I now have a twelve inch scar on each leg that runs from my hip to a few inches above my knee. That’s where they took the skin to save my foot. Twice. After spending three weeks in the hospital, I’ve been home for almost a month, and things are looking up. I still have a few more surgeries in the coming days and months, but they’ll be incredibly minor compared to what I’ve been through so far.
A little over a month ago, I went in to the hospital for my sixth surgery in three months to help me turn the corner with my foot problems. This hasn’t been a series of botched surgeries, but rather a sequence of progressively invasive surgeries and preparatory surgeries that we all would have preferred to avoid. Unfortunately, my foot had other ideas.
This most recent surgery involved removing a large piece of skin along with the underlying vascular tissue from a donor site on my body and using it to cover an exposed wound. Because of the need for vascular tissue, a flap is much more invasive than a skin graft. Once they removed the flap from my thigh, they’d be reconnecting it to a blood vessel in my foot. Then, my thigh would either be closed or need a skin graft to help it heal.
That hospital stay was planned to last 5-7 days, but due to complications, it ended up being three weeks. The initial surgery was scheduled to take 6-8 hours, but due to complications once they got underway, it lasted nine and a half hours. My wife had to wait a full twelve hours until I was out if recovery before she could see me. They were updating her regularly, but it never feels good when a surgery doesn’t go according to plan.
Coming out of the surgery, all I remember is the pain. However, the pain wasn’t from my foot or the first incision. It was from my arms being laid out, palms up, for almost 10 hours without being moved. For the next two days, in addition to recovering from the surgery, I couldn’t extend my arms.
At this point, I was in the ICU where nurses and technicians were monitoring the flap and my vitals every hour. If you’ve never been in an ICU before, people are in and out constantly. Sleep is incredibly difficult to come by, and the days just kind of run together.
Of course, I was also connected to a bevy of monitors. On top of having cords running everywhere, this made matters worse because the monitors had alarms if any of my vitals dropped below a certain threshold. Unfortunately, my resting heart rate is low due to years of playing basketball. Combine that with some narcotics for pain, and as soon as I fell asleep, my heart rate would be low enough to trigger the alarm. So, even when I did manage to fall asleep, the alarm would immediately wake me back up.
I was told that flaps rarely fail after 48 hours. Unfortunately for me, right around 48 hours, my first flap started showing signs of failing. We gave it another day to declare itself, and I went in for my second surgery. This time, the flap came from my good leg. Like the first surgery, this one went long as well, and I was under for 9 hours again. The worst part of this is that this was the leg I used to get around. It would be over a week before I could put any weight on it again.
It turns out that being in ICU is a lot to handle. The pain, narcotics, and lack of sleep or even getting out of bed add up. As a result, I had a run-in with a bit of anxiety. I’m not really sure why, but apparently it’s common enough that the doctors and nurses took it in stride. In hindsight, I guess being stuck in a bed in a hospital room after two invasive surgeries and without sleep for a few days takes more of a toll than I expected.
After a week in ICU, it was time to be moved to a normal hospital room. I believe it was around this time that we moved to checks every two hours instead of every hour. Eventually we went to every four hours as the second flap looked like it was going to make it. Of course, I still had to get a blood thinning shot every morning at 5am, so sleep was still a luxury to some degree.
After a day or two in the normal hospital room, we wanted to try and get me from my bed to a chair, a simple enough task. However, when both legs and one of your feet are really beat up and you have a drain attached to each leg wound, this isn’t an easy task. While I expected it to be challenging, I wasn’t even remotely ready for the shot of pain in my leg when I put weight on it for the first time in over a week. That pain would linger for the next week or so and make getting out of bed really rough, but I had to do it.
After about a week in my normal hospital room, we began the process of dangling my foot. With a flap relocated and connected to a new blood source, it’s key to make sure that blood is flowing alright so that the flap doesn’t die. Given the fact that I was on my second flap, we were really conservative. The first time that I lowered my foot, it lasted for about thirty seconds before we decided to raise it again.
Over the course of the next week, the process increased in duration and frequency. The goal was to get my foot to being comfortable being down for 25-30 minutes at a time. It started slowly, but then we were increasing it by about 5 minutes each day.
During this process, I also began walking again with the assistance of a walker and a physical therapist to make sure I didn’t fall over. Being in bed for two weeks with a couple of surgeries and a beat up “good” leg make hopping along in a walker a challenge. I was still only weight bearing on one foot, and my upper body was weaker as well. So, going even 10 feet was a challenge at first. Eventually, I was able to make a lap around the entire floor with just a single break.
Spending three weeks in the hospital was unexpected and challenging, but the staff at UT Southwestern blew me away. Every single person that I met was incredible. Patient. Kind. Helpful. Understanding. I can’t explain just how much they helped me get through this and back on my feet. (Back on my foot?)
All in all, it’s been an incredibly long journey, and one that’s not over yet. With seven surgeries down and at least two more to go, I’m not out of the woods just yet. Thankfully, the worst of it is behind me, and I’ll hopefully be walking unassisted again in the next couple of months. My legs have healed to the point where I barely notice the wounds on my thighs, and I’m back to using crutches and even putting a little weight on my bad foot.
So here’s to hoping the upcoming (minor) surgeries and physical therapy go smoothly and that this whole experience is just a blip on the radar of life by the middle of 2014.