Getting back on my feet one day at a time…

Setting goals…
After walking on the front part of my feet since around 1973, the goal of having foot surgeries was to get them back to a 90° angle so they would be flat to the floor again. One down, one to go…

My left foot…
With the left foot, I had three separate surgeries. On August 4, 2008, Dr. Thomas Lee from Orthopedic Foot & Ankle Center, then in Columbus, did the first surgery at Grant Medical Center's Bone & Joint Center in Columbus. Dr. Lee did four things: 1) the metatarsals heads were cut and flattened, 2) a bunion was removed, 3) the toes were straightened, and 4) the big toe was fused. On October 24, 2008, Dr. Lee’s associate, Dr. William DeCarbo, whom Dr. Lee said was a wiz with external fixators, a.k.a. “halo”, did the second surgery by putting a halo on it. After 73 days, Dr. DeCarbo surgically removed it on January 5, 2009. After I was able to walk on the left foot for several months, people asked me how I felt about it and I would always say, “I love my left foot." After walking like a ballerina since 1973, it’s so nice to be flat-footed again.”

My right foot…
On Tuesday, April 6th, I had the right foot surgery, which was also done by Dr. William DeCarbo, from Orthopedic Foot & Ankle, now in Westerville. He also did the surgery at Grant Medical Center's Bone & Joint Center in Columbus. Once again, the metatarsals heads were cut and flattened and he also put the halo on, which had two wires going the forefoot, two wires went through the heal and four wires went above the ankle. Dr. DeCarbo did not straighten the toes, because the wires from the halo would have been in the way since wires are also put down through the toes. I came home from the hospital on Thursday, April 8th.

This was taken on May 5th, almost a
month after I had the surgery. Since the
angle of the bottom U-ring is slanted
quite a bit, I now believe the two wires
in the heal had already torn through it,
but I had no clue at the time.

Straightening the foot by turning the halo struts…
From April 18th to May 22nd, my brother Rick turned the halo struts to gradually straighten my ankle. On Monday, May 24th, I returned to Dr. DeCarbo’s office, at which point he took X-rays and then pointed out that the two wires which went through the heal had cut through it and the wires were only being held in place by skin. Since I had been standing on the front part of my foot for over 30 years, Dr. DeCarbo said that my heel bone had become porous over time, better known as osteoporosis. Last year when Dr. DeCarbo put the halo on the left foot, he was concerned that the wire might break through the heal, but since it didn’t, we were hoping that the right foot would also stay intact. Dr. DeCarbo had intended to leave the halo on four more weeks (June 22nd) so the ankle could maintain the 90° position, but he had no other choice to remove the halo the next day, Tuesday, May 25th, because the skin was also starting to break down. I was in the hospital from May 24th to May 27th and a half cast with thick, fluffy dressing was put on, which was changed once before I left to go home.

Friday, June 4th office appointment…
Dr. DeCarbo removed the half cast to reveal what I would describe as an open, slightly indented wound on both sides of my heal. One of the assistance, Mark (by the way, he's a super nice guy), put on antibiotic cream, gauze and an ace bandage and when I came home, I put on a walking boot (which I still had from the left foot surgery) to keep the ankle at the 90° angle. For nine days, nurses from Comprehensive Health Network came to put antibiotic cream on my foot and once again wrapped it with the gauze and an ace bandage. The last day was Sunday, June 13th and then I went back to Dr. DeCarbo’s the next day.

A wide view of my foot with the ankle
much straighter at the desired 90° angle,
but the skin surrounding the heal was
torn in the process. This picture and the
next close-up were taken on June 9th.
Since soap to clean the skin was out of
the question, only saline was used so that
is why there is so much surgical debris
on it. The black areas are necrosis, or
dead skin tissue. Eventually Dr. DeCarbo
will have to debride the necrosis so
new skin can grow back.

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The outside and sole of the right foot,
also taken on June 9th. The white stuff is
the debris from the half cast I had on earlier.

Monday, June 14th appointment…
I was hoping Dr. DeCarbo would remove the black dead skin tissue (also known as necrosis), because I thought it would hasten the healing process, but he said the skin needed to cover the rest of the open wounds first so he said I would have to continue with getting the dressings changed another four weeks and I wouldn’t return to his office until Monday, July 12th. Thanks to the Comprehensive Health Network nurses, who change the dressing every day, my heel has gradually gotten better. On Tuesday, June 15th, I did walk from my bedroom to the kitchen sink, (about 90 feet), but it totally wore me out. I used both crutches, took really short steps and it took me about 5 minutes. Today, June 18th, is day 74 since I had the first surgery on April 6th, so I hope to walk a lot better and longer by the time I go back on July 12th. Dr. DeCarbo reminded me again that as much as I want to walk, it’s going to hurt for awhile because the heal bone is going to be tender.

The above and below pictures are the same
one, but once again, one is the wide
view and the other is a close-up. They
were taken on June 17th, eight days
after the other pictures were taken from
June 9th. There's not a significant
improvement, but Dr. DeCarbo was "very
happy". The dressings will continue to be
changed every day until July 11th, the
day before I go back to Orthopedic Foot
And Ankle on June 12th.

Dr-Wacka-Do, uh, I mean, Do-Wacka-Do...
From Wikipedia, the Official Internet Encyclopedia, they write: Do-Wacka-Do is a song, released in 1965, by American country music artist Roger Miller. The expression "do-wacka-do" is a funny way of saying "do-like-I-do". The song expresses envy in a humorous way. The lyrics are written like a letter to a friend or possibly a former friend ("I hear tell you're doing well, good things have come to you...") with whom the singer would like to trade places ("I wish I had your good luck charm, and you hadda do-wacka-do, wacka-do, wacka-do, wacka-do, wacka-do").

Below is the song link at YouTube if you would like to hear it:

Roger Miller singing, “Do-Wacka-Do”

Allow me to clarify…
The only reason I bring up this song is because it reminds me of Dr. DeCarbo. First and foremost, he’s a top-notch doctor and surgeon and he’s always been very caring, considerate and professional with me. On the other hand, the relationship with his colleagues is well, let’s say … a little off-beat. When I first witnessed his wise-cracking sense of humor to the X-ray techs, Mark and Judith and Blair and Jill, who changed my dressings, I was a bit put off by it. After two visits, I told him he should be nice, because he was always nice to me and he is a professional after all.

And the survey says…
Then I got an email survey from the hospital asking me to rate, on a scale from 1–10, everything from the hospital setting, the nurses, other hospital workers, and yes, my physician. Once again, I gave Dr. DeCarbo a 10 for the way he treated me, but I did comment that it made me uncomfortable the way he treated his office staff.

Breaking the news…
When I saw Dr. DeCarbo on June 4th, I told him that I had filled out the email survey and he was surprised. Ten days later when I saw him on June 14th, I recorded the visit, like I had done in many previous visits and he told Jason and Brian, the EMT’s from Spirit Medical Transport who took me: “So, you know, like since kindergarten, I’ve never been in trouble, right? I got written up by her to the hospital.”

The office staff changes…
With my last appointment on June 14th, it became very clear that the office staff are also making fun of Dr. DeCarbo, which as far as I could tell makes everyone happy, especially Dr. DeCarbo, because even though he likes to tease his co-workers, he also likes to receive it. Like I said, Dr-Wacka-Do!!!

A footnote on Dr. DeCarbo... (yes, that was a very bad pun)
One of my favorite things to do on the internet besides emailing and playing games, is Googling a wide variety of topics. After having the second halo surgery, I decided to Google the doctor in question and found out he has a Facebook & Twitter page. Apparently, besides having that Wacka-Do sense of humor, he is very competitive, particularly with the recent Orthopedic Foot & Ankle Fitness Challenge. It was a three month contest (January 4th - March 31st) encouraging doctors, staff and patients to get back in shape after the holidays. Even after going to the website, I still do not know who won, so I'll have to ask the next time I go back on July 12th and report back.