Archive for September, 2015

Surgery On My Left Foot

My left foot was in stage one of Charcot. My toes were becoming hammer toes and the Achilles’ tendon was not very flexible. My ankle and foot were exhibiting some of the same problems my right foot and ankle did. In that, they felt like they were not wanting to stay together.

Maybe I shouldn’t have been surprised, but I was, when Dr. Roukis said he would perform surgery on my left foot the next summer. I guess I didn’t think I needed it. After all, I was not having major pain in that foot. Surgery made a lot of sense though. It did mean recovery time, but only about six weeks compared to years. It would also be an out patient surgery so no hospital stay. This is why it is so important to get this diagnosis in the early stages.

Surgery was June 13, 2008. Of course I went through all the physical and permission stuff. We arrived at MAMC at 5:50 AM, checked in and was sent to the area to prepare for surgery. Max took my shoes and clothes as I would be in the surgical gown. My anesthesiologist was excellent. I had no bruises. There was only a small entry point between my thumb and pointer finger. I also asked him if I could be awake when I went into the operating room as I was out for the other two surgeries. He said sure. He kept his promise. I was surprised at how large the room was and that there were so many people there. I’m sure some were Dr. Roukis’ students. As soon as they began to swab my toes, I was out like a light.

Before my left foot operation

One rather funny thing happened while waiting to go into surgery, though I’m not sure Dr. Roukis thought it was. He came rushing in to the waiting area right past us. Stopped quickly, backing up. Greeted me and introduced himself to my anesthesiologist. Then he asked him, “What operating room are we in?” He replied “A.” Dr. Roukis said “They told me C. When I went in there , looked around and said, “I don’t do this type of surgery” and left. ”

We discussed the type of anesthesia, so, I asked Dr. Roukis what he wanted for me. Apparently, I could have had a spinal, but we decided completely out. (I really don’t think he wanted me to be able to talk.)

Recovery, after surgery, was very quick. No sore throat, so was able to dress, get in the wheel chair and to the van, back seat and packed in. This was quite awkward as I couldn’t use the foot I had depended on for so long, and I wasn’t sure of the right one. We were back home by 11 AM. I slept most of the way home. All went well until about 2:30 AM. I thought I could get up on my own. I knew I should wake Max and have him help me, but he was sleeping so soundly. (Not for long) As I tried to slide my feet to the potty, my shoe caught in the carpet and I fell. I tried to save my feet, so my knees hit the walker and I hit the right side of my head when I hit the floor.

After the operation

It took a while to gain my senses so I could roll, crawl and get up enough to sit on the small stool Max was holding so I could stand as I couldn’t put weight on the left foot. Need I say I asked for help after this. Was I afraid to tell Dr. R about this? Oh, Yes!

During surgery Dr. R straightened my hammer toes, lengthened the achilles tendon by slipping the calf muscle and placed a pin in my ankle like my right foot. They sent pain medication home with me. I only used a couple of the pills. One after the fall and another the next evening to help me sleep. That didn’t work. I didn’t take any more again. I really didn’t have any pain.

Now, I have to tell DR. Roukis about my fall three days after surgery.

This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

History Of and My Experience With The Orbital Fixator

When I decided to have foot surgery, an entirely new learning curve was about to take place. I was ready, but apprehensive. We had already checked my surgeon out and were impressed with his credentials even though he was only 36 years old (about the same age as our son). We were very comfortable with him. He was thorough, professional, knowledgeable, had a great sense of humor and explained things so we could understand them. In explaining what was to be expected, we were told he was going to use a device on my foot called the Orbital Fixator. This would04Bconfine my foot so it couldn’t move at all during the first two to three months after surgery. This was to help the foot heal.

The wires criss crossed through my leg bones allowing no movement of my foot and leg. I was shown the device, but I don’t remember holding it. If I did, it didn’t sink in how heavy the device was. Nor, did they suggest I tie a 10 pound weight on my right foot and practice playing hop scotch for a few weeks before. surgery. I truly thought that would have helped once I was ready to try to move around and wasn’t able to do anything, but scoot, or try to hop on my left foot.The Orbital Fixator was awkward and very heavy. I didn’t have strength in my hip or leg enough to lift my foot. So, I often needed help. It was, actually, exciting when I was able to lift my foot on my own. This came about because of the exercises that were given to me before I left the hospital.

The history of the Orbital Fixator is fascinating. In 1921, in Caucasus, in the Soviet Union, Professor Gavril Ilizarov was born. He had no formal education until he was 11. His parents were illiterate. Yet, he quickly went through medical school practicing in the Kurgan region of Siberia. He was having to deal with orthopedic problems. Though he wasn’t trained as a surgeon, he was the only doctor in the region. In the 1950’s he developed and created a method for treating fractures, deformities and other bone defects. It was called the Circular External Fixator. (Orbital Fixator)It is said he was riding in a wagon and started studying the hub and spokes on the wagon wheel. This gave him the insight to create the Circular External fixator to stabilize the leg. He worked quietly and basically unknown until 1967 when Olympic high jump champion Valery Brumel sustained a non-union fracture. He successfully treated this infected fracture.

His methods were brought to the west in 1981 by an Italian doctor.Professor Ilizarov was the only orthopedic surgeon ever elected to the prestigious Soviet Academy of Medicine. He headed the world’s largest orthopedic hospital in . Kurgan, All-Union Scientific Centre for Restorative Orthopedics and Traumatology which has 1700 beds. He continued working an lecturing world wide in this field for 41 years until his death in 1992 at age 71.Because of his work, he showed that controlled mechanically applied tension, stress that there could be regeneration of bone and soft tissue. Various names of his circular external fixator have come about, the Orbital Fixator, the External Fixator and in the past decade the Taylor Spatial Frame has been introduced. It has been determined the external fixation devices disrupt the soft tissue less in patients whose healing potential is compromised in the case of those with diabetes mellitus and Charcot disease.

This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

The Reality of Recovery

Passing time between appointments, healing, keeping busy, staying comfortable and learning to go out in public now my new goals. One really needs to set these goals before you have surgery. Plan with someone, a spouse, caregiver, professional, or a good friend that may be around a lot. Have a pretty good idea about the length of time you will need to get well, the type of care you will need, how mobile you will be. In my instance, I knew I would not be able to walk, climb stairs, move around, take a shower or bath, especially the first three to six months. Because of these limitations, it was suggested we consider a care facility. But after Max and I talked it over, we decided we had a space that would work for us, the studio in our home. Max could care for me there.

I really wanted to be as independent as possible. I soon learned I needed a lot of help. The hardest was waking up at night, having to go to the bathroom and having to wake my husband every time. Max had to put a shoe on my left foot and steady me, so I wouldn’t fall as I hopped on the foot. I couldn’t lift my right foot up, because of the Orbital Fixator, to even get back in bed. He had to. If I wanted to read a magazine, sort papers, watch TV, draw or write, we had to organize things in such a way that I could reach them on a small table by the bed, or have them placed on the bed. Other wise I would drive him crazy. He spent a great deal of his time in the computer room next door. This meant if I needed him, I could call on the phone, but he checked on me regularly, so I didn’t need to call very often.

There were times I just enjoyed looking outside. Since it was summer, PB080025we could leave the sliding glass doors open with the screen in place. I really enjoyed the deer bringing her twin fawns by, all the chipmunks, birds and especially the Pea Hen as she seemed to check on me. We would carry on quite a conversation at times. Our cats kept me company. They didn’t understand what was going on.P7260049I was beginning to become uncomfortable. The mattress on the bed was really old. My legs were hurting, not to mention my behind. Max would have to see what he could do about the mattress. I was sleeping off and on all day. Some times at night I couldn’t sleep. One of my good friends would record movies and programs for me. I often watched them at night.

Bath time was a new experience. I began to appreciate those soldiers that were in the field with no facilities. I used disposable wash cloths that were heated in the microwave. I even had a shower cap that I could use to wash my hair. This took some getting used to until I could finally use a basin with real soap and water. Just try to keep the bed dry.

Our friends, neighbors and our son were great. They came to visit P9040029often and many times brought food and flowers. Get well cards came from every where. Soon, I was on the phone visiting with friends and relatives across the states. I also wanted to know more about . I remembered our local paper, the Central Kitsap Reporter, put out a health issue at the beginning of the year. I called the editor, after a brief discussion about Charcot, they decided to do an article on me as they were unfamiliar with Charcot. They sent out a reporter, Erin, who took pictures and interviewed me. I was pleased at their interest and the article they published 10/8/2007.

Message by the Founder Annita

Brought to you by Charcot Awareness Education Foundation

Ice Bag Duty & Going Home

My new routine started the day of surgery. I was concerned Annita might have a very high glucose reading as she hadn’t had medication and that is not medically desired. I did not realize that the surgical team was keeping her glucose under control using insulin.

At about 1700, military usage, 5 pm to every one else, I went to the cafeteria for dinner. One unique thing about this hospital is its cafeteria. The food is really good. There is plenty of it at a price that’s very reasonable. Hospital cafeterias are not usually known to be Epicurean Palaces. At about 8 pm, I left the hospital to allow Annita to get as good a night’s sleep as was possible.

The following day and for many more thereafter, I left the RV around 7:30 at McChord AFB to drive the few miles to Madigan. I would go to Annita’s room to see how she was doing then go down and have breakfast. This allowed staff to do their morning routine. In addition to the Orbital Fixator, on Annita’s left leg was a device which gave her right leg muscles movement, similar to walking, done by inflating the deflating an air bag. P7100113The view from this room was outstanding, almost restful in a way. Mount Rainier was easily visible every day with differing amounts of cloud cover. Some times lightly tinted in pink, gray, or white depending on the levels of sun light. The water features around the hospital added to the restful effect. Rather than being bored while Annita slept, I read, watched TV some and helped in a small way by getting ice that was required to control swelling. She was to have an ice filled ice-bag placed above the right knee for 20 minutes out of each hour, 24/7, to help keep swelling down. They were very willing to show me where the crushed ice was located for “Ice Bag Duty.” By finding out where the ice was kept, I took care of the ice-bag requirement. I was not a hindrance, being thanked by a couple of the nurses. I left Madigan about 9 pm each day to drive back to the RV.

By the third day in the hospital room, Annita was well on her way to becoming acquainted with the medical staff assigned to her room. They were a good bunch, very willing to share humor and talk about places they had been and what it was like. They were a little surprised to learn we had gotten an entire six-pack of soda after she had been placed on the clear liquid diet. One nurse stated they could only get one can of soda at a time from the kitchen.

After 6 days, Dr. Roukis came in Thursday morning telling us he was going to release Annita the following day because of her recovery progress. I called Justin, our son, asking him to help me take Annita home the following day. In this way we would get us and the vehicles home in one trip. That evening I drove to Silverdale. I brought Justin back with me. The following morning we went to Madigan to await Annita’s release. Before we left, we loaded all the blankets and pillows brought from home to cushion Annita for her trip.

Not long before Annita was discharged, I went to the parking lot to get thePillpws:van van. It had to be brought very close to the side walk by the hospital entrance. Justin and I, with medic assistance got Annita “Inch Wormed” onto seats behind the driver. The difficulty was, she had to slide across two bucket style seats with seat belt connectors asP8220016obstacles. No roof straps or handles to grab, she had to lift and move herself where she could get purchase to do so. We held up her right foot and braced her left foot to assist. Annita worked, pushed, and wiggled her way in. Once properly on the seat with her legs stretched across the seats and her right leg elevated, we placed numerous pillows and blankets under her legs making for a more comfortable ride. She was seated with her back to the driver’s side. She had the ice-bag on her right leg. I’m sure she was very tired after getting all the way in.

After leaving MAMC, we stopped at McChord campground to get the RV. Then I followed Justin and Annita home. Once home, we used the borrowed wheel chair helping to maneuver Annita onto it. This was accomplished after she wiggled her way back across the seats, out of the van as we kept her right foot suspended. She hopped and slid her left foot turning about 90? keeping her balance so she could sit on the wheel chair. From there into the house was a snap, that is, until we came to the threshold of the doorway into the studio. It was about 3 inches higher than the patio with a slight ramp so we had to back into the room. We got in all right only bouncing slightly.

This was the start of at home recovery. It was also the beginning of my new learning experience.

This weeks article was contributed by Max Shaw, husband of the founder of Charcot Awareness Education Foundation

Brought to you by Charcot Awareness Education Foundation