New Cast

After seeing my incision for the first time, it was time to pick a color for my cast.  My son wanted me to selected Blue & Gold - but that was not an option.  Here is my cast for the next ten days

Surgery Photo

Here is the photo

As you can see, the brevis tendon is fully intact with no splits, tears and appears to be healthy. This should have two tendons and I only have one.  What you see just below the brevis is one end of the long tendon fully retracted in the cuboid tunnel which was causing significant discomfort.  He was able to pull the retracted long tendon out of the cuboid tunnel, cut the frayed portoin and secured it to the brevis





Day Five ~ Post surgery update

Hello All!

Today is day five since my peroneal tendon repair on Monday and I'm doing very well.  Yesterday was my first follow up appointment with my surgeon and the first time I was able to see the incision. When they removed the cast, we were all relieved to see that there was little to no swelling and the incision is starting to heal. 

The surgeon told me he was able to clean out a large amount of scar tissue and successfully secured the peroneal long tendon to the brevis tendon.  He asked if I wanted to see a photo.  Why did he take a photo?  Because this is a very rare injury and my case may be able to help others in the future.  I'll  post the photo in the next blog

Day Two ~ Post Surgery

We were told that my nerve block would last 6-12 hours with a maximum of 24.  My nerve block lasted over 31 HOURS!!!!!  What a blessing!  Though when the block wore off ~ HOLY MOLY!  That pain was intense!  It hasnt been easy not being able to put weight on that foot, but this is all a part of the recovery process.  My family will leave tomorrow and I have a good friend coming in to stay with me for the weekend.  Ill backdate all of my history when Im alone tomorrow

The purporse of my blog is to provide awarness of a very rare injury sustained to my peroneal longus tendon.  After of months of research, I can positively say that there are very few articles, blogs or journals regarding the treatment/surgical repair of a fully ruptured peroneal longus tendon.  Also, I can speak to the effects of not being able to have my tendon repaired immediately after it ruptured.  If you are reading this blog, you are searching for answers just like I was.

Today, I had my surgery to surgically repairand will backdate my blog to catch you up,

History:

In the fall of 2012, I developed a small growth under my right ankle bone.  This growth (which Ive learned is called a peroneal tubercle prominence) caused radiating nerve pain  up my leg and was especially irriatated when I wore shoes.  I had a series of cortisone injections which intially provided relief and after three injections ~ the pain worsened.

(If you look below my ankle, you can see a lump.  This was my peroneal tubercle prominence)

On 12/19/12.  My podiatrist performed a "simple surgery", where he made a small incision and shaved down the prominence.  My recovery was unremarkable and the stitches were removed on Day 15.  On Day 18, my incision began to dehis.

Welcome to the first sign of my post surgical staph infection.  The infection then advanced and on a Monday afternoon, I was barely able to put weight on my right leg. 

After a trip to the infectious disease MD, the puss draining from my ankle was sent off to be cultured and I was immediately put on Keflex and Doxycycline to cover both staph infections that it could have been.  I had an MRI to confirm that I did not have osteomielitis ~ thank GOD!  And after two weeks of antibiotics ~ I had a hole in my foot from the staph. The staph was MSSA not MRSA (sensitive not resistant)

                                                                                          
Commence weekly wound debridement ~ which is a form of torture.   After five full weeks of wound debridement, my wound worsened.  I was immediately scheduled for surgery #2  for a I&D (irrigation & debridement) and forced secondary closure.

Again, my surgery went as planned.  My recovery again was unremarkable.  This time, the stitches stayed in for 21 days.  At the recommendation of my wound care doctor, I participated in 90 minutes of hyperbaric chamber sessions before and after work for 20 days.

I was cleared for normal activity and three weeks later when stepping down I felt something snap in my foot and found myself on the ground from the pain.  Something seriously wrong had happened in my foot, I was immediately limping, feeling sharp pain in my ankle with every step and this was significantly worse on uneven surface. I was out of town for work and scheduled an emergency appointment with an orthopedic surgeon. 

After my initial appointment with Orthopedic surgeon #1, he scheduled an immediate MRI.  This MRI took place one week later and it was during my next visit I was told my peroneal long tendon had completely/fully ruptured. 

How in the world did I rupture a tendon?  Staph had contaminated my tendon, weakened over time and then completely severed with normal activity.   Orthopedic surgeon #1 recommended surgery, told me I had 90 days to make a decision as the ends of the severed tendon would retracted and be inoperable within three months.

There was a chance in hell I was going to have another surgery at this stage considering all of the events that had gone wrong from surgeries #1 & #2.  After researching the top ankle Orthopedic surgeons in Atlanta, I then contacted orthopedic surgeon #2.  I called Orthopedic surgeon #2 my “house doctor”.  He stated in his 35 years of experience, he had never seen a patient come in with a fully ruptured peroneal long tendon.  He ordered a series of blood panels to see if I had an autoimmune disorder ~ which I didn’t.  After six weeks with Orthopedic surgeon #2, he told me that I definitely needed surgery, but he would not perform surgery due to the prior staph infection.  The question remained ~ was the other peroneal tendon (the brevis) contaminated with the staph. If so, then the surgical option available to me could possibly fail and I would be headed for a foot fusion surgery.  A foot fusion surgery………are you kidding me…………  This led me to research Stem cell therapy and to a top Stem cell doctor in Birmingham.  Lets call him Orthopedic Surgeon #3.  After taking two vacation days, driving to Birmingham to have my consult ~ I was informed that I would never be considered a stem cell candidate due to the prior staph.

Meanwhile: I had developed a permanent limp, my foot swelled everyday beyond recognition and I was rapidly losing the arch in my foot.  After 60 days of this and being turned down by two orthopedic surgeons, I then scheduled a consult with Orthopedic surgeon #1.  During my visit to Orthopedic surgeon #1, he reviewed all of my new notes, MRIs (with and without contrast) and told me that even though I needed surgery ~ I was not a surgical candidate.  At which point, I looked at him and said ~ I limp, everyday I limp, I cant chase my son, I have pain with every step I take and I’m losing the arch in my foot. To which he responded ~ “This is your new normal”

 

I was devastated and then after a small, one person pity party, I then reached out to a couple of friends who are MD’s and asked for their guidance.  This led me to four of the top ankle Orthopedic Surgeons in the US.  We are talking about my foot, my quality of life and my future health.  Would I travel to find the best Orthopedic surgeon.......YES!

This led me to NYC.  Two of the top ankle orthopedic surgeons in the US are located in NYC.  I reached out to both of them, both of which had at least a two month wait and pleaded my case.  One of them stated that me case would not be a case he would be willing to take on and the other agreed to see me the following Tuesday.  I wrote an email to the first NYC Orthopedic who refused my case and pleaded for him to meet me with while I was in NYC the following week.  He responded within five minutes…….”Ok”

So off to NYC we went ~ one appointment on Monday and one appointment on Tuesday.  After meeting with both of the top ankle Orthopedic surgeons in the US, they both agreed to take my case, agreed to not fuse my foot and stated that I needed surgery as soon as possible.  We made the decision to go with the 2^nd Orthopedic Surgeon.  When I asked him how long he was booked out for surgeries ~ he said months……..  He agreed to make room for me the following Monday and we scheduled the surgery before we left NYC.

I am and will be forever grateful to the surgeon who gave me hope, took on my case and pathed the way for my recovery