Update on Debbie's Leg
Update on Debbie
February 3, 2023
We are blessed to have so many well-wishers and friends reaching out to inquire about Debbie’s health and standing, I thought it would be good/easier to type it out just once and share from my personal website.
If you don't want to read through this, I perfectly understand, the summary is we got some cautiously hopeful news today when we met with the Orthopedic Trauma Surgeon today. There is a lot to do to get to a conclusive point, but it feels like a path is forming - details below.
Background:
Today’s Update:
Today we drove north of home about an hour to meet with the highly regarded trauma surgeon. He evoked a lot of confidence, seemed to instantly recognize what needed to be done and gave us two non-amputation paths, which will depend on whether Debbie has an infection in her bone (you might remember that Debbie was in the hospital for 11-days in December/January with a severe infection that was treated with multiple rounds of antibiotics. She still has the infection, though the hospitalists were never able to pinpoint the source or origin. Recently, her white blood counts rose again, and she’s felt poorly for several weeks.
Path #1: There is no infection in the bone:
Two surgeries, one with a fixator after they remove a lot of the hardware in her leg and focus on compressing the bones to heal. They will have to do a bone graph from her femur. The second surgery would be to insert rods into the leg for additional reinforcement.
Path #2: There is an infection in the bone:
They will have to do three surgical procedures. The first would be to direct six-weeks of IV-based antibiotics to the bone region. The second and third would be nearly the same except would employ a cutting-edge approach to the fixator surgery using what is known as a ring external fixator; I need to do some research on this yet as I am not familiar with the procedure. There is a specialist who is advanced with the ring external fixator approach who would do the second surgery. The third surgery would be to insert the rods as mentioned above.
If the bones are severely damaged, ravaged by infection or other complications come up, it is possible that the leg may still need to be amputated – we can’t put a percentage of likelihood to that until we get some more tests wrapped up.
Between now and the next medical procedure, there are several appointments that we must attend to and conditions that need to be addressed:
Thank you for all the positive thoughts, prayers, kind words, and offers for support. Given Debbie’s track-record with healing, seizures and all that is surely to come, the next year is going to be challenging, so keep them coming!!! With a little luck though, 2023 may be the year that our lives were given back to us, and we get Debbie back on her feet!!!
Dan
February 3, 2023
We are blessed to have so many well-wishers and friends reaching out to inquire about Debbie’s health and standing, I thought it would be good/easier to type it out just once and share from my personal website.
If you don't want to read through this, I perfectly understand, the summary is we got some cautiously hopeful news today when we met with the Orthopedic Trauma Surgeon today. There is a lot to do to get to a conclusive point, but it feels like a path is forming - details below.
Background:
- In January of 2019, Debbie fell on the ice in front of our house and broker her ankle and her lower leg. She was taken to the ER via ambulance as I was out of town.
- The breaks required two surgeries – the first used a fixator and bone graphing, and the second inserted several plates and screws into the broken areas.
- Debbie has diabetes and several other medical issues that challenge how well she heals. She was in ICU in February for two weeks treating a severe case of Hyponatremia, of which she nearly died.
- The wounds/breaks healed very slowly – she still had numerous hairline fractures and was in a great amount of pain and lacked mobility in the summer of 2020. The surgeon left the practice, so we got a new doctor who recommended a bone stimulator, which she used for several months. Bone stimulators are controversial and most orthopedic surgeons are either absolutely against them, thinking that they are nothing more than a psychosomatic tool and others swear by them. Debbie’s recovery was positive and a dozen’s orthopedics across the country were introduced to her case at a conference, which demonstrated very progressive recovery.
- Though Debbie would not be running marathons or navigating without a cane in some terrains or scenarios, we started going on trips and living a more normal life around 2020.
- Fast-forward to October 2021, Debbie felt lightheaded and fell in the bathroom. We called an ambulance, and she was shuttled to the emergency room. This break pierced her skin and was isolated into the mid-shin area, though it was broken in several places.
- A different on-call surgeon reviewed everything and proposed to take out all the hardware from the previous surgeon and to introduce rods to help stabilize the bone.
- In surgery, however, the ER surgeon could not get the screws out and had to abandon the rod plan opting instead to further reinforce with more plates and screws – today Debbie has 5 plates and 55 screws in her leg below her knee.
- Surprisingly, the leg healed well and relatively quickly for Debbie. Debbie is an epileptic and there is always a 2–3-month period, usually a month after she has surgery, where she has constant and very dangerous massive seizures – those are not fun nights!
- In December 2021, we got a clean bill of health from the doctor, the bone had 100% healed and she was gearing up for physical therapy.
- A few days later, while on an exercise bike, something happened, and Debbie reinjured her leg. The leg began to swell, which steadily grew worse and became misshapen.
- After a few weeks of rest, the leg was not healing and Debbie was in intense pain (I think it is amazing that Debbie has been in such pain for so many years without taking pain killers, etc.).
- We re-visited the surgeon and he said that there were several breaks along the leg, that he couldn’t see the extent of the damage because of all the hardware, his recommendation was to amputate the leg.
- After getting through a ton of insurance and provider red tape, we were able to visit a surgeon a few weeks ago to seek a second opinion, which also came back with a recommendation of amputation.
- Through a fluke, Debbie was able to get a wonderfully nice lady from our insurance company who had meetings with her supervisor and was determined to find an excellent trauma doctor in our network who may be able to help her.
- It’s worth noting that Debbie has pretty much been bedridden since October 2021 as her leg worsened.
Today’s Update:
Today we drove north of home about an hour to meet with the highly regarded trauma surgeon. He evoked a lot of confidence, seemed to instantly recognize what needed to be done and gave us two non-amputation paths, which will depend on whether Debbie has an infection in her bone (you might remember that Debbie was in the hospital for 11-days in December/January with a severe infection that was treated with multiple rounds of antibiotics. She still has the infection, though the hospitalists were never able to pinpoint the source or origin. Recently, her white blood counts rose again, and she’s felt poorly for several weeks.
Path #1: There is no infection in the bone:
Two surgeries, one with a fixator after they remove a lot of the hardware in her leg and focus on compressing the bones to heal. They will have to do a bone graph from her femur. The second surgery would be to insert rods into the leg for additional reinforcement.
Path #2: There is an infection in the bone:
They will have to do three surgical procedures. The first would be to direct six-weeks of IV-based antibiotics to the bone region. The second and third would be nearly the same except would employ a cutting-edge approach to the fixator surgery using what is known as a ring external fixator; I need to do some research on this yet as I am not familiar with the procedure. There is a specialist who is advanced with the ring external fixator approach who would do the second surgery. The third surgery would be to insert the rods as mentioned above.
If the bones are severely damaged, ravaged by infection or other complications come up, it is possible that the leg may still need to be amputated – we can’t put a percentage of likelihood to that until we get some more tests wrapped up.
Between now and the next medical procedure, there are several appointments that we must attend to and conditions that need to be addressed:
- Debbie needs a specialized set of lab work done to assess the leg and its potential level of infection more specifically – we’ll try to get these done next week.
- Secondly, Debbie needs to have a new CT scan, which we’ll try to get to the following week.
- Third, Debbie still must have at least one, but more likely, multiple iron infusions to address the anemia she has had since the last surgery in 2021. The last round of infusion did not work as well as some have in the past, but she is not in a good position to have 2-3 surgeries give her current anemia level.
- Debbie’s Hyponatremia is improved, she’s off water restrictions and has lowered the Sodium Chloride dosage she was taking.
- I’m sure there are a few things that I am missing that we must address along the way, but at least we have a path to explore and, no matter the outcome, we can be more comfortable knowing that we explored all reasonable possibilities before we opt for a more radical approach to trying to give Debbie her life back.
Thank you for all the positive thoughts, prayers, kind words, and offers for support. Given Debbie’s track-record with healing, seizures and all that is surely to come, the next year is going to be challenging, so keep them coming!!! With a little luck though, 2023 may be the year that our lives were given back to us, and we get Debbie back on her feet!!!
Dan