Our chat with the Plastic Surgeon

Now that all of our proverbial "ducks" are in a row medically (had the ultrasound which revealed a clot in my right leg;  Had an inferior vena cava filter inserted and was started on temporary high-dose anticoagulants to deal with that clot;  Had an angiogram to give the plastic surgeon an idea of the vascularity in my lower extremities, three incision and drainage procedures, and began a course of prophalactic antibiotics), we are scheduled to go ahead with the reason that we're here at Froedtert.  

The plastic surgeon came by late Friday to discuss the 6-7 hr grafting / tissue transfer surgery that I will have tomorrow.    All the folks I talk to here mention what an awesome plastic surgeon Dr. Logiudice  is (and Dr. Schmeling , my orthopedic surgeon claims his success rates are extremely high.).    He seriously looks like he could still be in high-school....well, truthfully, LOTS of the medical docs look incredibly young to me.   Guess that means I'm getting old.  ;)

Here's the Scoop :
I learned that, because the tissues surrounding my ankle are incredibly thin (feel them on yourself....there is hardly anything there), and the hardware/bone is directly underneath the skin,  I will be having procedure called a Free Flap.....in which the surgeon will transfer a portion from my gracilis muscle , along with [self]donor skin tissue to cover the affected area of my inside lower ankle.  Again, because of the initial high-impact trauma to the soft tissues in my ankle and resultant swelling, this is apparently not that uncommon.  

As I (naturally) inquired about the extent of cosmetic damage and scarring involved with this surgery, Dr. Logiudice did state that it would be a bit bulky and may take several months to a year to look more "normal."   He went on to say that he will do his best to minimize cosmetic scarring (for example, obtaining tissue from as far up the inner thigh as possible, and pointing out that the inner ankle is a less obvious location than the outside of the ankle).  I segwayed a bit and told him about Jade and Kai who are both cleft-affected, and how, with Jade in particular, we are continually reminding her of how beautiful she is despite the keloid scarring on her upper lip.  I admitted that, despite all of my assurance to my child, now it is time for me to embrace this understanding and it is really hard.   

Dr. Logiudice gracefully reminded me that I literally smashed my ankle.   Really.  In his words:  "Chris if you would have had this climbing fall in another country, or even many parts of our own country [where there is no access to trauma center with cutting-edge medical technology], we would not even be having this conversation.  There used to be, and in some places still is no other option other than amputation."   (gulp...)  The term he used I believe was "limb preservation," and yes, we recalled that this is an acceptance thing and regardless of how ugly things may turn out, I really have no choice in the matter.   He smiled and reassured me that I will do fine.    Sigh...

Sometimes to get exercise while I'm here, I will do "laps" in the wheelchair around the 5th floor and through the other units.   Those include neuro, spinal cord injury, and stroke.   Lemma tell ya, when I get back to my room (despite how sore my ankle or sacrum is) I feel really blessed.   Man, some of those folks are lucky if they will ever be able to talk or feed themselves or breathe on their own again....ever.    I don't know how I would deal with that and hope I never have to. 

Some people that I see here are always alone.   Every time I pass their room they are sitting in a wheelchair in the corner or laying in bed.  Really, really sad.  I am lucky to have a husband that has stayed with me nearly every night, and parents and a mother-in-law who we trust to take good care of our kids. I have wonderful family and friends who have stood by me every step of the way (excuse me as I wipe a tear while writing this...), salt-of-the-earth teachers at my son's school and staff at Scott's school who are bringing meals,  and even a great hairdresser who squeezed me in for a hilight when I pleaded with her that I want to feel somewhat like a human being as I lay in a hospital bed for a couple of weeks (she went all out on the stylin' then....thought she'd give me some "come hither" curls that Scott would enjoy.   Hee hee....)  

SO...tomorrow is a big day.   Am I scared?   Heck yeah!   One of the internists that drops by my room almost every day to check in said "you'll do some grieving."  I'm kinda preparing for that.  There will be some pain, of course, but that's what good drugs are for.   I'm mostly concerned about needing to continue laying in bed with my ankle elevated for the weeks to come and how my sacrum will do with that.   (I ain't got no booty and that won't change until I'm up and able to do steps and other things that strengthen the gluteal muscles). There will be a six-week recovery period in which I will need to keep my leg elevated at nearly all times. I also learned today that I will need to refrain from drinking coffee and eating chocolate (seriously) because caffiene constricts blood flow, and we don't want that to happen in an extremity like an ankle. I do think I'm gonna ask the surgeon if red wine is okay though....because I hear it actually helps with blood flow! We'll see.... ;)


Keep those prayers and positive energy comin'!