Tuesday, April 20, 2010

Foot updates

We had quite an eventful day yesterday…
First, we went to have blood drawn for the kidney doctor (see him next week). Then we went to see the new plastic surgeon/wound specialist. He looked at Ron’s foot for quite a while and came up with these suggestions:

• Get the brace changed in such a way that it offloads more pressure off the wound.
• Get better shoes that provide more support and so he doesn’t roll as much to the outside of his foot.
• Operate on the wound, shave off some bone, and add a wound VAC to it.
• Operate on the wound, shave off some bone, take a flap from the top of his foot and wrap around the wound, and then take a skin graft from his hip back down to replace the skin on the top of the foot. The flap is to provide a good blood supply (unlike a skin graft, it won’t have to “take”) but since they’d be taking quite a bit from the top of the foot he’d have to have the skin graft.

No matter what he chooses as far as approach, we still have to get work done on the brace to make it offload more pressure. We saw the orthotist yesterday afternoon also and he worked on the brace some and took one of the orthopedic shoes and put it in his stretcher to see if he can expand the toe box enough to accommodate the brace. I’ll pick it up Thursday.

In either of the operation scenarios, he’d have to be non-weight bearing for at least 2-3 weeks. This leaves a big concern for me. He is unable to maintain his balance, especially if he is having one of his “shake” days. With only ½ of his left foot, and no upper body strength because of his neck injury, and since he also needs knee surgery, he would need nearly around the clock care. He is against having a wound VAC put back on his foot, and we’re not even sure they’d let us since we still owe them nearly $4,000 from 2008 (I pay over $100 per month on the bill). I’m not sure his insurance would pay for him to be in a skilled nursing facility but the doctor did say they would at least keep him overnight and maybe an extra day before they sent him home. Thinking about lifting him and getting him from point A to point B has me terrified.

Dr. Khandlewal (the new guy) sent dad right from his office over to St. Francis to have a vascular ultrasound of his legs and feet to make sure he’s got good enough circulation to even consider surgery. The test results will be sent back to him. In the meantime, he has an appointment on Thursday to see the wound care team at St. Francis and they are also going to try and get him in to the lymphedema specialist at the same time. The lymphedema nurse will teach me how to do the compression wrap. Dr. Khandlewal will see him back in the wound clinic 7-10 days from Thursday, but since he’s only in the clinic on Thursday afternoons, it will most likely be the 29th.

We’ll continue this non-invasive approach through May to see if we can get better results and healing and then consider more invasive treatment if necessary. There’s not really anything anyone can do for us but if I could have some of the house pressures taken off my shoulders that would help; there’s really not anyone to do that. I need some yard work done, I need Maisey’s area fixed so she can’t get out, I need the areas that are affected by downspout runoff turned into “river bed” type of things with rock to help direct the runoff and not create a gully in the yard. I hired someone to mow every week but I’m afraid the $35 per week charge will really add up fast. He won’t do a hit and miss type of job – it’s either all or none. I still need our downstairs finished so I can get it cleaned and get carpet ordered/installed.

Ron has at least three appointments next week – one on Tuesday and two on Thursday.

I need, I need, I need. LOL – selfish of me, eh?

I'm actually in a very good mood. Not happy about the situation we're in but definitely not letting it get me down. I am concerned, of course, about the long-term ramifications of any further surgical work on Ron's foot but I also have to be realistic and know that we've worked on this for far too long and all we get is nowhere. It's good that Dr. H sent us to another surgeon for some new thoughts and new ideas. I was just hoping they didn't involve anything nearly as drastic.


Pat said...

At least you have some options to chose from, and go from there. That's better than hearing, "There's nothing we can do for him."

Hang tough, girlie. I think about you all the time. :)

Kathy's Klothesline said...

Thinking of you. Hope for the best results. Hey, I would mow for you if I lived close by.......

Donna B said...

You are AMAZING!