Post op day 5 day 2 hotel
10 July 2016 | Zapopan, Guadalajara
Jeanne Sunny with some clouds
It’s really hard for me to believe that it’s only been 5 days post op. Somewhat like cruisers, I’ve lost total track of days and hours.
As I mentioned in the Blog July 3 Guadalajara I wasn’t sure if I would be blogging or not.
I’ve decided to continue and to also give you a bit of a back story.
As mentioned in the previous blog, I have a very rare – 1 in 150,000 people- bone disease. I am lucky that I am only affected on the left leg. Others who have this disease, Olliers, it is quite common for one side of the body to be affected – arms, legs, feet and hands.
This was discovered shortly after I started walking and fell. After the fall, I didn’t want to stand on the leg. I am very lucky to have lived in a city that had top notch ortho docs, who knew what to do, and parents who asked the right questions.
The disease, in my case, caused cartilaginous spots – soft areas – and the leg didn’t grow in length. These soft areas caused bending of femur and a bit in the tibia – in my case a ‘varus’ deformity or bowleggedness. As a child and into my early teens I had a surgery to correct this almost every year. At the age of 14 I was given a reprieve and got to enjoy junior and senior high school.
After a year in college a new procedure was introduced to me that could possibly correct a lot of the leg length difference – at that point almost 7“ even after all the surgeries. I underwent the procedure which involved removing 2”of bone from my right femur and placing it into my left. That was so successful, that nine months later, my right leg was shortened again. I vaguely remember what it was like to be almost 5’7” tall!
Once I had healed and rehabbed from that procedure I was sent upon my way with the warning that most likely at some point in the future, I’d need a total knee replacement (TKR).
Thirty plus years later, I’d started to have knee pain. It really came to a head – or to my knee- on our trip to Mexico City. Here we were in this wonderful city, full of photographic opportunities, and I hurt too much to do the exploring that I really wanted to do.
After we returned, I had some x-rays taken and started to interview local doctors. The x-ray confirmed what I already knew – there was nothing left of the medial, inside, of my knee.
Having had top notch doctors in the past, I was pretty picky about choosing a doctor.
Through a reference from Gaby, the friend who is helping me at the hotel now, I learned of Dr Jaime Michel Guiterez. He had done a TKR on her mother last July and from everyone’s point of view its been a success. So we booked a trip over to talk to him, ask tons of questions, look at hospitals and rehab locations. Needless to say, we all felt a good fit and were very excited to have found a very talented doctor – who only does knees!
Before leaving I had a full length standing x-ray taken. We headed off to explore some of the city and get back to La Paz to get some things lined up for a TKR. However, the following morning we got an email “OMG” from him after he had seen the full x-ray. Yes, my knee was I really bad shape, but he wanted to confer with his colleagues as the varus deformity was pretty extreme – he’d get back to us.
A week later, he and his colleagues from around the world, had reviewed the x-rays and determined a better plan. A distal femoral osteotomy was proposed. (Distal is farthest point from the body – as in the femur/thigh bone closest to the knee). An osteotomy is a procedure to take a wedge of bone from the leg and thereby straightening the leg. This procedure is exactly what I had experienced as a child.
It was quite a shock, but Tom and I and other family that were privy to the x-rays determined that it made good sense and was the right way to go. By doing a DFO, it might delay the need for a TKR for several years, and would, at the least, line things up correctly for the placement of a prosthetic.
So, on Monday of last week, we met with Dr Jaime once again, and bombarded him with questions which he graciously answered and then some. Monday night I checked into the hospital to begin heavy doses of antibiotics.
Tuesday morning at 7:30 I was taken down to the surgery center with an anticipated return to the room by 12. The procedure went as expected, however they felt one part could be a bit better, so they fixed it, ultimately doubling the surgery time, and causing Tom lots of extra stress. I understand he put 6000 steps in my room on the fitbit pacing while waiting!
This next part is graphic in detail if you wish you skip ahead.
The doctors – there were 6 or 7 participating, cut my femur on the inside edge just above the knee leaving the outside/lateral edge connected. By opening up this cut and creating a ‘wedge’ shaped empty space it brought the deformity to zero and added some length. A piece of donor bone was placed in the wedge. It was all secured with a rod placed in the center of the femur. The rod was then secured with the local hardware store! I have an incision on the front of my knee, where the rod was placed. I have a small incision on the inside of my knee where 3 bolts were used to secure the distal end of the rod and bone. I have a small incision on the very top of my thigh that is now home to a front to back screw, and lastly on the lateral or outside of my thigh one more screw left to right securing the rod in that direction.
Most amazing to me is there has been relatively little pain. Even my family members who’ve been through this with me before are amazed. I know that I have a very high pain tolerance which can be good and bad. In the hospital I maybe felt a 7 once or twice on a 1-10 scale. The nursing staff were quick to remedy that. The procedure was accomplished through an epidural anesthetic, which is then pressurized to last for 2 days and left in place. I can say with authority that this worked. My only issue now, is that I seem to have developed a very itchy rash exactly where the tape was placed on my back to keep the system in place.
There has been very little, if any bleeding. Although the post surgery bruising is becoming pretty impressive!
I chose to write about this in more detail, perhaps as sort of a catharsis for me. For the first time, this surgery was totally my decision. Of course, Tom and I discussed it a LOT. Having a surgery such as this as an adult has so many more issues, one little one being that we’ve lived on Eagle for 15.5 years! As a massage therapist one learns about emotions hiding in muscles from traumas and injuries, - usually resulting in tears and other responses. I’ve experienced the wave of tears first hand and know that I have some things to work through.
Unfortunately, the rehab on this is a bit more involved and longer in time than a TKR. I’ve been told to expect to use crutches for at least 8 weeks with absolutely NO weight bearing. It all depends on the knitting of my bone to the donor bone. I started taking bone building vitamins a week before the surgery, as well as for the past 6 weeks have been swimming almost daily and doing rehab exercises. We’ve made arrangements to rent a condo at the marina, and family will be coming to help out for a few weeks. I’m really glad that I started swimming as my upper back and shoulders are telling me that I’m using crutches!
The good side of this is that I am allowed to place my left foot on the ground. And I can actually put my foot on the ground. So some length has been gained, as never before would my foot touch if I stood with hips level….. and that statement alone is enough to get another round of tears, happy tears, flowing!
So, as I can and feel up to it, I’ll continue to blog. And they won’t be this heavy. In fact, perhaps tomorrow I’ll share with you the experiences of taking a shower in a hotel room on a plastic chair using an item that looks like it should be an elephants’ condom!
I’d also like to take this time to thank all of our friends and family that have texted, emailed, called and wished me speeding healing and recovery. I have felt each and every one of your blessings.
With all my heart to you,
Jeanne