June 11, 2011

I really am at a loss on how to explain the situation with Sadie’s ankle. What I can say is that what showed up on her CT scan had Dr. M’s concerns about her heel bone shifting resurface and we literally were at a stopping spot.

First, I have to explain that when you look at the skeletal structure of an ankle and the many bones involved in the ankle and foot this is NOT how Sadie’s bones look. She has bones that are not shaped as they should (including the calcanueus), some which are under developed, some with boney growth causing them all too look nothing as they should (these are her surgeons words and can be seen clearly to the untrained eye). This situation is making it very difficult.

The area of impingement is obvious and must be corrected with a calcanueus osteotomy (cutting of the calcanues away from the area of impingement). However, in order to do this it would inevitably cause the calcanueus to shift again towards the fibula and cause the same situation within a matter of time. Dr. M feels that the possibility of this happening is great (even absolute) even with a screw put in for stabilization. That information paired with the images from the CT showing significant damage to the sub-taylor join on both sides of the joint (not only is there boney area with little to no cartilage, but some of the bone has been rubbed down) and with evidence that she already has limited range of motion with her sub-taylor joint points to sub-taylor fusion.

Before I go much further I must answer the question that I had myself and I am sure is a question in anyone’s mind… why would Dr. M think both her ankle and sub-taylor joint looked so good before our appointment and CT scan. I can say with absolute confidence that after looking at the say a bone scan looks verses the way a CT scan looks it would be very hard to tell based on the bone scan. I can see why Dr. M would have felt that the issue was just the impingement between the calcaanues and the fibula and how he would feel differently after reviewing the CT scan. I will also say that Dr. M is a humble man who does not get prideful about his work… he brought in another doctor to discuss this with him and both agreed that the sub-taylor fusion is going to happen.

He presented all of this to Sadie while holding her hand and answered all of my questions by facing her and talking to her – not me. I completely appreciate this AND he left this 100% up to her. He explained that is #1 priority is preserving mobility however; he also is in favor of not doing multiple surgeries that take a very long recovery time. He said he could just do the impingement surgery and wait and see if it helps her pain, but that in his clinical opinion she would not have full pain relief unless the sub-taylor was fused and he could not give any time frame on when he thought that calcanueus bone would shift again, only that it was going to happen and probably very soon as it is clear that her ankle learns to adapt quickly.

Sadie decided that she wants to move forward with both the impingement and the fusion surgery. He said… you can tell me the day of if you would rather more time to think about this and she said “no, I am sure, I just want to get this done and be done with it”. He confirmed with me and I can say that after all he went over, pictures, discussions and information; I feel certain in this choice too.

All that said… Surgery will be a little longer than 2 hours, her in patient stay will be the same 2-4 days, but her home recovery will be much longer. She will be non-weight bearing in a cast for a minimum of 12 weeks! At that point they will evaluate if her bones have fused well enough together and if she is able to start putting weight on her foot.

I will updated as soon as I can after surgery, but obviously appreciate your prayers for Sadie, for the surgeon and the nurses and staff caring for her and for our family as we will have a summer that looks much different than planned. We could also use prayer for the next few days leading up as we have a lot to do to end out the school year and get as prepared as we can for what is ahead.

Hey Everyone! This is Sadie, and I would just like to put in a quick word of thanks to all of you have been supporting me from the beginning. I really appreciate all the support over these years, especially now. I can’t describe what an adventure this has been, not a very fun one, and hopefully soon it will be over. Thank you for your thoughts and prayers.