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Old 06-09-2013, 12:57 PM   #197
diesel1959 OP
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Joined: Apr 2008
Location: Houston
Oddometer: 156
Thanks for the comments and questions, folks. It's just shy of being 21 months since the crash, and they are still struggling to put me back together. The lymphedema is being well managed, and the right femur shows that it has healed about as much as it is going to on its own (about 25-30%, according to the radiologist and surgeon). The plan is to admit me to Memorial Hermann right away, and conduct a series of three to four surgeries over a two week period.

The first procedure will involve going in and taking a deep tissue sample in the femur to culture and check for osteomyelitis. They'll deburr a sharp bone shard that appears on the x-rays, and place a quantity of antibiotic beads in the right places. They'll wrap up the leg but not close,wait a couple days, and if no infection is shown by the cultures, then they'll go back in, remove the two screws in the bone, do a bone graft, and deburr more if needed, then plate and screw the femur above and below the break. Those last few items may require more than one surgery to complete. Lastly, after a few days, the plastic surgeon will come and join the party and they'll close the whole thing up, with an eye to preserving the flap and transplant that was done before. If all goes well, it will result in a strong femur that will allow the surgeon to plan the next big step--lengthening the leg another three inches.

The lengthening process entails them going in and breaking the femur more proximally (further up the shaft), and reinstalling the Ilisarov device. Once in place, the hardware (a series of five or six nuts and bolts) gets adjusted 1/4 turn every six hours. Each 1/4 turn separates the two rings (and each side of the femur break) 1/4 millimeter, thus one full millimeter each day. Thus, the leg is actually lengthened by that amount each and every day until we get back to the desired length. At that point, the turning stops and the bone is allowed a period of consolidation and the result is new bone that is supposedly stronger than before. During at least the latter portions of the several months that the Ilisarov is in place, I'll be doing PT and learning to walk again, as the Ilisarov acts as an exoskeletal device carrying the structural forces. I am told that the lengthening phase is very painful, but we'll cross that bridge when we come to it.

After I've got two good legs under me, then the surgeons will turn to my right shoulder and see what more can be done. I have a lot of deficits there and may or may not have suffered some nerve loss.

The left femur fracture was a simple fracture and was reduced during my initial surgeries, and a titanium plate and a series of screws are still in place. Likely the plate and pins will be removed eventually, as they cause me a good bit of discomfort.

Currently, I am still in a wheelchair but I manage to get to the local indoor range once or twice a week. I've had to teach myself how to shoot long guns right-handed, as I can't raise my right arm/hand enough to support the weapon; however, it has gone smoother than I imagined. My handgun skills were very rusty--even with the left hand, but the trigger time has been a huge boost. Both to the skillset and to my mental outlook. It is very difficult to keep rolling when you spend months and months in a holding pattern, but what choice have I? You take what comes and do the best you can. And then do better the next day . . .
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