Adventure Update - and potential Additional Chapters....

Life does tend to catch up with us - and get away from us - and so it has with this. I had every intention of continuing this blog and whoops - here I am not quite two years later and have not mentioned a thing. So - to catch up..... After that MRI that I had in 2011 - the doctor felt there were no real changes in my ankle. The OCD was still there and not much had changed. He recommended a shot of cortisone - which I agreed to. He advised I might want to have crutches available for three-five days in case the ankle was painful or unstable - which I took him up on. The day after the shot, I attended a university football game to watch my daughter with the band. That day a freak October snow-storm (more like a blizzard) started just as the band was welcoming the football team to the stadium. That snow continued through the game and into the evening. Trying to crutch through the snow was a real adventure. The stadium offers trolley service for those that need it. After half-time, I went to find the trolley to take me back to the bus (to parking) only to be told because of the weather, they shut down trolley service! Finally, they put me in a wheel-chair and tried to push me through the six inches of snow/slush and ice. As you might imagine, it didn't work. So I put on my big-girl panties and crutched my way to the bus - and once at the parking facility - to my car. Actually, crutching in that mess wasn't that bad. I could securely plant my crutches into the snow/slush/ice and they would hold solid while I "stepped" to the next safe spot. Crutches are also quite useful in clearing snow/slush/ice off of car windshields! So after the cortisone shot, the ankle was no better, but my surgeon was stumped. He felt perhaps we could try a lubricating injection or plasma-rich injection. However, my insurance felt those were all "experimental" and wouldn't approve them. So - I just coped. For the next 18 months - coping was all I did with the ankle. Sometimes it seemed "perfect" - no catching, no locking, no pain. Then there were the days/weeks when that's all it had - catching/locking/PAIN. A couple of ER visits when it went out on me very badly and swelled up - but all they could do was check to make sure I didn't break it and put me in an aircast and crutches. Finally, several weeks ago, while stretching the ankle suddenly and very loudly went POP!!! Pain and swelling accompanied it. I thought of going to the ER - but passed on that decision - knowing they would only re-x-ray and pronounce nothing broken/nothing to be done but rest it. But what I did do, was contact a new orthopedist - one highly recommended by my primary - who was in my new insurance. Got an immediate appointment with him. He looked at my old scans and told his PA in the hall - "That thing is HUGE! Huge I tell you!" and then told me - "its a very big OCD". Also at problem was where it is on my talus - on the corner. So much so, that he would not do any surgery on it himself as he felt an OATS or other surgery would be pointless since it would easily fail (by breaking off the corner again). His recommendation was a referral to a specialist who had developed a technique of using a cadaver talus to fill the OCD. But first a new MRI. While waiting for my MRI appointment, I checked online about this new surgery potential. Very big surgery. Full ankle exposure - almost double the recovery time. Enough to make me pause on this... The MRI went without issue - except my ankle felt worse after it was over. When I called the office to check with my doctor about it - he called back with the MRI results. Seeing the new MRI - he was now comfortable in recommending another shot at microfracture and debridement (what I had in 2010) rather than the cadaver surgery. I see him on Monday to actually review the films with him and to talk about/schedule surgery. Seems like we are back on this merry-go-round for another ride. Oh the joy of it!

Back on the Merry-Go-Round

So. I am now 17+ months post surgery. Been able to lead a fairly normal life (at least normal for me) over this time - and so have not had the urge to write.

Perhaps before I go any further - I should recap.

*Surgery - debridement and microfracture - was in late April 2010.
*I began PT in May 2010 and continued into October when there was an issue with my insurance coverage.
*During longer walking trips, the ankle started catching and even locking.
*By March 2011, all my insurance issues were resolved.
*In April, I chaperoned the HS band trip to Disney World. While the trip itself was a joy - my ankle was not joyous.
*Once back from Florida, I called my primary care physician. After examining my ankle thoroughly, he put me back in an air cast temporarily, and on a regimen of Naproxen. Eight days into the Naproxen therapy I had to stop because it affected my blood pressure.
*On follow-up with my primary - he now thought perhaps I was suffering from tendinitis and sent me back to PT - with a follow-up half-way through the process.
*PT was uneventful. Yet the pain the my ankle continued and issues with catching and locking increased.
*Again, on follow-up with my primary - he now felt we "went at" the ankle from every angle - and there were still problem - so he decided to send me back to the surgeon.

This brings us pretty current.

Yesterday I saw my surgeon. First - a set of new x-rays, and then into an exam room so he could see me. His first words to me - "You're back?" and then after we chat about the ankle he says - "Don't tell me you tore MORE cartilage?"

He checked the x-rays and they are inconclusive. Based on my symptom-ology though, it seems I have most likely got "something" floating around in the joint. When it's floating "free" - things are good - when it gets stuck - the joint locks and I'm in pain. He also showed some concern in the area where he removed a large amount of inflammatory tissue.

So - it's off for a new MRI to better see what's up in my ankle.

And then we go from there...

:::::Why do I think its going to be another surgery and more months on crutches?::::::

Do I want to ride this merry-go-round yet again?

May have no choice.

MRI

So - the surgeon referred me for an MRI. The first hospital that I was referred to couldn't get me in until the end of June (and by then I am hoping to be healed and on my road to recovery). I called a second hospital and they were able to get me in yesterday - so I jumped at the appointment.

Everyone at the hospital was nice and cordial. They did everything in their power to make me comfortable and happy.

The tech who did my MRI was wonderful. He explained things to me and answered all my questions. He warned about the noise and handed me headphones with "background music". I put them on and it was a "soft music" station - but they were playing some stuff with a good beat. Kind of hard not to be tapping my toes to the beat. ;-)

So this was my first ever MRI. I savored the entire experience.

I had to jump up on the table and place my right foot and ankle into this contraption that was similar to the bottom half of a foot/leg cast. The foot had to be flexed so that the tendons could be seen more clearly. (This was painful in and of itself - flexion for an extended period....) Once I was in this contraption, the tech placed the other half of the foot portion of the "cast" over my toes and lower arch, and then another piece over the lower leg. He told me not to move - and I seriously doubt I could have moved my foot/ankle even if I wanted to. The uninjured, free leg was simply laying next to the whole contraption.

I laid down with the headphones and was slid into the machine. Since it was an MRI of the ankle, I was in to about the "empire" line (for those that don't understand that - just below my breasts).

I was fascinated by this whole process. The machine showed when the radio waves were being emitted by flashing a little "lightening bolt" on one side. The count-down clock was ticking on the other side and I could follow it for the length of time each particular wave set was going. Two minutes, three minutes...repeated over and with different sounds for each group. (I asked about the different sounds and the tech did say that there were different radio frequencies so that's what I was probably aware of). If I didn't have my contact lenses in, I probably would have snoozed off during this whole thing! :-D

I was really good through out until the last four minute "blast". Whatever that particular frequency was, it was uncomfortable on my ankle. While not painful enough to make me cry or cry out - it was enough pain to make me wince and it lasted through much of that four minute barrage of waves. The tech was surprised I "felt" it - but said it does happen on occasion.

Afterward, I got copies of both the films and the disk with all the shots of my ankle. Of course I looked at them, but I have no idea exactly what I'm looking for - so it was an exercise in futility.

The ankle felt no better - no worse - after this test. It still hurts and I know it will until the surgery.

Stopping at church for the fish fry later that evening - the minister was asking me about the ankle. When I told him I was definitely having surgery - he seemed saddened and concerned. I told him in my happiest voice that I was THRILLED to be having the surgery - because it was going to FIX the problem and I was not going to be hurting all the time any more. (Of course I know there will be pain during the healing and recovery process - but that is different than this pain.)

As soon as people start realizing that I'm happy to be getting this done and stop this kind of pain and limitations on my daily life - I will be a much happier camper.

Pain index - 1-no pain and 10-worst pain ever....
Pain index for Friday - probably 4-5
Pain index for Saturday - about 3-4 so far.....

Yes! We have a surgery!!!!!

So - here we are - no more history - in the here and now...

Today I saw the new surgeon for the first time. I actually liked him. He is a specialist in ankle and foot issues.

He apologized when he came in, for taking time to get to me, but he said he was reviewing my CT scan films and the x-rays I had brought along. After taking a brief medical history, he examined my ankle - actually, BOTH ankles.

Does this hurt, does that hurt, can you feel this, can you feel that...

I can feel you, ah - that's a sweet spot....that's ok - aye - now that hurts....

He took me in the hall and slowly took the time to rotate the images from the CT scan and show me exactly where the lesion was/is. He pointed out on the x-ray precisely what we were looking at....

Back in the room, I'm told - you've had this now for two years, and its not gotten better - you are a good candidate for surgery. (Did I want to hug this man or what????) He explained he would like me to have an MRI so he would have a better idea of what he's looking at. I told him my time concerns and that I'd like to have the surgery done as soon as possible after guard championships.

His response was that going to championships with the kids was more important than surgery....(Did I want to kiss this man or what?????)

He also said that given that time frame, there was certainly time to get the MRI done as well. So I'm good with that. His office called me shortly after I got home with the approval code for the MRI...sadly, the hospital where I was to have it doesn't have an appointment until the end of JUNE!!!! Now I need another pre-cert....

Microfracture surgery is most likely what we will do, perhaps repair the cartilage or maybe even drill - this will depend on what he sees in the MRI and when he finally gets in there. It may be done arthroscopically - but he did warn it might be open - again, depending on what the findings are...

He feels if I have the surgery in April, I should be good to go for marching season and definitely good to go for my own season in November....

Had problems finding where to put the ankle/foot last night to sleep...finally fell asleep from exhaustion, but woke while it was still dark to throbbing....after he prodded and poked - it throbbed...it is swollen....

BUT I'M GETTING FIXED!!!!!!!

Oops - maybe I should re-phrase that?????