On Pins and Needles

(This is a continuation of the tale that began with the previous entry:')

'It's been a very long six more weeks of winter'

After getting the stitches out, I was told that I could now walk w/out the crutches, but ONLY if I was wearing the boot at the time, and only on the heel.
I figured even walking on my right heel while wearing the boot HAD to be better than using crutches. I had been looking forward to that moment for a long time - being able to put my crutches away! Well, like a lot of things in life, what is promised is not always what is delivered.

When we arrived home from the clinic that Friday, I was all excited to start taking my first steps w/out the crutches - at this stage, I had been using the crutches for five weeks.

I took my first tentative steps on my heel, and immediately felt something in the top of my foot, something slightly painful.
This immediately brought back to mind a stern warning I had received at the Clinic that day, supposedly people at this stage attempt to walk w/out the boot - and end up bending their pins (and bones) which prolongs their recovery time - and postpones when the pins can be removed.

Since I did not want to risk even the slightest possibility of bending my pins - I reluctantly cut my experiment short - and went back to the crutches.
To say I was disappointed would be a major understatement, I had been looking forward to walking w/out crutches for weeks - and now I was terrified to do so.

I was able to change my lifestyle slightly though - I decided to return to work 2-3 days a week while on crutches - as a way of proving to myself that things were getting better, that things HAD changed (even slightly) after all.

The next two weeks passed pretty uneventfully, my Dad offered to drive me to work on the days I would be in the office, which meant Julie only had to pick me up in the evening. This worked out very well for us - and was VERY much appreciated.

As the day came closer to get the pins out, I started asking around to try to gauge what sort of experience I would be in for. If you are wondering the same - I will be pulling no punches in my upcoming description....

My boss at work told me at one time he had pins in his hand, and that when they were removed, he was given a pain killer and the pins we removed w/out any pain at all.

Speaking of the pins, at one point I was under the mistaken impression that they went along side the bones - sorta like a splint, but the surgeon set me straight - the pins had been bored INTO my bones - right down the middle.
That made me all the more glad I had been completely out of it during that procedure. In all honesty - I wish their removal could have been done similar to their insertion - with my out of it, but I knew that was impractical.

The night before the appointment to get my foot XRAYed in anticipation of being able to remove the pins (it had to look good on the XRAY first - before they would come out) I was worrying myself sick - but somehow managed to sleep.

This appointment, unlike me previous ones, was in the middle of the afternoon, so I had the entire morning to continue worrying about it...

Of course, the Clinic was very busy that afternoon, so I had plenty more time on arrival to continue my worrying about what was to come. Finally - it was time to head for the XRAYs - and then some more waiting and more worrying.

At this point I was worried that the XRAYs would show that the bones had not healed enough to remove the pins, and I was also worried that they HAD healed enough - a "lose / lose situation" in my worried mind.

Finally, the surgeon whom I had not seen since the sugery comes into the exam room wielding a small silver pair of pliers - and asked me if I was ready to get the pins out.

*Ulp!*

I was relived that the XRAYs showed they could come out - but seeing the pliers also terrified me.

Luckily Julie was there - so I was able to hold her hand while the surgeon went to work on my foot - merely removing the cover on one of the pins, and a makeshift band-aid cover from the one where I had lost the rubber cover.

At this point I resolved NOT to watch and gripped Julie's hand - and the surgeon went to work on the first pin. I could lie and say that it slid out of my toe like a greased pig - but sadly, it did not. It took some CONSIDERABLE tugging to and I assume twisting to get the first pin out - and boy did it HURT!

I was very much relived when the first one came out, and it did not remove my toe in the process.

And then the second pin... this one gave him trouble - and by that I mean it gave ME trouble - in the form of pain!

After what seemed like hours (probably less than a minute) it was done - the second pin was out.
I actually amazed myself by not passing out - although by the way I was hyperventinlating, I was definitely trying...

My toe tips were bleeding where the pins had been - so he applied some gauzed to them and bundled my foot back up in ace bandages.

I asked to keep the pins as souveniors, something I had planned all a long. With a smile, he told me I could now walk in shoes - at least when my foot would actually fit in one.

When we left the Clinic I was still wearing the boot, but I was walking on it - and not on the heel - but really walking for the first time in seven weeks!
That would truly be end of the road for my crutches, I am happy to stay I have not used them since, and hopefully, I'll never be on crutches again in my life.

(Here I am showing how long the pins are by holding them up against a short metal rule)

One of the pins is approximately 3" long, and the other is 3 1/2 " long.
About 1/4" of each pin protruded from the tip of my toes - which left the remainder buried inside my foot.

To see roughly just how deep into my foot these pins were, I tried laying them on top of my foot, but they kept rolling off. So I used the handy man's secret weapon to hold them in place for the following picture.

As you can see - those pins went considerably past the visible portion of my toes - deep into the underlying bones.
You can also see the scar above the #4 toe that required the serious surgery.

As I write this, I am now beginning my third week of walking w/out the crutches, and my second week of being at the office full time - and driving myself to get there :-)

I still park in the handicap section since it is the closest to the doors, my temporary placard is good until May, although I doubt I'll use it that long. But at the rate my foot swelling is not going down, who knows - maybe I will.

My final (?) appointment is in a couple of days, this will be for physical therapy. I have no idea what they intend for me to accomplish there - since I am already walking with only a slight limp.
Maybe they will bend my toes - which sadly, I have not been able to bend since their pins were removed.
I am positive they will loosen up with time - and even if they don't they support my weight while walking, and quite frankly - that is good enough for me.

Well, this saga is hopefully almost over - at least the physical portion.
I was very relieved to learn last week that we had been found NOT at fault - which I had suspected all along - due to our light being green - and the other driver's insurance company had accepted liability - in their words.

To this day, it is still a mystery to us what exactly happened - but you can bet we'll never drive through another intersection w/out thinking back just a little bit - at what happened that January evening...

It's been a very long six more weeks of winter

As I write this, seven weeks have now passed since I have had foot surgery, and almost nine weeks since Julie and I attended a Geocaching event entitled "Six more weeks of Winter".

The event was aptly named, since it was held on January 31rst of this year (2009) just a couple days before Groundhog Day. As most are probably familiar with the legend, if the groundhog sees its shadow on February 2nd, then we have six more weeks of winter coming.

January 31rst was a Saturday, of a weekend following a very healthy snow storm in North Eastern Ohio. I do not recall how much snow was on the ground at the time, but there was at least a foot in the Akron area.

We had not done much geocaching for quite some time - and this event promised to bring us very close to our goal of 500 finds. There were to be approximately 40 or so caches hidden at a public park - and we were only given 3 hours to find them all.
We attended the event with some of our geochums - Timeage and Team RAGAR among others.
The event was COLD and there was a lot of tromping through deep snow - but we had dressed appropriately with heavy coats and heavy hiking boots. Those heavy boots would later play an important and unexpected role in my evening....

We were considering attending a motorcycle show at the IX Center in Cleveland the following day with our GWRRA Motorcycle Cycle chapter, but after leaving the park at around 9:00pm, our evening was sadly just getting started.

At approximately 9:30pm we were almost home - maybe 3 miles away, when we proved the saying that most car accidents happen within 5 miles of where you live.

We were motoring home along Ohio State Route 585 in a section where it is a 4 lane divided highway with the speed limit of 55MPH. I probably was doing 56 - maybe a little slower, since the speedometer on my 4 month old (5000 miles) 2008 Chevy HHR SS always read slightly high.

We came to an intersection we had crossed thousands of times in the past both on 4 wheels and 2, when something crossed in front of us.
I was driving at the time as usual, and we quite literally never even saw what we hit - it happened that fast. All we knew is that we had a green light - and that something was where it did not belong - in front of us.

That was the beginning of a series of events that is still continuing on to this day...

I do not remember if the impact was loud or not - I probably could not have heard it over my own yelling anyhow. It seemed like only seconds had passed, and we were on the side of the road facing a ditch - with someone on Onstar asking us if there had been an accident - since our airbags had deployed. The January night was quite chilly - and even more so since now my driver door seemed to be minus a window - it was completely shattered.

Onstar had helpfully called 911 to report the accident and gave the location of the vehicle - and remained on the line to talk us to see if we were ok or not.

As luck would have it - nothing had intruded into the cabin, and we both were alive and breathing. I do not recall being more relieved in my life, than when I turned to look at the front passenger seat to see if Julie was badly injured or worse. Both of us were in shock at what just happened, and we both were positive the light had been green.

Someone not involved in the accident, a trained trauma nurse had pulled over and came to us to see if we were OK. Julie was complaining of chest pains - no doubt due to hitting the seat belts which we have always faithfully worn. There is no doubt in my mind, that if she had not been wearing her seat belt, she probably would have gone through the windshield - so great was our impact speed.

While EMT and the police were arriving on the scene, we were assessing our injuries, the only ones I seemed to have were a sprained right thumb (no doubt caught on the airbag hatch) and a very sore right foot.

Julie was carried out on a board as a precaution since they were concerned she might have suffered neck injuries. After she was safely in an ambulance, I tried to open my driver door - but it would not open, so I managed to crawl out the passenger side.

At first, I was reluctant to even say anything about my foot, thinking that maybe it was bruised, but I agreed to go to the ER to have it checked out. In hind sight, I am quite glad that I did.
To this day, people are still amazed that I actually walked on it to the ambulance w/out any assistance, and soon you will understand why...
Walking to the ambulance was the first time I was able to see the front end of my car, and I knew in my heart that it was totaled. It did not look good at all.

(Here is how the car looked a day after I bought it, prior to having the front license plate bracket installed. )

(pictures taken a couple days later where the car was towed)

(passenger side actually doesn't look all that bad)

(The interior is amazingly intact, but then this car has a 5 star crash rating. We can attest to its safety in a collision)

(This may explain why my driver door would not open. I'm guessing the other vehicle was white)

That was the first and hopefully last time I have ever been in an ambulance. The EMT techs had me remove my boot and examined my foot - and could tell that something was wrong.
Until today (4/2) that was the last time I would wear a shoe on my foot.
Since I knew that I was not grievously injured, I asked the EMT techs if I could sit on the bench alongside the gurney, but they told me that insurance would not allow it - that I had to be strapped down - even for just a sore foot.

Arriving at the hospital - I was wheel chaired into the room where Julie had already arrived - still on the board with the collar around her neck immobilizing her head.
Luckily, they soon determined that there were no neck injuries, and that they could remove the collar which was causing her quite some discomfort.

We spent the next 5 hours being wheeled from that room to the XRAY room and back, and doing a lot of waiting - while patients with more critical needs were looked after.
It was during this time that I realized my glasses were missing - no doubt they had flown off of my face during the impact. I never did find them.

Julie luckily came out of the accident mainly with a slew of very graphic bruises - some of the deepest purple colors I have ever seen. They made almost a perfect outline of the seat belts across her chest and waist.

Me on the other hand, well, after returning from the XRAY room, a doctor came in and told me that I had done quite a number on my foot. It was broken in three places - with my big toe being toe #1, the #2 and #3 toes had fractures, and the #4 toe had a bone with a part that completely snapped off and was laying beside it. All of the breaks were internal - none of the external toe bones were harmed. The bones in my foot were broken right where it would have been on the brake pedal - with me tromping on it as if my life had been at stake.
I assume that my foot was slammed on the brake pedal during the impact - since my other foot and both of Julie's feet were fine.

(This XRAY clearly shows the bone part that has broken off the #4 toe, the surgeon described the lump similar to ice cream haven fallen off the cone.)

As I had mentioned earlier, at the time of the collision, I was wearing heavy hiking boots since we had been tromping through snow all evening. Considering the damage that was done to my foot while wearing THOSE - it scares me to think of what the damage might have been had I been wearing my normal tennis shoes. It also goes with out saying that my summer days of driving barefoot are completely over. As I proved, you never know when you might wish you had been wearing shoes while driving...

The first two toes would require surgical pins, and the third toe would require more extensive surgery and a screw to re-attach the loose portion back onto the rest of the bone.

The XRAY also showed that my small toe was dislocated, and the doctor told me that it was going to hurt, but he had to put it back in the socket properly.
I was given 2-3 shots of painkiller in my foot - and he told me that it would sting - and that was an understatement - but nothing compared to what came next.

Having the doctor pull on my toe to pop it back into place was probably the most intense pain I would have - at least until after surgery. I would be surprised if half of the hospital did not hear me holler out while he worked on my toe.

After the toe relocation was performed, I went back for another XRAY to verify that it was back in place. Luckily, for me, it was. First thing that had gone right that evening.

While we were in our private room waiting, I used a wall phone to call our insurance company to open a claim and to report the accident. Seeing that most hospitals have policies against using cell phones, I had turned mine off on arrival, and the wall phone would not allow us to call long distance - so I was unable to alert any of our family about what had happened.
The ER was unable to do anything for my foot - except to splint it and give us the name of a doctor who specialized in these particular injuries. They also gave me a CD copy of my XRAYS to give to the surgeon. I, of course, made a copy of it immediately.


At approximately 3am, we were finally picked up by a taxi we had called for at 2am, and arrived home around 3:15am. Instead of getting home around 9:45pm and being fast asleep already - we could not sleep a wink. I was now on crutches for the 2nd time in my life, the first time being in 1978 when I had broken an ankle in Jr. High.

Prior to turning in for the night - I sent out some emails to our families letting them know that we had been in a very bad accident - but that we were OK, except for bumps and bruises, and my broken right foot.

My job allows me to be able to work from home on occasion, and for the entire month of February, I would take advantage of that fact. Originally, I thought that I would be able to return to work, but was told that I needed to get the swelling down on my foot before they could perform the required surgery.

We managed to get an appointment with the surgeon recommended by the ER doctor who treated me, but after taking a look at the XRAYs, he told us that this required more expertise than he had - someone who specialized in treatment of the foot.
We were given the name of a surgeon at a nearby clinic - and they were able to see us that day. (Wednesday following the accident)

The surgeon who would be performing the operation looked at my foot and told me that there was no way he could work on it while it was badly swollen. The only way to get the swelling down was to keep the foot elevated - preferably above my heart.
After seeing him - we went to another section of the clinic where I was fitted for a "boot" that would become like a part of me for the better part of the next seven weeks.
The boot served to immobilize my foot like a cast would, but unlike a cast, I could remove the boot to occasionally wash the foot.

I was not allowed to place any weight on the foot while in or out of the boot, but I was allowed to use the boot to help balance me - something I could not do while the foot was in the ER supplied splint. As for keeping the foot above my heart, my foot soon became a constant companion to other objects on my desk and worktable at home. I learned to slouch in my chair enough so that with my foot on two pillows, it was more or less above my heart.

Having a broken right foot meant of course that I was not allowed to drive, and if I were to attempt to do so with my left foot - the doctors would go on the record as having told me not to.
Seeing that I had just came out of one really bad car accident - I had no desire to encourage the chance of another.
Prior to leaving the clinic that day, we scheduled a date for the surgery, February 12, at 1pm.

I will admit to an intense feeling of dread while awaiting the surgery date - especially since an IV would be required, and unlike when I had a hernia operated on in 2004, they were unwilling to give me a sedative. I just have this thing about big pointy needles, they tend to double my heart rate and make my veins run and hide - which of course just makes everything even more tense for me...

Surgery day finally arrived, and after fasting from the previous midnight, we met my parents and I was lead away for pre-surgery prep. This entailed the insertion of the IV into my left hand, which was done quite skillfully by a trained nurse. She gave my hand a shot of something that she warned would first "sting" and then "burn" and after enduring both of those - the pain went away. I quite literally never even felt it when she inserted the IV.

While waiting for the surgery time to arrive, the anesthesiologist who would be present during the surgery dropped by and asked me how I wanted to be during the surgery. Up until this point, I had been assuming I would be completely out - like I was for my hernia and appendectomy in my youth.

He told me I had the choice of just a local, a local and a "twilight sleep" or being completely out.
Seeing that I was pretty terrified by the first choice, and unsure at all about the second choice - I opted for the third. That was a mistake. A little while later, the surgeon dropped by and questioned my decision. He warned me that since I opted for the choice that did not get the local, I would be in intense pain after surgery, and he did not want me calling him late that night asking for the local - since by then it would be too late.

Of course, this really made my day complete. The anesthesiologist again dropped by and I begged and pleaded with him to change my decision to choice #2. He told me that it was too late to get prepped for choice #2 but that they could do #3 and give me a block in my leg.
Unfortunately, since it takes time for the block to take effect, it would not be active when I came out of surgery. I immediately opted for that choice.

The block was administered to the back of my right knee, and was something I had never had done before. After the block was done, it was time to roll me into surgery - where I said hi to the operating crew - and then all went blank....

I remember waking up in intensely indescribable pain - pain that I would rate a 15 on a scale of 1 to 10. A nurse gave me pain medication, which mercifully, worked pretty quickly.
Meanwhile, the surgeon was showing Julie an XRAY of the results of the operation.
I now had a screw in one toe (completely inside the foot) and two long pins poking out of my toes.
Again, I was sent home with my foot in a splint, and it would remain in that splint for a week - until our first return trip to the clinic. For the remainder of that day and late into the evening of the day after surgery, I had absolutely no feeling in my leg from the knee down. It was like my leg was asleep - I could not move anything - my ankle, toes - nothing.
My leg could have dropped off and it would have felt no different.

At the next appointment a week after the surgery, they removed the splint and unwrapped my foot - and I saw the results of the surgery for the first time. It was not nearly as bad as I had imagined - only 6 stitches around the incision, and a 7th stitch on the bottom of my foot - where they had entered to insert the screw into my toe.
This was the first time I was able to clearly see the pins protruding from my toes, a sight that would remain with me for the next four weeks.

(you can see my surgeon's initials "DK" clearly in this picture, he marked the foot prior to surgery as probably a precaution to operate on the correct one)

We were told that my next appointment would be in two weeks, at which time they would remove the stitches, and two weeks after that, another XRAY would be taken, and if the healing was going well - the pins would be removed...

Fast forward two weeks to the second follow up appointment, it was now March 6th and time to get the stitches removed. I was assured that it would be completely painless - and I was quite glad the day had arrived, since they were starting to pull.

The bottom stitch came out w/out any problem, as did five of the six stitches on the top of the foot. Unfortunately, the sixth top stitch was starting to become ingrown, so it was a little painful.
We were then told at this time that getting the pins out would not be any more painful - which would be done two weeks from that day - assuming all was going well.
Next time - the pins or "this wont hurt a bit"...