are about a year ahead of me. I called a prosthetist. I called Dr. Hutson's office. Etc. etc. etc.

My amputee friends were very kind--all letting me know that they had been through this, too. Lots of ups and downs--I get it. A nurse from the insurance company called and--after listening to me--asked if I would benefit from joining an amputee support group. But then my Mom, Annika, and Elise came in the house and brought some life into the house. My Mom sat with me as a cried a little and then I felt better. Elise took me out on a walk with the dog in my wheelchair. Later on, the phone rang and it was Dr. Hutson. He explained why he had chosen to do the gauze wrap as opposed to the cast--made good sense. He was encouraged by my decreased level in pain. He was looking forward to my appointment with him on Thursday where he could take a look at my stitches. Yes--I will show you how to wrap the leg then. No--there is no need to see a prosthetist or PT yet--we will get to that in good time. Your job now is to recuperate and keep your leg elevated.

Recuperate and keep my leg elevated.

OK . . .

So for now, I am going to try really hard to stay away from Google, try to get outside a little so the walls don't start coming in on me, recuperate, and keep my leg elevated.

Doug went back to school today and was overwhelmed by the amount of people sending love and prayers our way. Made him feel really good.

I guess I made it through my first roller coaster ride--I'm sure it won't be the last. But happy to be safe on the other side nonetheless.

Love to all of you who helped our family this week by watching our kids, driving around from place to place, making meals, sending cards, praying in earnest, and sending love our way.

Love back at you--

Anne

P.S. When Dr. Hutson came to my hospital room to take out the drain from the wound site, I took pictures of what my leg now looks like without the bandages on. If you would like to see, go to the upper right corner and click on "Anne's Great Fall Wound Pics." Don't worry--its more interesting than gross if you ask me. :)

Thursday night, September 30

2010-09-30T22:48:00.007-04:00

Today ended up being kind of a strange day. After they pulled out the nerve block, I feel like I was in a mental tug of war trying to discern my level of pain and how best to handle it. They haven't been real generous with pain medication so I can now tell that I need to be a little more direct in asking for help. No matter what--I made it through my first day and am now a little wiser in what to ask for tomorrow.

Whatever. The best part of the day was getting a visit from my Dad, and my friends and co-workers, Sharon and Lisa. They brought some cards that kids had made for me. They were all adorable, thoughtful, and sweet. I can tell that we should probably have a school-wide spelling test on how to spell our last name (Heettricks, Heetdreeks, Hendricks, Heaterks, etc.) . . . But one especially cracked me up.

It started as a piece of paper folded up so many times that it resembled a very unique form of origami--only to be carefully secured with about three miles of scotch tape. After spending 10 minutes just trying to open it up, I could tell that there was another wad of paper inside the package. Well--the paper was none other than $21.00 in bills. When I opened up the card, there was a beautiful watercolor painting of water and a prosthetic leg with the message, "For the water leg."

When talking with the kids on Monday, a lot of them asked if my fake leg would rust in water. I explained that I was going to have to save up some money for a special prosthetic called a "water leg" that can be used when walking in and out of water at the beach, washing a car, or going waterskiing (for example). Well, this little girl took it upon herself to get a "water leg" fund going for me. Too funny. So sweet. (Don't worry--I will get the money back to her parents as soon as I can.) :)

Anyway--I am slowly getting used to the look of my new body. I haven't had a chance to stand up yet--we will cross that bridge tomorrow. Thanks for all of the encouragement. Love to you all!

Anne

Thursday, September 30 -10:40

2010-09-30T10:40:00.006-04:00

They just took out my nerve block pain pump so I am trying to distract myself from what might be coming. The pain management doctor was incredible. She would like to avoid putting me on the morphine and go straight to an oral pain medication so I can go home. She says that there are so many nasty germs in the hospital that I am better off getting home tomorrow. She is also going to put me on a medication called neurontin that is a medication that targets nerve pain. I know that many amputees have been helped by this medication so I am excited to try it.

Doug and I slept for 11 hours last night. I think we should vacation in the hospital more often.

The man in the room to the left of me has been screaming constantly since last night. The man on the other side of me likes to sing. Doug said that he was singing out all the things on his breakfast tray the last time he passed by. The man two doors down apparently committed a serious crime two nights ago so there are two policemen outside his door at all times. Makes me feel like I don't need to worry about my laptop sitting out in plain view. Miami's finest have got the place covered.

Just in case you are getting the impression that I am not pleased with my stay here at Jackson Memorial--let me set you straight. The staff here is LOVELY. Everyone is happy and helpful--very compassionate and willing to get what you need at a moment's notice. I had my brother on speaker on my cell phone last night when a male nurse came in. The nurse introduced himself, helped me move my rear end to make room for the pain pump, and then told me the names of the other evening nurses. He told me how well I was moving my body and did a little dance while he explained that I should keep trying to keep my body limber. When he left, I checked back with my brother to see if he was still on the phone. He said, "Gee--are you at DisneyWorld or something? Sounds like the happiest place on Earth! You have Jonny, Janet, and Jennell helping you tonight and they even dance and sing!" Yes, despite my noisy neighbors, I feel like I am in a good place.

Dr. Hutson woke us up this morning and answered our gazillion questions. He explained a bit more about how he performed the surgery. As for the nerves, he said that he isolated each one, stretched it out, and then cut it so that it would retract back into the leg. He said that this keeps the nerve endings away from the bottom of the stump. He was also pleased that he used an extra piece of the tibia that still had arteries attached to it to create the bone bridge at the base of the tibia and fibula. This would make it more likely to heal and connect with the other bones. Doug wanted to know if he spent any time going through my ankle (I think Doug would have liked to do a dissection of it just to see what a mess it was). He said that he would never have done that because it creates the possibility of introducing bacteria to the sterile part of my good leg. We thanked him for taking his time to do a great job. What a kind man.

Well, it is now 11:05 and the pain is starting to kick in. I am going to rest now.

I thank you again for all the love. Doug sat this morning and read each email to me out loud. He can hardly get through any of them without his voice cracking or starting to tear up. Such a honey.

Thanks for coming along on this journey with us.

Anne

Wednesday, September 29

2010-09-29T18:45:00.005-04:00

All is well, my friends. All is well.

The alarm went off this morning at 4:45 so we could get to the hospital by 6:00. I anticipated having to wait, fill out forms, answer gazillions of questions, etc. etc. Boy was I wrong. After a brief wait in the waiting room, my name was called and Doug wheeled me over to the Ryder Trauma Center. In no time my IV was in, my big black boot was in the trash, my gown was on, and was being wheeled into surgery. Dr. Hutson was as sweet as ever--giving me every confidence that all would go well. And it did.

I can't get over how light my new leg is--makes me wonder how much a foot weighs. Although it is gone, I find myself protecting my foot from getting bumped or moved. When I was waking up from surgery, I had a charlie horse-type feeling in my foot--but had no way to relieve it! Even now, my foot feels like it is asleep and needs to be flexed. I keep moving my good foot just to see if it makes the feeling go away. So weird. If you think of what it feels like to have a pinched nerve, you can only imagine what your body is going through when you actually cut all the nerves for an entire leg!

I am not using any IV or oral pain meds because they put a nerve block on my leg. This little machine puts anesthetic into a major nerve down to my leg so I don't feel pain. Starting tomorrow, they will transition me to morphine and then or percocet. I am grateful to be feeling the way I do right now. Definitely feeling pain--but it is manageable. It makes me a little nervous to think that major pain might be coming but I will take that one on when it comes.

I guess my eyes were open a bit during surgery so my eyes are killing me. So grateful that my eyes are my biggest issue right now. :)

They have me on heavy duty antibiotics (Vancomycin) which makes me happy. I really don't want to deal with any infection anymore!

They have my new leg all wrapped up in a splint to keep it straight. Apparently, many people bend their leg to relieve the pain. The only problem is that this prohibits amputees from being able to fully straighten their leg later on (which becomes a problem when adjusting to the prosthetic).

Doug is the sweetest man ever. I just love having him here with me. We are just hanging out in my hospital room--talking, processing, reading emails, and feeling thankful. He and my Mom hung out during the surgery (it ended up taking 6 hours!) and had lots of time to think about the last 20 months. Time to say goodbye.

We have a tropical storm coming through right now. Elise was all excited at school today saying that it was a perfect day for me to have my leg amputated because I always love it when it rains. So sweet. She thought I would love watching the rain from my hospital room. So true.

We had a lovely evening last night. Right after school, we finished homework and then went to a nail place to get our nails done. I decided that I wanted to get a french manicure on my good foot so I could wake up to a beautiful foot. And yes--I only had to pay half price. :) After that, we went out to dinner together and then got dressed up for Annika's choir concert.

I was struck by how pretty and grown up she looked up there on stage. They started the concert by praying over me--very kind. After the concert, we drove each of the girls to a friend's house to spend the night. When I got in bed, it was weird to think that I had just spent my last day with my foot.

Everyone is knocking themselves out to help us out in any way possible. One Mom made us blueberry muffins in case we got hungry at the hospital. My students drew lovely pictures for me and even wrote little prayers for me to read. The lovely emails coming in have been so encouraging. Friends are offering to help our kids with homework and drive them from place to place. Not enough space to mention everyone--just understand that we appreciate all the love.

Our Farewell to the Foot party was very therapeutic and fun. We all raised our glasses and toasted my foot thanking it for 41 years of faithful service. I loved going through all of my photographs in preparation for the party. So amazing to see all the times I had used my ankle and didn't even think to be grateful for how well it worked. Makes me just want to be thankful for everything that works well--my hands, my good foot, my eyes. So blessed.

I met with all of my students on Monday morning to let them know what was going on. They were amazing. I thanked them for praying so faithfully for me and explained that sometimes God doesn't answer prayers in exactly the way we might expect. However, I assured them that my new "fake foot" was indeed a wonderful answer to prayer. They had lots of questions and comments:

- You have a fake foot and I have a fake tooth!

- My Mom has fake hair!

- Why can't they just get you some new bones?

- If you take a bath, will your fake leg rust?

- I saw a boy at Disney World with one real leg and one fake leg and he could walk and go on all the rides just fine.

- A lot of people get things cut off their body. My Mom had fat cut off of her belly.

- During the surgery--will you be asleep or awake?

- How will they cut it off? Do they have a big saw? Are you going to watch them do it?

- Where will they put your foot after they cut it off?

- Can you put nail polish on your fake foot?

The remarkable thing about kids is that if you treat them with respect, stay calm, and tell them the truth--they respond in kind. So many kids came back to tell me how much they loved me, that they would pray for me every day, and that they were glad that I was going to get to walk again.

We spoke to the girls tonight and they both sound good. We are so proud of them.

Doug is staying here with me in the hospital tonight. It isn't even 9:00 and he has already made his little bed out of the vinyl chair thing they have here in the room. He is freezing so the nurse keeps bringing him more and more sheets. I don't think he has ever been in bed this early. Going through the stress of watching your wife get her leg amputated must be exhausting. He took good care of me today.

We love and appreciate all of you so much. Pray that tomorrow will be a manageable day.

Anne

September 19, 2010

2010-09-20T00:23:00.008-04:00

Hello! So many of you have been writing to say that you need an update! Well, up until now, you really would have only heard the depressed ramblings of a thoroughly confused and lost woman. However, in the last few weeks, things have quickly come into focus. I am at peace and feel like I am beginning a new journey that will bring about a new celebration of life for my family and me.

I have scheduled myself for a lower leg amputation on September 29 with Dr. James Hutson of the University of Miami.

OK—Don’t panic. Don’t start dialing my number telling me to rethink this. It is OK. Trust me.

Since my last update, we have researched, talked with experts, prayed, consulted with friends, received counseling, talked as a family, and done lots of soul-searching (If you want all the details, just scroll forward to “How we reached the decision to amputate.”). I must tell you that the last 5 weeks have been very difficult. However, there is such a peace and joy that has washed over us as we have finally reached a decision that we know is the right one for us.

I googled the “stages of grief” the other day because I was pretty sure I had been going through them. Yep, when I saw them, they looked very familiar . . .

Shock and Denial (fear, blame, confusion) – 5 weeks ago: “I haven’t prayed hard enough. I haven’t had enough faith.” “We never should have worked so long to try and save my ankle. If we had tried blah-dee-blah a year ago, I might be walking by now . . .”

Anger (frustration, anxiety, shame) – Soon after: “What will people think of me if I choose the surgery? What will people think of me if I amputate? Will people judge me for my decision? It is my choice—so if something goes wrong, it will be my fault.”

Depression and Detachment (overwhelmed, helplessness, lack of energy) – 3 weeks ago: “I feel like I am drowning. I am completely lost. I know I have to do something but I don’t have the first idea which one to choose. They are both lousy options.”

Dialogue and Bargaining (reaching out to others, struggle to find meaning for what has happened, desire to tell one’s story)- Last few weeks: Lots of research and talking with others.

Acceptance (Exploring new options, putting a new plan in place) – Last Monday: “I can’t say I am thrilled about it, but I feel very confident that my best option is to amputate.”

Return to Meaningful Life (Empowerment, Security, Self-esteem, Meaning) – Working on it as we speak . . .

It has really been in just the last two weeks or so that we have been talking like this is actually happening (I guess signing off on the pre-op papers at U of M sort of made it seem real, also!). The girls have been telling their friends at school and Annika posted it to her Facebook (therefore, the whole entire world was informed). My school is sending home a letter to parents this week, and I will talk to each of my classes next Monday to let them know what is happening. My sweet students have been praying for me for so long—I really want them to understand that this is a really good thing—not a scary disappointment.

Looking back on it, I think God was leading me to amputation all along—I just REALLY didn’t want to see it.

It is weird, but I have a need to say goodbye to my foot and thank it for all it has done for me. Lisa and I are going to take an impression of my foot with some dental alginate and then fill it with plaster. This 30-pound, size 12 paperweight will be sitting on my desk whenever I have the need to reflect back fondly on my foot. I am also going to start sifting through old photo albums and find pictures of my foot and me together. For some strange reason, it makes me feel better just knowing that I am honoring it before I get rid of it forever. The girls are also putting together a little “Farewell to the Foot” party to say goodbye to the past and celebrate our new future with high-tech prosthetics.

All of this may sound a bit strange, but I am allowing us to do what feels right. I read so much about the grief that amputees feel right after the amputation. Although having a “choice” to amputate was miserable, one good thing is that we have had time to prepare ourselves a bit for the loss. Most amputees loose their limbs so quickly due to tragic and sudden accidents--they are forced to handle both emotional and physical issues upon waking up from surgery. In fact, one of my prosthetists told me that I was the first patient he ever met who still had all their limbs intact! All this being said--I know that this is going to be tough for us, too.

We were all a little sad to think about what they would do with my foot after the surgery. Annika hoped we could maybe take it home with us and bury it somewhere. Dr. Hutson told me that many people feel the same way and--for emotional and/or religious reasons—want to keep the remains of the amputated limb. He said that we would need to make arrangements for a coroner to come to the hospital and have a private cremation. Sounds expensive. I think we will pass on that and just cuddle with my foot paperweight.

I feel so confident about Dr. Hutson doing my amputation surgery. He talks about “meticulously” tracing back each nerve and cutting it carefully. He says that he will make small holes at the base of the bones and reattached each muscle. Sounds neat and clean--I like that. With all that I have read about phantom pain, stump revisions, and infection—it makes me feel good that Dr. Hutson will be doing all he can to get everything back where it belongs. I also have the advantage that my lower leg is being surgically removed as opposed to being violently severed in an accident.

The surgery will take about 3 hours. This is about an hour longer than usual because I am requesting an “Ertl” amputation. This is where the tibia and fibula are cut, and then a small piece of the tibia is used to create a bridge connecting the two bones. This will make my stump stronger and able to bear some weight unlike traditional amputation procedures. Dr. Hutson showed me an X-ray of an Ertl that he had done on another patient (I couldn’t photograph it because of HIPAA laws—Grrr) and was thrilled at how neat and precise it all looked (the picture here is from the Internet—Dr. Hutson’s was much prettier). He really is an awesome surgeon.

Getting back to stages of grief—I feel like I am at the point where I can even joke about my future as an amputee. I think about the satisfaction of walking into my next Weight Watchers meeting and bragging about my sudden weight loss. How much do you think a lower leg weighs anyway? I go to Party City and see the severed, bloody limbs for sale and think, “I wonder if that foot would make a nice decoration for my Farewell to the Foot party?” Will I get my pedicures for half-price now?

But I am not ready for other people to get on the “jokey” bandwagon yet. You know how you can criticize and make fun of your own family, but if your spouse joins in and does the same thing you are suddenly hurt and offended? That’s how I feel. I am sure in a year or so I will be up for people suggesting that I dress up as a peg-legged pirate for our annual Book Character Parade--but not quite yet.

Honestly, I am at peace with our decision, but I am still not thrilled that I am actually going to be amputating my lower leg next Wednesday. It is not going to be easy. It saddens me that I am asking my family to go through another big upheaval. But I must tell you that I am looking forward to the future. I have such hope that I will be able to walk and run and be myself again. I have dragged this tired, infected, and partially dead foot around for so long now . . . I have done my best and it is time to move on.

We were in Palm Beach a few weekends ago and I had to watch Doug and the girls walk up and down the beach without me. It has almost been two years since I have been able to do the things that we used to do together. I want to get back to my life. I want to be able to run in and out of the ocean next year when we visit Palm Beach again. That will be me—wearing my water leg and being a Mom again with my family. That’s where I am at.

I have been inspired watching my Dad recover from a recent hip replacement. He has been limping for years--unable to roller blade, run, boat, or do all of the things he has always loved to do. In almost three short weeks, he is pushing his walker around like it is grocery cart at the store and beginning to plan trips and outings. (This picture is from the day he got discharged from the hospital. Don't we look like Dumb and Dumber?)

The bottom line is that I am in terrible pain and have been unable to function normally for a long time. The tibiocalcaneal surgery would be a two year process that would leave me with a foot that would be extremely limited in function. Walking would be difficult and eventually painful. Amputation leaves a lot to be desired but it is do-able. I am just so grateful that there is so much of my body that works great! My hands work, my head works (I think), I'm not dying--all is well.

I am tremendously grateful for all the people who have already offered to help us out during the recovery period. Our family, school, and church have once again been amazing.

I continue to covet your prayers for peace, healing, and freedom from pain.

I promise to update as things start to happen (two months on disability from work should give me more time to write!).

Love to you all, my friends.

Anne

How we reached the decision to amputate

2010-09-20T00:19:00.004-04:00

Right after my last entry, I felt very convinced that the tibiocalcaneal surgery (explained in my August 9th entry) was the way to go. Yes, it sounded miserable, but at least I would end up with my own foot. Truly--in the last year and a half, I had had so many things attached to my foot, and had used so many gadgets to move my body from place to place—another year and a half was not going to be that bad. Easy schmeazy.

So, I went in to see Dr. Hutson to get some more information and get myself scheduled for surgery. Well, I sat with him and started going down my list of questions. Yes, not only would I be in the external fixator for 9-12 months, but also I would need to be in a cast, followed by a boot, followed by a brace for about another 12 months. He thought it would be at least 2 years before I could walk on my own. He was quite sure that my ability to walk would be fairly limited. He said that for the purposes of getting around my classroom or my house, I would be able to function. However, for example, when facing the need to get to the paint section of Home Depot, I might want to opt for the electric scooter rather than shuffle slowly to the back of the store (Hmmm . . .). Yes, my foot would become very arthritic, but we could deal with that when it happened. He said that he developed this surgery as a way to “salvage” the foot for those who found amputation unacceptable and/or came from cultures that typically ostracized those with obvious disabilities. In fact, of the 13 people he had operated on in the last 25 years, only three were from the U.S. Yes, he could probably get their phone numbers so I could talk to them about their “quality of life.” Again—whether going with the surgery or an amputation—I was going to have to make modifications to my lifestyle. However, with the surgery, you still get to go to the bathroom in the middle of the night without having to put on your leg.

OK—not quite the rosy presentation I was looking for but it still seemed like “right” thing to do. I went out and set up another appointment to sign the papers for the surgery but I would have to wait two weeks.

The next day I called Dr. Hutson’s office to get the phone numbers of prior patients. Sorry, his assistant was on vacation. Call in two days.

I called good ol' Dr. Carbonell to ask him about “quality of life” with the surgery option. No—he didn’t know anyone who had ever had the surgery. Yes--he agreed that I would definitely need to wear a brace for a long time—if not life-long. Also—fast walking was not going to happen. But he felt like my calcaneus and tibia “wanted” to heal and that the surgery could be successful. He explained that I could always opt for an amputation if I wasn’t happy with the results of the surgery.

I was determined to find a living human being who had had this surgery. I found one lady on my fusion support site that said that she had had the surgery two years ago and “she was able to walk a little bit more every day.” She said she really wasn’t sure about the success of the surgery because she suffered from other injuries (sustained during a car crash) that complicated her ability to walk.

I spoke to another man who said that he had had the surgery following a motorcycle accident. He said that he was a construction worker and desperately needed to get back to work following his recovery so he opted not to have his leg lengthened and decided to skip physical therapy. As a result, he could only walk by putting his foot out sideways (since the ankle does not bend). Although he walks with a very noticeable limp, he was thrilled that he could work at his construction job without using a prosthetic.

I started scouring the medical articles written about the surgery. Truly, if there is a contest somewhere for who can type the words “tibiocalcaneal arthrodesis with tibial lengthening using the Ilizarov frame” the fastest—I know I will win. Since I don’t belong to a medical school, I had access to the abstracts of many of the studies written on the subject—but not the actual full articles. Therefore, I had to pay about $20 for any one article. About $100 later, here’s what I learned: there are only a handful of people around the world who have had this surgery. Most have complications during the two-year process (infection/need to take more bone from another part of the body/non-union); however, most eventually had a successful fusion. All of the articles ended with some sort of conclusion saying that the patients were usually 80-85% satisfied with the outcome of the surgery.

But what did that mean? They were satisfied it was over? Satisfied that they could walk? If so—how fast? How far? How long? Inquiring minds wanted to know . . .

Meanwhile, I was stalking this assistant at Dr. Hutson’s office for phone numbers. After a few days of looking through files to even find the numbers, the doctor’s office needed to call the former patients to ask permission for me to contact them. A week later, the assistant assured me that messages had been left for all three former patients and that Hutson’s office would let me know when--and if--any would call back.

About this time, I was really feeling down. I kept trying to make a decision—but I really didn’t have the information necessary to make one. I felt very sure that the surgery was the “responsible” thing to do. It seemed reasonable that I should try it out, and then if I didn’t like the results—I could have the amputation then.

As the girls began talking to people about our options, we started getting some very negative responses. One day I took the girls to the pediatrician and the nurse asked the girls how their Mom’s foot got hurt. Elise went right into “information-sharing” mode and pretty much caught the lady up to speed in about 3 sentences. The minute the subject of amputation came up, the nurse said, “Oh girls—don’t let your Mom get an amputation. You don’t want her to limp at your wedding, do you?” As she kept talking, I managed to mutter something like, “Well, it seems like the prosthetics available now are pretty amazing . . .” To which she said, “But why would you do that when you can have your own foot?” And then again to the girls with, “You don’t want your Mom to limp everywhere she goes, do you?”

Good grief. Even though I knew this woman had no business talking to my kids like this, AND was obviously ignorant about my situation—I had such a feeling of guilt/shame about considering an amputation that I really felt like she was somewhat justified in showing her disgust.

Not that I was running around asking everyone what I should do—but it did seem that when people heard my options, they didn’t need to hear much to say that I should opt for the surgery. It got to the point that I felt I could say, “Well, they can take my foot, surgically attach it to my head, and within two years of physical therapy I could walk by hopping on my head . . . OR . . . I could have an amputation.” and the person listening would most likely say, “Oh, by all means—definitely have the surgery. At least then you will have your own foot.”

I started to feel the pressure of being judged for whatever I decided. Would people think I that I had made a rash decision if I went with the amputation? Would they always whisper that I hadn’t tried hard enough, or been patient enough to go through the process required for the surgery?

About this time, I decided that I was going to stop trying to make a decision. Rather, I was just going to research every option, suggestions, idea—whatever might lead me in the right direction. When people would say, “Oh, we have a friend who had the same problem as you . . .” I would get the phone number of the friend and call them—usually to find out that their problem was VERY different than mine. If someone gave me the name of an amputee, I would call and listen with an open mind. The burden I felt trying to MAKE a decision was lifted when I just allowed myself to research, listen, and let the decision come to me.

Talking with amputees was very interesting. Truly—you could not get these people off the phone. They were SO HAPPY to have their lives back. They all had very interesting and sad stories to explain how they lost their leg; however, all of them sounded the same when they spoke of the freedom, joy, and “new lease on life”-feeling that they had since adjusting to life with a prosthetic. Yes—going through the process of an amputation, stump-reduction, nerve-pain management, prosthetic fitting, etc. was difficult—but the quality of life that they gained as a result was worth the struggle.

When I heard these people speak, it became obvious to me that the general public did not understand how the life of an amputee was not this pathetic idea of a woman “limping” at her daughter’s wedding. However, I didn’t want to choose the amputation simply because it was the quicker way to get up and going again.

So—I started doing more research on the surgery.

I went back to the articles I had read and noticed that some of the doctors who had written the articles had their email addresses attached to the document. Ah hah! That night, I wrote to five prominent doctors and told them of my story, my predicament, and my search for information regarding “quality of life” issues. By the next day, two of the doctors had written me back! One summed things up for me by saying, “There is no question that you experienced a severe and devastating injury. Patients who undergo tibiocalcaneal fusions do not have a normal gait. The single most important outcome from surgery is pain relief. Below knee amputation can be a very good operation with a much shorter recovery. Fusion patients are satisfied about 85% of the time, but recognize they are not normal. If you look at AOFAS scores that range from zero (the worst) to 100 (normal person), fusion patients score about 55-60. Preop they are usually 15-20. It is a difficult decision to make.”

I wrote him back with a few questions. He responded with some polite answers with regard to the surgery, but ended by saying, “I think that with a contemporary prosthesis, you probably have a better chance of resuming normal activities.”

Just a few days before emailing the doctors, I felt so strongly that the surgery was the only responsible option. I think in my gut I felt that the pain I would endure by having the surgery would be a more “noble” suffering because I had chosen to do the “right” thing. However, if I chose to have an amputation and I had complications or experienced bad phantom pain—I better shut up about it because I was the one who “CHOSE” to do this to myself.

After getting insight about the surgery from someone who was highly knowledgeable about the subject, I felt the guilt of making a bad decision lift—and allowed myself to start considering both options in a positive light.

The next day, a Mom from our school called me to tell me about a friend who had had an amputation last November. I called her friend—Susan—and we started sharing our war stories of infection, wound vacs, picc lines—the whole thing. After about an hour on the phone, she said, “Why don’t you just come over and you can see how the prosthetic works and what it all looks like.” Wonderful! The girls and I got in the car and went straight to her house. She was amazing. There she was--walking barefoot through her home, navigating stairs, moving around her kitchen with ease—all with a prosthetic leg. The girls began sharing our story and she reciprocated with similar stories of her own. She asked the girls if they would like to see how the prosthetic was attached to her body. They eagerly said yes. Two silicone liners, a prosthetic leg, and a shiny human stump later—we were suddenly wrapping our brains around the reality of a lower-leg amputation. They were fascinated and amazed. She explained her routines for showering, and her method for getting in and out of the pool—but other than that—couldn’t say more about how happy she was to be able to function normally. While we were there, her daughter (aged 10) came home and talked with the girls. She was so proud of her Mom. She told Annika and Elise that if they ever felt sad about what was happening to their Mom, they should just give her a call. So sweet.

Driving home from Susan’s house Annika said, “Well, Mom. This is a no-brainer. You should definitely have an amputation.” Elise chimed in from the back seat, “Finally people are starting to see things my way! I said we should chop it off from the very beginning!”

Later, Annika caught me sitting on my bed with my head down. She said, “Mom are your feeling sad?” When I said yes, she said, “Mom, a year from now you are going to laugh. You are going to LAUGH that you even gave amputation a second thought. You are going to be just fine.”

I couldn’t believe it. Annika was always the one that wanted to be cautious and try the surgery first. But after meeting Susan, she could see things so clearly.

At this point, I was intrigued and encouraged—but not convinced. So I decided to start meeting some prosthetists. Long story short—I met with four prosthetists around town (my Mom, Annika, or Lisa even came along for the ride sometimes) and came away with basically the same information. 1) The fact that I have a knee makes all the difference. The function that you can have with a BK (below knee) prosthetic is almost 95% of a normal foot. The inside of the foot is made of carbon-fiber components and then covered with a plastic foot. 2) Although they work great, the legs are not cute. Not even a little. They look very plastic and fake. We would have to work on that. 3) A few months following the amputation, I would be fitted with a temporary leg that I would wear for about 5-6 months while the stump reduces to its final size. This leg would not have a cosmetic cover over the inner workings of the leg so it would look like a fake foot--attached to a pipe--attached to a big socket that would fit onto me. Once the stump is “matured” I would get a leg with all the bells and whistles—a high-functioning foot, axis ankle, cosmetic cover, split toe for sandals, and (if I like) a foot that will adjust to different heel heights. Pretty slick but still not cute.

Very interesting that each of these guys had some very similar personality traits: nurturing, caring, technical, artistic, practical, and “this is not a problem”-view of life. Every time I had another appointment, I would come back telling Doug that I had fallen in love with another prosthetist. They just make you feel very much like they are going to see you through this tough time—and insurance will pay for it. A guy who acts as your personal mental health therapist AND makes legs—what a combo. Who wouldn’t fall in love with that?

I looked into our health insurance and found that my insurance would pay for the first temporary leg and then the final leg. They would also cover to repair and/or replace prosthetics from normal wear and tear. The prosthetists I met with said that this means that you get a new leg about once every three years. I would really want to be able to have a cosmetic leg for every day wear, and then a leg that I could use when I was doing rougher stuff like woodworking, painting, gardening—or during a particularly messy week of projects at school. I would also want to get a water leg for days at the beach, swimming, etc. The prosthetists said that I might be able to convert my temporary leg into my second “beat up” leg for a couple thousand dollars. The water leg would not be covered by insurance and would cost about $5-8 thousand dollars. I thought I could maybe do a couple rounds of summer camp to finance my new water leg!

As I inched closer to thinking that amputation might be a decent idea, I would find myself quickly clinging back to the surgery option. I had to continually tell myself, “You haven’t cut your leg off yet—you are just exploring options. Chill.”

But as time went on, the panic I felt about making a decision started to subside and I started to feel real peace. I kept thinking that God would send me a big sign letting me know what to do. The harder I looked, the less I saw any sign of anything. But when I allowed myself to just openly explore, explore, explore and follow every lead that came my way, God actually led me to my final destination:

Amputation.

Never saw that coming.

There are so many pieces to this final puzzle that I didn’t go into detail to explain . . .

-All the calls to friends of friends, who had personal experiences with amputation or reconstructive ankle surgery,

-Finding my girls sitting on the couch happily looking through a prosthetics catalog,

-Meeting a physical therapist at a volleyball game who had experience with both BK amputees and patients recovering from ankle reconstruction surgeries (“Oh yea, your functioning would be much better with an amputation . . .”),

-Hearing the stories of people who personally know amputees who swim, run, walk—“and you would never know. . .”

-Discussing the phantom pain medications available with a middle school boy who lost part of his hand this summer during a boating accident,

-Marveling at the amazing abilities of a little girl in my Art class who was born without her lower arm,

-Sensing the deep desire of my family to put all this behind us and move forward in faith,

-All the friends and co-workers who made sure that I was seeing the best people in town,

-The faithful people who have also experienced ankle trauma (my ankle fusion support group friends, Sarah, Susan, and many others) and have given me lots of advice and resources,

-Being able to process the gazillions of thoughts and emotions that went through my head with friends, teachers and parents from school, and people at our church,

-The honest and straightforward emotional input from my girls, my parents, and Lisa (my friend and assistant at school),

-And all the late night talks with my dear, faithful husband--Doug.

Truly—this has been a journey. I know that it will not be easy. However, I am so completely confident that amputation is the right thing for us to do. We are not the first people to go through this and we will not be the last. God has been so faithful—He will not leave us. He is so good.

If you are still awake after reading all of this--bless you.

Love to you all!

Anne

Saturday, August 9, 2010

2010-08-07T13:31:00.008-04:00

Goodness, gracious . . . a lot of time has passed since February 26! I have mentally updated my blog so many times but I have not had the gumption or courage to get on and write--mostly because things have slowly gone downhill since my last entry. Sometimes it seems like ignoring the situation might make things get better but that has not been the case. Let me get you back up to speed . . .

When I first got my news that the fusion seemed to be progressing well, it was such an answer to prayer. There was a real sense of relief that we might be seeing the light at the end of the tunnel.

The staff surprised me with a funny luncheon prepared by our genuine, “bone”-ified school skeleton, people (especially my students) were thrilled to see me bearing weight with my

walker, and we found (what was hopefully going to be) a final parking space for my scooter in a dark part of the garage. Amazingly--as I slowly started putting weight on my foot--it felt solid and good.

Around Spring Break, Dr. Carbonell let me know that it was time for me to start going to physical therapy. All of a sudden, I was buying canes in different colors and shopping around for rocker bottom shoes. At $250 a piece, my lovely rocker shoes weren’t cheap—but they were sure better than my big boot! My physical therapist, Doug, was amazed at how well I could walk right off the bat. He worked with me to adjust going up and down stairs, build strength in my legs, and loosen up some very stiff toes. After just three weeks, he discharged me saying that I just needed to keep using the cane and wearing a compression sock for at least a year while my body got used to forever functioning with a "block" foot (a foot with an ankle that can not bend at all).

The thing is--although all of this was very encouraging--I was quietly beginning to panic. I was in so much pain. Although I wanted to prove to myself that I was getting better, every step was telling me that something had to be very wrong--or if not “wrong”—at least not what I was hoping for as an “end” result. If this was what the rest of my life was going to be like, I honestly hoped that I wouldn’t live too long.

The thing is, when walking is that painful, you don’t want to go ANYWHERE. You just want to sit in your chair and figure out how to take the least amount of steps to accomplish what you absolutely have to do.

Pain is a crazy thing. It is all your brain thinks about. You get irritable. Short with people.

Demanding. Your mind keeps thinking about that pain pill or glass of wine that can give you a little break from the misery.

My x-rays eventually showed that the screws were moving a bit and were boring holes in my tibia. Dr. Carbonell put me back in my boot, and then got me fitted for a brace that would give me some support—all in hope that somehow this was going to work out.

By the end of May, I was convinced that something had to be very wrong. We looked

at my x-rays and saw something new . . . the cadaver bone in my ankle had collapsed. My tibia was out of place and the screws were causing part of the tibia to shear away from the shaft. I was relieved to see that my pain was being caused by an actual problem. I thought I was maybe just being a baby about normal fusion-recovery pain.

Anyway—Dr. Carbonell put me in a cast and said that I would stay non-weight bearing for at least three months while we waited to see if the bone would solidify again.

At this point, it seemed clear that I really needed to see some orthopedic surgeons to discuss the next step. I spent the beginning of June navigating the big world of orthopedic surgeons.

The main doctor I really wanted to see didn’t take my insurance, but his appointment guy, Enzo, took pity on me and started pointing me in the right direction. “No—he sounds like he would be good but he really only does knees. No—don’t go to him—he only does ankle trauma—you will just see him and he will send you to someone else. Yea—he is really good. He does all of the really difficult ankle surgeries.” I wouldn’t even bother trying to get into an office unless the doctor had been “Enzo-approved.”

After living in the kind and friendly fishbowl of Dr. Carbonell’s office for 18 months, it was weird starting fresh with other doctors. You practically had to send flowers and chocolates just to get them to consider giving you an appointment! In the end, I had three appointments for the end of July.

So—knowing we had about a month to wait before we could do anything—we decided to get busy! We went on a family vacation to Curacao, and later travelled to Michigan for two family reunions.

During this waiting time, I really needed a chance to sort out some things in my head. Was God disappointed with how I was handling this situation? Was I not praying enough? Did I not have enough faith? Was I trying too hard to be in control?

When I first got hurt, so many people would come to me and say, “Oh my goodness, Anne! What a terrible thing that has happened to you!”

And I would say, “Oh—it is OK! I will be all right. God has a plan . . .”—and I meant it with my whole heart! Everything really was going to work out. I believe that still.

But about a year after my fall, when I was using my cane but suffering from so much pain, people would see me and say, “Oh, wow! You are doing so much better! Our prayers have been answered! I just knew you were going to be OK!”

These comments put me into panic. No—I was not OK. This was not good. I may LOOK like I am doing better, but this is horrendous.

For some reason, I just couldn’t lie and say, “Oh, I know—aren’t I doing great!!” I would say something depressing like, “Oh, but I really am not doing that well. I am in a lot of pain.”

The minute it came out of my mouth, I felt like I could read their mind . . . “Well, no wonder she isn’t doing better—she isn’t focusing on the positive.”

In Curacao, I tried to think of a better response. This is what I came up with: “We are still struggling with the healing of my ankle, but I know that—somehow—I will walk again someday.”

Nice. Honest. To the point. Hope for the future.

But Doug—never wanting me to give up hope—would say, “Why do you have to say, ‘somehow?’ That makes it sound like you are planning on an amputation or something.”

OK—fine—I will take out the “somehow.”

Next time I tried it out, Doug says—“What do you mean you will walk?!? You are going to dance, Baby--DANCE!”

“Good grief, I don’t know if I am going to dance! Right now I am just shooting for being able to walk!!! Let’s be realistic!”

I always felt like I was being corrected for being realistic. This was not going to be easy. It was obvious that when they told me this was a “catastrophic” injury—they weren’t saying it to be dramatic. Yes, I am strong. Yes, I am always going to try to have a great attitude. Yes, I fully believe to my core that God has an amazing plan for me. However, I also realize that my life will not be the same again. We can sugar-coat this all we want, but my foot will never be like it was.

But was that the wrong approach? You always hear of people who experience medical miracles. Was I shortchanging myself by being realistic? I have always loved the verse saying that God can doimmeasurably more that you could ask or imagine. Was I not allowing myself to imagine myself dancing with a perfectly functioning ankle? If I did—would things start to work out differently?

When Doug’s Dad was sick in the hospital, Dad said, “My prayer is that I can be at peace with whatever God would have happen in my life.” That struck me so much—I have never forgotten it. That is how I feel. I am truly at peace with whatever happens to me.

But—apart from having a good attitude and doing all I can to get better--do I have some sort of power to determine the outcome of my healing? Am I expecting too little to simply be content and at peace with whatever happens? Is God waiting for me to have the faith to plead for a miracle?

Honestly, writing this right now, I still don’t know. And for that reason, I always have a little shadow of guilt hanging over me as I go on this journey.

Anyway—I realized how easy it is to trap people in the dreams and hopes you have for their lives with our friend, Elaine. She is a lovely woman at our church who always leaves the most encouraging messages on our phone letting us know that we are in her prayers. She fell a while back and was in a health-care facility for months. During this time, she was in a large neck brace, confined to bed, and unable to walk.

Well, I come in to church the other day and there is Elaine, using a walker to move across the church and holding her head up on her own power. I was so shocked and thrilled to see her I exclaimed, “Elaine! Oh my goodness, you look amazing! I can’t believe how great you look! You must be so happy!”

As soon as I said it, I could read in her eyes that she was not feeling what I was saying. In fact, she looked terrified. All of a sudden I realized that I was projecting my feelings on her. I quieted my voice and came to her and said, “Elaine, I am so happy to see you. How are you doing? Has this transition been hard?” She opened up so quickly and began telling me how scary it has been to come home. That she feels like a burden to her daughter who is now caring for her, and feels uneasy away from the hospital. She talked about the pain that she is now managing on her own without nursing care.

I couldn’t believe that I had almost missed an opportunity to encourage Elaine. She needed me to ask her how she was feeling—not TELL her how she was feeling. Even though my initial intentions were good, they were not what she needed at that time. I am grateful I know that now.

OK—enough mental rock-tumbling—back to basic info . . .

About two weeks ago, I got ready for my big appointments by having a CT scan done in advance, collecting all of my current X-rays, making multiple copies of my surgical reports, and creating a nasty photo album featuring our favorite shots of my infected, mangled ankle. (I can send you a copy for your coffee table if you like.)

Within three days, Doug and I had sat with multiple doctors and were given the same news over and over (thank goodness, really). We left the experience feeling like we had been hit in gut, BUT also extremely grateful for the expertise of the doctors that we were meeting with. We feel like we are in very good hands—no matter what our final decision might be.

Here is what they said . . .

1) The fusion surgery that I had in November failed. The talus was unable to produce bony tissue to create a bond with the tibia and the calcaneus. My talus was also unable to grow in and through the cadaver bone. That is why it collapsed and why my ankle is a big piece of mush right now.

2) The talus portion of my ankle is most likely still infected as is rapidly dying. It is getting only about a 5% blood supply, so it will never be able to heal or generate new bone. It needs to be completely removed soon. This will obviously render my ankle completely useless.

3) My options are simple . . .

a) Have a below the knee amputation.

b) Have a rare surgery called a tibiocalcaneal fusion and tibial lengthening with external fixation.

Both of these options clearly have some drawbacks. However, I am ready to take on the difficulties either of these options will throw my way and know that I will be better for it. It is all do-able!! Go! Fight! Win!

Here is the problem . . . which one do I choose?!?!?

I’ll tell you what I have found out:

Amputees are amazing. I have spoken to more people who have a laundry list a mile long of the things they have done with their prosthetic leg. Most struggle with phantom pain and manage it with various drugs such as neurontin, lyrica, and/or oxycodone. It is very important to take good care of your amputated limb (I found out quickly that people don’t like to call it a “stump”—my bad). Most have given up using the leg cover things and just like to walk around showing the inner mechanical workings of the prosthetic. Some always wear long pants to keep it discreet, others are proud to show their leg. Prosethics are very expensive and usually involve a certain amount of finagling with insurance companies. Most talk about the annoyance of having to use crutches to go to the bathroom in the middle of the night, or needing to take their leg off to go in the pool. But other than that, most say that having an amputated limb has not held them back one bit.

To date, I have not been able to talk to anyone who has had the tibiocalcaneal fusion (we will call it the TC fusion from now on, OK?). Dr. Hutson, at the University of Miami is the expert on this surgery and would perform mine if I chose to have it. He said that they would first go in and take every shred of my talus out of my foot, stuff it full of antibiotic beads, and put me on IV antibiotics for a week or two to make sure that any infection has been killed. Later, I would go back in and they would attach my tibia to the calcaneus. This would all be held in place with a large external fixator which would press the two bones together so that they would hopefully fuse within about 4-6 months.

Now—removing the talus would create about a two inch discrepancy between the length of my two legs. Therefore, they would use the fixator to slowly stretch my tibia. Over about 9-12 months, I would turn a small crank on the fixator every 6 hours. The pins going through my bones would pull on the bone and slowly persuade it to grow longer. In time, my tibia would eventually grow the two extra inches of bone that I would need to be even on both sides of my body. They say that there are lots of complications to plan on (intense pain, infection of pin sites, weakening of the tibia, non-union of the calcaneus and the tibia)—but that most eventually end up with a good result within one or two years.

All of the doctors say that the TC fusion would leave me with a “salvaged” foot (such a positive term). My foot would never flex or bend. I would definitely need to wear rocker bottom shoes (no biggie) and would probably need an ankle brace for support. I would never be able to jump, run, or walk quickly because of the strain it would put on my metatarsals and knee. In fact, these parts of my body would most likely become arthritic within about 5 years of the surgery. However, with this option—I would STILL have my own foot.

There they are—my two options.

Since getting this news, my heart has felt like a clenched fist.

My first concern was that I was going to mess up yet another school year by being out on disability two months. However—once again—the school has been incredibly supportive. Such a blessing.

The girls went on a four-day road trip with my parents right after we had these appointments. This was wonderful because it gave Doug and I time to process, brainstorm, research, grieve, plan, and pray. One minute we would be leaning towards one option, and then suddenly the other option would seem more favorable.

If someone just told me I had to do one or the other, I would be ready to go with gusto. But having to decide between one or the other has been tough.

I grieve that Doug and the girls will have to endure more upheaval. I think the worst is that the girls have to keep hearing about it all the time. That is one reason I am writing this massive novel right now because I just can’t keep walking around explaining the whole ordeal to people again and again. It is too hard for the girls to hear—and frankly—kind of hard for me to relive again and again. I need a little mental space from it now and then just to feel like I am not drowning.

We were pulling in the driveway the other day and Elise suddenly said, “Mom—I think you just need to chop your leg off. We have been dealing with this for a year and a half and we are sick of it!” She slammed the car door and marched in the house. But this morning she said to me, “Mom—maybe you should first have the surgery and then see how it goes. If you don’t like how it turns out, then you can have the amputation.” She waffles back and forth just like me.

Annika just wants to make sure that we make the final decision together as a family. She doesn’t want anything happening without having had a chance to hear the pros and cons and sharing her own insight into what she thinks should happen. After all—it affects them just as much as me.

I called Dr. Carbonell and he absolutely agrees with what these doctors have said. I have so appreciated all that he has done for me and so it feels good to me to have his blessing.

I am having a follow-up appointment with Dr. Hutson on Monday—just to have a chance to ask him some more “quality of life” questions about the CT surgery, and to inquire about an “Ertl” amputation that claims to cause less phantom pain. I also want to get the names of some people who have had the CT surgery so I can talk to them.

So many people have already tenderly shared their own concerns and ideas about each option. People on my ankle fusion support groups (they actually exist!) have all written me to share some of their personal experiences. I have googled so far into the dark corners of the Google dimension to find as many medical papers written about this topic.

Doug assures me that we will come out better because we have gone through this—but I still have such a heavy heart. I’m not really sad because I feel like both options are really quite do-able. I just dread that we might later resent or second-guess our choice.

In all honesty—I am not leaning one way or the other at all. I genuinely have absolutely no idea which way to go (fantastic!).

So, we wait, listen, research some more, look for signs from God (Cloud formations spelling out the letters CT? A funky new line of art-themed prosthetic legs?), and pray in earnest that God would lead us to a decision that brings us peace.

We have a few weeks to reach a decision.

Again, I thank the Lord every day for each of you. We treasure your prayers, encouragement, and love.

With so much love,

Anne

Friday, February 26, 2010

2010-02-26T23:57:00.003-05:00

We have UNION!

After three months of being non-weight bearing, I finally got to go to Dr. Carbonell to check on the status of my ankle. The X-ray revealed the miraculous growth of my bone! Basically, my bone has grown through and around the cadaver bone that was inserted into my ankle during the surgery in November. The bones of the ankle have also fused together into one non-moving mass. This is awesome news.

So, now that step one of my healing is completed, we are on for the next step. Basically, the bone has grown—but now it needs to be strengthened. My ankle still wants to flex in order to walk. Therefore, if I were to step on my foot without the boot, the newly-formed bone would most likely break. So, for the next six weeks, I need to SLOWLY and gradually begin putting more and more weight on my foot (while wearing the boot). This will cause the bone to become more dense and strong.

Sounds strange, but Dr. Carbonell explained that this process is called Wolff’s law of bone growth. It is so cool. In the 19th century, Wolff discovered that the bone of a healthy person or animal will adapt to the loads it is placed under. If the loading on a particular bone increases, the bone will remodel itself over time to become stronger to resist that sort of loading. So the bones of a racquetball player’s racquet-holding arm will become much more dense and strong than the bones of the other arm. Likewise, astronauts who spend a long time in space will often return to Earth with weaker bones, since gravity hasn’t been exerting a load on their bones.

So—hopefully Wolff’s law will work its magic on my ankle so I can one day walk without this boot.

Although I have a way to go, it is wonderful to see a ray of hope at the end of the tunnel.

Dr. Carbonell also told me that I can now DRIVE! Doug has been driving all of us (and my scooter) for the last three months. Although it has been nice to have just one kid in my car at a time, leave school when I want to, or avoid going on errands—I have to admit that I slightly miss our family togetherness time in the car.

Having been on my scooter for a long time, I have gotten pretty good at zipping around the house and our school campus like a woman on a mission. Now I am back to travelling .02 miles per hour on my walker (and looking about 129 years old). No big deal. It is just so nice to be getting closer to walking on my own. The kids at school are so excited to see me walking “like a normal person.” They have prayed for me so faithfully and are encouraged to see any signs of change or improvement. So sweet.

Dr. Carbonell also told me that I can sleep without wearing my boot. So wierd. In the past, I have always slept on my belly. However, ever since I fell I have had to sleep on my back with my leg elevated in the boot. Well, the other night, I tried for the first time to sleep on my belly. My foot felt so naked and vulnerable—I hardly knew where to stick it. So, since my foot doesn’t bend anymore, I find that if I scoot down way under the covers and let my foot fall off the end of the bed—I can sleep on my stomach—and keep my foot safe. Sweet victory!

I feel so blessed to be moving forward. I thank each of you who have faithfully prayed for me and my ankle. It feels so good to have a big thing go right in my healing. I just have to try not to do anything dumb during the next six weeks to mess it up! Thanks for your prayers.

Love to you all!

Anne

P.S. My amazing Grandma turns 90 this weekend and she is having a big party in Chicago. I am bummed that I couldn’t be there but I didn’t dare try to tackle icy sidewalks and unknown terrain with my walker. I love you, Grandma! Happy Birthday!

Sunday, January 17, 2010

2010-01-18T00:45:00.003-05:00

Today is the one-year anniversary of my fall. So weird to think that one year has passed.

My Auntie Jan called yesterday around noon to say she was thinking of me. Although the actual anniversary was today, it would have been yesterday (on a Saturday) at about noon that the ambulance would have been called to our house. Strangely enough, Saturday was a beautiful day and Doug was itching to get out to do some yard work. Fine--as long as no ladders were involved.

My Mom called last night to say that she was feeling a little sad--just thinking back to last year and what we have each been through this year.

Doug won't admit it--but I can tell he is down. This has been a very waring year for him. Each of the small gains we have made in my healing have always been followed by some new bad news. I think the emotional roller coaster ride has been very long and hard.

Dad wanted to take us all out for Thai food tonight to mark the one year mark. He delivered a sweet toast at the meal--noting the changes in all of us as a result of my fall. Annika has become very responsible and organized. Elise has become a servant helper. Doug has been a nurturing husband--willing to take on tasks and responsibilities without complaint. Mom has become a great taxi driver. And me--well he said I had become a woman of great faith.

So, tonight I am just grateful to everyone who has helped us get through this year. We could not have done it without you.

My greatest prayer is that I will be walking--through whatever means necessary--by this time next year. That would be nice.

Love to you all--

Anne

Saturday, January 9, 2010

2010-01-10T03:26:00.006-05:00

Yikes! January 9--where have I been?

First--Happy New Year to all of you, my faithful and wonderful friends! We spent the New Year's Eve with the Kern family down at their Keys place. A little before midnight, the kids put on glow necklaces and started throwing those Pop-It things at anything that would make them explode. They were so happy--writing their names in the air with their sparklers, scaring each other in the dark, howling at the blue moon overhead, and creating fires out of fallen palm

fronds (making me very nervous). We were so busy that the sudden appearance of fireworks in the sky was our first indication that it was indeed--2010.

Standing on the dock watching every firework display going off for miles down the shore, I suddenly felt like I was being given a fresh start. It was a new year--2009 was gone--with all of its struggles--and we were starting new.

It is so weird, but ever since then, I feel like I am on a new journey with my ankle. My scooter, boot, dressing changes--they all feel like something that has been with me forever. Somehow they have become my "normal"--almost like they are just another one of life's mundane chores like brushing your teeth or walking the dog. So, wondering if my bones will heal, the infection will clear up, or if I am facing an amputation in a year or two--all feels like a journey that we have just started--rather than a continuation of the struggles of the past year.

So, with great joy I returned to work this week and was reunited with all of my faithful students. Although I am wiped by the end of the day--it is a "good" wiped. The biggest difference is that I am in no pain. So wonderful.

My infectious disease doctor was initially pleased with the appearance of the scab over my wound--only to become suspicious when it became wet with drainage and smeared off. Although it is almost 7 weeks post-op and my one stubborn spot refuses to close up--he is remaining "cautiously optimistic" that my wound will close. He took my off the IV antibiotics last week saying that the antibiotics have done all they can at this point. Now it is a waiting game to see if things starting going downhill. I am just praying that the wound will close. That would be so reassuring.

Dr. Carbonell said that he saw some signs of bone growth on my last X-ray but we won't really know anything for sure until April. Until then, I may not put ANY weight on my foot. This means that I am always on my scooter, and (the real bummer) I can't drive. We made it one week so far with all of us sharing one car and we survived. We'll have to see if we are still speaking to each other by Valentine's Day.

I feel compelled to thank all of you who have been praying for us and helping us get through this rough year. It has been a tough journey--but filled with precious life lessons that will help us weather the future storms that come in living every day.

We love you so much--

Thanks to you all!

Anne

P.S. If you are wondering where all of the old blog entries went--just look at the "Blog Archive" in the right sidebar and click on "2009."

Sunday, December 20, 2009

2009-12-21T23:47:00.011-05:00

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

2009-12-10T22:31:00.008-05:00

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

2009-12-07T02:09:00.007-05:00

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

2009-12-03T22:56:00.012-05:00

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 (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

2009-12-02T01:13:00.006-05:00

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

2009-11-29T19:38:00.004-05:00

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

2009-11-28T18:41:00.008-05:00

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

2009-11-27T00:47:00.014-05:00

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

2009-11-25T00:01:00.005-05:00

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

2009-11-22T22:48:00.001-05:00

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

2009-11-22T21:56:00.006-05:00

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

2009-11-22T18:33:00.009-05:00

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

2009-09-05T15:29:00.009-04:00

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

2009-08-31T21:41:00.002-04:00

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

2009-08-10T20:15:00.008-04:00

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

2009-07-18T16:34:00.004-04:00

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

2009-07-09T17:51:00.005-04:00

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

2009-06-29T23:58:00.008-04:00

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

2009-06-21T00:22:00.007-04:00

"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

2009-06-16T23:32:00.006-04:00

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

2009-06-10T17:06:00.019-04:00

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

2009-05-27T23:01:00.005-04:00

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

2009-05-25T23:40:00.001-04:00

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

2009-05-22T12:09:00.008-04:00

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

2009-05-21T01:20:00.003-04:00

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

2009-05-20T11:08:00.003-04:00

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

2009-05-19T23:28:00.007-04:00

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

2009-05-18T09:57:00.005-04:00

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

2009-05-13T23:23:00.006-04:00

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

2009-05-11T22:58:00.002-04:00

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

2009-05-11T22:56:00.001-04:00

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

2009-05-11T22:47:00.008-04:00

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

2009-05-07T00:52:00.003-04:00

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

2009-05-07T00:48:00.001-04:00

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

2009-05-03T00:25:00.003-04:00

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

2009-04-26T22:15:00.002-04:00

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

2009-04-22T19:05:00.007-04:00

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

2009-04-18T23:56:00.002-04:00

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

2009-04-15T06:36:00.005-04:00

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

2009-04-11T11:49:00.009-04:00

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

2009-04-10T23:21:00.006-04:00

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

2009-04-10T23:09:00.003-04:00

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

2009-04-04T19:17:00.006-04:00

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

2009-04-01T18:58:00.006-04:00

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

2009-04-01T16:07:00.005-04:00

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

2009-03-30T01:07:00.004-04:00

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

2009-03-27T20:54:00.001-04:00

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