Wednesday, July 9, 2008

In My Affinity with the Bionic Woman, I Was Sad to See the Series Was Cancelled

I suppose to start this story, you need to know that I have a plate and seven screws in my left ankle.

Fifteen years ago I slid into second base a bit too late and broke my left fibula and crushed my left ankle. I was really, really lucky I didn't blow out my knee, too. It was during the state softball tournament (FAST PITCH, slow pitch is for sissies) and we were playing our rival team. I was safe.Yay! Until I lifted my leg off the bag to see if the bone I HEARD BREAK was breaking through my skin. DEAR GOD.

Clear as day, as if the words were typed in the air in front of my face, I thought:

"If there is blood on my sock then I know it is a compound fracture and I will pass out."

There wasn't any blood or broken skin, but there was a really, really grotesque bump where the bone was sticking out. *GAG* Anyway, the second baseman tagged me out when I lifted up my leg for a better look. Bitch. I was so furious I elbowed her below the knee, brought her down and started crawling after her, ready to kick her ass. I used to be rather -- spunky. The umpire, a kid who was probably 17 years old, didn't have the slightest idea what to do with me.

The fractures were enough that I had to have surgery. Surgery, based on what the doctor I saw last week said, that was "major" and "traumatic." I was too young (17) and oblivious to really have thought all of that through. Good thing. The surgeon told me I could leave the hardware in there unless it started to bother me.

***
Well, it's been bugging me.

So, last week I went to an orthopedic center 60 miles away to have an orthopedic surgeon with an ankle specialty take a look. One of the screws had migrated out a bit (but not through the skin!) a few years ago and I've been worried it would keep going, break the skin (DEAR GOD) or cause infections in the surrounding tissue, plus all sorts of other overly imaginative possibilities inspired in no small part by the X-Files and CSI. Also, I've been getting some tenderness in the area every now and then, especially during and after exercising. I thought it might be time to have all that hardware removed.

The good news is that my ankle recovered from the trauma and surgery 15 years ago like a total champ. I've never had bad arthritis or really any stiffness.  The doctor was seriously tickled and said he rarely ever sees anything look this good. Yay! I told him about what activities I am able to participate in, including volleyball, hiking, yoga, fly-fishing in sandals in uneven, rocky streams, etc. and he was really impressed that I have such a pain-free ankle with so much movement. Apparently, I could have been hobbling around, wracked with arthritis. I was pretty ignorant of that possibility. Thank goodness I broke the bones when I was young, healthy and active! So, I am very, very pleased to hear this. And truly, I can't say that my ankle has ever held be back from doing anything I've ever wanted. (Except is is really uncomfortable to wear hiking boots, it really, really sucks to shave over the bump where the screw is *shudder* and to sit in Hero Pose.)

The kind of bad news is - I can decide to have the hardware taken out or not. My decision. The doctor thought there were some good reasons to take it out, including that he could scope around and remove some scar tissue and something else while he was in there. But he also thought it was a really wonderfully healed ankle and that it is not necessary. This was the worst possible news for someone as indecisive as me.

One of the screws has broken.



Graphic evidence for your viewing pleasure.

I guess this happens all the time to the screws that cross a joint. Anyway - GROSS. So, the head of the screw that broke did indeed move out a bit but most likely is done migrating. HOLY HELL, I sound like I am writing about an alien in me or something. Oh, the nightmares.

There is also some calcium/bone tissue growing around that same screw. This didn't overly concern the doctor, and he didn't think it would turn into an issue down the road. I am having a hard time wrapping my mind around this. It really won't -- say -- fuse to the other bone or grow large enough to start to impede my range of motion? This area (and the fact that the screw that has migrated rubs on my hiking boots and HURTS A LOT and totally grosses me out) leads me toward considering surgery.

I am young enough that supposedly I am still able to deposit calcium in my bones. Wouldn't it be a good idea to have the hardware removed now, while my bones can heal while adding calcium rather than later, when bone density and strength are a much bigger concern? But - I healed wonderfully from the first surgery. Should I leave well enough alone? Argh. Plus, going under again? Scary.

I have lots of thoughts either way, and of course, have come up with a slew of questions I couldn't think to ask while at the surgeon's office. I have copies of my x-rays, so I think I am going to get a second opinion. If it looks like I should have surgery, I will go back to the OCoR to do it. (Many colleagues and friends have gone there and every last one of them has been very pleased with their care and results.)

(A surgeon friend showed another ortho my x-rays and they agree that just removing that one screw would be best. Leave a well-healed trauma site alone, and all that. Also, they are both wary of scoping if I am not actually having trouble with the ankle. I am really leaning toward this decision, myself, and plan on calling Consulting Surgeon Number One to discuss this.)

Oh, the indecision!!

14 comments:

  1. Okay, this kind of gave me the heebie-jeebies but still very interesting! I had no idea that screws could back out (EW EW!!) Glad you're not feeling any real discomfort with all that metal in your leg! ~LA

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  2. I'm feeling a little woozy after all that, but I'm still laughing at spunky 17-year-old Artemisia going after the second baseman!

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  3. Well, I just shoved a gigantic piece of sandwich into my mouth before I saw the x-ray and THANK YOU. Gah. That migrating screw creeps me out.

    Can I say I laughed so hard at the thought of you taking down that second baseman? I would've kicked her ass too!

    Hmmm...this is a tough decision and I'm glad you're going to get a 2nd opinion. Although I was excited to see that just removing the screw head was an option; that's probably what I'd choose to do as well. That way, you still get rid of the screw that's impeding your comfort in hiking boots, while leaving everything else that's OK alone. Seems the least invasive.

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  4. OMG, that screw thing is SO GROSS slash AWESOME.

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  5. Good luck deciding! I also had to decide if I wanted parathyroid surgery or not, and if so, when, and although the answer seemed to be very straightforward in my case, it was still a difficult decision. Good luck figuring this all out.

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  6. Dude you are INDEED still spunky. I wouldn't be able to even TALK about this stuff let alone LOOK AT THE XRAY WITH THE SCREWS. Wow.

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  7. I am so impressed with you! I mean, I knew you were cool, but you are also HARD CORE! Awesome!

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  8. Oh, eek, ow.

    I have nothing to offer except sympathy.

    and cockatails, if you're in my neck o' the woods.

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  9. how would the recovery from the screw-head-removal be? like, would it require crutches? hobbling? casts? etc?

    i had foot surgery on one foot and will likely need it on my other foot soon too, but the recovery from surgery #1 was SUCH A PAIN IN MY ASS that i am holding off on surgery 2 until i'm sure that the shitty recovery period (vicodin, crutches, pain, no driving for weeks on end, the like) will be LESS ANNOYING than the pain that's driving me to get the surgery in the first place.

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  10. Alice - if I have just the once screw head removed it will be a 10-minute in-office procedure WITH LOCALIZED ANESTHISIA at the site while I AM WIDE AWAKE.

    Even if I were to have all stuff removed, I'd be in a boot for two weeks and back to 100% in four weeks or so.

    As you can see, it is the wide awake while someone opens me up, drills out a screw, etc. that has me the most worried.

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  11. Ok - how funny is the spelling of anesthesia up there?!?!?! HA HA HA !!!

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  12. That is so fucking awesome. I am so glad you gave us x-ray documentation.

    I would leave at least one screw in so you you could screw with people the rest of your life by making screw jokes. I certainly hope you currently make use of lame-ass puns at your disposal. Things like "the medical system totally screwed me", and "yeah, the doctors put the screws to me", or "I screwed up my ankle back in the day". I would keep a wallet size x-ray on my person at all times, and whip it out for people after speaking each cheesy pun.

    God, I'm such a dork.

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  13. Hey there.... I know this is a couple years late but i am currently in a smilier situation than you were.... I fractured my right ankle and had a screw placement 5 years ago.... now it starting to bug me and the physician said i could possibly have it removed.... did you do the procedure and how did it affect you?
    thank you for your time... kendal
    please respond to Kenomdahl@aol.com

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