Saturday, November 28, 2009

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

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

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

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

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

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

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

Love to you all--

Anne

Thursday, November 26, 2009

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

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

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

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

Unbelievable.

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

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

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

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

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

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

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

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

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

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

I love all of you so much.

Talk later (when my head is clearer).

Anne

Tuesday, November 24, 2009

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

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

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

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

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

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

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

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

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

Love to you all--

Anne

Sunday, November 22, 2009

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

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

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

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

I will write more later when I know more.

Love to you all.

Anne

Wednesday, November 18, 2009

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

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

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

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

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

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

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

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

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

Good News mixed with Bad News.

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

Love to you all--

Anne

Friday, November 13, 2009

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

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

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

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

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

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

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

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

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

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

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

Love to you all!

Anne

Saturday, September 5, 2009

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

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

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

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

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

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

So . . .

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

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

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

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

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

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

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

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

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

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

Anne

Monday, August 31, 2009

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

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

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

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

Insert here: curve ball.

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

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

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

Well, here is what we found out.

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

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

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

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

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

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

The End.

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

Tuesday, August 18, 2009

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Let me tell you about some good things . . .

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

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

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

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

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

I am alive AND VERY WELL.

Love to you all,

Anne

Saturday, July 18, 2009

Surgery #7 . . . coming on up!

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

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

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

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

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

Love to you all!

Anne

Wednesday, July 8, 2009

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

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

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

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

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

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

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

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

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

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

Monday, June 29, 2009

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

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

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

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

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

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

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

Anne

Saturday, June 20, 2009

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

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

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

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

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

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

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

Love to you all!

Anne

  

Tuesday, June 16, 2009

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

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

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

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

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

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

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

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

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

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

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

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

Love to you all!

Anne

Wednesday, June 10, 2009

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

Nevertheless, we have been busy enjoying our summer.  

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Faith to see beyond what I can see,

Faith to know that you will do great things.

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

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

Love to you all!  

Anne