Friday, July 13, 2012

Joe update

Fracture Clinic appointment

Joe leaving the house today. His main question was - when are the pins coming out and how's it going to be done. Previously when he broke and dislocated his arm they were pulled out with a pair of pliers with no aneasthetic, so he's having visions of a similar approach.
Joe in the hospital waiting for the consultant.
 Over-head view looking down on to the shin.
Side view.

Thankfully I went in no real expectation of any major leap forwards and the overall feeling was just that. In the early stages, because of the nature of the wounds, it seems as though each time we went to the clinic there were dramatic changes, but then six weeks ago when we last had an xray we came away gutted. The wounds as you've been seeing have healed well, and we're now at the stage where they are almost all sealed, so the differences between each visit are now minimal. So much so I'm not even going upload any pictures of them. But today the main event was the Xray and again if I'm honest they were a little disappointing and yes this is really going to be a long process - at least a year. As you can see here, both the Tibia and Fibia are not that well alligned and again the consultant was no concerned and he's still 100% sure of a full recovery and the leg being normal once again in the future.

I think it's the fact that if you know about sports injuries, you know that people bounce back from these relatively quickly and it's only if you scroll back through the blog to here that you can refresh your memory of how bad this injury is and you see the situation from a realistic perspective.

So with that in mind think about the positives.

1. The scar tissue is nearly completely sealed and the bloke said not to look at the scar tissue now from an aesthetic point of view and think that this is how it's going to be, he was saying in a year, the difference will be dramatic. I asked about having the scars treated with massage and he seemed to agree that it was a good idea, but also seemed to think that this will be inlcuded in the physio stages of the recovery. Michelle asked about the physio and he said that this could now start and forms were filled in to instigate the physio. I asked about whether the scar tissue and wounds were such that they affected the muscle structure and he said that on the scans this wasn't evident.

2. The bones he was happy with and feels there's no issue. What he did say though was that Joe needs to be progressively looking to load weight onto the foot/leg. He explained to Joe, that in space where the astronauts are subjected to weightless-ness all their muscle tissue wastes away and calcium deficiency in the bones becomes an issue...

From -

Musculoskeletal Impacts

Even during periods of short duration in space, your muscles and bones begin to deteriorate. This is particularly true in your legs, which rapidly lose calcium in weightless conditions where they don't have much work to do. You'll lose muscle mass, and your bones will become weaker. You might lose up to 10 percent of bone in your lower limbs, according to the Canadian Space Agency. It's been estimated that astronauts risk losing two percent of their total bone mass for every month spent in zero gravity.

Read more:

He then said that if Joe puts weight onto the leg, the body responds in that it feeds more calcium and hormones to the leg and the recovery process speeds up and becomes more efficient. Michelle asked - in that case could Joe remove the boot and walk around indoors without the boot putting weight through the injury and he said yes. So indoors now the order of the day is boot off and more weight, hopefully Joe will buy into it and do this. I'm trying to get him to have the leg up high as well when he's sitting around.

3. The Pins; The next appointment is at the end of August and the consultant has said that they'll then consider the removal of the pins, if the bones look good enough, it then maybe as little as a month and the pins will be removed. I think the procedure for the removal is general aneasthetic and a over-night stay?

4. Physio; This is to start soon it seems, it's just a case of waiting for the letter to come with the 1st appointment. This will be interesting as the physio's that we saw last time were hard-core, we were joking in the car that they'll have Joe hopping around the ward on his bad leg within minutes. But seriously these Physio's at the hospital don't muck about - they will have him doing stuff straight away miles out of his comfort zone, but I reckon he needs it, especially now that I know about the astronaut analogy.

5.Weight; I'm concerned about his weight, with no exercise and still eating in the way that he normally does, he is definitely putting on weight and this is something that we'll have to address.

In summary, it is a long process and I can see that it is going to take a year and that there's no way that he's going to be taking part actively in sports during the first months he at his new senior school. I was kind of hoping that by mid September he may be walking around without crutches, but increasingly that seems unlikely. But, everything is moving slowly forwards and the thing I'm looking forward to seeing is the physio taking place.