First of all I went for an X-ray - I think the consultant has given the radiographers a bit of a challenge with the position of the X-ray because it seems to take some messing about to achieve. I guess the goal is to see the movement of my bone under the adjustments of the frame, so ideally the top rings should be in the same place on each X-ray. As it turned out, seeing the movement of the bone was easy as the gap that's being opened up is clearly visible. You can see that in the following picture which shows a comparison of today's X-ray with the one taken a couple of days after the operation.
|Here's today's X-ray with a comparison from before adjustment started.|
(1) gap opening up in tibia; (2) fibula broken and bit removed.
The point marked (1) shows where the gap is opening up - the bone is moving! - eventually new bone will grow in this gap. Point (2) shows where a section of my fibula was removed - before there were jagged bits which I could feel through my skin and caused strange sensations in my foot when touched. That doesn't happen now, because that chunk of bone isn't there anymore! There's also a bit of bone floating around in there somewhere which my consultant tried to find and remove but couldn't :) A good question is what will happen to my fibula? The answer is nothing - it will remain broken. I asked about this and your fibula only supports about 10% of your weight. In any case, apparently my tibia is so thick now that it'll more than compensate when it's healed up.
After X-ray I had the three shortest struts changed out and did the 4th adjustment at the same time. Well, it wasn't as simple as that! First strut (#6) changed and adjusted no problem. Second one (#5) took a bit of getting off! Evidently the threads on the bolt had crossed somehow and my consultant struggled with the spanners before deciding to call for bolt cutters! This had never happened to him before with these frames. Anyway, after a bit of a wait the bolt cutters arrived and fortunately with a bit of effort and someone else holding my leg steady, the bolt was cut through and the strut was off. I say fortunately because the next option was a hacksaw and I don't think that would have felt very nice with the vibrations through the pins etc.. Anyway, strut 5 was off and the new one attached.... no! because it wouldn't fit - too long. This is because the one that was removed was not fully extended and so the gap between the rings at that point is not yet wide enough to put the next longer strut in place! SO, the old one went back on, and I will have to replace this strut myself in a couple of days when it's fully extended. More fun for me :)
After all that strut 4 was replaced easily and the remaining adjustments done. So we're now at 4/12 - a third of the programme completed. From today's photos which I took just now at home, you can clearly see it's straightening out.
My consultant said that from the X-rays the bone was moving the right way, so everything looks good so far. I remembered to ask a few questions which I've had during the strut replacement procedure: for example, I had been wondering about whether the reason the correction is done gradually is more for your soft tissue than your bone. I was almost right, it is partly that but mainly because of the nerves - they can only stretch safely 1mm/day. Another thing I was curious about is whether the adjustment takes place in both planes simultaneously. It does, so even though it looks like the front/back movement is happening first, it must be an illusion. In fact, from today's pictures I think the side/side movement is more pronounced now. The computer program that works out the adjustments takes into account the positions of your nerves as well - pretty impressive - I think it's web-based, maybe I'll ask to see it next time ;)
|Day 0 (left) to Day 4 (right).|
I asked about my top wire pin which is the only one I am concerned about. The skin around it is a bit red and inflamed. I've now got some antibiotic cream to put on that area in case it's the first sign of an infection (really hope not). If it doesn't clear up I have to start taking antibiotics again :(
After all the strut stuff and looking at my X-rays, I went to the treatment room to have the clips that stapled my two main wounds from the operation removed. They really are like staples and John, a student nurse, removed them with what looked pretty much like a staple remover. Apparently they go in with a staple gun!
|Day 0 (top) to Day 4 (bottom).|
I have my next appointment on April 30, 2 weeks away, when the current adjustment programme will be complete. Depending on the results of the X-ray that day, there may be some more adjustment necessary because the measurements they take that define the programme are not 100% accurate (they couldn't be). So maybe in total there'll be more than 12 adjustments, don't know yet.
In the last 2 days I've spent quite a bit of time upright - crutching around to the station, train, hospital etc.. My leg is a bit more swollen now so I will have to take it easy for the next few days. It's OK, I've plenty of programming work (programming's not really work though it's fun) to do.
The adjustments will now take place every day, so next pictures tomorrow! A few people have asked what it feels like making the adjustment. The best I can do is that it feels like the frame is getting tighter - like you had your leg in a vice and tightened it up a bit. It doesn't hurt at all.