surgery

A Brief Litany of the Woes Experienced By My Family, Fall 2009-Present

Kidney cancer (in an image I won’t forgot anytime soon, I handed the phone to my sister so she could be told while she sat on top of my car at the beach house, fixing the bike rack)

Lumbar puncture

Post lumbar puncture blood patch

Kidney removal

Post kidney removal kidney failure

Pancreatic cancer

Pancreatic cancer surgery

Broken ankle

Surgery to repair broken ankle (ORIF surgery)

“Yes, this is the minute clinic. You might be having a stroke. Better go the ER”

“Yes, this is the minute clinic. You might have meningitis. Better get to the ER”

Giant hernia requiring major surgery removed

“Yes, this is the minute clinic. Because you just had antibiotics for another sinus infection, I cannot give you anything else. You’re allergic to too much. Better go to urgent care.”

“Yes, this is your university. Yes, we are being assholes about this, and this, and this. Suck it up, where else are you going to get a degree?”

Stage 4 bladder cancer

Strongest chemo drug known to man, given in four cycles, at nearly twice as much the normal amount

Radiation given

Insane side effects that I won’t even get into

Modified Brostrum procedure attempted on ankle, where it turned out there was no ligament: surgery failed

Job loss

Ankle reconstruction, hopefully successful, for the second time in 4 months. Lots of pain.

Turns out this kind of cancer gives one a prognosis of two to three years. That’s fun news to hear on a Thursday!

Also today: air conditioning not working (high today was 102, with a heat index well above that); roof leaking like crazy; pink eye, COBRA not working.

 

Universe. Give us a fucking break, already. I’m thinking swim up bar.

 


Ankle Stuff Part Six Thousand Three Hundred and Forty-Two

This slideshow requires JavaScript.

So I went to the doctor for my first post op. Here is what I learned:

1. this much pain is normal.

2. there was a tunnel drilled into my fibula to pass a tendon through.

3. said tendon came from some other tendon that had torn that he harvested from.

4. he believes it will provide “excellent stability” which, yay!

5. I don’t have to be on crutches which is excellent.

6. it will be 4 months to running.

7. and then another 2 until I can jump etc.

8. no waterproof cast, boo. if any water gets in I have to get it changed immediately or it will get horridly infected.

9. there were staples. the staples had to removed. my cast is black.

10. here  are graphic and gross pictures!


An Approximate Surgery Timeline

@font-face { font-family: “Cambria”; }p.MsoNormal, li.MsoNormal, div.MsoNormal { margin: 0in 0in 0.0001pt; font-size: 12pt; font-family: “Times New Roman”; }div.Section1 { page: Section1; }

1230 Arrive at hospital. Get bracelet-ed up.

1240 Arrive at surgery center.

110 Taken back to surgery area. Rather than a stretcher they have a big chair. Give them some urine to confirm my not-knocked-up status. Change into an ugly gown.

130ish Give nurse and then adorable Med Student Chad my medical history. Med Student Chad is only on his second week of ortho and is fascinated by my ankle. Move the ankle around in it’s freaky ways to show him.

2 Tell nurse I’m anxious and am always anxious pre surgery. It’s true, ever since they left me alone for an hour in a surgery center before my tonsils came out many years ago and I had a full blown panic attack. Nurse says that the OR that I am booked in is running late and so my anesthesia doctor is not available.

230 My surgery is scheduled to start in 10 minutes but they are running late. Summon nurse. Tell her that she if she leaves me alone for much longer I am going to start having panic attacks.

240 A totally random anesthesiologist arrives and informs me that he cannot give me anything good because he isn’t working on my case. Would a valium help? It would help SOME, I guess, I tell him.  As he’s arriving my surgeon, Dr. McGuigan, arrives and asks if I have any more questions.  I don’t, really.

300: Med Student Chad reappears. Still waiting? he asks, and I say yes. Mind if I join you, he asks, and I say no, not at all.

3-340: Med Student Chad sits and talks to me for quite awhile. He is funny and interesting and it is very helpful to have someone distract me. We talk about how he is having trouble figuring out his specialty because he doesn’t get to rotate through everything he’s interested in. And other random stuff. I also showed him more ankle tricks and he was fascinated. It was adorable.

335: Another nurse finally comes in and says that they are coming out of the OR. Now they have to clean it. Just get the blood off the floor? I say, and she laughs and says something like that.

345: Anesthesiologist shows up with her nurse. I don’t especially like the doctor herself—I don’t dislike her either but she just isn’t terrific—but the nurse is very sweet. She inserts a needle into my arm with some numbing stuff in it and then tries to start an IV. It does not work. She tries again and again. Still nothing. She goes for my hand. Nope. There are now bruises everywhere she tried, and may I say, thank goodness for numbing stuff inserted BEFORE she starts messing with a bigger needle. Apparently the fact that I haven’t had water in 30 hours means that my veins are not interested in popping up. There’s no choice, the nurse says, they have to take me back totally awake and put me to sleep with the gas. Somebody checks to make sure that the doctor initialed my right leg. Med Student Chad jokes that otherwise they might amputate it. Drug Nurse says that isn’t funny. I say it was. Drug Nurse tells my mom they’ll take care of me and they start to wheel me back.

355: I am definitely a little freaked out and feel tears gathering at the corner of my eyes. Normally they start the knocking out process BEFORE one gets to the OR. It’s freezing cold and someone brings me a warm blanket. Every descends on me all at once, lifting the sleeve of my gown off, attaching EKGs sensors and pulse monitors, etc. It’s a bit overwhelming.  Drug Nurse puts her hands on my face and tells me to take deep breaths. The gas smells gross and gassy (technical term) and I feel myself drift off slowly.

4-645ish: Surgery. I have the operative report but I have no idea what it means. Apparently I was draped and cleaned and then the leg was exsanguinated and a tourniquet applied, which basically means they sucked all the blood out of it and then cut off blood flow to the leg. Hmm. Also, apparently there was all sorts of gross sublaxation and gross laxity and gross instability. Dense scarring was  found as well as a kind of stitches. Something called a rotary sucker shaver was used to debride areas, which apparently means sucking out the dead parts. Or something. Blah blah blah, basically I gather it was really fucking lose. He took, I gather, a 5 mm graft from another tendon ad did some sort of weave involving a tunnel in a bone. WEIRD RIGHT?

7-8: waking up. Slowly. I kept waking up a little bit and saying I was OK only to have the nurse push me back into bed (gently!) and tell me my blood pressure was still high, etc. I got more drugs. And my blood pressure kept getting checked. I drifted in and out for quite awhile before they finally let me go to the other recovery area, where I met Nicole and got my favorite part of the surgery, the post surgery drink and crackers.

9ish: They took my blood pressure one last time and explained the antibiotic/other drugs to me. I fell asleep so Nicole signed for it instead.

930: When we got home I couldn’t walk even on crutches. I crawled up the hill, up the stairs, into the bathroom and into bed.

Since then I’ve been in a fair amount of pain. The ankle hurts every time I move, especially to stand up. I think it’s partially the blood rushing to it. If it’s still and elevated it’s more tolerable, just a general ache rather than the sharp pain. When I move around though—whoa. I don’t like the way narcotics make me feel but I am not fucking around with this: we’re talking Percocet every 4 hours, an antibiotic every 6, and an anti-nausea every 8. Plus daily aspirin to prevent blood clots.

Overall this was a pretty good experience. The pain is awful and I HATED waiting for an OR but Georgetown exuded competence in a way that Sibley did not, and overall I think they did a  good job. The surgeon was apparently very confident that it would work and also very unhappy at what the previous ortho had done: when I get more details about that at my follow up next week I will post again!


My Stupid Fucking Ankle (Update)

Still hurts a fair bit. Dr. Ryan has informed me that he is still not sure if it will work  (“well, Vanessa, I just don’t know what to say about this…”) I told him that if I have to have more surgery I’d rather have it sooner rather than later and was informed that he’s not that pessimistic. It is…..frustrating. I can swim (though I haven’t yet) and bike (which I have done, and which feels okay for awhile) but no running, jumping, anything even remotely high impact. I started PT and it’s going okay, though my ankle hurts afterwords. My other ankle has been throbbing a bit as well, and the heel spur in that foot has kicked up like whoa–despite the cortisone shot I finally talked Dr. Ryan into giving me. I’m seeing a foot and ankle specialist at Hopkins in a couple weeks and I’m really, really, REALLY hoping he has some answers. I wonder if there’s an MRI or something that might show if this damn thing holds. I’m really frustrating by barely being able to exercise. Since I couldn’t at ALL for eight weeks I’ve definitely gained weight (okay, so there were some times when I felt rather defeatist about the whole thing and just ate cookie dough…) but anyway. I am frustrated. Really, really, really frustrated.

The semester is almost over and I haven’t been able to do any gymnastics practically since it started.

 

Grr.

 

 


Conversations With The Surgeon

So, Dr Ryan, I hear there wasn’t much to work with when you got in there–

There wasn’t ANYTHING! As soon as I cut open your ankle I should have seen a ligament, but I just saw bone.

Really? What ligament was it?

It was the one that goes from the fibula to your tallis.

Where’s your tallis?

It’s…never mind, it’s a bone in your foot. So anyway, I showed it to the nurses and then I started thinking. There’s one procedure that I can take a tendon from the calf and put in the ankle…

Sounds good!

Well, you can’t just do that when…something or other about I hadn’t signed off on that.

So I started dissecting further into the ankle and found some ligament in below the tallis and fibula and anchored it–

What do you mean by anchored it?

Well, I drilled a hole in the fibula and stretched the pieces of ligament I’d found and attached to them to the anchor I put in the hole.

So there are holes in my bone?

Yes. And then I stitched it together, which is why you can’t move your ankle, because if those stitches break…

There are stitches INSIDE my ankle?

Yes.

And you think this will work?

I think so.

So we shouldn’t try to do the other surgery now or anything?

Oh God no!

How will I know if it works?

I’ll know.

So…how can there be no ligament?

No one is born without that ligament. You must have torn it at some point and then it just got reabsorbed.

So…what next?

You’ll be in a cast for three weeks.

Ick.

Yea, yea. Your ankle will be at a slight eversion–nevermind, Mike knows what I’m talking about.

Okay…and then what?

And then you’ll be in a boot, and then rehab.

Yes!

Ha!

So 30-40% weight bearing. Be careful. BE CAREFUL.

I’m always careful.

Ha!

Can I drive?

Well, there’s a difference between can and may. You could, maybe, with your left foot…but I don’t know what the police would think if you got into a fender bender and stepped out with a cast.  I wouldn’t want to run into you on the roads.

You probably wouldn’t want to run into me on the road anyway.

Ha!

I put the video of my ankle and what it could do on facebook.

You know, what your ankle could do was really one for the ages. I’ve been showing it to residents at Sibley.

Glad I could be of service.


Steps to a Successful Surgery

1. Have something wrong that can only be fixed surgically. One option is an unstable ankle where the ligament is so stretched that, when your doctor feels it, he will exclaim “shit!” and when looking at the stress x-ray you will hear him say to the tech “oh my god, Mike, LOOK AT THIS.”

2. Schedule the surgery. If your doctor is amazing but his office staff is awful, this can be a very annoying process.

3. Receive documents in the mail that explain that you need a History and Physical before the appointment. Three days before the surgery, in fact. Note that the surgery is in a week. See: office staff.

4. Get in to see nurse practitioner at hospital where surgery will be. Basically, this consists of answering roughly 234232 questions about what kinds of medicine you take, whether or not you smoke, and how often you drink. Also if you are a druggie. Then she listens to your heart and checks your reflexes. If House is right and “people lie” this H&P just ain’t gonna cut it. On the plus side, the nurse says your surgery is at 9am Friday, not 10, as the office staff told you. See: office staff.

5. The day before surgery take a shower using Hibiclens, a bizarre pre-surgical scrub. Repeat the next morning, taking extra care to scrub the affected area for 2 minutes. Try making it to 2 minutes. Fail.

6. Arrive at the hospital by 7am. Say hello to the admin people. Wait around in a room outside 2West with a bunch of pieces of paper. Finally get taken back to a room.

7. Wait a little longer.

8. A tech at last arrives and starts quizzing you on your DOB, full name, etc. Tell her you get very anxious about general anesthesia and would like somthing for the anxiety. She says she’ll check on that. Take off your clothes and put on your gown, socks and sexy hairnet. Get in bed/stretcher.

9. Nurse. She attaches, but does not turn on, blood pressure, pulse ox, and EKG stuff. Mention the anxiety thing again.

10. Anesthesia Man. Anxiety, anxiety, you tell him. You aren’t actually feeling super anxious right now, but the time you had your tonsils out they left you alone for awhile, and you freaked out and told the doctor to call it off. You want to head things like this off at the pass. You tell him you get very anxious because you know someone who woke up during surgery (you do) and he says you won’t. You confirm he will be monitoring you and to your surprise he says they usually don’t but since you asked he will.

11. Nurse comes in and hangs antibiotics. She reassures you it will not conflict with any of the 23423423 antibiotics you are allergic too. She also says your pregnancy test was negative. You already know this, but on this one they never ever believe the patient.

12. Dad arrives! You play the last letter-first letter game with places.  He’s never actually played, which is amusing.

13. Surgeon comes in. You show him more ankle tricks. He rolls his eyes and says “don’t do that in front of me” and “after this you can’t do that!” We agree on a recovery time of eight weeks. He says “at LEAST for the weekend…” and you say “at least for the weekend I will stay in bed with my leg elevated and then on Monday I’ll go to school.” “See how you feel” he says and marks his initials and a giant fucking arrow over the appropriate ankle, just in case he forgets and slices open the other one only to find the plate he put in there last year.

 

14. Anesthesia Lady, whom you like more, comes in. She pulls a tube of some sort of anti anxiety something out of her pocket and says she’s just going to run it. She runs it and sticks it in your IV. You start feeling calmer. And more peaceful. Like a cloud.

15. Dad leaves.

16. Wheels up! Down the hall to the OR. It’s cold and you keep asking for more blankets. You think you read a compelling reason the other day why ORs are kept at 60 degrees but you cannot remember what it was. You ask why it’s cold but the person pushing says so it doesn’t get too hot for the surgeons under the lights.

17. The Anesthesia Lady strokes your hairnet for a minute as a the nurse puts two heated blankets over you. A mask is placed over your face. You remove it briefly to ask something. Then she puts it back on and says just breathe, and you do.

18. You are aware of some pain in your leg. You open your eyes and croak (since they shoved a tube down your throat while your asleep, croaking is the only thing possible) something about pain and nausea and going home. A nurse tells you to sleep and shoots you up with something for both.

19. You drift in and out, periodically complaining and getting drugs.

20. You start getting sick of the whole thing and attempt to sit up. It takes awhile but eventually the nurse, albeit a little reluctantly, takes you into a room.

21. Another nurse you recognize from last time appears. “Can I go home,” you ask, and she says almost. “Is that ginger ale for me?” you ask. “Yes, but yet,” she says. She makes you have temp check etc and then finally, FINALLY, ginger ale. SO GOOD.

22. Then you get dressed and have to wait for a little longer until a wheelchair arrives. An old lady pushes you down to the car. Your dad says the surgeon says that “there wasn’t a lot to work with there” and no one is yet sure what this means. Your dad apparently heard that a lot of ligament was ground down and they had to take ligament from elsewhere. The whole thing is really a bit confusing. He did mention the possibility of having to go back for more surgery, a possibility you have nixed if at ll possible: and now you are especially glad you had it done now.


Who’s The Boss of Rebecca Bross?

 

According to an article on IG, Rebecca Bross recently had surgery to her ankle, which according her was a “stress reaction” pre Worlds and was a “stress fracture” by the time Worlds was over (competing AA three times–prelims, TF, and AA–will do that you!)

There’s an interesting debate going on over at WWGym about whether or not Becca should have been allowed to compete. On the one hand, Becca is 17, and as one poster at WWGym pointed out, in most arguments with their parents, 17 year olds tend to win. They are not technically adults, but they are pretty damn close. And, after all, World Championships only come along once a year. The U.S. team did have a decent chance of winning the gold–they would have had NO chance if Russia hadn’t had three falls, but then again, they would have won if Russia’d had the falls and Mattie Larson hadn’t screwed up floor. But that’s all speculation. At any rate, it’s easy to see how Becca would want to compete. Last year, she blew Worlds on her last pass on her last event: otherwise she would have blown the rest of the field out of the water, becoming the World Champion. Obviously, she was hungry for redemption. Unfortunately for her (although not for the sport as whole) this year Aliya Mustafina and the rest of the Russians were in her way! And although Becca remains one the strongest competitors the U.S. has, that doesn’t make her a lock for future Worlds and more importantly Olympic teams: Jordyn Wieber turns senior next year, as do McKayla Maroney, Sabrina Vega, Mackenzie Wofford and Gabrielle Douglas, and 2o12 will see Kyla Ross, 2 time National Junior Champ, and others hit the senior ranks–not to mention the comeback efforts of 2008 Olympic medalists Shawn Johnson (at camp now!) and Nastia Liukin (apparently training laidout Jaegar from el-grip!) Several of these girls have Amanars: Becca has a DTY with no chance of upgrading. Her beam and floor sets are basically full. Her bars could be upgraded, it’s true, but regardless, Becca is going to have to be on the top of her game for the next two years to make these teams. And she probably knows this. Her coach, Valeri Liukin, certainly does. This may have been her last chance on the world stage.

So it is easy to see why Becca would want–would demand, even–to compete. It’s easy to see why she would ignore whatever nagging pain she felt in her ankle and fight through it. Especially if it wasn’t actually broken, I can even see how she did it: I know all *I’ve* done on a broken ankle is walk on it for a week, but Bross is of course roughly 10,000,000,000 times tougher than me. And stronger. And in better shape. So there’s that.

And there are rumors that Becca’s dad is a crazy gym dad, so perhaps that has something to do with it. Not to mention the whole being coached by Valeri thing, which I think might have something to do with it.

On the other hand.

No one is denying that Becca got an x-ray before she left for Worlds. And there is no way that she competed on an injured ankle without the full knowledge of not only her coach and her parents but Marta Karolyi and USA Gymnastics as a whole. And the question then becomes: is it worth it?

For Team USA, who knows? Chelsea Davis could have been great on bars and floor, but she blew out a knee (rats!) in training. Who knows who Marta would’ve chosen instead? Kytra Hunter, probably, who would have been useful on 3 events, but again–all speculation.

AA wise, Bross did worse than last year. I actually think it was a better performance on her part–she fell last year, too, but last year she didn’t have a chance to redeem herself. This year, on the other hand, she came off the beam on her arabian and attempted a truly heroic save, and then came back to perform the best floor routine I’ve ever seen her do. That was a strong, and very cool, performance.

So she may regret it. She may, in retrospect, have been better off taking the time off to heal properly, work on her Start Values, and come back stronger, with much greater bars and possibly a few tenths here and there on floor and beam, next year. But of course it wouldn’t seem like that, at home in Texas or at the Ranch. It would feel, to Becca, like she had to keep going no matter the cost.

And of course only Becca will be able to tell us if it worth it–and I doubt she can tell us now. She’ll need to wait and see how her ankle heals. It will heal, I’m sure, enough for her to compete and attempt to make the 2011 Worlds Team and 2012 Olympic Team, and possibly the American Cup as well. And then who knows? Maybe she’ll do NCAA. Maybe her body will just collapse because she’s been pushing it so far, so fast, for so long.

This is the question–and the problem–with gymnastics, and I suppose with sports as a whole. How far is too far? Rebecca Bross, and many other gymnasts, are not yet adults. It’s one thing for, say, Alicia Sacramone to make a decision to compete injured: Alicia is 23 (nearly 24!) and has been around for awhile. She is an adult with all the responsibilities and, hopefully, knowledge that that implies. Adult athletes have earned the right to make decisions about their bodies and when they should and should not compete on injuries. Younger athletes, (Wieber, Ross, etc) decidedly have not. They are far too young, in their early teens, to be making decisions that will likely effect them for the rest of their lives. That is why they need parents and coaches: it’s among the reasons parents need to be so very careful about the coaches they select (as for crazy parents, I got nothing). But athletes like Becca are just on the verge: they are not quite adults, but neither are they children.

And so the best thing that we can do, I think, is to teach young gymnasts as they come up through the ranks the very things that we try to teach other children, especially girls, especially teenagers: to take agency and ownership over their bodies. To know when to say when. So that Becca Bross can make the right choice for herself.