Sunday 31 March 2013

Slow processes...

So in August last year (2012), my right ankle was fused meaning it will never move again.  The theory behind this move was to rid me of pain!  For the year prior to that, ever step had hurt and because me foot was in stuck in such a poor position, only if I walked down a steep hill could I get my whole foot flat to the floor. It was a real faff to walk on and extremely painful to boot!  

At the time it appeared that I had two choices...  To fuse it or loose it!  If I fused the joint, the ankle should be pain free but it would never work as an ankle again - beyond basic walking, and had the potential for long term complications on the surrounding joints such as the foot, knee and of course the spine (anyone reading this who doesn't know me, I broke my back in two places in the same injury in 2010, a whole other story for another day blogging...).  The other option was to loose the foot and have a below knee amputation.. This seemed quite drastic but would have the potential for better walking, more activity, less strain on other joints and so on but of course it came with the complications of only having one full leg and using prosthetics, needing to swap legs for different activities and so on.  In reality, I was quite sold on amputation then as there was an element of finality about it but after a few appointments my consultant had won me around to the idea the if I fuse it and it doesn't work, I still have options...

The fusion was completed and the op itself went well.  I was in and out of the hospital in a day, although the nurses weren't too happy about it and I went home expecting a 6 week non weight bearing followed by 6 weeks partial weight bearing before full weight bearing.  By the mid January (a little over the predicted 12 weeks), I was just about bac k to moving without crutches.  The problem is, it is not the pain free result we were hoping for!  It's less painful than it was, but in all honesty, its only a marginal improvement, in fact, if i am walking on anything other than pretty flat tarmac, Im still pulling at least one crutch out the car!  The initial thought was that the fusion may have failed but it actually looks very good in the rays and by a process of investigation it seems pretty clear that its the joints around the ankle, at the heel and in the foot which are giving me grief!  A problem that was always potentially on the cards but meant to be 10/20 years down the line.. Not 6 months!  I can only assume the joints took more of a pounding than we had realised and it was all simply over shadowed by the pain in the joint which has now been fused! 

So what now?  It seems we are back to that same question, fuse it or loose it?  We could fuse the subtalar joint and the joints in the mid foot but that really would make walking a nightmare, putting masses of strain on other joints, particularly the spine - my top priority! Amputation now totally looks like the top option, and my treating consultant appears to agree (as does my spinal consultant).  Sadly, it appears that nothing in medicine happens fast.  My treating consultant wanted a second opinion from another consultant who, based on a tiny fraction or the picture came up with a theory of why I am in pain which has more holes in it than your average sieve, but nevertheless, its a theory, which means delays in making ANYTHING happen.  I'm now in the process of waiting to see my treating consultant
 to see his views.  Hopefully, he will have the guts to say that no, that theory is ridiculous so we don't waste 2 months faffing about before being productive!  

In the meantime, I'm meeting with prosthetists, rehab consultants etc and finding out more and more about potential life as an amputee.  Is it weird to be excited?  The idea of less pain, better mobility and more activity is actually thrilling!  Even if I have to put a leg on in the morning to get there!  Who needs four limbs anyway...