Saturday 22 October 2016

Operation 15

It's been a long time since I blogged about my leg. Unfortunately that doesn't mean it's been all back to normal, it just means there's been nothing significant to write about, but now, well, there is. On Wednesday October 26th I'll have an operation to break it again, this time in Liverpool (at Broadgreen Hospital). About 18 months ago my consultant in Preston referred me to the Specialist Limb Reconstruction Unit there, and I saw them for the first time in July 2015. They were so positive about what a difference another surgery would make that it felt inevitable that I would go through with it, and so, after a bit of a delay, I am doing.

This is elective surgery which means that I've chosen to have it. That makes it quite a lot different in principle from my previous operations, which have really been compulsory to regain any sort of function in my leg. You may, or may not, remember that my last operation in 2012 was necessary because my leg healed up with a 17 degree bend in my tibia (shin). That absolutely had to be corrected for me to be able to weight bear again. You'll remember I was in external fixation for 6 months to straighten it out and wait for it to heal up. While that operation allowed me to walk unaided again (as well as bike, etc.) it didn't correct either the length of my left leg, which is 2.5cm shorter than it used to be and than my right leg, and it also didn't correct the angle of my ankle or the relative positions of my knee, ankle and heel. You can kind of see the problem from the photo Rebecca took of me recently from behind after I'd been biking. I'm lop-sided and my foot doesn't hit the ground properly.

Photo of my legs from behind. You can clearly see I hope what the problem is!

Anyway, the length of my leg and the positions of my ankle and heel will be corrected all-at-once by this next operation. Ultimately this will mean walking will be easier, less painful, and I won't be damaging my ankle and back further by trying to behave normally. So it's worth doing, even if it does feel like a massive step backwards. I've been talking myself into it for ages now basically along the lines of the following conversation:

"I don't really need this operation, I can manage just fine now, I've adapted."

"Yes but what about in 10 years' time, will you be able to manage then?"

"I don't know, possibly not if it gets worse."

"Well if you can't, or if it gets much worse, will you regret not having this operation then?"

"Yes I will."

And that is not good, and that is why I'm going through with it, even though I know what it means in terms of mobility, pain, and hassle. I will have a frame bolted to my tibia not unlike the previous one, except this time I will adjust the struts to lengthen my leg out, not straighten it. You can grow your bone 1mm per day, so that will be about 25 days of adjustment, after an initial settling-in period of about 2 weeks if it is like last time. Then you are just waiting for the bone to fill in the gap you've made. That will probably take 4-5 months. At the same time, they're going to break my pretty much completely fused already ankle, and re-fuse it in a better position, more perpendicular to my leg, so I can put it flat on the ground. And, they will break my heel bone and pin it so that it is in better alignment with my ankle and knee. So all these adjustments are to improve my biomechanics, make them more like a normal person would have.

In hassle terms, it means wearing the frame for about 6 months, which is awkward and irritating because it's bulky, you can't wear normal clothes, it looks awful, and mainly because you have to keep the pin sites, the bits where metal enters your body, very clean. In practice it means cleaning and dressing them all probably every other day. This means lots of dressings and stuff, but I remember all that stuff from the two previous times so as long as I can get everything from the pharmacy it should be OK, it just takes time and you have to do it properly because infection would not be good. Really not.

This is what it looked like last time.  This time will be similar, except my leg is now straighter,
and it may be longer this time, going down closer to my ankle.

Obviously it means no driving, no biking, difficult to get around. I now have quite a lot more going on than I did last time, so I'm probably going to get more frustrated than I did last time, and then on top of that there's the knowledge that I chose to have this done and I'm doing it from a position of relative activity, not like last time.

I haven't written this to make you feel sorry for me, not at all, just to explain what's going to happen so that if you see me afterwards you know some of the story. This is operation number 15 in total. It will hopefully be the last. If you want to know the full story, look at my previous post called 'Recover' (https://ajmk-est1974.blogspot.co.uk/2013/08/recover-slide-show.html). Or click on 'The Accident and My Leg' above.

Another thing that's very different from last time is that I have a lovely wife at home who is prepared to suffer me, and a great extended family through our church. This will make a massive difference I'm sure. We started going to Revive Church just before my last frame was removed, in November 2012. I'm really thankful for how my life is now. I thank God every day for it, but the truth is that the good is inseparable from the 'bad'. What happened to me and the resulting changes in my life and faith are completely inseparable, so I thank God for my accident and my dodgy leg. And for the NHS and blood donors. For my wife, my family, our church, my job and my altered perspective.

No doubt I'll feel the need to blog again about this, and post photos, after the op :)

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