In which I make a post ankle replacement update while hopped up on Vicodin.

If you aren't already familiar, episodes 2 and 1 are available for reading. I won't go over it again because that would be tedious. Here's the rundown of life since my Total Ankle Replacement surgery in January.

The surgery itself went pretty well. There was a small complication where the amount of bone required to be cut caused the end of my fibula to break off. This is of small consequence since a plate gets put over the bone in that location anyway. A plate is used because the tibia and fibula get screwed and fused together in order to firmly secure the top portion of the appliance into place. But enough about the boring stuff!

Two weeks after surgery I had a follow up appointment to get the bandages off, remove stitches and be put into a cast while healing continues. The long cut that was made from the top of my foot and over the ankle healed perfectly, and did the smaller cuts that were made to cut and lengthen tendons in my calves. X-rays are taken which reveal that a small screw placed into the fibula plate has come loose and is now floating in the soft tissue of the leg, just below the second large incision on the outside of my left ankle. This wound was also not healing properly so stiches were not removed yet.

Two weeks later the option of leaving the stitches any longer was not on the table. So, out they came. Since the wound was messy, they decided to trim away part of the skin beginning to form. After much prodding, the nurse found and retrieved the approximately one centimeter screw from my wound. This was most likely the cause of improper healing. So there I am with a small hole in my leg that requires twice daily gauze changes. For those not familiar, that means that twice a day, sterile gauze gets doused with saline solution and is pushed into my ankle wound until it fill the cavity. It really is as gross as it sounds.

Expecting a decent speed of recovery, I didn't let it bother me too much. Subsequent visits to the doctors office did not leave me much to be hopeful about. It seemed that the cavity continued upward the entire length of the cut. So, they cut open the top portion as well. You see, wounds need to heal from the inside out and having it heal closed while a gaping hole was below would only cause infections and other nastiness. In the case of an ankle replacement, the bone and appliance need to be protected in a very aggressive manner.

So there I was now with two, yes TWO holes in my ankle. I guess really it was just one cavity with two places of entry. No matter. Now, three times daily they needed to be packed with fresh gauze to keep it clean and absorb the blood discharge. At this point, At this point I started imagining about how terrible the whole experience was to turn out. Might I really get my wish and need my foot cut off?
After yet another week of bandage changes the doctor declared that it was time to take more drastic measures. It was decided that the wound needed reopened completely. An outpatient surgery was needed to open, clean out and fit the wound with a Vacuum Assisted Wound Closure. This is also referred to as Topical Negative Pressure. A special type of foam is cut to fit into the wound. It is then sealed with a plastic sheath. A tube runs from the foam to a small device that keeps suction on the wound and has a canister for blood and fluid. Every other day a nurse comes to the house to change the dressing and care for the wound.

The short of it is that I'm not out of the rough yet. I can't begin to put more than partial weight on my heal until the wound heals. I also have extended physical therapy to endure as well.

That's all there is for the time being, I sure hope you weren't expecting a happy ending.